How Social Media is Shaking Up Clinical Research - Brad Hightower

Welcome to the Totally Clinical podcast, Brad. Could you start by explaining more about

your background and your experience in the industry? Yeah, like so many people, I had sort of a circuitous and sort of accidental entry into clinical research. I initially started college with the hopes of, you know, being able to go to Med school.

That did not work out. So I actually dropped out of college for a long time and joined a band, traveled around the country, came back to life and, you know, the real world. And I actually worked in a plasma center, and I had a friend who worked at the University as a clinical research coordinator. They were leaving their job and they're like, hey, you should check this out.

I went in and interviewed and actually had a lot of transferable skills from working in a plasma center, being able to draw blood and some of the documentation practices. So I started out at the university, realized very quickly that it was really just terribly inefficient way to do clinical research and in such a big academic center. So I got out of there kind of as quickly as I could and worked a little bit more on the private side. I worked as a research director for a privately owned hospital and really still came across a lot of the same, same problems.

And it really led me to break out and start my own site network, where we really provide infrastructure for physicians who want to participate

in trials but don't otherwise have the means to do so. So, you know, we provide really an end to end solution for physicians so that they can offer clinical trials to their patients. And that's where I've been for almost the last five years now, kind of been building out my network. There's an interesting back story as to how our podcast team discovered you.

If we can refer to it like that as a potential interviewee, we came across on LinkedIn and we were so excited to see someone in the industry facilitating such engaging conversations on social. Especially in the site space, because it's not always a common thing. When did you first realize that LinkedIn was such a great platform for enabling these discussions? Yeah, I mean, that's a great question.

And I think like so many people, as I was especially earlier on in my career, I was really looking for resources for clinical trial coordinators and clinical trial staff in general. And unfortunately, just wasn't a lot out there. And even now, it can still be hard to find really good resources. So I've never been really heavy on social media in general, but I did have an account on LinkedIn.

I started just looking for other people who were research coordinators and really realizing that we work in a really small industry. But when you're on LinkedIn, you really realize there's a lot of people on there in the clinical trial space and sort of something you would never know unless you really went looking for it.

And then from there, the next thing that occurred to me was the people dominating the conversations on LinkedIn tended to be more from the sponsor or vendor side. In my mind, I saw this sort of disconnect between what were happening on in these conversations versus what I saw in real life, which to me meant that there was a gap that needed to be filled there and over time, building out a network of other people who are, you know, at my level in the industry and pushing through these conversations that I think really need to be had.

And I'm still surprised, honestly, that I'm able to get the level of engagement that I am, which probably says something more about the industry than it is about me. But I think there's still really a need for these conversations to be had. And for better or worse, LinkedIn just seems to be the perfect place for these conversations to happen. It's, you know, sort of an open public forum anybody can join in.

And I think it helps, you know, give people just a little bit more of a voice out there. The fact that you have such success on LinkedIn definitely speaks to how underserved sites are when it comes to having a voice. As you said, they're not in terms of the industry. They're not the group who are mainly on there.

Why do you think they are so neglected in this way? Yeah it's a complicated question. And I think about this all the time. I mean, I think a lot of it sort of has to do with the way the industry works, right?

Where obviously, you know, patients and the idea of patient centricity is sort of a big deal. I mean, that's why we're doing what we're doing. And we can't do it without patients. On the other side, you've got sponsors, and vendors are the ones who I mean, especially sponsors who have the money, who are funding these projects.

So sites are kind of feel, I think, at times like they live in a little bit of a no man's land. Right so we're not the customer per se. We're not the buyer either. We're sort of this group in the middle, but we're obviously an extremely important

liaison between the two.

I mean, studies cannot enroll patients without sites. So I think that leads to some frustration. I also think there's still a little bit of a old school sort of scarcity mindset amongst a lot of more traditional research sites where people don't want to always share or sort of show all their cards. I think that's changing a great deal.

And again, I think there hasn't been a good platform for sites to really express themselves in an open way. So again, I think in some ways, LinkedIn starting to feel that void. But again, I think a lot of it goes back to just the alienation in some ways that sites feel is sort of being this, you know, focuses on patients from the sponsors. But again, sites are the glue in the middle.

