Leveraging Mobile Health Technology for Patient Recruitment: An Emerging Opportunity

Leveraging Mobile Health Technology for Patient Recruitment: An Emerging Opportunity

In Introduction The adoption of mobile devices smartphones and electronic tablets is proceeding at an astounding pace. In 2011, more smartphones were purchased worldwide than computers, desktops and laptops combined. 1 In the US, roughly half of the adult population owns a smartphone. 2 The growing popularity of mobile devices also includes the tablet; no consumer product has ever been adopted faster than Apple s ipad. 3 The healthcare sector has steadily embraced mobile technology, having widely adopted the term mhealth. mhealth refers to the use of mobile and wireless devices to improve health outcomes, healthcare services and health research. 4 Hospitals are giving tablets to outpatients for improved compliance and outcomes. Four out of five physicians now own smartphones 5, and in a recent survey, 85% of nurses have been clamoring for the just-released mobile version of the 2013 Nursing Drug Handbook. 6 Blue Chip Patient Recruitment believes that mhealth can positively transform clinical trial recruitment as well. Blue Chip conducted a survey with patients, physicians and coordinators to identify trends and opportunities within each of these groups. While mhealth is largely in its infancy for patient recruitment, the survey results point to some exciting ways sponsors can leverage the technology now and in the not-too-distant future. Though mobile presently may not be a priority for clinical development teams, sponsors who incorporate mobile strategies now will be better prepared to capitalize on this sector growth as new mobile innovations are created. Methodology Between March and May 2012, an online survey was conducted of patients, physicians and coordinators. All participants were required to have a smartphone and/or tablet. Patient Panel: 705 adults Ages 35 and older Currently have at least one medical condition Physician Panel: 32 Physicians Served as an investigator in a clinical trial in the past 12 months Specialties included Internal Medicine, Obstetrics/Gynecology, Psychiatry and Allergy/Immunology Coordinator Panel: 50 Study Coordinators Worked on a clinical trial in the past 12 months Specialties included Obstetrics/Gynecology, Internal Medicine and Family Medicine 2 Introduction Blue Chip Patient Recruitment

Co Communication vs Computing A Common Thread Among respondents in all three survey groups, mobile devices are currently used for communication more frequently than computing. Mobile Communication: telephony (phone use), text messaging and emailing Mobile Computing: accessing the internet or using apps Respondents use their mobile devices less frequently for computing, especially for healthrelated purposes. When respondents use mobile computing for health-related purposes, it is almost always for reference or information, rather than specific health care needs. For example, a patient might visit WebMD to learn more about their diabetes, but they are not yet scanning their prescription bar code on their smartphone to request a refill at their local pharmacy. Strategically, this is significant because it is more cost-effective to inform large numbers of people about a clinical trial through a mobile computing function (i.e., a banner ad on a mobile-optimized website) than through a communication function (i.e., leaving a voicemail on an individual phone). As more users become comfortable using their smartphones and tablets for computing functions, the opportunities to deliver clinical trials messaging on a wider level will grow. Communication VS Computing Computing Communication Internet Apps Phone Text Email General Specific Reference Info Education Prescription Refill View Lab Results Communication vs Computing Blue Chip Patient Recruitment 3

Pa Patients A Mixed Picture Patient respondents have largely embraced smartphones. In the past year, 45-54 year olds have acquired them faster than just about any other demographic. 7 They are, however, relatively new users. Just 41% of them have had their devices for more than three years. As mentioned earlier, patients prefer their smartphones and tablets for communication: 98% use them for phone calls 76% for emailing 82% for text messaging Patients have been slower to adopt mobile technology for computing: 49% use it to visit social media sites 23% reported using a mobile device to watch or download movies 15% click on ads 15% make purchases The majority of participants who own both a smartphone and tablet prefer a tablet to access movies, click on ads and e-commerce. This trend suggests that adults may be more receptive to clinical trial messaging via tablets than smartphones. However, the numbers drop significantly when it comes to health-related computing: 26% of users visit health-related websites 18% download health-related mobile applications, or apps 8% spend time at online health communities 4 Patients Blue Chip Patient Recruitment

