Episode Transcript
[00:00:03] Speaker A: Welcome to Power to the Patients, a LinkedIn live and podcast series hosted by Power, where clinical research leaders across sponsors sites, CROs and patient advocacy groups discuss patient centricity in clinical trials. We explore the bottlenecks in today's system, challenge the status quo, and talk about future opportunities for innovation. Let's dive in today.
[00:00:30] Speaker B: We're joined by Brian Wiley. Brian, thank you so much for taking the time to have this conversation with us. Talk about patient centricity. I know it's a topic that's dear to your heart, but before we jump into that specifically, I'd love to maybe just for the audience, give an overview about your background and how you got to where you are today.
[00:00:47] Speaker C: Thanks, Brandon. Yeah, I'm really happy to be here.
[00:00:49] Speaker D: To talk about patient centricity.
[00:00:51] Speaker C: I think it's something as I've been.
[00:00:53] Speaker D: In medical device for over 20 years, clinical research, I've kind of been in a lot of cardiovascular electrophysiology, heart failure, renal denervation. But I think as I've run trials and had teams that we've been running trials, it's hard and I think enrollment can be harder than you think, finding the right sites, et cetera. But I think one of the things is finding patients and patient centricity is kind of that focus on the patient and throughout the lifecycle of the trial. And how can we make a trial easier to understand for that patient?
[00:01:25] Speaker C: How can we get that more access.
[00:01:27] Speaker D: To more diverse patient population? And then how can we make it a little bit less cumbersome to be in research because there's so many novel therapies.
[00:01:35] Speaker C: And I think the reason I got.
[00:01:36] Speaker D: Into clinical research is to help patients. I think that's a lot of our.
[00:01:40] Speaker C: Why we all know somebody that's been in a clinical trial.
[00:01:44] Speaker D: I like that there's this new approach to really focusing on the patient and I think that's going to help us create better trials.
[00:01:50] Speaker C: And that's kind of my background and my passion.
[00:01:53] Speaker B: Yeah, absolutely. Well, I mean, let's go there. Let's talk about how you think it's going to impact the way that we do trials. How is it going to help us create better trials?
[00:02:02] Speaker D: I think really considering patients throughout the as I said, throughout the lifecycle of the clinical study and how do they fit in? I think sponsors, we're doing a good.
[00:02:12] Speaker C: Job of trying to bring a little.
[00:02:13] Speaker D: Bit more patient focus in. But I think in the past and still we think of patients as a subject, as a number, n equals, and we have a lot of pressure on us to execute trials and maybe sometimes not deviate too far from what others have done in the past.
[00:02:29] Speaker C: So there's a lot of risk to.
[00:02:31] Speaker D: We want to get approvals, we want to get these good, innovative technologies out there.
[00:02:35] Speaker C: But if we take a step back and really think about the way the.
[00:02:38] Speaker D: Patient interacts in all the different steps, I think we can do a better.
[00:02:41] Speaker C: Job I think one of the things.
[00:02:42] Speaker D: I think about is education.
[00:02:44] Speaker C: How do we get scientific data to.
[00:02:47] Speaker D: A patient in a way that they could understand it, that they understand the risk going in. I mean, we have our informed consent process, but it's usually a lengthy document. It's almost so legal that a patient would tune out. But when we've been having discussions in the past, I think the power platform is really nice that you're taking clinicaltrials.
[00:03:05] Speaker C: Gov info that's hard to navigate and a patient isn't really used to it.
[00:03:10] Speaker D: As a sponsor, as researchers, we're on it every day, so we understand it.
[00:03:13] Speaker C: But taking that information and kind of.
[00:03:15] Speaker D: Bringing it over to the patient and then trying to condense it down in.
[00:03:19] Speaker C: A user friendly way.
[00:03:20] Speaker D: And so I think that's a patient.
[00:03:21] Speaker C: Centric approach that could really help. But when I made a recent trial I was doing was a heart failure trial.
[00:03:29] Speaker D: And I know that the device has been implanted in, say, thousands of people before. I know it's been in people for 20 years. It's approved in the FDA for another indicate by the FDA and European regulators for another indication. And the data is very compelling to go into the area that this study was researching.
[00:03:47] Speaker C: But how do you get the patients.
[00:03:49] Speaker D: To understand that this is a really innovative therapy for their condition and it.
[00:03:54] Speaker C: Has a lot of safety data trying to address that with patients too.