But again, I think they have a hard time finding their voice in that relationship. So, again, I think we're starting to see that change a little bit. You have a site called clinical trial confidential where users can post anonymously, and it's also accessible through LinkedIn. How did you come up with this idea?

Yeah so to kind of go back to, you know, the previous question too, I think another issue is that, you know, coordinators and people at the site level oftentimes work for academic medical centers, or they work for private equity owned site networks. And a lot of times, again, they may feel they may feel like they can't be completely open and honest. And also, you know, there's always the off chance that a sponsor sees what you say and you feel like you may lose study opportunities or, you know, any number of things. So I really wanted to create a place where people could feel safe to go talk about some things.

And I've been part of other forums where I've been like blocked and shouted down for trying to have open conversations.

And this were these were site forums. And, you know, I found that very, very frustrating. And again, it occurred to me that such a place doesn't exist.

I really think we are missing out on a lot of opportunities by not having these conversations. So I really just wanted to, again, create an environment where you can go. It doesn't necessarily matter who you are. If you've got something of value to bring that could help other sites or other site level personnel or even, you know, industry wide where people can go and share information, not feel as though they're going to catch any flack from it, from their employer or a sponsor or CRO or their CRA who maybe they're complaining about and just want a safe space to do that.

And that was really it. Again, I would have people message me in the background on LinkedIn to, you know, give me their opinions on a post I made. And I was like, well, why don't you go post that? And they're like, nah, I don't want to, you know, I don't want to put my necessarily put my name out there.

So that's really the hope. It's still, you know, kind of in its infancy right now. You know, I do have seen some support and interest. So I think maybe it's we're kind of on the right track that again, maybe it'll open up the open up the airwaves a little bit and let people speak more freely without fear of some sort of backlash.

Wow culture of fear is never good. What has been the most shocking thing you've heard from your feedback on the forum on the site? Probably I mean, I'd have to say also, it's kind of been the most funny. At the same time, it's just hearing some of the interactions people have with their CRAs at the site level, hearing just some of the crazy stuff that CRAs do.

And I think I read a story about a site who had two crews from different studies on site, and they were fighting with each other over who gets the nice desk and things like that. I mean, sort of good humored in a way, but just more funny stuff. And I think also knowing some of the more inner workings that people will share when, again, I feel like they're not going to be outed.

So knowing that some of the things that cross are paid for that don't get sort of funneled down to sites, you know, things like that, that you would never know unless somebody came out and shared that with you.

So, you know, again, things that are maybe shocking isn't the best word, but I think enlightening, you know, might be a good way to put it. And then, you know, on the lighter side, some of the more maybe shocking or funny situations that sites are often in with their interactions with cras, I think that's kind of been that'd probably be some of the most entertaining, entertaining and shocking content on there. That's such a funny story about fighting over the desk, right? Well, you know, I mean, you hear CRAs.

I've heard God bless them. I could never do the job. But, you know, I hear them getting stuck in stairwells, you know, to do their job. Someone told me they were put in a, you know, the room where they stored.

We're storing urine specimens and that's where they had to do their monitoring. So it's a wild, wild world out there sometimes. Wow Yeah. So many series site staff work so hard, so they need a bit of a break and to be able to voice their thoughts.

So back to LinkedIn. What have been some of your most popular posts

and what are the most engaging topics? I mean, I think the irony is that the most, you know, popular posts, I think, are the things that sites share the most commonly, you know, things that, again, like cite budget issues. I mean, this is a big ongoing thing is how to structure budgets or how, you know, you calculate your overhead.

I mean, I think all sites want to be financially

viable and would keep the doors open. So we can keep serving patients. And that's a challenge sometimes with cross and sponsors. So those tend to get quite a bit of engagement and discussion and sort of in that same vein, you know, patient stipends and patient recruitment and retention and sort of what revolves around that because I think, again, the disconnect exists between what sponsors think and what actually happens as sites.

