Communication Best Practices for Enhanced Site Engagement

Hello everyone, and welcome to today's Teckro webinar. My name is Brian Deighan, and I'll be your host today alongside my colleague, Ger Sweeney. We'll be taking you through communication best practices for enhanced site engagement. Let's get started with some introductions.

My name is Brian Deighan, and as I said, and my role at Teckro is program director, so I'm working day in and day out with clinical operations teams right across the globe. The roles and the titles may change from sponsor to sponsor or even across CRO, but it's people just like you. So they are, I suppose, study managers, members of the study team, program directors, in some cases clinical scientists, and study physicians. And I'm working with them to ensure Teckro best practices are implemented on their trial.

Working to ensure successful site engagement and really working to optimize the site relationships and the relationships that they have with their sites. As I mentioned, I'm joined by Ger, so Ger if you wanna provide a brief introduction for everyone on your role in Teckro. Thanks, Brian. Hi, everyone.

My name is Ger Sweeney, and I'm the head of growth at Teckro. As a company, we invested in the growth team to help us to really tap into the unique data points that our platform enables and how we can then use that data to drive better site engagement outcomes for study So as Brian steps through the presentation, I'll try to add additional context on some of the patterns we see in our data when it comes to achieving best in class site engagement. So with that, I'll hand you back over to Brian who will take you through the slide deck. Thanks Ger.

There are four key parts to today's agenda, and this should take us approximately forty five minutes. As I mentioned earlier, For those of you who are joining us live, we'd really welcome your questions. Please submit those to Ger and I through the webinar chat. We'll have the ability to moderate and review them and share and discuss maybe those answers at different timepoints during the webinar.

Firstly, in the agenda we'll step through clinical trials in crisis. Now we're aware that there are many challenges in the industry we work in today. And these challenges are really having a direct impact on the ability of clinical operations teams to successfully engage with their sites. Then in the second part, I'll move through defining site engagement.

So looking at what is successful site engagement and how it can work with you optimize that engagement with the sites. In part three, Ger and I will share some success stories, examples or case studies where current teams are successfully using Teckro to drive site engagement. And finally, in part four, we'll really reflect back on your trials in your studies, allowing you to mean a step by step way to look how you can replicate these best practices on your own studies. Some of your studies may be in startup, maybe in maintenance, or maybe a follow-up, but that will be the aim that we can do that with you.

So let's get started. I referenced clinical trials in crisis, but maybe let's put more context on that. We're lucky to work in an industry where new ground has been broken every day. There's new trials coming online, but this present challenges for sponsors, study teams, and also for sites.

On the visual that's on screen, just draw your attention to the very left hand corner where we have your study documents, maybe it's your protocols. Then if we look all the way over to the right, you can see your your investigators and your patients. But in between, I suppose, for the sponsor, there are lots of challenges that can crop up. If we look at the sponsor in particular, sometimes, sponsor teams may be hindered by current processes that are quite slow.

And in turn, this can impact communication pathways to sites. Sometimes teams on the front line at a site, investigators can receive communication that's as was outdated or even how to sync. If we then look at the the investigator or the site, certainly there's more and more clinical trials being pushed to site in the last few years. And from the data that we see, people operating in the industry, we know that there are fewer and fewer physicians choosing to be investigators.

So this brings an ultimate squeeze on the site. What I would like to show you today, really, is how we can optimize and improve this communication process. But maybe just pause for one moment and highlight one thing on screen that I think we can all relate to. The investigator and their associated site staff, they're really the only stakeholder who can enroll patients in our trials.

What I want to be able to show you today is how you can cut through the noise, how you can cut through the number of items that exist between you and your sites. Also how you can improve the ability and ensure that your sites are listening and aware of your trial. And then, in turn, how you can be available to listen and hear from your sites how you can hear their feedback, but also answer their questions effectively and accurately. As I mentioned earlier, I work with operational teams across the globe regularly and even on a daily basis I'm meeting with those teams.

I've put up on screen here three common questions that come up a lot when we have those meetings with the teams. Let's talk about the first one here. How do, they say, Brian, how do I define side engagement? And more importantly, then they move to how do you assess site engagement?

