Todd Albin, CEO of Cedar Health Research, discusses the groundbreaking recruitment strategy that earned them the SCRS Site Patient Innovation Recruitment Award (SPRIA). Hear Cedar Health's integration of technology to pre-identify eligible patients in healthcare practices for a challenging study.
Albin emphasizes their comprehensive approach to diversity, highlighting the success of engaging diverse communities through a dedicated task force. Explore the synergy between site and industry partnerships and Cedar Health's plans for the future, focusing on optimizing technology, enhancing outreach, and improving diversity initiatives.
Todd Albin, CEO of Cedar Health Research, discusses the groundbreaking recruitment strategy that earned them the SCRS Site Patient Innovation Recruitment Award (SPRIA). Hear Cedar Health's integration of technology to pre-identify eligible patients in healthcare practices for a challenging study.
Albin emphasizes their comprehensive approach to diversity, highlighting the success of engaging diverse communities through a dedicated task force. Explore the synergy between site and industry partnerships and Cedar Health's plans for the future, focusing on optimizing technology, enhancing outreach, and improving diversity initiatives.
Welcome and thank you for joining the Society for Clinical Research Sites for SCRS Talks. I'm Jimmy Bechtel, the Vice President of Site Engagement with the Society. SCRS Talks allows our partners and those that we work closely with to take a few minutes to address issues of industry concern, share exciting achievements, and learn more about our community. Today, we have Todd Albin, the CEO of Cedar Health Research, here to share his exciting achievement, having been the most recent recipient of the SCRS site Patient Innovation Recruitment Award or SPRIA. Todd it's great to have you back with us again this time in a little bit of a different capacity now being the recipient of this great award, if you wouldn't mind, let our listeners know who you are and a little bit about Cedar Health.
Todd Albin:Sure. Thanks, Jimmy. Great to be back on SCRS Talks to talk about this great achievement we accomplished here at Cedar with SCRS. A little bit about myself, as Jimmy mentioned, I'm Todd Albin, CEO for Cedar Health Research. I've been working in the clinical research field for over 27 years now, most of that time focused with The site operations, operating clinical trial sites, either integrated, standalone, or SMO sites. I've also spent about six years in the solution provider space around patient recruitment retention solutions, as well as the CRO space and investment in development of investigator site networks. I joined Cedar Health Research to launch us back in late 2019 into 2020. We are a what we would call a technology enabled clinical trial site and patient network based out of the Dallas Fort Worth area of Texas, where we have four operating sites two standalone sites partnered with healthcare practices throughout the area and then two integrated sites one in Fort Worth and one in Midland, Texas as well. We specialize in outpatient trials phase one through four in a variety of therapeutic areas. Everything from all age groups from pediatric to geriatric and stretching from women's health and pediatric studies to vaccines and cardiovascular and metabolics and orthopedics as well.
Jimmy Bechtel:That's excellent. I know Cedar Health is is busy, busy, busy all the time, so it's great to hear a little bit about the background and and what you guys do all that you cover. So Todd, you know, again, congratulations on receiving the 2023 SPRIA Award. Can you start us off by maybe talking a little bit more about the strategy behind that specific recruitment strategy that you presented?
Todd Albin:Sure. Absolutely. So we were brought on as a rescue site for a very challenging vaccine study in the adolescent pediatric population for for meningitis disease. And it had, you know, a lot of vaccine studies are pretty straightforward and simple. They're looking for healthy normal populations within a particular age group. This particular vaccine study required a specific history related to meningitis, a vaccine series. It has a specific temporal criteria around when the person could be vaccinated in association with their age and how much time passed between the initial vaccine and the study initiation as well. So. So very complex in, in, in criteria there so it definitely was going to require a wide net and, and what we would call a combination of art and science in terms of being able to achieve a positive recruitment result. And this is really where we, we, we got innovative in terms of both our model and in our partnering model and how we expand clinical trial access in our community. You know, first on the, on the science side of what we do. As I mentioned before, we, we are a technology enabled clinical trial site and patient network with our partner Aspen Insights and the Aspen FORGE platform, which is an AI machine learning EMR integration platform. And what this does is it allows us to bridge clinical research into practices But alleviating the burden of these practices to comb their own charts or wait for that unicorn patient to show up in the exam room, it'll pre identify the patients in their population using the AIML technologies in review of both structured and unstructured data within the medical record. And in this case, it required, a custom algorithm to be designed to not just match patients on the IE criteria, but also that temporal criteria. Of the vaccine record. The art aspect of this was that great. You can identify patients in a practice population that qualify with this technology, and that's super effective. And it certainly closes the gap. It took us from 45, 000 patients that had a meningitis A vaccine to about 1800 patients who met all of that specific criteria. But how do you actually get them on a trial? You don't just kind of put them off the shelf and put them on a trial. It takes a lot of education and engagement with the parents of these in the case, adolescent patients through our pediatric practice partners. So we, we spent a great deal of time in terms of providing up front patient education and engagement with the pediatric practices that we partner with and integrate our technology into. And this is everything from having clinical trial awareness and education materials in the waiting rooms, whether they be on posters, on the TVs in the exam rooms partnering on social media, really talking to the practice patients through the same channels that they talk to their patients in having, you know, QR codes to landing pages with education and prescreening as well. And then really spending time educating the staff members at these practices, both the physicians and the nurses and the front desk staff. So they were well informed about the clinical trials we were working with in these practices. And it can also be helpful in terms of directing patients to those opportunities. you know, things like lunch and learns and things of that, for example. So all of that really, you know, went into the effort around the technology piece to identify the right patients, the proper education and engagement within these practices to really lead to a better conversion of those patients. Once the study was introduced to them through that, that trusted practice relationship.
