Begin With The End in Mind: Research Site Vision for the Structure, Management, and Implementation of ClinCard
Steven Covey famously advised, “Begin with the End in Mind” when planning a complex project in his popular book, “7 Habits of Highly Effective People”. This notion has served me well throughout my career. My Department of Medicine, Vice Chair for Finance would always lead work group discussions by pausing to say, let’s begin with the end in mind. The group would then brainstorm regarding important outcomes envisioned for the project. Specifically, what new benefits do we want to unlock for faculty and staff once the project is completed?
As I begin my third year working at Greenphire, I’ve seen how ~ 100 academic medical centers, universities, and hospitals have structured their ClinCard management. I contrast these structures with how my former academic medical center configured our ClinCard Program (within our NIH CTSA infrastructure) and the rationale for doing so.
Across academia and large hospitals, I see two common structures for patient payment programs: a Finance Office or a Hybrid (Finance and Research Office) shared management model. Both structures have demonstrated effectiveness, but to evaluate which model is best, I recommend that institutional leadership begin with the end in mind.
This process requires consideration of three important areas:
1) alignment and co-location of clinical trial services;
2) agreement on “ownership” of the program; and
3) policies for ensuring optimal financial controls and bi-directional communication (between the ClinCard administrators and the departmental users).
Alignment and Co-Location of Clinical Trial Services
The new dynamics occurring in clinical trials today toward the shift to become fully digital (EMR, CTMS, IC, EDC, Tele-visits) have created many new systems and processes. Given this backdrop, I ask prospective clients at the outset to describe their institution’s current status with these technologies and location of their major clinical research support services (e.g., budgeting, regulatory, billing assistance, etc.). Are these services purposely centralized to support all departments (or, is there a leadership vision to create such centralized support in the future)? If the answer is yes, I encourage universities to co-locate ClinCard management as a complement to one of these units centrally.
Alternatively, if an institution’s clinical research support activities are more decentralized, and the Office of Finance prefers to “fully own” control over participant payments and 1099 tax accounting, the decision can be made to manage ClinCard within the Central Finance Office.
Ownership of ClinCard Management
Regardless of the structure chosen, it’s critical ClinCard administrators maintain not just day-to-day management but also the responsibilities of communication, training, and onboarding of users. A key responsibility initially is for institutional leadership to:
- Define the scope of all departments that will use the ClinCard; and
- Develop the sequential plan for “enterprise” adoption across all departments.
A best practice is to identify departments that will lead the way as “early adopters” and specify the timeline for all departments, schools, centers, and institutes to follow once the early adopters have launched with workflows and SOPs in place.
An essential best practice to support enterprise adoption is to create an online resource center for your institution to contain all important documents, such as:
Summary of the ClinCard Program and Goals
- ClinCard Access Request Form/Process
- ClinCard Discontinue Access Request Form/Process
Training Materials – Webinars and Other Recordings
- ClinCard Univ Webinars
GP Support Link
ClinCard Reports Overview
- Univ-based Support Email
- Greenphire Support Form
Bi-Directional Communication and Financial Controls
One of the key reasons institutions choose ClinCard is to ensure streamlined financial compliance with payments, grant reconciliation, and 1099 reporting. A key to success in this area is to ensure SOPs and policies are part of user access, training, and ongoing management. ClinCard provides the unique opportunity to centralize these accounting activities so all users are familiar with the commonly used ClinCard Reports and accounting workflows across the Program.
If institutions thoughtfully address the three areas above (Alignment, Ownership and Communication) as they are thinking about leveraging a more efficient participant payment platform with ClinCard, they will benefit by beginning with the end in mind. I’m happy to guide you through this thought process and any questions! Please reach out to me: firstname.lastname@example.org or learn more about ClinCard here.
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