The challenge that many clinical teams have is site engagement is something that's intangible. It's difficult for them to measure. And in some cases, it's really only there as a sentiment or a feeling, they may be receiving site engagement sentiment back from the CRA or back from the local study teams. But as professionals in this clinical operation industry, we really want leading indicators into what is successful site engagement and indicators that can help drive decisions that we make on those trials.

And I'll be sharing some insights with you today of how we can successfully do that. The second question that comes up is, how do you make my protocol more accessible? How do you drive familiarity with that protocol? Well, we all know a lot of effort goes into creating the protocol.

You and your teams will be working to to write the protocol, then maybe sending it out to a wider group to review, getting that feedback. Once it's final, it then goes through for regulator approval. You may even get more feedback of more changes. A lot of time and effort goes into the creation of that protocol, and that's your essential document.

What study teams want I suppose is to ensure that that document is accessible to sites. When we know people put it in folders, people put it behind passwords, but really what sites want is the ability to have that easily accessible, be able to mimic the behavior they have in their everyday life of how they access other information. And I'm going to show you today how we can successfully do that and drive familiarity with the protocol. And a final common question that comes up is, how can I be proactive in identifying issues before they show up in the monthly reports?

Now you're all maybe familiar when I say that word monthly report. That's the Excel file you probably get from some of your teams. Sometimes that information that report can be effectively thirty one days out of date. We wanna show you today how we can enable for you an oversight of that information.

Allowing you to have oversight of successful site engagement and how that can be successfully implemented on your trial. Before we dig deeper into specific examples, and Ger and I can share some case studies, I suppose real success stories with you. I wanna pause to really frame what is site engagement, and how do we define site engagement here at Teckro? Well, I've built this as three essential building blocks of site engagement.

And let's go through each of these. On the first, on the left hand side of your screens, a key part of site engagement is you want your sites to be repeatedly interacting with your study content. And more importantly, interacting at the right time, that's your protocol, repeated interactions with the protocol, but also at the right time, not just at the investigator meeting. You want to know they're interacting with it when they need it, when they need to reference it to make the right decisions, and that's a successful indicator and part of site engagement.

The second core building block is want to be able to know that your sites are listening for your study and also aware of your study. And how that's referenced really is that the right people knowing the right people are reading your communications on your trial. And the third building block to the right hand side is really extra step in site engagement is where you're actually collaborating with your sites. A successful indicator of site engagement is that your sites are willing to share feedback with you.

And more importantly, that your sites are actually able to reach out and seek guidance when challenges arise. Now that we've defined successful site engagement or what that is, what I'd like to do is take you through some real examples before we have successful engagement in action. So the first example here is, I suppose it's a Phase III study, so let me take you through what's on screen and frame the study first of all, and then we'll go through the goals and the results and also the figure to the right hand side of the screen. This study is a Phase III study, is operating as quite large as twenty one countries with four hundred sites and approximately five hundred and sixty patients.

In this specific trial, the team had a challenge. They were struggling with enrollment, and we met with this team, and they implemented a successful site engagement strategy through Teckro to solve their enrollment challenges. So their focus and their goal was to implement a communication strategy, an engagement strategy to sites to increase their study enrollment. Why they were doing that was, well for a six month period, they had recruited seventy nine patients in the trial.

As they approached February of this year, they had a specific target to meet. By the end of that month, they needed to hit their recruitment target. Their main focus was to increase awareness of their trial with the sites, and then also successfully keep the sites engaged and up to date on how they were progressing. If we look at the results here on the left in those two bullets, you'll see there was a seventy nine percent site open rate of those regular communication So here you can see this team successfully cut through that noise.

These sites are busy. These sites are stressed and under pressure. But they successfully cut through that noise to communicate with the site. Now, the outcome of that is actually evident in them exceeding their enrollment target.

If we move over to the right hand side, you'll see that there's four bars in the chart in orange. These are the recruitment numbers, progress and you'll see a nice steady increasing trajectory for the month of February. And this was in line with these sites receiving regular updates succeeding in achieving regular site engagement in that month. And just to recap, they successfully cut through the noise, and exceeded their target of thirty eight patients recruited in that twenty five day period.