Jimmy Bechtel:Thanks, Todd. And what I really like about your solution, there's a lot of things I really like, and I think a lot of things that the judges really liked as well, is that it's, I'll use the word comprehensive for lack of a better term, right? It's really is an end to end solution that tackles a pretty big challenge that I know sites face when it comes to recruitment. It also is a really wonderful case of synergy and walking a parallel path between a large site group such as yours. That is so multifaceted but also a technology company and how you guys really worked together to bring a solution and employ and operationalize a solution in an effective way that worked for the sites, which I know is a major challenge that we face in the industry. On top of the challenges that we face when it comes to just general patient recruitment and then we couple it with the challenge that you faced with the uniqueness of that trial being a rescue site and what you were able to accomplish is really, really cool to see and hear about. So again, congratulations. I think it's, it's clear to me. I hope it's clear to everyone listening exactly why you were the recipient of this year's award. And I really want our listeners to hone in. On what I just mentioned the fact that site and service provider or we'll call it industry for now site and industry partnership in an effective way moving towards the same goal is possible despite what some of us might think sometimes and what some of us are faced with. So thank you for sharing Todd and thank you for highlighting some of the key aspects of the work that you guys had done.
Todd Albin:Absolutely.
Jimmy Bechtel:Todd, I know that having heard your presentation, ensuring diverse representation was also a key priority for this trial. And we'll call it yet another unique challenge that you faced when it came to the, the insurmountable odds that you, you all were up against here. So how did you engage diverse communities to participate in this study and maybe talk about how your recruitment methods were affected by that process or or those procedures.
Todd Albin:Yeah, absolutely. You know, I think, obviously, there's been tons of discussion on on the diversity initiatives and how to increase clinical trial diversity, obviously, with the coming requirements here, as I mentioned, you know, we're relatively new site organization that launched in 2020 having a lot of past experience work very closely with SCRS and in other roles that I've had, I understood the importance of really setting up our site for being successful at being able to engage in the community and, and recruit diverse populations. So it was really part of our DNA and how we formed the company. Our chief medical officer, Dr. Ezekiel Fink created a diversity task force at our inception before we even finished building out our sites and hiring our staff and really lay down a foundation of what we need to have in place in terms of our processes how we assembled our staff and our capabilities and the resources made available for patients so that we would be well suited to recruit from initially, in Dallas Fort Worth, which is one of the most diverse metroplexes in the United States. You know, how could we really take advantage of that? A big core part of it was our technology enabled model. Because in our model, we kind of have a different spin on integrated research. We can partner with practices where integrated research is not a good option for them. But these are also practices that tend to have some of the best populations for clinical research. They're very high volume, they're very busy and their, their physicians want to make clinical research available to their patients, but they they just cannot support integrating clinical research on their premises. They don't have the space for it. Their physicians don't have the time to be investigators. So how do you bridge that gap? And we did that through the technology integration with Aspen Insights. So now we're, we're bridging and bringing clinical research to practices in, in diverse and underserved communities that otherwise couldn't, couldn't make that happen, couldn't make it available, couldn't really make it viable either on their own or with a an integrated SMO partnership. So in this case, we worked with three pediatric practices that surround our Dallas site. And each of them represented three very distinct socioeconomic, racial, race and ethnicity profiles of our community, one that was in more of an upscale Caucasian neighborhood. Another that was in more of a a black middle class neighborhood and another one that was in more of an Asian, Middle Eastern Hispanic area. So all three of these practices, again, were candidates to work with us because they wanted to bring clinical research to their patients, but they didn't necessarily have the ability to do that or work in integrated research. So our, our technology was able to identify the right patients within these practices. And then all of the work we did in our diversity task force really helped us in terms of the cultural sensitivity the language capabilities, everything we needed to be able to really communicate with these patients through their trusted practice relationship to introduce the study to them. And then those patients that were obviously qualified were more open to considering that, in this case, the parents, you know, for their children. And then, you know, we fold in other things. Obviously, the one challenge in our model is, we're not on premises, so we're asking the patients to come to our dedicated site, which is in the vicinity. But not necessarily close by. So we always provide transportation service. We use the Lyft concierge service in our case. A lot of times this does get funded by the sponsors, but even when it's not, it's worthwhile to us to fund it to ourselves so that we know we can get these patients. We can't, you don't want to make transportation a barrier. If they don't have reliable access to their own private transportation or public transportation services, so they can come in not just for their screening visits, but stay on and be retained in the study as well. So all of these facets really allowed that to come together and what we saw was that our actual enrolled population on this study was very reflective of the highly diverse population of the Metroplex and not just the demographics of the neighborhood that might exist right around where a traditional research site might exist.