[00:04:01] Speaker D: How do you get that safety data.
[00:04:02] Speaker C: Risk data, how do you categorize it.
[00:04:05] Speaker D: So a patient can digest it, and importantly, the patient's family, the loved ones?
[00:04:11] Speaker B: Yeah, absolutely. I think this topic of education and understanding the potential safety implications, especially in trials, studying devices or drugs that are better understood, is so important. How do you do it today? You were just on this journey. How did you approach it today? How are others doing it today?
[00:04:29] Speaker D: Approaching getting education out there?
[00:04:31] Speaker B: Yeah, like meeting patients where they are with the information that's relevant.
[00:04:34] Speaker C: It's a great question.
[00:04:35] Speaker D: I think we're still using some of the standard methods, patient recruitment materials. Most sponsors will create a brochure. They're good, they touch on this a little bit.
[00:04:46] Speaker C: On the surface, you have to say.
[00:04:48] Speaker D: That there may not be benefits, that there are risks, so they will have.
[00:04:51] Speaker C: The risks and benefits in front of them.
[00:04:55] Speaker D: It's very common. I've done this a lot, creating a website for patients to be able to go to. I think the more information you have access, the patients and their loved ones have access today because people do Google so much. The more they are able to get out there and find information and the better.
[00:05:11] Speaker C: But I think we could do better.
[00:05:12] Speaker D: And it's maybe finding better platforms to reach patients.
[00:05:16] Speaker C: Is it always going to be a.
[00:05:18] Speaker D: Brochure or is it going to be a website?
Know, I have in the past used Facebook to create Facebook page for the clinical trial. Or we've used Twitter. Twitter sometimes maybe is more investigator or research team focused.
[00:05:30] Speaker C: But I think new platforms are definitely.
[00:05:32] Speaker D: Going to be a then, you know, new technology that maybe condense this data.
[00:05:37] Speaker C: A little easier and help patients get to it and understand it. I think as a clinical researcher and.
[00:05:43] Speaker D: I know most of my colleagues in.
[00:05:45] Speaker C: Their career, we get a lot of.
[00:05:46] Speaker D: People contacting you and say, my loved one has this condition.
[00:05:49] Speaker C: We know of any clinical trials, they.
[00:05:51] Speaker D: Don'T know where to start.
[00:05:53] Speaker C: I think we could do better there.
Sure.
[00:05:56] Speaker B: Yeah. So we're creating one of these platforms.
[00:05:58] Speaker C: Right?
[00:05:59] Speaker B: What are the top three things you would like to see on our website to support this patient education material that is so critical, like on your website?
[00:06:06] Speaker D: What I think would be great is a patient has a very specific condition, like atrial fibrillation or persistent atrial fibrillation, and they can go on your website, search that and it comes up with a number of trials. Then when you click into them, it could tell you really quickly being able.
[00:06:21] Speaker C: To summarize the eligibility and easy to understand way. And then I think, how do you.
[00:06:27] Speaker D: Get, for instance, the trial I was just referencing earlier in heart failure, if there's 16 trials that have come before.
[00:06:34] Speaker C: It, if there's 150 PubMed papers and.
[00:06:37] Speaker D: A lot of safety data, how do you get that?
[00:06:39] Speaker C: And how could you help the patient.
[00:06:41] Speaker D: Condense that down into almost a score or something, digestible that they could really understand the safety of the device or.
[00:06:49] Speaker C: The risks in weighing the benefits as well.
[00:06:53] Speaker B: Yeah, I love that idea. So you're going to love this new feature that we've just developed. We're calling it Simplified eligibility. And it's essentially what you've just described, which is on each study page, being able to really simplify the eligibility criteria away from kind of the clinical stuff towards more patient friendly terminology. So at a glance, anybody can kind of read through and understand, could I be a fit for this study? But I want to talk about this idea of a score because the idea of creating a score has been on our minds for quite some time, for all intents and purposes. Let's use the Zestimate example from Zillow, right? It's a quantifiable score, but you know how much the dollar value of a house is and it's not so objectionable. How would you think about a safety score? What dimension would that even be on?
[00:07:39] Speaker C: I think it would be really interesting.
[00:07:41] Speaker D: Especially maybe I'm getting ahead of my thinking.
[00:07:43] Speaker C: But I think with AI, digest all of the data and really get an.