And I know, Ger, you're familiar with this data as well. So maybe is there anything else you want to add from what we probably seen in Teckro? Just two two quick points to add here, Brian. So what's not showing on this slide is that the study team surveyed their site near the end of this recruitment drive.

Their goal was to understand what activity helped sites most during that four week period. A fifty eight percent of sites said the weekly enrollment updates were the most beneficial support for them, and that was significantly higher than the other options including support from their CRA and a few others that made up the remainder. So if your study is recruiting, we definitely recommend focusing on frequent enrollment dates because we consistently see high site engagement on these type of communications. My second point is around the frequency of communication.

Across all recruiting studies on Teckro, we see that weekly communications are the best practice. Whether it's immediately post your site's SIV, or twelve months into recruitment. Studies that send out relevant communications on a weekly basis see the highest levels of repeat site engagement. And the indicator to gauge how useful your weekly communications are is the open rate.

Benchmarks for email open rates are somewhere between ten and twenty percent. So achieving seventy nine percent site open rate as per this example is an amazing result. Thanks, Ger for that extra context, it's really helpful. And you've actually touched on something there that allows us to move nicely into the the second example of site engagement success for another team.

So I'm gonna move to the next slide. I can see some questions coming in as well from from people on the webinar. So thank you for submitting those. Any of you of other questions, please feel free to enter those in the chat, and during myself and Ger will be able to to answer those for you.

The second example is to move to a different study with a focus on site engagement success This specific trial is an oncology trial. It's a Phase III trial, and again, it's quite large with twenty five countries, and their target was seven hundred and forty patients. But if we focus on the title of this slide, their key target here was identifying and resolving screening challenges. So for this specific team, screening was ongoing, but the screening success rates were not actually at where they believe they should be.

And what one key challenge was, they were not clear on what were the challenges that sites were experiencing. When we met and discussed this with the team, what we were able to learn was they were gathering feedback, not really in formal or structured ways from their sites, sometime it was through the CRA, other times it was from the local study teams. What the global team wanted to do was reach out directly to the sites to engage the sites in a in a strategic way. The first step in that communication strategy was reaching out with a survey through Teckro.

So what you can see here is on the results, very quickly, they got rapid responses for sites. So we're going to going to use that phrase of cutting through the noise. They reached out to the site for feedback, and the sites shared that. They received eighteen responses in three days from eleven countries.

So getting a broad pool, a broad view across the study of what those challenges were. If you look at the figure on the right hand side of your screen, you'll see one of the questions that they asked in this survey. Again, we can look at the answers that I suppose you can relate to this in terms of the context maybe for your own trials, asking specific questions and getting those answers in a clear simple format. You'll notice on screen it says, I suppose the biggest answer, thirty three percent was the patients were not eligible due to PD-L1.

Again, that's more specific to the trial. And the inclusion exclusion criteria that they have around the factors to include in the trial. But if we look at the next two biggest answers, twenty eight percent and twenty two percent, these are actionable insights that the team could take from the survey back to their team and resolve them, and then I suppose make an improvement for the sites or any future sites that are going through those screening steps. The twenty eight percent response or was related to lab kit supply.

Again, meeting with the central team was one of their actions to resolve a streamlined process to ensure adequate lab kits were available for those sites. The twenty two percent was central lab turnaround time. In the same meeting with the same team, they were able to do the process and the procedures that were in place for a lab turnaround of samples. And to resolve any, I suppose, delays or impeding factors affecting their sites.

So you can clearly see here where they're able to identify from gathering feedback from their sites, the issues that existed, getting that feedback really quickly allowed them to resolve that to move their study along at a faster pace. The surveys here that were sent on this study, I've showed you one question. What we'd recommend and what we see is usually quite short surveys in duration, about four questions. Very targeted and very specific to give you real actionable insights to the information that you need from your specific sites.

I'm going to move now to a third example. Take you through this in detail. This site engagement success story is a a broader view, really. This study was a large study.

It's operating in respiratory. And again, it's a Phase II trial. And what we can see here is they were looking to address site engagement challenges, and really the retention of site engagement over a longer duration. And why that's important for this team, is this therapy area is very competitive.

