Patient Recruitment Funnel for Clinical Trials

Recruiting and retaining patients has been an issue for most clinical research sites since we all can remember. What are we doing wrong? What can we do to improve patient recruitment? Are we moving fast enough and following the newest trends? Or are getting left behind?

The Industry Shift

Patient recruitment has been a process often delegated to the CRO or research sites but the times are changing, and now there are more studies. Correction. More complex studies. Inclusion and exclusion criteria are far more complicated than how they used to be in the past. This led to an industry shift, and now a site has to look for patients outside of their facilities, databases, and database service providers.

Because of this industry shift, as well as the fact that sponsors are aiming to get their drugs approved without any delays, many sites have to be creative in their approaches. The picture that we see right now is that you cannot be successful unless the sponsor sees that you have a large pool of patients available. So, being able to enroll patients quickly and without any delays is becoming a normal expectation in the clinical research industry.

In fact, this expectation of having tons of potential patients available is why all sites need to adopt faster methods of referrals and recruitment.

Doctor referrals and TV ads are not enough anymore. Sites have to look at newer methods and ditch the traditional ways of recruitment from the past: TV, newspaper, and Radio ads.

These newer recruitment methods focus on digital marketing. Keeping up and staying up-to-date is crucial here! With the help of these new methods of recruitment, we manage to collect more referrals in half the time required in the past.

Essentially, PIs and sites have to do more of their own referral generation to stay competitive.

The Good and the Bad

This evolution toward digital patient recruitment leads to new problems for the industry. One of the positives (and negatives at the same time) of the new digital methods is their ability to generate a lot of referrals. For instance, for a Pro Package, TrialJoin can produce over 80+ referrals in a very short period.

This fantastic turnout can often be a burden (the “negative” we mentioned above) and a large cost center for research sites that have not yet adapted to handling this larger volume. More referrals mean more phone calls and also more uncommitted people...

Wait, did we say uncommitted people? Yes, we did! People can often sign-up for a study without much thought.

Think about how easy it is to fill out a form in the first place. Sort of like the 1-click buy to purchase on Amazon (purchases we often regret later). Well, the same thing can happen when you ask patients to fill out a form and sign up for a study...

Unlike in private practice, a patient is less bound to your research site. These absences leave a gap which you have to fill. That missing component can be anything from trust, authority, influence, to obligation. Don’t sweat it though! It is easier to do all of that than you think.

Ask any clinical research expert, and they’ll tell you that patient retention challenges can sometimes be even bigger than recruitment. Focusing only on recruitment without having a long-term plan to nurture these patients is a mistake that most research sites do. So we’re not surprised when we look at the large patient drop-out rates.

The Patient Engagement Funnel

The process to make recruitment and retention easier is called a Patient Engagement Funnel. Patient engagement is basically getting patients more engaged and involved in their own healthcare. How can we do that? Easy! This engagement funnel is an easy thing to break down too. Let's start with the acronym AIDA. Ok, now moving on... Wait, did you want me to define AIDA?

Attention - the first one is getting the patient's attention, sort of like how I got yours by not defining AIDA after I introduced it.

Interest - next, you have to build their interest to participate in a clinical trial. A good way to do this is by educating them further on their condition, on what a clinical trial is, as well as the clinical trials you have going on currently. This step can be done through eBooks, videos, and articles!

Desire - Since you’ve already educated the patients about their conditions and the need to get better, hopefully, you’ve started this stage of the funnel automatically. A patient will be curious about the trial because it is potentially the latest treatment option and can also help out future generations.

Action - Don't confuse this with them filling out a form to express interest in the study. This stage is where the patients give you a call, complete the pre-screener, sign a medical authorization form, or come in for the actual screening visit.

So, after a patient expresses interest in a trial, get their email or phone number. This way if you have either one, and you receive their permission, you can start sending them general health information or even condition-specific information if they allow you. What’s more, you have to do this quickly. As quick as possible! Follow-up is the key here - do this immediately. Otherwise, your patient will forget you and lose interest.

Internet Marketing and Automation

Having the ability to email (or even text) can greatly benefit your automation strategies. Before I dive into automation strategies, I want to take a slight detour:

The clinical research industry has not yet had to deal with the plights of sales such as nurturing a lead, keeping a lead warm, and a larger volume of follow-ups as other industries have had to up until now. Well, now it’s time to adapt to the current ways of doing marketing.

