Predoc as an Enrollment Strategy

Background

For a network running vaccine, therapeutic, pediatric, and psychiatric trials in parallel, the process was slow, inconsistent, and difficult to scale. Leadership estimated that missing records alone accounted for nearly 40% of screen failures among otherwise-qualified patients.

The impact was especially acute in therapeutic research, where eligibility often depends on prior treatment history. Many of today's trials target patients who have not responded to standard care. Without efficient records retrieval, the studies that matter most cannot reach the patients they are designed to serve.

As one team member put it, "Understanding what has worked and what has not worked for a patient is only clinically valid when we understand it from another physician's perspective. Medical records make a big difference for that."

In one migraine trial, the network identified a patient who appeared to meet every protocol requirement. But the study closed without a single enrollment because the team could not secure the neurologist's records in time.

“We found this golden patient who met every single checkbox, and we got stuck on medical records. I personally called the neurologist's office every day, and we just didn't get anything back from them.”

Enrollment Manager

Multi-Site Therapeutic Research Network

The Challenge

Before Predoc, the record-retrieval process was manual and fragile:

1. The patient signs a release of information (ROI) onsite

2. Site coordinators fax the request from local office fax machines

3. The team waits, sometimes weeks, for a response that may never come.

When records didn't arrive, site operations teams, already juggling vaccine, therapeutic, pediatric, and psychiatric trials in parallel, had to manually re-fax, and follow-ups were ad-hoc.

To combat the records challenge in the past, the team tried building in a cash incentive for patients to bring their own records, but it's such a lengthy and time-consuming process that patients didn't feel like it was worth it.

“There was no pattern. Sometimes I would make them fill up manual Excel sheets to track when they submitted it again.”

Enrollment Manager

Multi-Site Therapeutic Research Network

The Predoc Partnership

Predoc worked with the team on a workflow that could reduce screen-fails and focus efforts on the patients most likely to medically qualify.

1. Patient consents electronically

2. Physician-led first-level eligibility review: Quick comparison against I/E criteria, using digital data with a clinical summary (Facesheet), returned in minutes to hours

3. Specific records and medication histories requested for sites needing deeper context

“You're more persistent than we are. You've helped us with the group of patients who are very difficult to otherwise get hold of.”

Team Member

Multi-Site Therapeutic Research Network

Outcomes

Physician reviews got faster. With facesheet and data returned in hours, and before patients reach the site, physician-led first-level review can confirm baseline eligibility in a fraction of the previous time. Some sites in the network now randomize patients on data alone.

Site operations got their time back. Coordinators no longer manage fax cycles or chase provider offices.

Hard-to-reach patients became reachable. Persistent record chases for out-of-state providers and solo practitioners are now completed without burdening coordinators.

Sponsors noticed. The operational lift has an external corollary: Predoc has become a credible answer in sponsor conversations. In a recent obesity program kickoff, early screen fails surfaced as a concern. The sponsor raised medical records as the likely gap, but the team quickly assuaged fears based on Predoc's success rates and record retrieval turnaround times.

“That's taken a lot of workload off my shoulders. I don't have to chase them and say, did you submit it the second time? Did you call them today?”

Team Member

Multi-Site Therapeutic Research Network