From speaking to the team and knowing this team very well, they're actually competing with other clinical teams in their own company, as well as other sponsors looking for the same sites for the same patients, on those trials. So the goal was to retain high site engagement. What they successfully did was implemented a strategic, I suppose, communication strategy through Teckro, and keep their sites engaged. They sent targeted communications at regular intervals, again, keeping their study top of mind with the sites.

When we look at the results that are evident from their engagement campaign, you can see ninety one percent of sites are engaged with the study documents and communications. And that's a really, really, really powerful impact in keeping the studies top in mind, especially in this competitive area. Also then on the right hand side, you'll see a figure, and I know, Ger, you're very familiar with this. You can take us through this in more detail, but you can see the different increases and decreases that exist and the regular interaction of sites on a continuous basis with the study content.

Also to allude to, we did speak to the team, they were able to share they were able to share with us some of the success stories, from the study. When we look at the information around screening and randomization, for those ninety one percent of sites that were engaged, they actually had a forty five percent increase in screening rate at those sites. So again, showing a clear connection between site engagement and site success And when you look at that in terms of randomization, there was an eighteen percent increase in, in engage or sorry, in randomization at those engaged sites. So I know, Ger, maybe if you want to add some extra context from the data side and from the growth side of what we're aware of here.

Yeah, so maybe just to explain the the chart on the right hand side, and it's something we typically see when communication best practices are followed. So the orange trend is site staff engagements with the protocol and study documents. And you could see an immediate uptake here from sites as recruitment started up. And about one third into the timeline, you can see the green lines start to appear, which is when the study team started to send communications through our platform.

The height of the green bar reflects, the number of site reads of those communications. The site staff opening and reading the communications. And as you will see, that's really where site engagement took off. One interesting thing to point out is you can see how the peaks between the green and orange lines move up and down together.

For example, if you look in the middle of the chart, you can see a big peak in the green line of sites engaging with the communications, and that correlates with a corresponding peak in the orange where sites are also interacting with the protocol. We consistently see this relationship in our data; targeted communications not only keep your study top in mind and sites informed on key study updates, but also drives site engagement with your protocol. Reruitment for this particular study closed two thirds of the way into that timeline, but again you see consistent reengagement from sites after that point in time.

The nature of your communications and how to engage with your study documents will change during maintenance and close out phases, but it's still very important to keep your sites engaged during that period. And as Brian mentioned, when we combine our site engagement data with site enrollment data, while the individual percentages may vary dependent on study size, we do typically see higher rates of screening and randomization from those sites that are engaged with a study on Teckro. So there's a lot of info on the slides, but the key takeaway is that this study engaged the vast majority of those sites, their sites, and those engaged sites achieved higher enrollment outcomes.

And you can see in the visual just how much of that overall engagement came from the study team's targeted communications. So I hope that that helps add a bit more context to the data story here. No that's that's really helpful, Ger. Thanks so much.

What we're going to do now is we've gone through as well as three examples of site engagement success, and they've been quite focused on on certain aspects of a study just to to provide context for for everyone here today. What I'd like to do now though is is go more step by step. So let's take a look at at this implementation of an engagement strategy in Tekro in action. To do this, I'm gonna take another example of a study, a study we're working with, where this is in place, and show you how communication best practices.

And this may be for you who are listening to the webinar, you have the ability maybe to think about this in terms of your own study and how you can relate these best practices to how you implement certain aspects of your own trial conduct. In the step by step example, it's relating to a Phase III or sorry, Phase II study. Again, we're operating across twenty six countries and they actually have a target of two thousand nine hundred patients. So you can imagine the amount of site activity, the amount of activity that's gonna be happening, and also the longer duration for this study.

What's key here is their clear implementation of an engagement strategy. Site engagement strategy is taking is commencing even prior to SIV. So quite early in the study ensuring there's, enhanced communication with those sites for the duration of the trial. The accompanying playbook that you'll receive as a result of attending and listening to today's webinar will provide additional details on the content we're going to do and go through here.