As you generate referrals online, you have to follow the trends of internet marketing. This is because you are now competing against many other companies and the noise they make. So, while your research study may be extremely important to them one minute, another Ad showing them 6 easy tips to lose that belly fat may show up, stealing their attention away from your study.

Short and limited attention spans of customers have proven to be a really painful spot for marketers. Customers’ attention is basically counted in micro-moments which marketers have to “catch” and use smartly!

There are thousands of micro-moments occurring every day - each time a customer wants to search or look for something on their device. Unless this customer wants to find your website specifically, you will need to have all your content and posts search engine optimized (SEO) so that you increase the chances of this customer stumbling upon you while he’s browsing for answers.

To make matters worse, our Internet generation doesn’t have the time to think things through. Instead, we look for instant gratification.

So, unless the user sees something that benefits them immediately, they will move on to look for something better.

The way the marketing geniuses of the web have counteracted this short attention span is by building funnels. They continually use emails, videos, articles, etc... to stay on top-of-mind. Next, be creative and always try to get an edge on the competition.

Offer something that nobody else has offered before!

Take what any Software-as-a-service (SaaS) company does online as an example. One such service I'm sure many of us are familiar with is SalesForce.com. They have built many funnels to get people to eventually subscribe to their software. They offer eBooks which people can download by filling out a form or even sign-up for a webinar by filling out the same exact form.

Not only does this help keep a person’s attention but it also helps build trust. A common saying in the marketing world is that it takes seven encounters with your company for someone to start forming trust.

For the second part of this discussion, I want to talk some more about automation practices. First of all, setting up Google or Facebook ad campaigns requires good targeting practices. When you’re trying to recruit more patients for your study, you will need to target patients (or their caregivers) based on:

• Medical condition (therapeutic indication);
• Location;
• Age;
• Gender;
• Likes and interests;

These are the most important points that will allow you to form your target audience. However, depending on what you’re looking for, there can be many more things to consider. For example, if you already have an existing group of customers (in your case, patients), you can create a lookalike audience. Or, you can even target patients based on one specific like (whether it’s a patient community group or another research center in your area). Doing these things will greatly increase your chances of targeting the right type of people.

Aside from the importance of well-structured targeting, there are a few important metrics to consider when you’re setting up marketing campaigns. A great way to start is by grouping your results into:

• Awareness
• Engagement
• Conversion

To measure awareness, you might want to look at your number of followers, web traffic, and external referrals.

To measure engagement, you will look at page view numbers, as well as your visitors’ reaction to certain types of content. This will give you an idea of what works and what doesn’t so that you can adjust and update your content accordingly. Then, you will need to follow repeat site visits, time that the average user spends on your site, social media shares and mentions, email clicks, etc.

And finally, your conversion rate will be calculated based on different pre-set completed goals. These goals can be anything from filling out a form, downloading content, to actual study registrations.

Setting all of these metrics ahead of time together with good targeting and regular observation and improvement is the only way you’ll have successful campaigns that bring you the recruitment patients you need.

Types of Internet Marketing

Digital marketing is taking over the world! In the clinical research and healthcare world, this type of marketing is cost-effective and generates a lot of referrals. In the most basic sense of the word, digital marketing includes Search Engine Optimization (SEO), Search Engine Marketing (SEM), Pay-Per-Click Advertising (PPC), Social Media Marketing (SMM), Content Marketing, and Email Marketing. Of course, the list can go on and on. So, when I say digital marketing, feel free to think outside the box - SEO content, articles, interview podcasts, webinars, free eBooks, videos, voice recordings, etc.

Furthermore, don’t restrict yourself with just one platform - create a website, landing pages for different conditions, show testimonials, reviews, success stories, use Google ads, Facebook ads, Youtube, Twitter, LinkedIn, SlideShare, and even Pinterest or Snapchat. Go big!

Appear on all platforms to increase the chances of patients noticing you. This is how you create your patient engagement funnel, build connections and trust!

One important strategy to consider when it comes to social media advertising is influencers. These are people or businesses who are well-known in a certain industry and enjoy the privilege of having a huge number of followers. Besides, these are usually people whom patients trust and respect, which means that they will most likely follow their opinion.

Influencers exist in every industry and using them can bring you great success.

To strengthen your success even more, make sure that your website has an amazing interface, and provide interactive, targeted and personalized content.

Customers are sick and tired of generic content - they want to see something personalized and targeted to their specific needs.

