By John Seaner
From Funnel to System: How the PXO Model Turns Patient Trust into Trial Success
Clinical trials don’t fail because patients don’t care. They stall because patients don’t trust, don’t understand, or don’t see themselves in the process.
That was the central message of our latest webinar, where the Jumo Health team introduced the Patient Experience Organization (PXO) model–a concrete, system-level approach to designing trust into the clinical trial journey.
The big reframe: Trust–not attention–is the key to success
Awareness lights up dashboards but clicks do not equal commitment. The real drop-off happens between attention and action—right at the moment where trust breaks. Traditional recruitment approaches are built around funnels. They try to push more patients into the top of the funnel and hope that leads to higher enrollment. The PXO approach builds a system that orchestrates patients, caregivers, sites, HCPs, and sponsors around a unified experience.
What changes with PXO:
- From media quantity → to experience quality
- From medical eligibility only → to medical + behavioral eligibility
- From persuasion → to activation (lower decision investment; make “yes” the natural choice)
- From lagging metrics → to leading indicators and experience indexes
Recruitment is not a campaign; enrollment is not a transaction; retention is not a reminder.
Our PX Model Reimagines Trials as Patient-Centered Systems
The five-pillar PXO system is a closed, adaptive loop–a flywheel that learns. Each pillar informs the next.
Uncover:
Fuse medical eligibility with behavioral/SDOH/operational reality (distance to site, transportation, caregiver logistics, literacy). Map where trust is most likely to break.
Discover:
Identify what different patient archetypes and stakeholders need to decide and capture why they hesitate so you can resolve the right frictions.
Design:
Turn touch points into trust points with plain language, modular/visual consent, micro-interactions that signal safety and belonging, and social proof (“people like me”). Use choice architecture ethically: framing, anchoring, defaults, nudges.
Deliver: Orchestrate a shared narrative consistently across relevant channels–sites, HCPs, advocacy, and digital.
Measure:
Add leading indicators (pre-screen completion, abandonment, time from first touch to consent) and composite experience indexes (confidence, comprehension, trust, clarity, burden) to catch issues early.
Where trust breaks first (and how to fix it)
Pre-screening & consent are the most fragile moments. That’s where fear and complexity collide. The panel highlighted practical moves that consistently reduce friction:
Make consent a conversation, not a contract. Swap pages of dense, legal jargon for interactive, modular, visual flows (think “TurboTax for consent”). Add micro-learning and teach-back moments to confirm comprehension.
Explain eligibility–fairly. If patients don’t qualify, tell them why in plain language, and route them to alternatives. Fairness becomes an emotional anchor.
Embed social proof at decision points. Real patient stories (“In My Shoes” videos) placed in email sequences and pre-screen flows measurably increase next-step actions.
Equip sites as experience makers. Give concise scripts, artifacts, and “watch-outs” for predictable drop-offs; provide a site playbook so nothing is left to change.
Measure What Matters: Leading Indicators and Composite Indexes
Lagging KPIs (e.g. randomized counts, screen fail rates) tell you what happened–too late to intervene. PXO layers in leading indicators and composite indexes that tell you where and why trust is eroding:
- Confidence & Comprehension: quick pulses/teach-back scores in consent process
- Trust: Composite from micro-signals (engagement depth, caregiver involvement, silence after consent)
- Burden & Clarity: time-to-complete pre-screen, drop-off heat maps, question patterns
- Engagement: adherence cues, early disengagement signals, cadence responsiveness
Consider both qualitative and quantitative metrics. The emotional connection through impactful storytelling is often what unlocks measurable success. Site, patient and caregiver experience feedback can also be a valuable indicator.
Conclusion: PXO Reframes The Patient Journey
Design for human decision-making first, and enrollment, retention and diverse representation will follow.
- Rewrite your consent experience: Modular, visual, with comprehension checks and “what to expect” mini-journeys.
- Add social proof where decisions happen: Short patient story videos or caregiver testimonials on registration landing pages.
- Act on silence: Treat lack of response after consent handoff as a red flag; empower sites with a playbook for outreach.
- Start a reusable library. Build portfolio + disease + study-level assets to make a PXO approach fast and scaleable
Missed the live webinar?