And support you when you're doing this for your own trials. But today, But today I'm going to touch on three or four key elements just to ensure we can provide clear action for you. The targeted communications they sent were in line with study milestones. So key milestones, you may know, maybe have your SIV might have an investigator meeting.

Your first patient enrolled, other key milestones such as that, but also focus here is on recruitment tips. So some information may not be in line with a milestone. It may be in line with the trend or information you're receiving in other areas of the trial. And thirdly, an key important aspect is really region specific updates.

For example, region specific enrollment updates, ensuring again your communication is targeted to the right audience This "one to everyone" communication isn't suitable. You need to ensure that you have the right audience and the right message at the right time. These are all key elements that we implemented as part of this strategy. The final piece we want to emphasize is really the interconnection between study content and the communication.

And you would have seen that in jurors example in the in the previous slide where we had the green and orange graphics. You can see sites interacting successfully with the content and the protocol and also in line with the interaction to the communications and how both are important to drive that familiarity with their protocol as well as the engagement and retained engagement of your site with your trial for that longer duration. So let's look what this looks like for guests from a site perspective or from a message recipient perspective. They implemented this targeted engagement campaign through Teckro and sending targeted messages to the sites.

What's on screen here is a visual of what these messages might look like. Now we've anonymized them for the purposes of the webinar so the Teck Pharma logo is just a logo we've created, but you can imagine this is where your study or your sponsor logo would appear. Also, the content, you can see, study welcome, study population, recruitment tips, enrollment updates. These are all different types of communications that can be sent in their tailored communications that they should be sent to the right sites at the right time in line with the relevant milestones.

For this study, did send a welcome message to all sites at the beginning of the trial, then in line with the SIV and post SIV, importantly emphasizing areas around study population and recruitment tips to those sites that are in that early recruitment phase. Then as sites continue on successfully, maybe you're sharing enrollment updates with some successful sites, and you may again begin phase one of the campaign with those newer sites as they come on. So hopefully here you can see a visual of what they look like. What I want to do though is dig into maybe a message example and take you through some of the best practices that we recommend and that we've successfully implemented with these teams.

And there is best practice in use of Teckro. You'll see some icons listed on the left hand side of of the phone icon. Just to show you the first piece is sending targeted communications. For this specific team or for the teams you work with, we're recommending you're tailoring your audience.

So you'll see here you have the ability to select who you want to send this message to. Some messages maybe, one site, may need that update. So that's where global teams might send it to the specific site. In other examples, you may have members of the local team who send messages directly to their site.

In addition, I've mentioned the word localize as required, we do see an impact on using local language in certain settings. I think, Ger, you've got additional information, you can probably share with us as as we go through this. The second piece in the center of the screen is using message templates. So in Teckro, when we're taking you through best practices, we'll show you how you can utilize the templates that are there.

They can be created and configured specific for the study. But the benefit this brings is it really reduces the burden on the study team. You're not thinking every time, what do I need to type? What do I need to create?

You take the template. The other benefit that it brings consistency and security for the team because you know, a study team member will take the template, ensure that accurate communication is sent to the sites they're not creating content every time either. And the final piece along the bottom I want to touch on is really around direct links. So we emphasize again the importance of content and communication.

Here you can see how easily the links appear in the message. And these are direct links into important information. In this message, it's a protocol reminder. So adding a link to that section of the protocol is so important.

The site receives a message. They don't need to go look for the protocol. They don't need to access passwords to try and find information. They can simply click on that link and take the next step.

So, Ger, I touched on a few things there, and I know from your perspective. You you have additional data and additional support, I welcome your input here on this piece. Yeah, so I know we touched on this earlier, but the call to action links really help that engagement with your protocol. So when this approach is followed, targeted communications with a clear call to action within the body of the communication, we see the majority of engaged sites, both open the communication, and engage with study documents.

Right? And we really love to see that in the data because it qualifies that if you send the right message at the right time, then that will drive deep engagement with your protocol. And the second point I'll add is that localized communications typically achieve higher site open rates. So for example, on a study that localize their communications into Japanese, we see open rates nine percentage points higher than non localized.