[00:07:48] Speaker D: Understanding for what's out there and help put it into context, risk, benefit.
[00:07:53] Speaker C: And then when you're able to kind.
[00:07:54] Speaker D: Of click in and drill down to easy digestible metrics of why this is safe.
[00:08:00] Speaker C: And I think going back to your Zillow or Zestimate, there's a lot of.
[00:08:03] Speaker D: Measures in real estate that we know, like price per square foot or the scores of a school district, et cetera.
[00:08:10] Speaker C: That make your house worth a certain amount.
[00:08:13] Speaker D: If we could find those metrics for clinical studies and make people feel comfortable.
[00:08:16] Speaker C: With it, I think it could be a great benefit. Interesting.
[00:08:19] Speaker B: And is this score out of 100 in your mind? I'm trying to get the sense of is this like a 99 out of 100 kind of score? What is this?
[00:08:29] Speaker D: I think we looked in a patient centric way.
[00:08:32] Speaker C: Maybe a patient might respond a little bit better to one out of ten, or we know seven and above is very safe.
[00:08:41] Speaker D: Six is experimental therapy that there's nothing else out there for you.
[00:08:46] Speaker C: Maybe that's a good number. Yeah.
[00:08:48] Speaker B: Interesting. You can almost see like a walk score kind of solution here. Have you seen those Walk scores on Realtor.com? Or maybe some of those other rental platforms where they kind of grade apartment units with like, oh, this is in a 95 out of 100 walking neighborhood. And then you click in and maybe it actually unfurls six dimensions of safety and there's an objective way that you kind of score points against that.
[00:09:15] Speaker C: Yeah.
[00:09:15] Speaker D: And I think to back up the scoring, really having the categorized metrics when you click into it so that it stays relevant, stays scientific, and it doesn't.
[00:09:25] Speaker C: Become marketing, but yet it condenses it down.
[00:09:28] Speaker D: I think you're onto something because we do like our 4.5 out of five. I go to a restaurant, I want to see a score of four or five.
[00:09:37] Speaker B: Yeah, that's a lot of patient centricity from a patient education perspective. I know one of the things that you think a lot about is the site experience. Can you talk a little bit more about patient centricity from the perspective of sites?
[00:09:52] Speaker D: From the perspective of the sites, the.
[00:09:54] Speaker C: Sites also have the enrollment pressures that the sponsor does as well. So one for the site, getting the.
[00:10:01] Speaker D: Word out to patients and having them.
[00:10:04] Speaker C: Maybe come to them could be very helpful for the sites and for the patient. I think kind of helping sites manage.
[00:10:12] Speaker D: Their resources a little bit.
Dashboards that can organize the patients that have come into the pipeline and where they are in the process.
[00:10:23] Speaker C: I think it very much help research and patients.
[00:10:27] Speaker D: I think technology is, again, always something.
[00:10:30] Speaker C: That is going to start continuing to help patients.
[00:10:34] Speaker D: Researchers and sponsors, for instance, just simply automated follow up visits, text messages or different tools that can really ping patients. I think from a site perspective, we could help the sites by designing our follow up visits with patient needs in mind.
[00:10:50] Speaker C: For instance, a lot of research is going towards decentralized visits where one method.
[00:10:57] Speaker D: You could bring a clinician out to do follow up visits in the patient's home.
[00:11:01] Speaker C: That could save a lot of that.
[00:11:03] Speaker D: Loss to attrition patients.
[00:11:05] Speaker C: Maybe not being able to make follow.
[00:11:07] Speaker D: Up visits or moving away. I think it benefits the patient in.
[00:11:10] Speaker C: A way that have less burden.
[00:11:13] Speaker D: Sponsors do this really well and I think it helps the research team. But providing travel reimbursement, I think going a step further and maybe thinking about within the lines of an IRB approval, but thinking about can we offer ride shares, can we offer transportation? Some of our patient populations can be in their late 70s, early 80s, very sick. And to think about them getting to follow a visit for the next year.
[00:11:38] Speaker C: Year and a half, can be tough.
[00:11:40] Speaker D: Continuing to think about it every step.
[00:11:42] Speaker C: Of the way, where there might be roadblocks and where patients might suffer, it.
[00:11:48] Speaker D: Also starts weighing on the sites and sponsors as well.
