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In the earlier days of the pandemic, doctors at Wake Forest Baptist Health were exploring what role they could play in fighting COVID-19, and had begun working on a small research study that involved sending test kits to about 1,000 people to check for COVID-19 antibodies.
Dr. John Sanders, chief of infectious diseases for internal medicine at Wake Forest Baptist Health, one of the study’s creators, had experience working on other projects involving new at-home antibody tests. As stay-at-home orders proliferated, anything that allowed people to contribute data from home seemed like a good avenue to pursue.
“David [Herrington], our vice-chair of research for the medicine department at Wake, called me and said, ‘John, what are you doing for COVID?’,” says Sanders. “’This thing's coming. We have to do something big.’” Sanders pitched his team’s home-test idea.
“David responded, ‘That's great, but we have to go bigger, bigger, bigger,’” Sanders recalls.
At the same time, government leaders, including the Centers for Disease Control and Prevention (CDC), realized that they needed much more data about the virus, both in terms of the spread of the disease and the actions people were taking to combat it. Wake Forest couldn’t do this alone.
Vysnova Partners, one of the CDC’s rapid response partners, was working on a similar proposal to support the CDC. The company provided similar support to other outbreaks such as Zika and Ebola Virus. Vysnova and Wake Forest Baptist leveraged their existing relationship to join forces, turning to researchers at the institution to develop a proposal aimed at collecting real-time data on the virus and its spread across the mid-Atlantic, Southern, and Southeastern United States. Vysnova leadership worked with Sanders to develop and implement a large study that included several regions of the country to better represent the US population. Time was of the essence. “We were supporting other response initiatives at CDC, and so that sped up the process,” says Johnathan Ward, senior program manager at Vysnova. “But the other piece was the network that was already formed.” Vysnova leadership worked with Wake Forest Baptist and other partners to design, develop, and implement a large study that included several regions of the country to better represent the US population. CDC experts helped define the study design such as the frequency of the testing, sample size, follow-up time, study population, and other demographic characteristics, according to Ward.
To make this study possible, at-home testing kits weren’t the only crucial piece of technology. For this project, and the 43,000 people who eventually took part in the study, a platform to launch large-scale email communication would become a make-or-break capability for gathering this vital data.
The number of study partners expanded to include George Washington University’s Biostatistics Center as the center for data coordination, as well as Atrium Health, the University of Maryland Baltimore School of Medicine, Medstar Health Research Institute, Tulane University, and the University of Mississippi Medical Center.
Sanders connected Vysnova with Oracle, because of the COVID-19 work the tech company had underway. Oracle was already developing a system for the Department of Health and Human Services to allow vaccinated people to report COVID symptoms or any effects of the vaccine directly on a website, rather than relying only on getting data through healthcare providers. Vysnova coordinated with the CDC and the Oracle team to use this platform for the large-scale COVID-19 surveillance study with its university and health system partners.
Oracle developers had created a tool called the COVID-19 Patient Monitoring System (PMS). It allowed researchers to email or text participants links to questionnaires, which asked about daily COVID-19 exposures, risk-reduction behaviors, and the presence of any symptoms.
But by itself, the PMS didn’t do everything Vysnova needed. The PMS could send text or email links to ask study participants to complete survey questions, but it couldn’t handle mass messaging or address broader questions that a participant might have. Automation wasn’t part of PMS either, which meant the study’s managers couldn’t send mass emails on study updates or COVID-19 news. Given all the uncertainty of those early days, that kind of communication was sorely needed.
That communication became more essential once Vysnova saw rapid growth in participant numbers, and that’s where Oracle’s Eloqua, a marketing cloud automation program, filled the void. There would eventually be about 43,000 people in the study, and a subset of about 22,000 were selected for COVID-19 home serology testing. Program leaders had set up a call center to field queries from participants, but it was soon inundated with as many as 10,000 contacts each month from study participants looking for more information about COVID-19.
“When the study team needed to send out messaging like ‘Here's what we're learning’ or ‘This is why you should stay involved’ or ‘Please send in your test kits, and please don't use them on your kids,’ they didn’t have a mechanism to do it,” says Rebecca Laborde, senior director for the Oracle Healthcare Innovation team.
Vysnova needed a way to communicate with study participants quickly and effectively. Ward started looking at different marketing systems for a solution.
Derek Kuprianov, Vysnova’s recruitment and retention manager, was brought on board because of his experience with marketing and mass communications automation. He had a clear understanding from his previous job as a direct marketing manager of how to engage and inform people. Applying those communication skills to a research study took going deep into the Eloqua technology’s capability. “It was a chance to apply my skills to something that's going to do good for the world,” says Kuprianov.
He created different sender profiles for the six study sites so participants associated the research study with their own healthcare organization in their email inbox and not as some separate or random project. Early on the study learned that if participants received an email from their affiliated healthcare system, they would be more likely to open and act on it. Kuprianov also conducted A/B testing of subject lines to determine which subject line was most effective. The team also used Eloqua to send emails letting participants know that a test kit was coming soon, and then nudging those who hadn’t returned their test kit.
“We started out with about one message a week, and on a busy week a participant might get three emails,” Kuprianov says. “The amazing thing is that we had less than 100 unsubscribes out of 30,000 recipients since we started email through Eloqua, which I've never seen in my life before.”
Once Eloqua was established, Vysnova was able to effectively engage about 40,000 participants for more than 6 months on study updates and reminders. Vysnova is ready to expand on the success of this study and modernize the participant experience start to finish with marketing automation via Oracle Eloqua in future large-scale research studies.
“We’re applying the lessons that we’ve learned during this study to other diseases,” Sanders says. “We have been able to dramatically expand our network of participant interactions. It's led us to have a lot more community outreach in vulnerable populations.”
With what the researchers know now, the Vysnova team is confident it could handle an even bigger study. Ward’s decision to bring marketing automation software into the study toolkit was instrumental in the overall success of the study. “The number one thing I would've done differently would have been to start using Eloqua at the very beginning of the study,” Ward says. “We had aspirations of this involving 60,000 to 80,000 people. And I think that we missed an engagement opportunity with a significant number of volunteers early on because we couldn’t communicate quickly and effectively enough, because we just didn't have a tool that could reach that many people that fast.”
As the data collection project winds down, the knowledge that has come from the data collected and the systems that were developed will continue to support healthcare and research studies for years to come.
Learn more about implementing a marketing automation solution to support your needs.
Check out how COVID-19 is changing clinical trial design and data collection.
Margaret Lindquist is a senior director and writer at Oracle.