So it's an important consideration to discuss with your local teams when designing your site engagement plans. Great, thanks Ger. I think just to touch on some of the things you you mentioned there as well. If you're looking on the right hand side, one extra benefit here for the teams you touched on is the ability all these communications are now in one place.

So currently, I'm working with teams, and they're using emails, some are using Microsoft Teams, some are using other channels to communicate in different ways. At certain points in the trial, you want to centralize that information. The benefit here for the site, and also for the study team is that the communications are already centralized in one place. For the site staff, they can easily refer back.

They're not having defined items and folders, find items in different places. Second bullet in the center of the screen, is again just reiterating the content of the message. You're really choosing where to prioritize that. What message goes to each site at each specific time.

Some cases, you may send a message to everyone in the country. Other times, maybe more pertinent just to send it to one site. So you have that flexibility. And finally, the piece you referenced at the bottom is those quick links.

So we call them call to action. So for those of you who haven't heard that before, it's sometimes called CTA or call to action link, but these are these little buttons at the base. Call to actions are easy prompts for you to take the next right step. And a lot of the teams now sending out messages and alerts through Teckro are using links or linking directly call to action to those dedicated channels that then allows the site tap on that and start a conversation with an expert.

You as a team configure and design or tell us who you want that expert to but allows for ease of access. Again, as we talked about, there's a lot of barriers in communication currently due to the pressures and the stresses at site level. But enabling ease of access to the right person really helps and supports the sites. And what we're now seeing as we saw in this this example we're talking in the respiratory area is the high number of questions coming on on this study.

And the feedback we have from the medical teams who are actually answering some of these questions is so much simpler. They're quite happy to receive the messages in a direct channel and I suppose, it reduces the burden on them as a specific team. So I've guided you through some specific examples. What I'd now like to do is really take this back to a broader view.

So what might this look like on your trial? Best practice, what we will do, at Teckro was define and create a targeted campaign with a specific team. Your trial will vary depending if it's oncology, maybe it's respiratory, maybe it's cardiovascular, maybe total therapy areas. The trial designs are different.

Maybe your timeline is different. What I've tried to put up here on screen today is some milestones that are definitely applicable for everyone. You've your SID, your first screening, maybe first enrollment on the trial, and then enrollment targets being met. What we'd recommend is that you're planning, what are the communications that will be sent to sites around these specific milestones.

And as you can see, you might have a study welcome message, sharing recruitment tips. Also then as the trial progresses, the audience may change. The enrollment update may go to all sites, whereas some of those early messages just going to individual sites at the right time. Also to touch on, I suppose, the benefits here, the oversight that you will get through Teckro, and the oversight of that site engagement that I touched on earlier, you then have the ability to tailor and adjust the engagement strategy as you need.

In a different color towards the base of the screen, is the additional tailored touch points. You'll have the ability to identify who are your engaged sites, and effectively, who are your disengaged sites or your unengaged sites. Those sites may require different strategy and different communications. For example, you may send communications to those sites sharing best practice or screening tips that you've learned from the other sites.

You may also wish to survey those sites to identify how they're challenged, how can you learn from the behavior that you're seeing with those sites? This timeline is representative of a lot of the timelines that the teams are using at the moment. So in building their strategy, we would document and build this out with the teams. To ensure best practice and again optimizing the interaction you have with your sites.

A key point I talked about earlier was oversight. I'd like to touch on this today. Best practice is key. What really an important part of successful site engagement is the ability to measure site engagement in real time.

What you see on screen here is a visual of our dashboard. So those communications that I talked about being sent out by a global team or local team to sites, you have the ability now that that is centralized to Teckro. A member of the global team, you would have full visibility of all the communications sent on your trial. This is a fictional example today just to represent how it would view.

But the benefits here, if we look at them, you can clearly see all of these messages that are being sent, so screening recruitment surveys, there's administering IP updates. You can try to see who sent that message, but more importantly, you can see who the audience was, so who was part of that message. You can see the date when it was sent, and the final piece I'd like to highlight over on the right is you do get real oversight of that site engagement with your communications. You get a visibility of that open rate.