[00:11:50] Speaker B: Yeah, so there's been a lot of talk about these decentralized or hybrid clinical ops models. There's also been a lot of talk about increasing site burden. And when I think of those two things together, anything that feels like it requires new processes to be adopted across a lot of sites or now we have to get clinicians out of the site and into the home, all feels like increasing complexity from a site perspective. How do these things come together in your mind? Or how do we marry these two themes?
[00:12:23] Speaker C: It's a really good point.
[00:12:24] Speaker D: I mean, every time you introduce something.
[00:12:25] Speaker C: New, there is different.
[00:12:28] Speaker D: Logistical concern. And I think on this topic, as a sponsor, we need to be sitting.
[00:12:33] Speaker C: Down early as we're designing the study and really working with, I think working with the research team and patients.
[00:12:39] Speaker D: Maybe not at the same time, but.
[00:12:41] Speaker C: Separately, but having them kind of help weigh in on some of the places.
[00:12:45] Speaker D: Where we've got roadblocks.
[00:12:46] Speaker C: For instance, if you met while you're.
[00:12:49] Speaker D: Doing your trial design with patient advocates.
[00:12:51] Speaker C: Or patient advocate groups, they might say heart failure patients are too sick to be going every I'm just making this up.
[00:12:58] Speaker D: Going every six months to a follow up, you might want to consider this.
[00:13:02] Speaker C: Or I know that they're not mobile, et cetera.
[00:13:07] Speaker D: If you went and started talking to research coordinators and research teams and investigators.
[00:13:12] Speaker C: As you're designing trials, I think they could maybe say, oh, you're going to put this new process in and it's.
[00:13:18] Speaker D: Not going to fit with our hospital. SOP or something that could show roadblocks.
[00:13:23] Speaker C: So I think kind of the very.
[00:13:24] Speaker D: High level answer to your question is.
[00:13:26] Speaker C: If we involve some of that thinking, some of that planning into the design process, we can start getting to the.
[00:13:31] Speaker D: Place that has a more streamlined partnership between everybody.
[00:13:34] Speaker C: That could help trials be a lot more efficient.
[00:13:39] Speaker B: Got you. Thanks for that. Let's talk a little bit more about implementing this stuff. So what does it take to actually get all this stuff off the ground?
[00:13:48] Speaker C: Takes a good operations team, get all this off the ground as you said these are new concepts. I think it takes definitely a team with no time and a little bit of time pre planning to understand that.
[00:14:05] Speaker D: Some of this if we implement these.
[00:14:07] Speaker C: Things correctly and do it well, one.
[00:14:10] Speaker D: Some of the platforms might.
[00:14:11] Speaker C: Cost more money up front, but if it increases enrollment creases patient kind of.
[00:14:17] Speaker D: Happiness during the trial. And the research teams have less burden on them.
[00:14:21] Speaker C: I think the trial runs faster. We know that trials for a sponsor.
[00:14:25] Speaker D: Can be very costly per month.
[00:14:27] Speaker C: You shave two, three months off of.
[00:14:29] Speaker D: The study, it's a significant amount of money.
[00:14:31] Speaker C: So I think really starting in the front forefront and planning this out is important.
There's a lot of great platforms like.
[00:14:39] Speaker D: Yourself that can help bring patients to.
[00:14:42] Speaker C: The research teams, but making sure that.
[00:14:44] Speaker D: They can implement that it can be implemented up behind their firewall with business agreement set up.
[00:14:50] Speaker C: I think all that pre planning can be very helpful. And then I think what you get.
[00:14:54] Speaker D: At the end is you get maybe more patients understanding what the study is.
[00:14:57] Speaker C: More patients will need to be in the study, hopefully less attrition, less workload.
[00:15:02] Speaker D: On your research sites. Maybe some of these platforms organize the.
[00:15:06] Speaker C: Patients, kind of show you where they are.
[00:15:08] Speaker B: You mentioned save two months. Incredible impact, not just for the trial, but for the program, for the asset.
[00:15:16] Speaker C: As well as the patient, because patients hopefully get an approval quicker or absolutely.
[00:15:26] Speaker B: What are the things that you have seen drive that amount of impact the most regularly? What actually gets people to these two months? Three months of plan savings. Everybody talks about getting there, but what have you seen to really work?
[00:15:39] Speaker D: What works to getting people to have getting people to actually realize that two or three month impact or talk about.
[00:15:45] Speaker B: It and plan for it, to realize it, to realize.