Frequency of mobile healthcare activities among patients Use their mobile device several times a month or more for the following: 15 % Finding information about a medical condition 14 % Reading comments and reviews by others experiencing similar medical conditions 13 % Monitoring and recording your own health information 12 % Comparing prices on medication or other health-related products Posting comments about your health or discussing your condition 9 % Communicating with your healthcare provider 9 % 8 % Purchasing medication or other health-related products 0% 10% 20% 30% 40% 50% 60% 70% These percentages may be low, in part, because many healthcare sites are not designed specifically for mobile devices and, therefore, the user experience is not optimal. Of the top 10 pharmaceutical brands, only Plavix is optimized for mobile. 8 In spite of these low numbers, there is a subset of patients who are much more active in their use of mobile for healthcare. These early adopters reveal trends on where mobile usage is headed for this patient demographic. Make sure your clinical trial website is designed specifically for mobile viewing. Patients Blue Chip Patient Recruitment 5

Ea The Early Adopter A Glimpse into the Future of mhealth Not surprisingly, the most active users of mobile for healthcare purposes are younger (35-54) and have had their smartphones longer (three years or more). These early adopters have also expressed interest in participating in clinical trials. Compared to the total sample, these participants are significantly more engaged in mhealth. They are more likely to visit health-related websites, download mobile apps and visit health-related communities. Engagement in mhealth: Early Adopters vs. Total Sample } Adults 35 54 Smartphone ownership 3+ years Would participate in a clinical research study 26 % 39 % 51 % 65 % 18 % 27 % 72 % 74 % Total Sample Early Adopters Adults 35 54, Smartphone >3yrs, would participate in clinical research 705 101 Do you visit health-related websites? (Y) How frequently do you visit websites: Several times a month or more Have you downloaded health-related apps? (Y) How frequently do you use apps: Several times a month or more 8 % 16 % 75 % 94 % Do you visit health-related communities? (Y) How frequently do you visit communities: Several times a month or more 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 6 The Early Adopter Blue Chip Patient Recruitment

These early adopters are also more receptive to receiving clinical trial information via their smartphone or tablet: Emails (67%) Internet search engine (44%) Mobile voice mail message (35%) Early adopters are seeking clinical trial information on mobile search engines; therefore sponsors should consider implementing a mobile search engine optimization/marketing strategy. Patient interest in receiving clinical trial information via mobile Early Adopters vs. Total Sample Somewhat interested/ very interested in receiving clinical trial information on smartphone or tablet Total Sample Early Adopters Adults 35 54, Smartphone >3yrs, would participate in clinical research 705 101 38 % 67 % Emails 32 % 44 % 20 % 35 % Internet search engine Mobile voicemail messages 18 % 29 % Mobile ad 16 % 25 % A social media discussion 0% 10% 20% 30% 40% 50% 60% 70% 80% The Early Adopter Blue Chip Patient Recruitment 7

Oa Opportunity Awaits The waiting room provides a captive audience of patients who are interested in using mobile technology to occupy their waiting time. About half of patients surveyed use their mobile device while in the waiting room, spending an average of 5-15 minutes on it. Most commonly, patients use their mobile devices in the waiting room for: Email (61%) Texting (49%) Accessing the internet (47%) Patients were also asked whether their physicians offered Wi-Fi in their offices. Wireless-Fidelity, or Wi-Fi, offers greater bandwidth than cellular transmission and, when provided for free, is attractive to mobile users. Currently, only 16% of patients said their doctors provided Wi-Fi, while 57% said they were unsure if their doctors offered it or not. Interestingly, more than half of the physicians and coordinators said their offices were, in fact, Wi-Fi enabled. When patients knew it was available, 79% of them accessed it, indicating the high level of interest for this service. Physicians should consider offering free Wi-Fi to patients in their waiting rooms that provides them with clinical trial information. Also, consider the aperture. Patients are often unaware of research opportunities taking place at their physician s practice. Wi-Fi activates a new communication channel that can provide interactive content to encourage dialogue about clinical trial opportunities. Make certain that appropriate signage lets patients know that Wi-Fi is available. 8 Opportunity Awaits Blue Chip Patient Recruitment

