Why (and how) smaller clinic practices can and should participate in clinical research

I run a family medicine practice in Northwest Phoenix called Simply Direct Health. We use a new reimbursement model called Direct Primary Care (DPC) that is cash-based and thus avoids the need to involve insurance companies or collect co-pays. Instead, patients pay a monthly membership fee.

We find that this model has several advantages. The first is the power of removing insurance companies from the patient and physician dynamic, thereby streamlining care. We also find our model drives us to embrace unique care delivery options that best fit the needs of our patients. One of those includes embracing cutting edge treatments and care.

Fortunately for our patients, technology exists today that enables the easy management of site-based clinical trials and decentralized clinical trials (DCTs).

Simply Direct Health has been engaged with a decentralized clinical research company for nearly four years that allows our patients to participate in clinical trials. These types of clinic-based studies not only help patients, they offer unique care models that work well for practices like ours, as well as valuable medical research data that could fuel further breakthroughs.

However, clinical research trials can be complicated to run for outpatient clinics with limited resources. The right clinical trial management solution simplifies the process, saving time and money by leveraging digital and virtual resources, freeing up clinic staff to focus on our patients. This is the secret to making this model efficient. Technology and virtual support keep our manpower costs low, and we are able to provide highly efficient care for our patients.

We’ve participated in numerous trials over the past few years and there usually is a trial going on at our clinic at any given time. One trial that was heavily embraced by our patients involved an at-home test for sexually transmitted diseases (STDs).

A study of this nature is extremely difficult because people generally aren’t eager to share their dirty laundry, so to speak. But having an at-home test for STDs that is reliable and accurate, while helping us to educate patients, is fantastic for enabling patients to take care of themselves. In this scenario my job as a doctor isn’t to tell a patient what to do, it's to teach them how to help themselves.

This clinical trial enabled us to screen roughly 300 patients. Not only were participants able to better understand the clinical research process many learned that taking part in a clinical trial is kind of fun and medically rewarding. That has helped with future recruitment efforts for other trial opportunities.

In terms of clinical benefits to our patients, the at-home tests were a free, or in some cases paid diagnosis. And for the 10 or 12 patients who tested positive for an STD, their participation in the study resulted in them beginning to receive treatment and lead a healthier life.

Over the years we’ve integrated these clinical trial activities into our office space, with about half our facility devoted to traditional outpatient care and the other half to clinical trials. That way patients can choose whether clinical trials are a solution they’d like to embrace. Those patients who are interested in clinical studies understand the flow of our office, which makes the process relatively seamless.

Participating in clinical trials, even with a user-friendly, clinically integrated solution, does require some additional resources for smaller practices. The key is to manage your workflow – for example, you don’t have to say yes to every clinical trial – and to rely on your technology tools and support. But the key is to find a high-quality clinical research solution vendor, and work with their team of virtual professionals to help managed the added workload.

Even then there will be trials that won’t work for you. We tried participating in a trial for a heart failure app designed to help users understand congestive heart failure and its components, but only five or six of our patients showed enough symptoms to qualify for the study. You quickly learn to identify those that miss the mark and move on.

Still, these trials also provide doctors, nurses and other practice staff with opportunities to keep up with – and participate in – the latest medical research. For healthcare professionals whose necessary focus on a day-to-day basis is their patients, that can be quite gratifying. We all want to do our part to advance medical knowledge.

The COVID-19 pandemic and resulting shutdown accelerated the adoption of DCTs. Now is a perfect opportunity for smaller and more rural practices to become involved in clinical trials because technology and need are driving a trend toward re-deploying medical research from large institutions and academic centers. With the right DCT technology and services, smaller practices can help their patients while contributing to healthcare research and increasing revenue. Those are all favorable outcomes.

Dr. Kirby Farnsworth is a practicing family physician and founder of Simply Direct Health in Peoria, Ariz.