Patient burden
The study fits the disease. The visits don't fit the patient's life.
Travel, work and caring responsibilities can make participation impractical. Fewer patients can progress beyond that point.
CLINICAL TRIAL ENROLLMENT
Want to enrol patients faster?
You have two choices.
ADD MORE
- More sites.
- More advertising.
- More amendments.
- More time.
Increase the resources behind enrollment.
CONVERT MORE
Convert more patients.
Patients entering
Patients enrolled
We connect protocol design, site operations, and patient decisions into one conversion strategy. We call it Enrollment Engineering.
Free Enrollment AssessmentFree 1-hour enrollment assessment, delivered by one of our principals
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Recruitment is one part of enrollment
Your tightest constraint
sets your enrollment ceiling.
Eligibility criteria, patient burden, recruitment and site processes all shape how many patients can and will enroll. Addressing these constraints together helps more eligible patients enroll in the study.
Some of the factors that shape conversion
Protocol
An unnecessary exclusion reduces the whole opportunity.
Fewer patients can qualify. That smaller pool limits what can progress through every stage that follows.
A constraint limits the flow below it
Recruitment
The wrong response narrows the whole funnel.
An ad can generate interest without reaching suitable patients. Fewer suitable patients entering means fewer can progress at every stage.
Site operations
The referral arrives. The response doesn't.
An unworked referral or an unavailable appointment creates a bottleneck. More activity elsewhere cannot move that patient past it.
Patient understanding
Unanswered questions can stop progression.
Patients need clarity to make an informed choice. An unresolved concern can stop them progressing through the rest of the funnel.
One constraint can limit
the whole result.
7.9%
Percentage of recruitment target met without needing to extend the overall trial duration1
The missing strategy
Your enrollment target depends on the whole system.Does your strategy?
Enrollment Engineering finds and addresses constraints across the whole system, so more eligible patients can progress to enrollment.
Our delivery record
200+
studies
50
years between us
More than80%
on time
Kym and Liam, Principals.
Enrollment is learned in one place: at the sites, getting patients into studies. We've done that across the US, Europe and the rest of the world, in healthcare systems public, private and everything hybrid. Different cultures of care, different reasons a patient says yes. And we've sat on every side of the table it's done from: running site networks, delivering as a CRO, carrying the sponsor's accountability. We're not observers of those jobs. We've had them.
Built one of the first US site management organizations, acquired by UnitedHealthcare. Led two more.
Executives at three CROs. Grew one clinical organization from 20 people to more than 400. Floated one on the London Stock Exchange.
Scaled one site to 85,000 leads and 25,000 clinic appointments a year.
Enrollment Engineering is the methodology we built from that know-how.
ENROLLMENT ENGINEERING
Four disciplines.
One enrollment system.
Each discipline brings a way of thinking and a set of practical outputs.
Together, they shape how we deliver every service.
Modeling.
Test what enrollment depends on before committing to a plan.
Learn more about modelingBehavioral science.
Understand how patients and sites decide, and what helps them act.
Learn more about behavioral scienceOperational design.
Turn the study's requirements into workable processes for sites.
Learn more about operational designLive control.
See where progress is slipping and give the next action an owner.
Learn more about live controlApplied across every service.
A shared methodology. Practical outputs shaped around your study.
A funnel is mathematical. Movement through it is human.
Engineering is the part in between.
Enrollment Engineering, applied
The enrollment problem is rarely where it first appears.
Seven anonymized examples of what changed when someone looked beneath the enrollment number.
Clinical trial enrollment feasibility | Asthma
One extra screening test would have cost 4.5 months.
Result: 4.5 months removed from the enrollment timeline.
Read the enrollment feasibility case study
Patient communication and enrollment | Overactive bladder
The protocol spoke bladder. Patients were thinking about memory.
Result: 39 weeks of enrollment, matched in 10 weeks. Enrollment ran 3.9 times faster.
Read the patient communication case study
Clinical trial enrollment recovery | Alzheimer’s disease
The sponsor saw competing trials. Patients saw familiar care.
Result: Four of the five supported sites became top enrollers. Delivery speed increased by 36% once the rebuilt strategy, amendment included, was in place.
Read the enrollment recovery case study
PRACTICE ENGAGEMENT · SMALL CELL LUNG CANCER
The investigators were sold. Their practice partners weren't.
Result: a full year's enrollment backlog cleared in 3 months.
Read the practice engagement case study
TRIAL DESIGN · ULTRA-RARE NEURODEGENERATIVE DISEASE
There was no endpoint to measure, and almost nobody to measure it in.
Result: EMA approval 12 months after submission. 20 months from contract to publication.
Read the rare-disease trial design case study
TRIAL RESCUE · RENAL TRANSPLANTATION
The sites weren't failing. The support around them was.
Result: a stalled study back on track, without adding a single site or amending the protocol.
Read the renal transplant trial rescue case study
PROTOCOL FIT · ORAL CONTRACEPTION
The protocol was built around American medicine. The patients were European.
Result: a European trial that couldn't enroll, traced to four Pap smears.
Read the protocol fit case studyServices
Before the study starts
Enrollment Feasibility Audit
Is the rate in the forecast real? We test the evidence behind it and model the range it can support, before site count, timeline and budget harden around a number that was never true.
Enrollment scenarios, modeled through every stage of the funnel
Explore servicesModel the possibilities.
One starting point. A range of outcomes.
ConservativeExpectedPotential
Illustrative scenarios · no study data
Enrollment Strategy
What has to happen, and who owns it? One strategy that connects sites, patients, channels, materials and handoffs. We work out what each site needs to put your study first, and how we support it. What will slow enrollment is found and fixed before it does.
One enrollment strategy: sites, patients, channels, materials and handoffs, connected
Explore servicesConnect the whole system.
Every pathway. One enrollment strategy.
PatientsSitesOperations
One plan.
Illustrative framework · connected responsibilities
While it runs
Enrollment Control Tower
What's slowing the study, and who fixes it? We run the delivery as well as the numbers: advertising and patient channels, patient contact, and the work with sites that keeps your study at the top of their list. Every stage, every site, every week, each problem is traced, owned and fixed.
Variance, cause, owner, action, result, weekly
Explore servicesTurn a signal into an action.
Spot the variance. Own the response.
ExpectedActual
01 · OwnerSite lead
02 · ActionFix the handoff
03 · ResultCheck recovery
Illustrative operating view · no study data
Enrollment Rescue Audit
Where are patients being lost, and what fixes it? We rebuild the funnel from the study's own data, then act in three ways: close the leaks costing you patients now, add volume at the top only where the funnel can convert it, and redesign the stages holding the study back.
The funnel rebuilt from the study's own data, with the fixes ranked
Explore servicesFind the constraint. Rebuild the flow.
Target the stage that holds patients back.
Illustrative patient flow · no study data
Start with the study in front of you
Will your enrollment deliver?
Take the study in front of you, planned or live. Fifteen questions about how it will enroll tell you whether the plan holds at every stage, or whether it is a recruitment plan with a target attached. If your study qualifies, we'll offer you a free diagnostic assessment with Kym or Liam.
Free Enrollment Assessment
Free 1-hour enrollment assessment, delivered by one of our principals