Digital patient portal interface transforming into a clinical trial recruitment landscape.

Unlock the Power of Digital Health: How Electronic Records are Revolutionizing Patient Recruitment

Mira Elwood in Health & Wellness May 2025 • 4 min read.

"Discover how electronic health records and patient portals are transforming clinical trials, improving efficiency, and reaching diverse populations."

In today's rapidly evolving healthcare landscape, electronic health records (EHRs) are emerging as a powerful tool for transforming clinical research. Pragmatic clinical trials, which aim to evaluate the effectiveness of interventions in real-world settings, are increasingly leveraging EHRs to streamline patient recruitment, improve efficiency, and reach more diverse populations. This article explores how EHRs and patient portals are revolutionizing the way we approach clinical trials, offering a glimpse into the future of digital health.

Traditionally, patient recruitment for clinical trials has been a time-consuming and resource-intensive process, often relying on manual methods like in-clinic recruitment, letters, and phone calls. However, these approaches can be limited in their reach, leading to skewed demographics and slower enrollment rates. With the widespread adoption of EHRs, researchers now have access to a wealth of patient data that can be used to identify potential study participants more efficiently.

This article delves into a case study that highlights the successes and lessons learned from using EHRs and patient portals to recruit participants for ADAPTABLE (Aspirin Dosing: A Patient-centric Trial Assessing Benefits and Long-Term Effectiveness), a large-scale pragmatic trial. By examining the strategies employed, the challenges encountered, and the outcomes achieved, we can gain valuable insights into how digital health can be harnessed to improve clinical research and patient outcomes.

The Rise of EHR-Driven Recruitment: Efficiency and Inclusivity

Digital patient portal interface transforming into a clinical trial recruitment landscape.

Electronic health records (EHRs) offer a treasure trove of patient data, making it easier to identify individuals who meet specific study criteria. This targeted approach saves time and resources compared to traditional recruitment methods. EHR-driven recruitment has the potential to reach a wider and more diverse patient population, ensuring that clinical trials are more representative of the real-world population.

The ADAPTABLE study utilized four primary recruitment methods, two of which comprised an EHR-driven electronic recruitment workflow:

In-Clinic Recruitment: Research coordinators approached patients during their clinic visits.
Letters: Traditional recruitment letters were sent via U.S. mail.
Direct Email: Patients without My UNC Chart accounts but with known email addresses received email invitations.
Patient Portal Messages: Patients with active My UNC Chart accounts received messages directly through the portal.

The study's results highlighted the effectiveness of electronic recruitment, with 87.8% of UNC enrollees (509 out of 580) recruited via electronic methods. The electronic recruitment workflow sent messages to 12,254 recipients, resulting in 13.5% visiting the study website and 4.2% enrolling. Letters were sent to 427 recipients; 5.6% visited the study website, and 3.3% enrolled. Coordinators recruited 339 participants in clinic; 23.6% visited the study website, and 16.8% enrolled.

The Future of Recruitment: Leveraging the Digital Age

As EHRs and patient portals continue to evolve, their potential for transforming clinical research is immense. By embracing digital tools and strategies, we can create more efficient, inclusive, and impactful clinical trials that ultimately improve patient care. Electronic recruitment for ADAPTABLE proved successful, incorporating the workflow particularly into a pragmatic trial.

Everything You Need To Know

What are Electronic Health Records (EHRs), and why are they important?

Electronic health records (EHRs) are digital versions of a patient's paper chart. They contain a patient's medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory test results. EHRs are important because they allow researchers to identify potential study participants more efficiently by accessing a wealth of patient data. This targeted approach saves time and resources compared to traditional recruitment methods. The implementation of EHRs streamlines the identification process, making it easier to find patients who meet specific criteria for clinical trials, ultimately contributing to more efficient and inclusive research.

What are patient portals, and how do they fit into digital health?

Patient portals are secure online websites that give patients 24-hour access to their personal health information from anywhere with an internet connection. They are a crucial component in digital health because they enable direct communication with patients. For instance, in the ADAPTABLE study, patient portal messages were used as an electronic recruitment method. Patients with active My UNC Chart accounts received messages directly through the portal. This direct communication strategy resulted in higher enrollment rates, highlighting the effectiveness of integrating patient portals in clinical trials. Furthermore, patient portals enhance patient engagement by giving them control over their health information and facilitating active participation in research.

What are pragmatic clinical trials, and what is their importance?

In the context of clinical trials, pragmatic clinical trials are designed to evaluate the effectiveness of interventions in real-world settings. Unlike traditional clinical trials that often take place in highly controlled environments, pragmatic trials focus on real-world patient populations and clinical practices. The ADAPTABLE trial is an example of a pragmatic trial. They are significant because they provide insights into the actual impact of a treatment or intervention, as they evaluate effectiveness within diverse patient populations and normal clinical settings. This approach ensures that the research findings are more applicable and relevant to a broader patient population, leading to more generalizable results and improved patient outcomes.

What was the ADAPTABLE study, and why is it significant?

The ADAPTABLE study is a case study that highlights the successful application of electronic health records (EHRs) and patient portals in patient recruitment for a large-scale pragmatic trial. The study used EHR-driven electronic recruitment methods and compared them to traditional methods like letters and in-clinic recruitment. The main recruitment methods used were In-Clinic Recruitment, Letters, Direct Email and Patient Portal Messages. This is significant because it provides a real-world example of how digital health tools can streamline patient recruitment, improve efficiency, and reach diverse populations. For example, 87.8% of UNC enrollees were recruited via electronic methods. The successes and lessons learned from ADAPTABLE offer valuable insights into how digital health can be harnessed to improve clinical research and patient outcomes.

What is EHR-driven recruitment, and why is it important?

EHR-driven recruitment involves using electronic health records (EHRs) to identify and recruit patients for clinical trials. This method utilizes the data within EHRs to identify individuals who meet specific study criteria. EHR-driven recruitment is particularly significant because it improves the efficiency of the patient recruitment process, as it can reach a wider and more diverse patient population. The process is cost-effective and significantly faster than traditional methods like in-clinic recruitment or sending letters. Furthermore, the implementation of EHR-driven recruitment makes it easier to include diverse patient populations, ensuring that clinical trials are more representative of the real-world population, thus improving the generalizability and relevance of clinical research findings.