By Mary K.D. D'Rozario and Nazneen Qureshi
As clinical studies become more specialized and procedures become increasingly cumbersome, patient recruitment remains a challenge. Medical centers’ ability to fill enrollment continues to fall behind, and the focus has shifted to centralized advertising campaigns. But is a centralized advertising campaign a complete marketing strategy?
We know a lot about how people make decisions, whether they are contemplating participating in a clinical trial or purchasing a car. That knowledge, refined in the traditional sales cycle, has generally been shunned by the clinical trials industry. In refusing to use programs that are successful at meeting customer needs as a model, we make rookie mistakes in how we communicate and fail to take advantage of the latest communication technologies.
Mass advertising only targets the awareness layer of what has come to be known as the “sales funnel” or the “decision process.” While decision processes can vary widely depending on the product or service being purchased, we know customers require a diverse and proliferating set of contacts to make purchase decisions.1 The customer uses those contacts to gather information and determine if they trust the person offering the product or service. Nineteen percent of people want to talk to a person when they’re gathering information.2 The more questions the vendor asks and the more they build a conversation, the more successful they are in completing sales.3 There is no reason to think patients would be less cautious about their healthcare decisions than their household or business purchases or require fewer interactions and conversations.
Individuals who have been exposed to a mass advertisement are at the first level of decision making. They know an option exists. What they don’t know is if it is the right option for them or if you are a trusted party they should engage to meet their needs. Rather than rejecting traditional marketing knowledge, what if we make the best use of it to give patients the information they want to successfully reach the next level of the decision funnel?
Answer Their Questions
Marcus Sheridan is a popular sales speaker.4 His company sells above-ground swimming pools, and he has had tremendous success by simply answering people’s questions about pools. We might laugh at a sales guru going around sharing how awesome it is to answer customers’ questions, until we start thinking about whether clinical trial marketing does enough to answer patients’ questions.
Without meeting their need for trust and including adequate study information, we are not driving genuine interest. Mass advertising campaigns are meant to capture a moment of the patient’s time. These advertisements aren’t designed to answer the patient’s questions. Their potential questions, even if known, are too numerous and complex to respond to in an advertisement. And even if an advertisement could respond to their questions, it cannot build the relationship of trust the patient requires.
One reason the clinical trials industry has not reached the next level in the decision process is because we don’t know enough about patients, and what we do know is not effectively shared across stakeholders and reflected back to patients trying to make difficult healthcare decisions. Sponsors and CROs have their own social listening programs and sometimes conduct protocol reviews with patient focus groups, but the information gathered from these activities is not effectively shared with sites.
Do You Use People-First Language?
By listening to patients, trial sites can communicate more effectively with them, and thus improve enrollment efforts. One example comes from LMC|Manna Research, a Canadian network of clinical research sites. LMC|Manna Research works with a team that engages in its own social listening, which simply means logging on to social media sites such as Twitter when patients gather to discuss similar healthcare interests. You can find out about these gatherings by searching on the Healthcare Hashtag Project.5
LMC|Manna Research focuses its engagement around therapeutic areas it conducts studies in, such as diabetes. One thing it learned is patients with diabetes do not like to be referred to as “diabetics.” At the time of the social listening, the company was unaware of the communications movement called “people-first language;” it was simply listening to what patients said and responding.
Engagement can’t just be a plan or a strategy; it has to be built into the culture of the medical center. In this case, LMC|Manna Research changed all of the language in its advertising and patient materials. It had training sessions so all staff members knew they served “people living with diabetes.” But it found it also had to train CROs and sponsors that continued to bring central advertising campaigns about “diabetics.” LMC|Manna Research made it clear this was not language it wanted to be associated with.
This kind of listening, enacted as authentic change at the practice, allows the company to develop engagement opportunities where patients get more information and further build trust. This isn’t “advertising.” Advertising is what gets us to the moment when we can develop engagement. Another example of engagement occurred when LMC|Manna Research used social listening to understand which information channels parents of children living with Type 1 Diabetes were using and follow these conversations to hear their primary concerns.
An opportunity presented itself simply by staying engaged with patients. LMC|Manna Research recognized parents and kids wanted to meet others going through the same experience. The result was an education-infused experiential event to bring together kids with Type 1 Diabetes and their families. At the event, families were able to develop a better feel for LMC|Manna Research through informal interactions, and the company was able to share information about clinical research opportunities. This event was part of an engagement strategy which, in 2017, won the SCRS Site Patient Recruitment Innovation Award (the SPRIA).
Be Part Of The Conversation
The cycle of listening and responding doesn’t end there. Everyone who interacts with us has the opportunity to share their experience on social media. This is word-of-mouth with a very big megaphone, and patients are eager to hear it. “Social validation” is the term for when people seek out the experience of others on social media in order to make a decision. We can stand aside, or we can participate in the conversation.
Participating doesn’t simply mean getting out our own megaphone — that would be a lot like advertising. Engagement means activities such as identifying patient thought-leaders and reaching out to them to share information about the study. It means supporting patients who may want to blog about their experiences by promptly answering their questions and providing credible sources of information about their conditions.
Engagement is an ongoing process and commitment to other people. We can’t just reach out to the community when we want something. It takes months or even years to establish an online presence and credibility, and relationships grow over lifetimes. Practically, as a study recruitment tool, it doesn’t work to reinvent that for every study. Also, reaching out only when you want something from the patient community is inauthentic, even inhumane. As healthcare partners with our patients, we become a member of their community for the long haul.
Stakeholders in clinical research will continue to develop their own engagement strategies. As participation develops, coordination with other practices and with sponsors and CROs will become more important. Sponsors and CROs already have information that, if shared, could improve engagement efforts. As clinical research moves past advertising alone, entirely new techniques for coordination will need to be developed.
About The Authors:
Mary K.D. D'Rozario is the president of Clinical Research Performance, Inc., providing content development and social media management to companies in the life science space. She previously worked in clinical operations at several CROs. D’Rozario has a master’s degree in clinical research and an MBA, and holds certifications from ACRP, RAPS, and SoCRA.
Nazneen Qureshi is the manager of patient engagement at LMC|Manna Research. In this role, she manages study start-up activities, focusing on recruitment and retention strategies. Her objective is to increase the understanding of patient perceptions to improve clinical research processes such as study design, experience, and motivation to participate. Qureshi is the recipient of the SCRS 2017 Site Patient Recruitment Innovation Achievement Award. She holds an HBSc in neuroscience and psychology from the University of Toronto and is completing her MBA at Lazaridis School of Business & Economics.