So I think, again, it's really just a matter of I feel like sometimes I'm just saying what everyone's thinking, but nobody's said it out loud yet. And those tend to be again, I think the more engaging posts on the site level. And again, they tend to revolve around patient centric matters or a lot of times budgetary issues. Are you on any other platforms?

And if so, what kind of engagement reactions have you had? Yeah, I'm really not. I we have a, you know, a Facebook and an Instagram for more sort of generic patient facing material. But I really haven't gone off LinkedIn in terms of just, you know, community research, community engagement, and, you know, there's

probably, you know, some other great forums and media out there, but I'm getting to be an old man.

I can only handle so many, so many at a time. So yeah, I've really just kind of stayed in my lane on, on LinkedIn for better or worse. So no TikTok for you. Yeah, no, no TikTok for me.

I'd yeah, I wouldn't even know what to do there. So I just steer, I steer clear, stay in my lane. So you have all of this feedback and insight into site's pain points. What are your thoughts on how to resolve some of these issues?

I mean, my bigger hope is that. Just by sharing these things publicly and sites, being able to have access

to these conversations that, you know, we can better come to a consensus about things and we can better maybe begin to standardize some of the ways that we operate as sites. I mean, I think there's always been this a little bit of a thought of like, we want to do things our way and that's fine. But sometimes, you know, our way isn't always the best and we can learn from each other.

So I don't know that. You know, obviously we're not going to solve any problems overnight. But I think slowly if sites can sort of see like, oh, this site's asking for this, well, I'm going to I should ask for this, too. And then pretty soon if you get enough momentum, you know, across these sites, you're starting to see some real changes in the industry.

Interestingly, something else I've seen is an increased willingness for sponsors and vendors and cross to start engaging more directly with sites as a result of some of these conversations, too. So you know, I'm often guilty of. You know, complaining or making sort of I wouldn't want to say it's never really my intention to call anybody out as much as just bring attention to issues. But I'll say that if in instances where I've done that, the sponsor vendor is oftentimes reached out.

And more often than not in a very earnest way to where they want to solve the problem. You know, they want to know what can we do to fix this? What would be potentially a better way to do it? So again, I think if we can continue to make this information more transparent and public, then sponsors or vendors can have an opportunity to see that feedback and make changes based off of it.

So, you know, that's not a very well-organized answer necessarily. But again, I think just the very movement sort of forces the industry to pay attention and with that, make changes to improve efficiency and site level work for everybody. So I really think and hope that that's the outcome. That's great that you've been having response, getting responses from sponsors.

So looking to the future, what do you believe the future holds for social media and the clinical trials industry, for example?

Do you think sponsors will increase engagement as sites become much more aware of their power, finding their voice? Or do you think they will continue to take a more conservative approach to social media? It's a good question.

I mean, I imagine we're going to see a mixed bag. I mean, there are already some emerging site voices I've been engaging with. And I think it's awesome that there are more people sort of finding their voice at the, you know, all different levels, not just at the site level, but all across the industry. So I think what we'll see is probably a rise in some stronger voices.

Now, I do think in a more general sense, big pharma, for the most part will probably continue to take a relatively conservative approach. Now, I still think if they're smart. Again, they can maybe engage directly, you know, with some of these voices or again, use some of this to their advantage to help, you know, improve things for all of us. So, again, I think we'll see a mixed bag, but I do think we'll continue to see some strong, stronger voices and especially if we start to make some discernible change and changes by expressing these opinions.

So that's my hope anyway. Let's just hope that these changes will come into fruition. Do you have any final word on social media and clinical trials?

Again, I think it's important to continue to have these conversations in a very

open and transparent manner.

I think if we want to progress, that's what we need to do. They're not always comfortable. And, you know, sometimes even I am going to show my stupidity by having these conversations. But again, I think if that's what we want to progress, we have to have them.

So, you know, I would encourage everyone to engage meaningfully. Don't just spam or put out falsely or thinly veiled advertising, you know, try to have truly engaging conversations. And again, I think we can all learn a lot from each other. And I really hope that this trend continues.

Brought this has been a fascinating conversation. Thank you so much for joining me today. Thank you so much.