Using Technology to Transform Recruitment Strategies in Clinical Research

Executive Summary   

Research is the lifeblood of healthcare, and core to Cleveland Clinic’s mission of “Caring for life, researching for health and educating those who serve.” Recruiting participants in clinical research is key, but is often the Achilles heel in the research process. Identifying eligible participants and requesting their participation is a challenge made more acute by COVID-19 and virtual care. Cleveland Clinic has used technology and the electronic health record (EHR) to innovate efficient and effective electronic recruitment strategies. Examples include: 

• Creating an enterprise-level Epic-based digital infrastructure for subject identification, electronic consenting and automated phenotyping for the Cleveland Clinic BioRepository (CC-BioR) accelerated recruitment 20-fold while reducing cost five-fold. From the Heart, Vascular and Thoracic Institute alone, CC-BioR enrolled 1,172 subjects and collected 3,565 blood and cardiac tissue samples in 2021 for translational research with significant cost savings over traditional methods. 

• Leveraged Cleveland Clinic’s Research IT service to streamline the use of the EHR in research. The team completed programming and recruited 949 patients in 2020-2021 for interventional studies in the Heart, Vascular and Thoracic Institute, Neurological Institute and Primary Care services at Cleveland Clinic main campus and its 17 regional hospitals using the Epic’s secure patient messaging functionality (MyChart). On average, we recruited >100 patients/study; without the MyChart recruitment process, the typical enrollment rate was <10 patients per year.  

These two examples showcase a comprehensive EHR-based strategy to support our research mission. Aligning research processes with clinical care, and leveraging EHR-research technology (electronic consenting, secure messaging, interface with patient scheduling and procedures) can accelerate research and reduce cost.