Digital Health Off The Record

Farrell Healion and Edwin Cohen

Digital Health Off The Record is your unfiltered take on clinical technology and the future of trials. Hosted by Farrell Healion and Edwin Cohen, we explore the trends, tensions and breakthroughs shaping digital health today. Expect open, informal conversations, practical insights and honest perspectives from leaders across the ecosystem. No scripts, no spin, just real dialogue about what is working, what is not, and what comes next.

Episodes

  1. Jul 14

    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 - 01:13How patient outreach and access have evolved - 04:04Why sites remain central to recruitment success - 13:20Understanding site performance and where to focus - 17:26The cost of recruitment and different pricing models - 20:10How AI is changing patient identification and engagement - 26:04Digital twins, synthetic controls and the future of trials - 30:24Designing trials for patients, not around them - 34:00Ross leaves us with a simple but powerful principle: design every trial as though it were for you or someone you love.

  2. Jun 16

    Patient Voice in Clinical Trial Design: Recruitment, Retention and Real-World Burden

    Patient centricity is not a new topic in clinical trials, but it is one the industry still needs to keep coming back to. In this episode of Digital Health Off the Record, Farrell Healion and Edwin Cohen explore why incorporating patient voice earlier in study design can make a real difference to recruitment, retention and the overall patient experience. We discuss how patient input can help reduce unnecessary burden, improve protocol design, support more meaningful inclusion criteria and make trials work better around real life. We also look at where digital health technologies, DCT capabilities, patient feedback tools and patient engagement roles can help - and where simply adding more technology risks creating the opposite effect. As always, this is an honest conversation about what the industry is getting right, where we still fall short and how we can design better trials for patients, sites and sponsors. In this episode, we cover: Why patient voice matters for recruitment, retention and study success 00:25How earlier patient input can improve protocol design and reduce burden 03:50Designing trials around real-world patient needs, diversity and access 05:46The role of DCTs, digital tools and patient feedback in improving the trial experience 12:55Why patient centricity still struggles to stick in practice 21:10Balancing standardisation with meaningful flexibility in global trials 25:26

  3. May 19

    eCOA in Clinical Trials: Why Implementation Still Makes or Breaks Digital Patient Data

    eCOA has been part of clinical trials for decades, but it still has not reached its full potential. In this episode of Digital Health Off the Record, Farrell and Edwin go back to basics on electronic clinical outcome assessments - what eCOA actually covers, how it differs from eDiaries and remote patient monitoring, and why it is about much more than just ePRO. They also get into the practical side of eCOA implementation, including why paper still appears in study discussions, where hidden costs and data integrity risks come from, and how better planning can remove licensing, translations, submissions and device strategy from the critical path. We cover: What eCOA means across ePRO, ClinRO, ObsRO and PerfO [01:20]How eCOA can support primary and secondary endpoints [03:46]Why eDiaries and remote patient monitoring are related, but not the same thing [04:34]The history of eCOA and the move from paper to digital [06:17]The real cost comparison between paper and digital data capture [07:48]“Parking lot syndrome” and why timestamps matter [09:33]BYOD vs provisioned devices, including patient preference and reimbursement [11:10]Sustainability considerations for study devices [15:43]Why eCOA implementation often goes wrong [17:37]Why licensing, translations and submissions can delay study start-up [18:10]China-specific implementation considerations [21:00]Accessibility, caregiver support and assisted completion [23:53]Why paper introduces more risk than many teams realise [25:35]Ultimately, eCOA is not just a technology choice. It is an implementation, data quality and patient experience decision.

  4. Mar 2

    Digital Health Off The Record Ep 2 - Impact on Site Burden

    In Episode 2 of Digital Health Off The Record, we turn the spotlight onto one of the biggest tensions in modern clinical trials: site burden. Digital health technologies promise efficiency, better data, and improved patient experiences. But what does it actually feel like on the ground for sites? Are we reducing burden, or simply shifting it? From device overload and fragmented systems to duplicate data entry and endless training refreshers, we unpack the operational reality facing site teams today. With studies now involving 20 plus systems on average, increasing datapoint complexity, and shrinking timelines to first patient in, something has to give. We explore: Why more technology does not automatically mean more efficiency The hidden operational layer driving much of the burden How data overload is affecting clinicians and study teams It is not all bad news. Real time data, improved data integrity, decentralized models and better patient engagement are shifting the industry forward. But are we designing studies with a digital first mindset, or just layering innovation on top of legacy processes? We also debate what “good” could look like. From cohesive site journey design and centralized training models to the potential of AI co-pilots and connected flows, what would actually make life easier for sites? Expect candid reflections, practical examples and honest perspectives on what needs to change if we want digital health to deliver on its promise without overwhelming the people running our trials. Let us know your experiences. Are digital tools reducing burden at your site, or adding to it?

About

Digital Health Off The Record is your unfiltered take on clinical technology and the future of trials. Hosted by Farrell Healion and Edwin Cohen, we explore the trends, tensions and breakthroughs shaping digital health today. Expect open, informal conversations, practical insights and honest perspectives from leaders across the ecosystem. No scripts, no spin, just real dialogue about what is working, what is not, and what comes next.