Pr Privacy A Healthy Concern Concern over privacy is impacting the rate of mobile technology adoption. When using a mobile device for health-related activities, all three groups said they were somewhat or very concerned about privacy: 45% of patients 37% of physicians 44% of coordinators A general feeling exists that mobile devices are less secure than desktops or laptops. This is a misperception. While portable devices are inherently at greater risk for theft, the information on them can easily be secured with pass codes and locking features. Reassure patients with clear, concise messaging that smartphones and tablets are as safe as desktops and laptops for viewing personal health information. A secure web-based platform enables physicians and health care professionals to communicate with patients about their specific health care needs. It also allows health care professionals an easy, direct way to communicate with patients about appropriate clinical trial opportunities. Privacy Blue Chip Patient Recruitment 9

Ap Apt to Use Apps In general, mobile websites work better than apps. They provide the same experience, but require less for the patient to do. Despite the current buzz over mobile applications, the truth is that only 18% of patients surveyed have downloaded health-related apps to their mobile devices. Several patient recruitment organizations have developed mobile apps to help patients identify clinical trials. However, only 127 out of 705 patients (18%) downloaded health-related apps. Apps downloaded were primarily for health and fitness or pharmacy apps. These findings suggest that patients are neither looking for clinical trial information nor motivated to use an app for this purpose. Physicians and coordinators, on the other hand, are eager for such tools. Active Recruitment Both physicians and coordinators are excited about mobile technology in the work place, although their usage of and receptivity to the technology varies. Significantly more physicians surveyed owned smartphones (91%) than coordinators (41%). When asked whether they would use apps to help identify patients within their practice, the idea was enthusiastically welcomed by both physicians (75%) and coordinators (82%). Coordinators slightly higher interest level is likely because they are more involved with patient recruitment at the site level. Physicians Coordinators More technologically savvy Greater mobile ownership and usage Enthusiastic about using mobile for patient recruitment Less technologically savvy Lesser mobile ownership and usage Higher level of interest in mobile usage for patient recruitment 10 Apt to Use Apps Blue Chip Patient Recruitment

Ar Active Recruitment Coordinators also expressed interest in apps to: Contact patients and colleagues about a clinical trial Update referrals from a centrally managed ad campaign Manage scheduling How would practitioners use mobile technology for patient recruitment? Agree Somewhat/Agree Strongly with the following statement Physicians Coordinators 75 % 82 % 54 % 80 % 57 % 68 % I would use an app to identify eligible clinical trial study subjects. I would use a Smartphone or Tablet to contact our patients regarding a clinical trial. I would encourage my staff/colleagues to contact our patients regarding a clinical trial. NA 88 % I would use a Smartphone or Tablet to receive or update referrals from a centrally managed advertising campaign. 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Sponsors are already seizing an opportunity by providing mobile devices to coordinators. One surprising revelation was that 44% of coordinators have used a sponsor-provided tablet for a specific trial. When asked whether they would be interested in receiving a device from a sponsor, 92% of coordinators replied yes. They were most interested in receiving the following devices: Tablet (98%) Laptop (89%) Smartphone (79%) This enthusiasm reflects the importance of access and uniformity. Since coordinators do not have access to mobile technology on the scale of physicians, they welcome these devices to help them do their jobs more effectively. Furthermore, a sponsor provided device would ensure they are using technology in a way that the sponsor approves for their trial. Active Recruitment Blue Chip Patient Recruitment 11

