Patient Recruitment in Clinical Trials: It Starts with Better Design

Patient recruitment remains one of the biggest causes of clinical trial delays. So why, after decades of investment, innovation and expertise, does the industry still struggle to solve it? In this episode of Digital Health: Off the Record, Edwin Cohen and Farrell Healion are joined by patient recruitment specialist and author Ross Jackson. Ross challenges the idea that recruitment is primarily an advertising problem. The conversation explores why recruitment and retention must be considered from the earliest stages of trial design, the critical role sites continue to play, and why opening more sites is rarely a complete solution. The discussion also looks at recruitment costs and commercial models, the growing use of AI, and how digital twins and synthetic control arms could transform the number and type of patients required for future trials. What we cover: Why recruitment must begin with trial design - 01:13 How patient outreach and access have evolved - 04:04 Why sites remain central to recruitment success - 13:20 Understanding site performance and where to focus - 17:26 The cost of recruitment and different pricing models - 20:10 How AI is changing patient identification and engagement - 26:04 Digital twins, synthetic controls and the future of trials - 30:24 Designing trials for patients, not around them - 34:00 Ross leaves us with a simple but powerful principle: design every trial as though it were for you or someone you love.