One of the top things people do online is search for health-related topics. In fact, according to Pew Research, 72% of adult Internet users have searched online for a health topic in the last year.

The popularity of health-related Internet searches has been one of the driving factors in the use of online advertising for recruiting volunteers into clinical trials. Study-specific websites and digital media campaigns to drive Web traffic are becoming as standard as patient-facing brochures. Unlike the typical printed patient-recruitment tool, the effectiveness can be backed up with metrics.

In the movie “Jerry Maguire,” a professional athlete repeatedly tells his agent, “Show me the money.” The scene is eerily similar to some playing out today in clinical research where sponsors keep telling their patient recruitment vendors, “Show me the metrics.” The demand is understandable. Obtaining the data is not always easy.

Developing sound strategy for patient recruitment campaigns requires knowledge of what works and what does not work for a particular patient demographic. Such knowledge is obtainable only if metrics are obtained. For instance, a recruitment strategy may be comprised of multiple tactics such as printed educational materials, site tools, and a mix of digital and traditional media. It is hard to measure the effectiveness of printed patient education materials. It’s impossible to know for certain how many people took them out of the brochure holder in the waiting room and were prompted to action.

Site-facing tools can be the same way. If the strategy includes printed “at a glance” cards, for example, you may never know how many times a site staff refers to that card, but if you offer the site tools via an app, you can actually gain an understanding of how many times certain tools were accessed by site staff. Moving to the traditional media tactic, you can realistically begin to count actual patient interest. Traditional media is best carried out in a centralized campaign with either a toll-free phone number and/or a website. You can count the number of phone calls received and the number of website hits generated to get a pretty accurate picture of patient interest generated by traditional media. Online media is the easiest to measure, but there are limitations.

Collecting the data up to a certain point is fairly easy if you have included a website with an online pre-screener. There is the ability to see a set of data that includes the number of visits to the website and how many people passed the pre-screener. From there, the collection becomes trickier. Due to the rules and regulations surrounding the collection of personnel health information from the HIPAA Privacy Rule (designed to protect the privacy of individually identifiable health information) and the HIPAA Security Rule (which sets national standards for the security of electronic protected health information, or PHI), the collection of metrics past the patient referral stage becomes highly scrutinized, but it can be done. Sponsors and study managers may be thrilled to see how many patients were referred to sites from an online media campaign, but referrals are not the end of the line. What sponsors really want to know is “How many randomized patients did we get?” This is the truest measure of return on investment (ROI) from a media campaign and it may differ significantly from the referred metric.

The example funnel above shows that out of 2,667 patients who have passed the pre-screener and are referred, only 240 actually completed or randomized in the study.  Many digital campaigns are not set up with the end metric in mind. In order to capture true randomization metrics and ROI at every step, some type of PHI must be obtained. An online screener that directs patients to call a site is not an ideal way to capture data. The potential patient may or may not call; the site may or may not be available or may not have an answering system. Worse yet, the site may never call the potential patient back, and who would even know in that scenario? Sure, you can line up IVRS data with referrals and gauge the effectiveness of a digital campaign, but a better way to capture the data is to have potential patients who pass the online pre-screener fill out basic contact information to have the site contact the patient.

When the goal is to generate interest and refer interested and eligible potential candidates to a site, the collection of PHI will be necessary. The true measurement of the effectiveness of digital campaigns must be proven with metric evidence of how many patients actually randomized from the effort. After all, it’s not how many people you invited; it’s who actually shows up that is the ultimate measure of success. 

Ashley Tointon is principal consultant of Accelerate Clinical Enrollment LLC. Email comments and suggestions to tointon@icloud.com.

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