By Dr Graham Wylie, Chairman & CEO, MRN
I want to keep this short, because the answer is short.
Innovation in clinical trial management has to do one of two things — shorten the overall duration, or improve the data. Mobile nursing, what we at MRN call Home Trial Support (HTS), is squarely a play on the first. Done well, it speeds trials up without inflating the budget. Done badly, it does neither.
So when you are assessing a Home Trial Support vendor, you are trying to answer one question. Will this service genuinely improve recruitment and retention, and at what cost to you?
The mechanism, in plain terms
To speed a trial up without raising costs, the service has to do two things at once.
- Reduce the impact of the trial on each patient’s life. The less disruption, the more likely they consent and stay enrolled.
- Keep nurse travel time short. Otherwise costs creep up, or worse, you end up pulling site nurses off site to cover home visits — at which point you have created a resource bottleneck rather than solved one.
The patient experience question reduces to two freedoms.
- Freedom 1 – where they are seen. Patients do not have to travel into the site as often. That widens the catchment around the site dramatically, so patients much further out are now accessible.
- Freedom 2 – when they are seen. Visits any day of the week, in the evening, around school, work or whatever else patients have on. That is the difference between a trial that fits around someone’s life and a trial they drop out of.
With those two freedoms in place, recruitment goes up, retention goes up, and the trial finishes faster. Without them, you have added a line to the budget and not much else.
Assessing a mobile nursing vendor comes down to four questions.
1. Do they have available nurses?
Specifically — are they additional resources, not seconded from a site team, and do they live close to the patient? You want as many of these nurses as the geography needs, kept separate from the site nurse pool. That way the site nurses can run the increased in-clinic visit volume that mobile nursing makes possible. If the vendor’s nurse roster is the same roster as the sites’, you have not actually resolving the nurse resource constraints.
2. How big is their reach around the site?
The wider the radius they can comfortably cover, the bigger the pool of eligible patients you can recruit from. This is where the recruitment uplift actually comes from. A vendor with a small effective radius is a vendor with a small impact on your timeline.
3. What are their working hours?
You are looking for any day of the working week, including out of hours and weekends. If the answer is office hours only, patients with jobs and kids — which is most of them — cannot easily participate. Without this, you are not resolving the impact on the patient’s life.
4. How good is their communication with the site?
Mobile visits and site visits are part of one patient’s data journey. If the data, the scheduling and the clinical context do not move cleanly between mobile nurse and site team, the model collapses under its own admin. Ask to see the workflow and the tools, not just the brochure.
A closing thought:
If a vendor can answer those four questions well, you will see a meaningful speed-up in the trial. If they cannot, you will get a slightly more convenient set of visits and not much else.
In a market where every sponsor is being asked to do more with less, and faster, that is the difference between a service that earns its place in the protocol and one that does not.
Always happy to talk about what good looks like — drop a comment or a message.