And, as we said - instant gratification! Provide valuable content that’s easily seen on your website, and name it a “free gift”, “free webinar” or “free crash course”!

Nowadays, we want everything that’s time-efficient and served on a platter for us to easily reach.

Make sure that your website isn’t slow or too crowded. Another thing to do is to use subheadings, bullet points, and short paragraphs instead of large blocks of texts. Nobody has time to go through boring text.

Use infographics, videos, tests, and all types of different “hooks” to grab the attention of the visitor.

These so-called “hooks” are the things that are going to separate you from the rest of the crowd!

When it comes to search engine advertising, your best bet is to place ads with the help of Google AdWords. With the help of this tool, you can create and lead campaigns which are keyword-specific and search engine optimized (SEO). Doing this will allow you to target your group of potential participants in the most precise way!

Don’t forget about mobile phones!

Nowadays, smartphones are a pocket computer, so all the content you publish on the Internet has to be mobile optimized.

Use this opportunity and create an app with free educational and informational content. Or, why not create a condition-specific app that allows patients to participate in a community with fellow patients?

Other great mobile optimization options are pay-per-click (PPC) mobile ads as well as click-to-call (CTC) advertising. Use your creativity and the possibilities are endless.

The next thing I would like to remind you of is the importance of emails. Once you’ve gathered a list of your interested patients’ emails, you can start checking in and gifting them with some valuable content. You never want a lead to cool down. Get the leads while they’re still hot!

A great thing to do is to send out personalized emails and give away free eBooks or webinars with educational content on the patient’s medical condition.

The goal of this is for them to see that you’re a serious and trustworthy source of information. You can even take things up a notch and invite them to your research clinic for a free check-up. Nobody passes an opportunity for a free check-up! Aside from marketing purposes, you can also use emails to send patients reminders or to double-check and confirm appointment times.

And finally, the last thing I would recommend that can strengthen and build up your patient recruitment funnel is branding your study or research site.

Branding is a long-term strategy which will allow you to reap many benefits in the future.

Focus not only on short-term but also on the long-term success of your research center. In time, branding could become your main patient recruitment funnel!

The number one issue in people who try long-term branding strategies is that they give up too soon.

You have to remember that the goal of branding isn’t to give you immediate results. Instead, your aim should be to stand out and establish yourself on the market. This can be done by having a consistent feed of relevant and helpful content, thus gaining the trust of your future patients. In time, this investment will pay off, and branding can even become the number one way of acquiring new patients.

It is estimated that over 80% of the population uses the Internet to research medical issues. So basically, the online world can be seen as a vast recruitment funnel which is only waiting for you to take the initiative. Online presence is a must-have nowadays!

On the other hand, all of these marketing strategies require a great amount of media placement planning as well as budget planning. You don’t want to spend too much on the wrong type of advertising. This is an area where professionals can be of help. This media planning involves different areas such as targeting, scanning of the environment, type of audience, type of content that works for the specific audience, analysis of the results, etc. For someone with no previous experience, doing all of this can be time-consuming and not so budget-friendly. When in doubt, always seek help from a professional.

Factors for Recruitment and Retention

Patient recruitment and retention in a trial depend on many different variables, such as:

• Awareness;
• Feeling of appreciation;
• Trust;
• Proper education;
• Fulfillment of expectations;
• Credibility of the research center;
• Relationship;
• Responsiveness;
• General communication;
• Risks associated with the study itself;
• Inconveniences;

All of these factors (and many more) have to be taken into consideration if you wish to build a successful patient recruitment funnel.

Finally, I want you to remember one other important thing called personalized experience. Patients don’t want the feeling that they’re just a number to fill your quota. Instead, they want to be appreciated and treated like human beings.

Creating one-on-one personal relationships with every single patient will increase your chances of enrollment significantly.

Stay in touch with a patient, offer them personalized advice, follow-up. Trust me, it will pay off!

Some Parting Words

To summarize my tangent, you have to start adapting the strategies that many other industries selling online have. That is the only way to compete with the limited attention span you are given by a potential patient.

Clinical research in terms of marketing and attracting potential patients is just like any other business, so most of the same strategies apply. You still need to sell yourself and your services, you need to build a brand, increase your audience, keep up constant streams of content, and practically do everything else that goes into a great digital marketing strategy.

Remember - being proactive is the key here! Create awareness, engage the patients, offer free resources, work on the relationship, build trust, build creativity, lock those leads while they’re still hot. Be present everywhere and increase the chances of being noticed! A formula for success!