I recently wrote an article that focused on the frustrations sites have with sponsors. Their greatest gripe, to no one’s surprise, is site payments. Sites receiving payments late, and receiving a check with no supporting documentation, can cause delays and frustration, especially for smaller sites that can’t float a payment for three months or longer.
To gain a bit more insight into this problem, I spoke with Jim Murphy, CEO of payment solutions vendor Greenphire, to get his thoughts. Murphy believes the clinical research industry is at a pivotal time. No longer are companies viewing patients as subjects that deliver the needed data. Today, patients are seen as valuable and collaborative partners that play a critical role in advancing drug development.
Ed Miseta: The term “patient-centric trials” has quickly emerged as a hot topic in the industry. Is technology becoming a large part of that movement?
Jim Murphy: I think so. In order to support patient-centric trials, companies will need to focus exclusively on the patient experience. Centricity comes with empowering the entire clinical trial ecosystem—from sponsors and CROs, to sites and investigators—to do better. That will involve eliminating resource-draining tasks and focus on optimizing the clinical trial experience.
Notably, advances in payment technology can play a vital role in enhancing the trial for all involved, from start to finish. Payment technology designed to enhance the clinical trial performance can remove roadblocks and hurdles that are common pitfalls in research, such as patient dropout and site sustainability.
As an industry we will all need to optimize research site performance by creating a more supportive and collaborative relationship between sites and their sponsor/CRO partners. I think doing so will result in a better trial for all involved.
Miseta: Let’s start with patient engagement and retention. What can we do to make improvements in that area?
Murphy: Leveraging a payment technology that eliminates the hurdles to patient participation and engagement is proven to deliver a measurable increase in patient retention.
For example, sites will often use cash or checks to reimburse patients, which can be time-consuming, error prone, and unsecure. By automating patient reimbursements and arming study participants with an easy-to-use reloadable debit card, sites can optimize the experience for their study participants and provide a more secure, simplified way of both distributing and receiving reimbursements. This is one rather simple action that can lead to increased patient satisfaction and retention.
Payment technology can not only automate and simplify patient reimbursement, it can provide an easy-to-use mechanism to communicate with study participants. Sending reminders and notifications from an easy-to-use portal, for example, further improves patient engagement to continue participation in a study.
Miseta: Another complaint I hear from sites relates to the burden of receiving payments without proper supporting documentation. Can automation solutions help alleviate administrative burdens as well?
Murphy: Administrative burdens are definitely a problem. Research sites are faced with the task of reimbursing patients for their time as well as reconciling the funds received from their sponsor and CRO partners. Those might sound like small tasks, but they never are. Both tasks can become extremely cumbersome and prone to errors, causing distractions from the research and the patient experience.
Unfortunately, depending on the size and sustainability of the site, there is rarely a dedicated resource to perform these duties. As a result, someone is tasked with cutting checks to patients and/or reconciling reimbursements from their partners. Both tasks lead to a great deal of administrative work that is often added to someone’s primary responsibility. That creates a hardship on the part of the individual selected to perform the task and takes away from their other responsibilities.
By automating patient reimbursements and providing a centralized platform that distributes funds to study participants quickly and easily, administrative duties are dramatically reduced, allowing resources to be allocated to the trial experience.
The invoicing and reconciliation process can be lengthy, unpredictable, and extremely detrimental to the site’s operations. Automating these processes allows the sponsor or CRO to issue funds automatically, eliminating the need to issue and process invoices manually. Additionally, criteria can also be extended to empower the sites to request and receive payments for additional pass-through costs that may arise during the course of the study, further eliminating additional administrative tasks for site personnel.
Miseta: Cash flow can be an issue for many sites, especially the smaller ones. It can be difficult for them to pay patients without having the payment from partners in-hand. Can automation improve this situation?
Murphy: Absolutely. A large majority of research sites are reimbursed by their sponsor or CRO partners on a quarterly basis. Processing invoices in this cadence can often result in it taking six months until payments are received.
Expecting sites to front costs for months can have a number of negative impacts on a study, especially if the payment is not accurate or comprehensive. In fact, according to the Society for Clinical Research Sites (SCRS), 65 percent of U.S. research sites don’t have enough funds to sustain operations for more than three months. If their funds can sustain them for only three months, and it is taking six months for them to get paid, you start to see the extent of the problem.
Automating site reimbursements with more frequent, monthly payments optimizes cash flow at the site level, further reducing any performance factors that can be tied to resource constraints. Additionally, sponsors and CROs that reimburse sites monthly can see a strengthened, more collaborative relationship with improved trial performance.
Miseta: What kind of improved performance could you expect to see?
Murphy: Patient retention is a big one. Research sites, particularly those working in rare disease and orphan drug studies, have the difficult task of recruiting and retaining patients for their trials. Clinical trial patient reimbursement solutions are designed to eliminate out-of-pocket travel costs to ensure ongoing participation and engagement. By providing the funds and arranging travel upfront, patient reimbursement is taken a step further, eliminating any hurdles for continued participation.
As a result, patients, their families, and care givers gain a more optimal trial experience, knowing that their site is doing everything it can to ensure they continue to be active participants in the study.
Miseta: Will sites also have greater visibility into the payment processes?
Murphy: They will. Without a centralized payment platform, sites do not have a clear view into when payments will arrive, and neither cash nor checks will provide a proper paper trail. Payment solutions offer a centralized portal to gain visibility into when a reimbursement from a sponsor will arrive, improving business operations and eliminating unnecessary work around tracking payment status. Financial visibility and control will also improve business operations for budgeting and planning, and provide a comprehensive, clean repository of data for added financial transparency requirements.