Kt Key Takeaways Anticipate rapid growth. Start now to determine how to best leverage mobile technology for patient recruitment moving forward. Design your website specifically for mobile. This will ensure a positive, engaged experience for the user. Create apps for coordinators, not patients. They are looking for tools to do their jobs more effectively. Implement a mobile search engine optimization/ marketing campaign (SEO/SEM). Patients are seeking clinical trial information through search engines. Develop a comprehensive waiting room strategy. Capitalize on the captive mobile user. Di spel mobile privacy misperceptions. Make sure they are aware of the safety, security and privacy of mobile communication. Pr ovide a secure communication platform. This allows practitioners to deliver targeted clinical trial messaging. Pr ovide mobile devices and tools. Leverage the strong interest among coordinators to adopt mobile technology by providing them with mobile devices. 12 Key Takeaways Blue Chip Patient Recruitment

Co Conclusion Provide tablets to coordinators Develop a comprehensive waiting room strategy Develop apps for physicians and coordinators to help identify patients mhealth Opportunities Implement a mobile search engine optimization/ marketing (SEO/SEM) campaign Optimize your website for mobile Conclusion Build a secure communication platform at the physician s office Reinforce Privacy While currently in the early stages of adoption, mhealth for patient recruitment provides great potential for reducing clinical trial delays. Many of these opportunities exist today, and as patients and practitioners become more engaged in mhealth, many more will exist tomorrow. Over time, individuals will use devices for more computing and communication functions. The opportunity provided by today s mobile transformation can and will improve patient recruitment. Smartphones, tablets and any future devices all have potential to create new and highly productive ways of connecting patients to clinical trial opportunities and, in turn, accelerating the delivery of products to market. Conclusion Blue Chip Patient Recruitment 13

Bc About Blue Chip Patient Recruitment Blue Chip Patient Recruitment, a division of Blue Chip Marketing Worldwide, is a global, full-service patient recruitment and retention agency dedicated to accelerating clinical trial enrollment. We have proudly delivered success to the world s top healthcare corporations since 1993, across more than 600 clinical studies. We are recognized for our scientific approach to clinical trial marketing, our insights and strategies, our innovative recruitment tactics and our best in class creative. Most importantly, we are known for the intelligence and passionate service that we bring to every study. For more information about Blue Chip Patient Recruitment and how we may be able to enhance your clinical trial enrollment, contact: Mark Bielecki 248-546-5844 mbielecki@bluechipww.com 650 Dundee Rd, ste 250 Northbrook, IL 60062 phone 847.418.8000 fax 847.418.8088 www.bcpatientrecruitment.com 14 About Blue Chip Blue Chip Patient Recruitment

experience + process + innovation = enrollment accelerated Ex Pr In References 1 The World now buys more Smartphones than Computers, http://gizmodo.com/5882172/the-world-now-buys-more-smartphones-than-computers 2 46% of American Adults are Smartphone Owners, http://pewinternet.org/reports/2012/smartphone-update-2012.aspx 3 12 trends for mobile health in 2012, http://mobihealthnews.com/16310/12-trends-for-mobile-health-in-2012/ 4 Definitions of Mobile Health, http://www.mhimss.org/resource/definitions-mhealth 5 Smartphones, Tablets and Mobile Marketing, http://manhattanresearch.com/research-topics/healthcare-professional/mobile 6 Survey: 71 percent of US nurses use smartphones http://mobihealthnews.com/17172/survey-71-percent-of-us-nurses-use-smartphones/ 7 Nearly half of American Adults are Smartphone Owners, http://pewinternet.org/reports/2012/smartphone-update-2012/findings.aspx 8 http://www.mediapost.com/publications/article/169386/un-responsive-designs-plague-pharma-brand-websites.html References Blue Chip Patient Recruitment 15

16 Introduction Blue Chip Patient Recruitment