Hailey Miller, PhD, RN Postdoctoral Associate Duke University School of Nursing

Using the EMR to Identify Clinical Trial Candidates Can Increase Diversity in Studies

MedicalResearch.com Interview with:

Hailey Miller, PhD, RN Postdoctoral Associate Duke University School of Nursing

Dr. Miller

Hailey Miller, PhD, RN
Postdoctoral Associate
Duke University School of Nursing
Stephen P. Juraschek, MD PhD
Beth Israel Deaconess Medical Center

MedicalResearch.com: What is the background for this study?  

Response: Digital tools, such as the electronic medical record (EMR), are increasingly utilized to identify and recruit participants for clinical trials. These strategies offer a strong opportunity to increase recruitment yields, however, our previous work has demonstrated that patient portal users are disproportionately White, and therefore utilizing these strategies may contribute to the under-representation of Black Americans in clinical research.

This study examined multiple recruitment strategies, including EMR-based strategies and other non-EMR strategies, such as community mailing, Facebook advertisement and newspaper advertisement, to understand if recruitment strategies influenced the demographic composition of trial participants. Given our previous finding that patient portal users are disproportionately White, one of our EMR-based strategies included postal mailing to individuals without a patient portal.

MedicalResearch.com: What are the main findings? 

Response: Our results showed demographic differences in how White and Black adults were recruited into the trial. Specifically, we found that two-thirds of the Black adults screened in the trial were identified via the EMR, but were contacted through postal mailing. Utilizing solely the patient portal for participant outreach would have resulted in a large majority of Black adults not finding out about a research opportunity directly relevant to their health. These findings highlight the need to use a broad range of recruitment strategies to obtain a more inclusive and representative sample. 

MedicalResearch.com: What should readers take away from your report?

Response: The EMR can be leveraged to increase trial participation, however, complementary approaches should be deployed to ensure a diverse, heterogenous sample.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Future research should continue to investigate the influence of recruitment material and strategies on the representativeness of trial participants and how we can leverage our materials and strategies to be more inclusive to various racial, ethnic, and cultural groups.


Miller, H.N., et al. (2020) Use of electronic recruitment methods in a clinical trial of adults with gout. Clinical Trials. doi.org/10.1177/1740774520956969. 

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Last Updated on September 23, 2020 by Marie Benz MD FAAD