Jimmy Bechtel:Again, Todd, the message that I get from your very thorough explanation is that it wasn't one solution. You didn't identify one thing and move on that one track. You identified several different ways, different facets, different angles to take to enable diversity. And I think that's a really important discovery that we've made as a community of sites over the last couple of years, specifically is that there isn't any one solution and even the solutions that you might have implemented in a lot of ways probably worked very well for Cedar Health, obviously, but might not work for a different site of a different size or a different type, but they might be able to glean insights from some of those things in some of those actions and tailor them to their specific sites. So I it's really, really valuable and I appreciate your again thorough explanation on all of the different aspects of community engagement that your organization was able to implement. Because I think that's again a really important understanding that we as a community need to have is there isn't any one size fits all and you have to go about this in several different ways, coming at it from different angles.
Todd Albin:Yeah, absolutely. And it's, it's something again, it just, it just can't be a transactional thing. You, you, you put together for one study. It needs to be just part of how your site operates and works with the community. And if you're, if you're constantly building those relationships and fostering them as different study opportunities come up, you know, then those relationships can be, can be really leveraged to help support a diverse enrollment on those studies.
Jimmy Bechtel:Exactly. Couldn't agree more. Thank you. It's a great part is it's got to be ingrained into your operations. It's not a trial by trial necessarily instance. So Todd, what advice do you have for sites that might also be facing their own recruitment challenges? Or maybe I guess shed a little bit more light into the insights that you've gained on how they can work more closely with industry partners to deploy infrastructure, some of those innovative recruitment solutions like you were able to do with your service provider partner.
Todd Albin:Yeah, what we're seeing overall in the industry, studies are becoming more complex, not only in terms of inclusion, exclusion criteria, but in terms of, you know, the study visits themselves becoming, far more burdensome to the patients than ever before, just in terms of what's being asked of them in terms of visit frequency or electronic tools they need to manage or length of these studies. So, so you really need to start with a wider funnel of, of, of pre qualified candidates to be able to address these types of studies, and most of these patients can really, you know, be effectively accessed through that trusted provider patient relationship that exists in healthcare. And it's a question of how can you bridge that, and I know that integrated research is becoming more and more popular and because of this,, I think more sites and site networks are gravitating to that model. But how can you actually make that, make that happen? I think when we started doing this you know, three, four years ago, this application and this technology was really unheard of. I think the emergence of, you know, chat GPT and everything else in the last year or so, and you're seeing more, more players kind of coming to the scene, more use of this, it's becoming understood. And the best part about that is it's becoming something that sponsors are starting to recognize can be really effective. And they are starting to reimburse for it within study budget. So in terms of this initial study and other studies that we worked on, we had to really kind of couch this in our budgets in a, in a more unique way as kind of an accelerated chart review or something like that. But now I would say the sponsors that tend to be smaller, more dynamic, the biotechs tend to be very open to looking at this as a way to you know, change the recruitment paradigm and really address how do we find these more difficult patients and get them onto the trials, but again, it won't work unless you also have a really great patient education and engagement piece in there. And that's the part I really want to emphasize that, you know, just because you can match a patient in a practice population for a study doesn't mean that they're necessarily, want research made, you know, for them, unlike a patient who might see an ad in a. in a newspaper or on social media and call in wanting to be on a study where the challenge then becomes is how do you determine if they qualify? How do you get their medical records? So there's challenges on both sides, but really being able to increase you know, clinical trial awareness within these practice populations, engagements, reduce any barriers of misconceptions or mistrust. Outside of that, I would say, you know, the diversity initiatives, again mentioning, keeping them in place, making them part of what you do across all the ways you do that are going to help facilitate that ability to do it in a diverse way here but the great part is this technologies here. It's it's becoming a kind of a standard piece of how you want to access populations in a more qualified way getting away from doing ICD 9 billing reports and other ways that you would try to identify patients within the population, but then folding that into really robust education and awareness programs within these populations will help allow for a better conversion of those, of those qualified populations onto those studies. And what we find is patients through this trusted practice relationship, you know, once, once they, they indicate their interest they'll tend to you know, show up for their visits. They tend to be retained on these studies and be much more reliable subjects than the patients who might be sourced through external, advertising means who might be more financially motivated. So it's a, it's a better patient. It's a better experience. It's a, it's a better retained patient as well. You just need to be able to have technology to identify these more complex criteria and have a really good program in there to be able to engage and convert those patients into enrolled subjects.
