Clinical Trials Must Be More Equitable, Here’s How

Gav Martell, VP of Business Development & Co-founder at Yonalink

The Need to Address Accessibility Gaps

Clinical trials are a driving force of medical innovation. However, they are predominantly conducted in large urban hospitals that have larger staff and more resources, which puts trial participation out of reach for the majority of Americans who live outside of major city centers. Despite having as much interest as city-dwellers, these individuals often find participation in clinical trials nearly impossible due to daunting travel, logistical and financial challenges. Alarmingly, three out of four cancer patients eager to participate in clinical trials are thwarted by these barriers. 

This lack of accessibility not only exacerbates existing healthcare disparities but also prevents underserved communities from accessing potentially life-saving treatments. The inadvertent exclusion of communities that tend to live outside major cities can skew trial results by failing to accurately represent the effectiveness of the treatment for all population groups.

Fortunately, technological advancements are beginning to mitigate these challenges by simplifying access to clinical trials, enhancing research quality, and fostering health equity. This ensures that individuals, regardless of their geographic location, can benefit from the latest medical breakthroughs.

Overcoming Geographical Barriers

Travel logistics are a significant obstacle for those in rural, remote, and underserved areas wishing to engage in clinical trials. To participate, individuals must be near major medical centers or capable of traveling without undue hardship.

Research highlights the plight of rural cancer patients in the US, who face limited access to specialized care, transportation difficulties, and financial burdens such as the loss of income from taking time off work or the expense and challenge of childcare for time away to get treatment. Over 1.6 million rural households lack a vehicle, and even those with transportation often cannot afford the travel expenses.

While some trials offer grants and stipends to alleviate these costs, not all sponsors do so, potentially to avoid influencing participants’ decisions. However, reimbursement alone is insufficient. Many potential participants are logistically or medically unable to travel, with medically fragile individuals often facing significant health risks that preclude them from trial opportunities.

Enhancing Diversity and Inclusion

As we confront the logistical barriers that prevent broad participation in clinical trials, it’s equally vital to address the significant underrepresentation of minority communities, which impacts the efficacy and equity of medical research. Currently, minority communities are significantly underrepresented, partly due to barriers like limited access and deep-seated mistrust. For instance, a study from the University of Alabama at Birmingham revealed that minorities make up fewer than 10% of participants in cancer clinical trials.

Technology can help solve these problems by improving access to healthcare interventions and empowering communities to take an active role in their own healthcare decisions. Including a wide range of participants—different races, ethnicities, geographies, and socioeconomic backgrounds—enables researchers to better understand how medical treatments work across diverse groups. This insight is essential for tailoring healthcare to individual needs, influenced by genetics, environmental factors, and cultural practices. 

Addressing these issues requires infrastructural changes to support the participation of underserved populations. This includes collaboration between community members, healthcare providers, pharmaceutical companies, and governmental bodies to create a more inclusive environment. For example, appointing a health director in marginalized communities, who is linked to physicians in larger medical centers, could help with recruitment, promotion, and the logistics of participating in clinical trials that would otherwise seem impossible.

Furthermore, it’s important to acknowledge the historical reasons for mistrust towards clinical research among certain groups, such as Indigenous people, African Americans, and Jewish communities, due to unethical past research practices. Before implementing diversity, equity, and inclusion plans, sponsors must collaborate with research coordinators and local health directors to understand and address the unique cultural sensitivities of these groups. Providing culturally sensitive information and building trust can significantly enhance participation from these communities in clinical trials, leading to more inclusive and effective healthcare solutions.

The Role of Technology 

Data management platforms and interoperable technology solutions are revolutionizing the health system, making clinical trials more accessible and inclusive. These technologies streamline data collection, enhance accuracy, and enable real-time collaboration among researchers and medical professionals no matter where they’re located.

Predictive analytics and AI-driven tools have already proven to be particularly transformative. They help in recruiting participants by analyzing complex data sets and understanding patient needs and preferences more deeply. Remote monitoring technologies also play a crucial role by minimizing the need for in-person visits, which makes trial participation more feasible for those in remote locations. Additionally, AI-powered virtual assistants offer support to participants throughout the trial, accommodating various languages and geographical challenges.

Furthermore, the integration of connectivity and AI-driven platforms not only reduces the costs associated with clinical trials but also speeds up the process, enhancing both scalability and sustainability. This shift is pivotal as it ensures that healthcare innovations reach a broader audience and more accurately reflect the needs of diverse communities. This technological evolution underscores the essential role of advanced connectivity in reshaping the landscape of medical research.

Enhancing Equity through Connectivity 

Geographical, cultural, and socioeconomic barriers don’t just perpetuate healthcare disparities, they also challenge the accuracy of clinical trial research. Interoperable data management platforms enhance connectivity between small medical clinics and trial sponsors that previously relied predominantly on larger medical centers. This connectivity reduces the necessity for travel, easing the participation burden for prospective participants.

Additionally, they significantly reduce the workload of the sites. By lowering the bar of smaller sites to participate in trials, these systems make clinical trials more feasible for smaller sites, which in turn makes clinical trials more accessible for patients located in rural areas, smaller urban settings, or under-represented communities.

These platforms play a crucial role in advancing health equity by ensuring that underrepresented populations gain access to clinical trials. This is vital for improving access to potentially life-saving treatments for more patients. Moreover, by drawing on a more diverse pool of participants, these platforms help produce more representative and reliable research outcomes. Utilizing technology to dismantle barriers in clinical trial research fosters greater health equity and accessibility, making sure that medical solutions are appropriate for all people, and that no one is excluded from critical advancements in healthcare.


About Gav Martell

Gav Martell is the VP of Business Development and Co-founder of Yonalink. Gav orchestrates strategic initiatives aimed at engaging and guiding potential clients through the journey from prospect to partner. He excels in introducing new enterprise solutions within heavily regulated sectors and has an impressive track record of operational leadership across various industries.