From Funnel to System: How the PXO Model Turns Patient Trust into Trial Success
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?
Fixing the Friction in Trial Enrollment: From Persuasion to Activation
By John Seaner
Fixing the Friction in Trial Enrollment:
From Persuasion to Activation
Why do so many patients say “no” to clinical trials?
As our recent webinar made clear, the problem isn’t patient unwillingness–it’s design.
Most people are open to research (70%), but we’ve made saying “yes” too hard.
Clinical Study Success Hinges on Choice
Throughout the clinical trial journey, patients make many choices.
The choice to enroll.
The choice to engage.
The choice to stay.
Therefore, the path to success is through choice architecture + patient activation: applying behavioral science, health literacy, and human-centered design so that enrollment feels clear, safe, and actionable.
Don’t persuade harder– design smarter.
Traditional recruitment pushes more messages, more calls, more ads. A Patient Experience Organization (PXO).approach flips the script: reduce cognitive load, lower decision investment, and build confidence and agency. When we design for how humans actually make choices, they are empowered to say “yes.”
What Drives "Yes"
Patients rarely decline clinical trial participation for one reason–it’s death by a thousand frictions: confusion, fear, overload, and inertia. In our live poll, fear topped the list. And the antidote for fear isn’t more facts–its trust, built through:
Simplification: Plain-language, stepwise experiences (think “TurboTax for consent”) with interactive, modular education.
Choice Architecture: Anchoring, framing, helpful defaults, and social proof (“others like you have participated”)
Human Signals: Real patient stories, authentic imagery, and tactile/digital micro-interactions that reduce cognitive load and boost trust
Care Circle Inclusion: Equip caregivers and site staff with clear tools and scripts so everyone feels prepared.
Measure What Matters: Activation, Not Just Enrollment
Lagging indicators (e.g. randomized counts) don’t tell the whole story. We advocated for composit indexes and early signals to measure things like confidence, comprehension, trust, burden and clarity:
- Experience Index: Recruitment measurement
- Activation Index: Enrollment measurement
- Engagement Index: Retention measurement
Add micro-checks across the journey (quick confidence/comprehension pulses) and use AI where appropriate to detect and resolve friction before it becomes dropout. 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: Make it Fast and Practical
You don’t need to overhaul everything to see impact:
- Start small: Upgrade consent, add social proof, and introduce default “next best steps.”
- Scale smart: Build multi-layered libraries (portfolio>disease>study) so high-quality, behaviorally informed assets are ready on day one.
- Enable sites: Provide reusable scripts, tools, and engagement cadences that sustain participation–not just at enrollment, but all the way through retention.
- Co-create with communities: Tailor content by age, culture, language, and context and deliver through channels they already trust
Missed the live webinar?