We touched on the case studies and examples. We can see when the right messages are sent at the right time, they really have high engagement with your sites. Feedback we get from teams on this is it is quite centralized. It allows them to understand what communications are going to site and in some cases what communications are not going to sites.

If you were to select any of the lines in the dashboard, it would dig deeper into the data, so you'll be able to see at a site level, and even at a individual role level, who was viewing and who was not viewing those communications. Giving you actionable insights to identify how you can improve or optimize engagement with those sites. Just to take one example that we touched on the case studies, one of those messages is a survey type. If I was to click on the actual survey message, you would then be able to see which live in real time, the responses that are coming in on that survey.

You can see the bar chart visually giving you that availability of the answers. And allowing you to learn from your sites. Again, building that relationship, building that engagement to the next level. The dashboard itself allows you to filter you can look through the responses, identify, maybe I'm only interested in the US, maybe I'm interested in Europe.

You have that flexibility to look at the information in different ways to benefit you as you move on the trial. What we've covered there hopefully provides you with some context and real examples of areas I've touched on such as site engagement and how we have examples of successful site engagement with Tekro. I'm going to recap now just do on the on the definition of engagement to reiterate to those key points. So I said there was three building blocks to successful site engagement or meaningful site engagement.

The first is repeated interactions with your study content at the right time. What I hope I've shared with you in the examples from Ger and I is that we're enabling that for you. You have the ability to have oversight of those interactions with your content ensuring your sites are engaged. The second piece around communication to ensure your sites are listening and aware for your trial and your updates.

What's key important there is that you now have the oversight and visibility of, are the right people reading my communications? The last the last piece or the last building block is really that you have now the opportunity, to know that sites can share their feedback with you. To reach out with a survey to gather their feedback just like we saw in the two examples. Also, the sites have the ability to to reach out directly to through you in those call to action buttons where they can seek guidance when challenges arise.

Together, the building blocks ensure that you can then build authentic and enduring site relationships across the trials that you're working on. So where we are now in the webinar, I'm going to pause. It's a good opportunity. I can see lots of questions coming through.

And I think, Ger, maybe what we might do is review some of the questions and discuss and provide answers for different members. Perfect. So, Brian, the first question, how does site engagement and these best practices vary across different phases of the trial. So Phase I trials, for example.

Yep. I know it's an excellent question. So I think the case studies, the examples we presented were Phase II and Phase III. So how best practice is applied, it's it's very similar in the strategy that will be applied.

We would just tailor it for Phase I. To give you an example, the importance in Phase I may be your own dose escalation, cohort management. So the content and the frequency and the audience of your messages would change, but in principle, it's the same best practice and we've done that with many teams, again, taking their communication plan and ensuring that it's utilizing Teckro best practice to bring about successful site engagement. Perfect.

And I see a couple of questions around the same theme here. So you've shared some interesting examples of engagement in the recruitment phase, but is this also applicable to sites and studies as they move into maintenance follow-up stages on the trial? Specific question about, sorry, Brian, just to build on this, any communication best practices for later stages in the trial, for example, approaching database lock and after site closure. Yeah they're excellent questions.

So, again, the examples we focus on today just to bring context where specific, I suppose, probably in that recruitment area. But the answer is, yes, the best practice and the use of I suppose enhanced best practice for communications is applicable at any stage in the study. If I talk specifically, the way you communicate and the frequency of the communication may change. We currently are working with a team that comes to mind that are approaching database lock.

They're approximately two months out from database block. They're sending regular targeted updates to specific countries and specific sites. The content of those messages to give this team context is, in some cases, it's a survey, a survey to ask the sites, will they actually meet the date and are there any challenges, for them as they approach database lock, because they want that information firsthand, again, to ensure they can assist the sites in meeting their target. The second element of that is again, reminding sites of the dates, and providing links to relevant content in those messages.

Sometimes it might be links to supporting information or links to supporting systems to allow them to officially go about that database lock. So that that covers that database lock example. In the maintenance phase or follow-up phases, it is the same. You would have seen that maybe from the respiratory example that we shared, we had a longer duration in the trial.