[00:15:49] Speaker D: I think as a sponsor, I think I read a stat recently, 80% of.
[00:15:55] Speaker C: Trials enroll slower than sponsors.
[00:15:59] Speaker D: So we're always thinking of ways to.
[00:16:01] Speaker C: Try to help our site help ourselves roll faster. So we're willing to spend money to.
[00:16:08] Speaker D: Realize that sometimes two, three months could be two, 3 million.
[00:16:12] Speaker C: Some studies, I think little things have.
[00:16:15] Speaker D: Helped, but I don't know if anybody's really or we've really found exactly the.
[00:16:19] Speaker C: Right solution to get huge months worth of savings. But definitely I think some of the things that I've done is really partnering with your sites, having great customer service.
[00:16:31] Speaker D: As a sponsor, creating efficiencies. We talked about how you putting some new systems in.
[00:16:38] Speaker C: Challenge, really making sure CRFs are efficient, database efficient, instructions are efficient.
[00:16:44] Speaker D: We thought about our follow up visits. We make amendments to the protocol when we find that something maybe is too cumbersome and inclusive, exclusion criteria, all of those things together, just really working. Always keeping an eye on a pulse.
[00:16:57] Speaker C: On the study, seeing how it's all.
[00:16:59] Speaker D: Of those factors together and then start realizing months of savings.
[00:17:04] Speaker C: But I think on topic of the.
[00:17:05] Speaker D: Patient centricity and new platforms, I think there's a lot there for us to.
[00:17:09] Speaker C: Do even more, maybe have more consistently help.
[00:17:14] Speaker B: Yeah, absolutely. Maybe a spicy question, but what do you think people are getting wrong?
[00:17:19] Speaker C: That's a good question.
[00:17:22] Speaker D: I don't know if maybe getting it wrong is the right way, but maybe.
[00:17:28] Speaker C: I said earlier, it's pretty risky as.
[00:17:31] Speaker D: A sponsor, say, going back to an example when I was an AFib Ablation.
[00:17:36] Speaker C: Study, four or five studies have come before you.
[00:17:39] Speaker D: They've been run a certain way. The FDA has guidance documents on how to measure AFib, and sometimes sponsors have a hard time going outside of that box. They want approval.
[00:17:51] Speaker C: They don't want to take the risk.
[00:17:52] Speaker D: Of one instance would be certain monitors.
[00:17:56] Speaker C: For Erythmus, they're cumbersome or they're not the best technology.
[00:18:01] Speaker D: There's much better technology than, like, 24.
[00:18:03] Speaker C: Hours patches or even possibly wearables or planable link device.
[00:18:08] Speaker D: But that would actually get you more information than others have collected, could skew.
[00:18:13] Speaker C: The data if it's could be better, but it could be worse. So I think sometimes implementing things that.
[00:18:20] Speaker D: Could help study, help science, help the.
[00:18:22] Speaker C: Patients, unfortunately aren't done because they're risking DBA outside of them. So I think that would be one thing.
[00:18:29] Speaker D: Possibly we're getting wrong inhibiting, maybe putting.
[00:18:33] Speaker C: In some of these new techniques that can be more helpful.
[00:18:39] Speaker B: Yeah, absolutely. Is this different in Med device versus drug trials?
[00:18:44] Speaker C: How do you think about that?
[00:18:46] Speaker D: Most of my career has been Med.
[00:18:47] Speaker C: Device, so I really am focused there. I don't necessarily think it's different.
[00:18:53] Speaker D: I think pharmaceutical has much larger studies, statistically driven. I think in some ways, patients are.
[00:19:01] Speaker C: Really more accepting of a pharmaceutical, taking.
[00:19:04] Speaker D: A pill, sometimes getting a medical intervention.
[00:19:07] Speaker C: Or even a surgery interesting. I don't think it's that much different. I think we all have our ways. We think way we do, things.
[00:19:16] Speaker D: Evolve.
[00:19:16] Speaker C: But it takes a little bit of time.
[00:19:20] Speaker B: I'm really interested in this idea that patients might have more concern around a Med device, especially if it's implantable.
[00:19:28] Speaker C: Right.
[00:19:28] Speaker B: How do you bridge the kind of patient education challenge there?
It sounds like the hurdle might be even bigger in patient education there. How do you think about that?
[00:19:38] Speaker C: As I think about this, I think one of the keys to enrolling, one.