Jimmy Bechtel:That's great, Todd. It's so good to hear some, you know, tactile ways that you can work with your industry partners, some different approaches, different mindset that you might want to take when it comes to working with those relationships because we know they're Integral to the execution of our clinical trials. They're only going to become more integral as time goes on definitely not going anywhere. So I think we need to, as a collective, find ways to more effectively work with them. So thank you for sharing some of what you've done to make those relationships successful. What's next for this really innovative process and this idea and this partnership that you have? What's in store for the future?
Todd Albin:I think, for us and just kind of looking at the landscape and what we're seeing in terms of clinical trial design and where it's going, you know, things are not getting easier. They're only getting more complex. Studies are becoming more specialized. So I think that, you know, for us, we want to keep growing. Diverse practice partnerships in, in therapeutic areas that that seemed to be really driving a lot of the R and D right now, and you're getting more complex beyond just vaccine. You're getting into a lot of, you know, cardiovascular, metabolic neurology, all of these particular areas. So, so the ability you know, to work with our technology provider on honing in and optimizing how these technologies work. They call it, artificial intelligence, but it's really augmented intelligence. You know, we're working with them to really how to hone these systems in to really identify the right research candidates so that the time spent by our team is with engaging, you know, the most qualified subjects possible. The next level into that is, how can you, fold in A lot of these incredibly effective techniques that, that a lot of technology central recruitment companies have built for external patient recruitment, how can you fold that into and target it towards a match patient database, using AI machine learning, within a practice population. That's what we're working really closely with Aspen Insights on that specifically. You know, in improving the ways we can do outreach through through email and text messaging, direct mail campaigns, and then, the tracking of that and the optimization of all of these, these techniques, which have been really valuable in the, in the centralized recruitment role, how can you bring those to the sites to, to really manage an operation within, within a healthcare practice match patient database and converting them into the site level as efficiently as possible because that at the end of the day, You know, for a site, reducing that cost that it takes to identify and enroll a patient is really critical to the site sustainability and success. And these tools aren't cheap, so you really need to be able to, to optimize them well, work at scale, but also work at precision. And that's really where we're focusing that. And and then particularly How can we get better you know, with this on the diversity population? You know, one example, we have a trial now you know, it's a very valuable study in the, in the metabolic space and enrollment closed for all of their sites, except the ones that felt that they could enroll, a Native American population. And we were one of the sites that was picked to task for that because we had that capability. And we're the only site still enrolling on that study because we are able to use our technology and community relationships to identify specifically Native American populations that qualify for a pretty complex study. So those are the directions that we're really moving in. It's, it's, it's taking what we've done and further optimizing it, you know, getting more over the target, cutting out the noise improving that efficiency of being able to bring a study opportunity to a qualified patient of a medical practice, getting them enrolled and retained.
Jimmy Bechtel:That's great. Todd. It's exciting to hear that there are plans for the future. I think it sounds like it's headed in a really exciting direction, so I'm, I'm eager to see where this goes, and I'm hopeful that other partnerships, other technology companies and other sites might be able to look at this as a success. A successful case study because I think it's definitely headed in that direction on again. Excited to see where you all go with this. Hopefully we can maybe check in next year and see what sorts of advancements you made. But thank you for being with us today. Big congratulations again to you and the rest of the Cedar Health team on the recipiency of this year's award. And again, thanks for the conversation.
Todd Albin:Absolutely. Great to be a part of it. We're extremely honored and humbled by receiving the award and hope to have another great case study we can submit in the future to be considered again.
Jimmy Bechtel:For everyone listening, make sure that you register for upcoming summits being held throughout the year by visiting our summit page on our website, myscrs. org. While you're on our website, be sure to check out other SCRS publications and the plethora of resources for the site community on that same website. We appreciate your participation in today's program and look forward to having you join us for more great content coming out soon. Thanks for listening.