The frequency of communications did continue, and it was key to maintaining that successful site engagement, but it probably wasn't weekly. Maybe in those stages, some of the teams send an update monthly to some countries, and maybe the timing may vary depending on the milestone in the country, but it is important to maintain that site engagement in those phases. Very clear. Thanks, Brian.

Question on how how do you obtain site open rate data for messages? How about communications pushed to a site response report? So, Brian, maybe 'll have a go at this and maybe you add in. So, the site open rate metrics that we showed earlier in the presentation, so seventy nine percent on the best in class study that we howed you earlier.

That data is unique to Teckro. Right? So in order for a site, to read a message that has been sent to them, they need to open the app in order to view it. And when that happens, we're then able to track that event as an open, and then we're able to aggregate that information up.

So you're able to see the open rate for each of the messages that you've sent. We did compare to an email benchmark, and it's really hard to get, open rates for email. I hear some portals they don't offer open race related metrics. So in the ten to twenty percent benchmark that we used was market level benchmark data that we get from reputable companies, that specialize in email, system, email deliveries.

systems. Yeah. Then I can even add some context to us. What we're seeing from the teams you work with, the feedback I'm getting is that they're they're delighted to be able to have that oversight of of successful, I suppose opening of a message or review a message by the sites.

Again, in terms of the communications and the rates, it is quite effective in terms of when we're working with the teams and setting up integration and the implementation of a strategy, which is quite quick, would recommend that, I suppose, the message would would ping on the investigator's phone as well as through the application. So we're all familiar with these applications where you have a little number icon on them. That happens for Teckro. So it's, again, making it easy and everyday how they receive these messages.

It doesn't get buried in an email inbox where a lot of other communications go, and that's where we see that success. So for that, it's context to how it works, but also also why we see it's beneficial. Perfect. Do you see any regional variation of trends in site engagement, Brian?

Yeah. I think the answer is that there's, so there is variation on every study, but there isn't a consistent variation that certain countries are lower on-site engagement. It really depends on on your team, your structure, and how you're rolling out your truck. What we do see in some areas is maybe there's a stronger look team who are really engaged with the sites and communicating regularly, other teams may vary.

What I do see is now we're surfacing this information to the teams, is they have the ability to understand the site engagement and potential variations on their trial and then take that information to be actionable to address those differences in site engagement. And even to add the other piece I would say is where we do see differences in site engagement is sometimes where we have that use of local language. So, certain countries, as Ger referenced, Japanese for example, we do see significant successful site engagement where local language is used in those communications as opposed to in English will be used in those communications.

That's a good question. It's just coming on a on a related topic. How important is, is local language in site engagement, just to reiterate that. I think it is very important.

It really allows for the investigators and site staff, I suppose, to build that relationship with your sites. Particularly if those communications are coming from the local team, receiving the message in local language, and their ability to ask a question in local languages strengthens, the site engagement relationship. So I think in the interest of where we are with time today, there are if there are any additional questions that we weren't able to address we're more than happy to respond to those questions. We have the details of the person who submitted the question.

We can respond to them one to one. What I'd like to do now is to move to the next steps. What we'd like to do is to be able to share with you additional details how you can replicate some of the successful engagement that we shared on your specific study. On the left hand side of your screen, you'll have the ability to download the communications playbook.

I'd encourage you if you're part of a larger team to review the playbook with your team. Maybe review it side by side with your current communication plan or site engagement initiatives that you have ongoing and see how you could optimize utilizing Teckro best practice to optimize what you're currently doing. Also, on the right hand side of the screen, you will have the ability, as a as part of this webinar, to book a personalized communications workshop with some of the Teckro project management team. So just like I've shared with you today, some lessons learned from other studies and best practices in other areas members of our team will be able to meet you one to one to share and discuss your study and listen to the challenges you have and then implement or roll out as well best practices or changes that we would recommend.

In the center of their screen, there is a QR code. If you have got your cell phone handy, you can take a photo of that QR code and it will enable the playbook and the access to the personal workshop booking site for you to to engage with us. Thank you all, though, for your attendance today on behalf of Ger and I it was a pleasure for us to be able to share Teckro best practices with you for enhanced site engagement. And we look forward to interacting with you in those upcoming personalized workshops.

So thank you and enjoy your day.