[00:19:42] Speaker D: Of the keys running a good study is patient education. As I was saying, an implantable device or an Ablation procedure or any kind.
[00:19:51] Speaker C: Of interventional procedure runs a little bit of risk. But we have so much data out.
[00:19:56] Speaker D: There showing how low, and some of.
[00:19:57] Speaker C: The risk is how routine this has been.
[00:20:01] Speaker D: We try to get that information out, but that goes back to what we were speaking to earlier.
[00:20:05] Speaker C: How do we in a way that it's really understandable, sometimes it's how do.
[00:20:10] Speaker D: We package it in a way that's.
[00:20:11] Speaker C: Understandable to patients and their loved ones, but also the research teams and physicians.
[00:20:16] Speaker D: I think that medicine we're taught to.
[00:20:18] Speaker C: Be very skeptical and believe evidence that's smart. But I think there's a lot of things that this safety data could be.
[00:20:26] Speaker D: Supporting of this and supporting the bad.
[00:20:28] Speaker C: And therefore this expanded education should hold a lot of the safety that I.
[00:20:35] Speaker D: Don'T know if I answered your question.
[00:20:36] Speaker C: But I think that is the challenge. How do we get this information?
Yeah.
[00:20:44] Speaker B: Are there ways that you frame things that you have found to be more comprehensible for patients?
[00:20:52] Speaker C: Yeah, I think definitely stats of the.
[00:20:56] Speaker D: Health literacy of the average American is pretty low. So how do you write our ICF?
[00:21:01] Speaker C: I think fifth to 8th grade language, try to really keep the lay terms within our brochures and our patient websites.
[00:21:11] Speaker D: But I think there's still an opportunity.
[00:21:13] Speaker C: Maybe to find out what patients respond.
[00:21:17] Speaker D: To and what information do they need.
[00:21:19] Speaker C: It's kind of going back to started.
[00:21:21] Speaker D: Talking about patient centricity, but I think bringing the patients in and having them.
[00:21:25] Speaker C: Kind of give input into recruitment as.
[00:21:28] Speaker D: You'Re building it input into ICF language, how do they read it, how do they understand it? So bringing that them in early in the process could help sponsor target audiences better and then new technology platforms.
[00:21:43] Speaker C: Are we reaching patients in the right way?
[00:21:46] Speaker B: So I want to talk a little bit about the past and I want to talk a little bit about the future. So traditional patient recruitment, what does that mean to you?
[00:21:52] Speaker C: I think traditional patient recruitment is protocol. You create your recruitment material and brochures.
[00:21:59] Speaker D: Out to the site.
[00:22:00] Speaker C: You have a field team that tries to help educate the research team.
[00:22:03] Speaker D: But it's really just scrolling through EMRs and clinic and patient records and having your card of inclusion criteria down.
[00:22:11] Speaker C: And it's kind of a process that.
[00:22:13] Speaker D: Relies heavily on the research team's shoulders and how much resources.
[00:22:19] Speaker C: The historical way it's been done.
[00:22:21] Speaker D: And it works really well in some cases, in some indications in some trials.
[00:22:25] Speaker C: In some it can be challenging, especially if these aren't patients being seen on a daily basis or something.
[00:22:32] Speaker D: A rare condition that how do you.
[00:22:35] Speaker C: Get to the how do you find them?
[00:22:37] Speaker B: Yeah, absolutely. What about modern patient recruitment?
[00:22:39] Speaker C: What does that mean to you? Modern patient recruitment?
[00:22:41] Speaker D: And I think my first example really.
[00:22:46] Speaker C: Great success was working on a renal.
[00:22:48] Speaker D: Innovation project being resistant hypertension patients. How do you find patients that are resistant hypertension meds? They're really living deep within hypertension clinics.
[00:22:58] Speaker C: So we use Facebook and you can.
[00:23:01] Speaker D: Create a Facebook page, created awareness, save information there and search demographics and keywords.
[00:23:08] Speaker C: We started being able to reach more.
[00:23:10] Speaker D: Patients and bring them into the funnel.
[00:23:13] Speaker C: At a call center that would do.
[00:23:15] Speaker D: Some screening questions and then get the patients to the site.
[00:23:18] Speaker C: So it's not as modern as it used to sound, but something that was working. But I think just platforms.
[00:23:25] Speaker D: How do you get to some of these select?
[00:23:28] Speaker C: How do you search using social tools, et cetera?
[00:23:33] Speaker D: That's one of the modern ways, I.
[00:23:35] Speaker C: Think even platforms like Power that can.
[00:23:38] Speaker D: Go and condense information quickly, we can search trials so patients that didn't know.
[00:23:43] Speaker C: How to find a clinical trial that might be helpful for certain can go.
[00:23:47] Speaker D: There and then connect with sites or.
[00:23:49] Speaker C: Find out more information about it. Another kind of a modern approach.
[00:23:53] Speaker B: I'm so curious about this Facebook group that you created, or this Facebook page. Was it a Facebook page? Was it a Facebook group? Was there a difference?
[00:24:03] Speaker D: Named as the study title, really easy to start out. Consultants will come out and tell you.
[00:24:09] Speaker C: How they can do it for you.
[00:24:10] Speaker D: But I would almost encourage everybody. If you're interested in starting Facebook Page, it's really almost just start it.
[00:24:16] Speaker C: Put up a banner picture, put some.
[00:24:18] Speaker D: Key information, and then start searching demographics around the, say, 50 miles from every.
[00:24:23] Speaker C: Hospital that you put in all the.
[00:24:26] Speaker D: It was Facebook Page, but it was.
[00:24:27] Speaker C: Almost very simple to set up.
[00:24:29] Speaker B: And you set it up, and then you started searching. You just started inviting people to the page. That like the page to follow the page.
[00:24:37] Speaker D: When I started, I kicked it off.
[00:24:38] Speaker C: By inviting my contact.
I think these pages gain relevance on those tweets by the number of people I seeded my contact. I think since then it's grown to.
[00:24:53] Speaker D: Actually, there was one arm of this specific trial.
[00:24:58] Speaker C: Really?
Yeah.
[00:25:14] Speaker B: Fascinating. Now I know one thing that IRBs tend to get concerned about is when there's too much commentary happening amongst patients, or whatnot that is outside of the approved communications. I imagine that kind of stuff happens on Facebook Pages all the time. How did you think about that when you were running this page?
[00:25:34] Speaker D: This was, I think, 2016.
[00:25:37] Speaker C: Still sort of a little bit of.
[00:25:38] Speaker D: A gray area, but we did use.
[00:25:40] Speaker C: All IRB approved.
[00:25:43] Speaker D: Subsequently at another company, at another trial.
[00:25:47] Speaker C: We did submit Facebook Page content within.
[00:25:52] Speaker D: The submission, and we did have the IRB. So using IRB approved language. However, I think one of the things you're touching on, if you do have.
[00:25:59] Speaker C: The risk of a troll coming on.
[00:26:01] Speaker D: And making some comments, or somebody making some negative comments, or you wouldn't want.
[00:26:06] Speaker C: To stifle real talk. But I think one thing we did on the first page really kind of limit the amount of comments on post you could comment on.
[00:26:15] Speaker D: Some of it was just advertisers, getting the word out.
[00:26:18] Speaker C: Getting it.
Yeah.
[00:26:22] Speaker B: The thing I love about this play of yours was that you went to where the patients already were. These folks were already on Facebook. They didn't have to work that hard to find your page after you'd already made it on Facebook. And you contrast that, I think, with the strategy of creating microsites and there's nobody out there that's looking for the microsite. There aren't people just passively looking for your microsite. So being on Facebook where there's a network of patients, I think made a lot of sense.
[00:26:50] Speaker C: Yeah.
[00:26:50] Speaker D: And the key was the demographics.
[00:26:52] Speaker C: People have searched hypertension or search be.
[00:26:57] Speaker D: This would be pushed onto their feeds.
[00:26:59] Speaker C: I know in some ways we don't like it.
[00:27:04] Speaker B: Yeah, absolutely.
[00:27:05] Speaker C: And I think as we at the.
[00:27:07] Speaker D: Same time, Facebook might not be the.
[00:27:09] Speaker C: Right tool for a study that some.
[00:27:11] Speaker D: Clinical studies they're recruiting from a patient already scheduled procedure.
[00:27:15] Speaker C: So in some of those studies, like.
[00:27:17] Speaker D: Even Afylations patient is kind of scheduled.
[00:27:19] Speaker C: The doctor says Afylations guideline therapy, we're scheduled for it. We have a new catheter.
[00:27:24] Speaker D: Here are the benefits.
[00:27:25] Speaker C: Would you like to do it?
[00:27:26] Speaker D: I don't know if that would be.
[00:27:27] Speaker C: A right study, but these patients that are really hard to find sometimes yeah.
[00:27:33] Speaker B: I wonder what the new way of doing this would be because people aren't on Facebook the way that they were before, I wonder what the new way to do this would be.
[00:27:42] Speaker D: Luckily they say a lot of the.
[00:27:43] Speaker C: Older fair, maybe it's still good.
[00:27:47] Speaker D: But I have heard some teams have flourished with the idea of TikTok having.
[00:27:51] Speaker C: A little bit of a really short.
[00:27:54] Speaker D: Reel or TikTok about the study or Instagram's been used.
[00:27:58] Speaker C: Twitter to some extent.
[00:28:00] Speaker D: But again, I said earlier, I think.
[00:28:01] Speaker C: Twitter is something physicians really they find helpful negative information.
[00:28:06] Speaker D: There could be a Twitter page.
[00:28:07] Speaker C: It's not very but I agree.
[00:28:10] Speaker D: I think there's something out there that's more there's new technologies, new platforms.
[00:28:15] Speaker C: We haven't quite figured out the best way. I do know your team is working on bringing more.
[00:28:22] Speaker B: Yeah, well, we want to be a place that patients are when they're learning about clinical trials and in doing so be the best place to connect those patients with the trial teams that are actively trying to meet them as well.
[00:28:34] Speaker C: Well, Brian.
[00:28:35] Speaker B: Hey. I've so enjoyed this conversation. I'm going to give you the kind of traditional closing question here, which is if you had a magic wand and you could wave it and change anything about how clinical research is done today, what would you change?
[00:28:47] Speaker C: I think selfishly, I have two answers to this. If you want it.
[00:28:52] Speaker B: Yeah, please.
[00:28:53] Speaker D: Sponsor Point of View I think site.
[00:28:55] Speaker C: Startup can be a very painful process.
[00:28:58] Speaker D: Every sponsor uses essentially same clinical trial.
[00:29:02] Speaker C: Agreement, very similar to language.
[00:29:04] Speaker D: Every site, we get hung up on three sections, subject indemnification, maybe sometimes even publication policy or subject injury, but we.
[00:29:14] Speaker C: Always get through it. But it could take months. So the budgeting, the Funko file agreement.
[00:29:18] Speaker D: Process, I think they could be streamlined.
[00:29:20] Speaker C: A lot to get away from three to six month startup time. So that's a pain point. Sponsors it seems like you could really.
[00:29:30] Speaker D: Go faster by just sitting down at a table.
[00:29:32] Speaker C: And negotiating no time. So that's kind of my sponsor.
[00:29:37] Speaker D: I think the next thing, if I could change something magical on it's enrollment.
[00:29:42] Speaker C: Enrollment.
[00:29:42] Speaker D: It's really tough to say on reasonable enrollment.
[00:29:45] Speaker C: I want to be study everybody's putting all of their minds and thoughts on trying to how do we predict enrollment? And I think this discussion today is really centered on a lot of that easier for patients. Understand a trial, get into a trial.
[00:30:00] Speaker D: We make the trial easier for the.
[00:30:01] Speaker C: Patients and the research teams.
[00:30:03] Speaker D: Then people start being more productive.
[00:30:05] Speaker C: But I think everything starts coming along a little bit better. It affects enrollment, retention. And then even if you're doing this.
[00:30:13] Speaker D: Right and really thinking about the patient and advertising and getting the word out.
[00:30:16] Speaker C: In the right way, I think we increase diversity in the trial. Getting this trialed out to more people. There's my magic wand. I don't know if it's too ambitious, but love to tackle those two.
[00:30:26] Speaker B: I love those two things. I mean, at the end of the day, they all come down to time, right? Two really important problems that are routinely bottlenecks for researchers and for patients. Well, Brian, hey, again, thank you so much for taking the time to come on have this conversation. I've so enjoyed it, talking about sites and patient centricity and the future of this industry.
[00:30:46] Speaker A: Thank you for tuning in. If you haven't already, please follow Power on LinkedIn, sign up for our live events and engage with us in the conversation. We hope to have you join us next time on Power to the Patients.
[00:30:59] Speaker C: Take care.
