How To Pick The Perfect ePRO/eCOA For Your Trial (And Everyone In It)

By Naomi Naik, principal strategist, Better Said

Clinical trials don’t fail because the tech isn’t shiny enough; they fail when the tech doesn’t work for the people using it. Sponsors are under pressure to move faster, cut costs, and generate cleaner data, which makes technology look like an easy fix. But when the wrong system is chosen, it doesn’t just frustrate patients and sites. It threatens recruitment, retention, and data integrity.

Choosing the right ePRO/eCOA platform isn’t about comparing feature lists. It’s about asking: Will this work for patients, for sites, and for the trial as a whole? Here’s a practical, field-tested framework for getting that decision right.

Start With The Why, Not The Widget

Before sitting through demos, get clear on what your trial truly needs. I once worked with a sponsor who got sold on a platform’s slick dashboards and real-time visualizations. The vendor showed beautiful demo charts of how data could be sliced by region, site, and demographic group, which impressed leadership. But no one asked whether the tool could actually capture the specific PRO instrument required for the study. Six months later, the operations team realized the platform couldn’t support that validated questionnaire out of the box. By then, patients were already enrolled, and the workaround involved layering in a second vendor, which proved costly and confusing for sites.

The miss happened because procurement and leadership drove the decision without looping in medical affairs and site operations early enough. Having those voices at the table from the start — especially the people closest to endpoint selection and patient burden — would have flagged the gap right away. A good rule of thumb: Before you ever see a demo, make sure protocol designers, medical monitors, and site reps have aligned on the must-haves.

Make It Patient-Proof

If patients can’t (or won’t) use the platform, the cleanest protocol in the world won’t save your data. In one rare disease trial, we knew from patient advocacy groups that a significant portion of participants were native Spanish and Portuguese speakers. The original interface was only in English, which created a real barrier to daily compliance. By adding simplified versions of the tool in Spanish and Portuguese, and stripping out some overly technical language, we saw compliance climb by nearly 20%.

The lesson was clear: Usability isn’t a bonus; it’s a driver of data quality. The best way to get there is by asking questions up front about who your patients are: their languages, tech comfort, and daily realities. Then design the tool around that, not the other way around. Involving advocacy groups, caregivers, or even a handful of potential patients early can surface barriers you might otherwise miss.

Keep The Sites Onside

The most patient-friendly platform will still flop if sites find it a burden. In one study, the tool’s success came down to one thing: coordinators didn’t need new logins or extra data entry steps. Site staff are pressed for time, and if a tool adds even 15 minutes of work, adoption drops.

That’s why site input needs to happen before contracts are signed, not after. Too often, sponsors bring sites in only once implementation has started. By then, it’s too late to course-correct. The best practice I’ve seen is to pilot with a handful of sites during the vendor evaluation stage, even if it’s just a sandbox demo. Their feedback will tell you quickly whether the platform fits the realities of clinic workflows. It also builds site buy-in; when staff feel heard, they’re more likely to champion the tool during rollout.

Interrogate The Sales Pitch

Shiny demos rarely show what happens when things break. In one trial, a vendor promised 24/7 support, but when a server outage hit, it took three days to restore syncing, and critical patient data was lost.

That’s why I always push teams to ask specific questions, not just “Do you have support?” Try:

• What’s your average response time when a site or patient calls with an issue?
• Do you have an offline capture mode if connectivity fails?
• How quickly do you release updates when regulatory requirements change?
• Can you share real-world examples of how you handled a system outage or data error?
• What training do you provide for sites, and is it available on demand?

If the answers are vague or all glossy marketing language, that’s a red flag. The best vendors are transparent about past issues and how they solved them.

Learn From Other People’s Headaches

I’ve seen small oversights cause big headaches. In one trial, a platform rolled out at the start of enrollment and seemed fine, until patients with older Android phones tried to download the app. Within two weeks, nearly 40% of participants couldn’t log data consistently. The sponsor had to scramble to supply compatible devices, adding cost and delays.

In another study, the daily symptom diary wasn’t just long, it was clunky. The questionnaire itself was lengthy, but the app design made it worse: Every question required scrolling and multiple taps. What should have taken 5 minutes stretched into 20, and patients quietly disengaged. Dropout rates rose, not because patients didn’t care but because the burden felt unreasonable.

Both situations could have been avoided with up-front usability testing. That means not just asking whether the content is valid but putting the platform in the hands of real users, on real devices, in the real world.

The “Right Fit” Checklist

When evaluating vendors, use a simple framework:

• Does it support our endpoints and goals?
• Can patients of all backgrounds realistically use it?
• Does it fit into site workflows without friction?
• What happens when it breaks, and how fast is support?
• Is it scalable and compliant with regulations?

These five questions sound basic, but you’d be surprised how often they’re skipped. Build them into your RFP process, and you’ll surface weaknesses before they derail your trial.

Final Thoughts

Choosing ePRO/eCOA tech isn’t about chasing the latest bells and whistles — it’s about finding tools that respect the lived reality of patients and sites while meeting trial rigor. When selection is done right, you don’t just get cleaner data. You get better enrollment, stronger retention, fewer costly delays, and ultimately, more credible outcomes.

The stakes are high. Every glitch adds burden to patients who are already making sacrifices, and every inefficiency risks exhausting site staff. Technology should reduce that burden, not add to it. The right platform does more than collect data — it helps trials run smoother, faster, and more equitably.

And in today’s competitive trial environment, that’s the kind of success no demo reel alone can promise.

About The Author:

Naomi Naik is the founder and principal strategist of Better Said, a consultancy specializing in brand and marketing strategy, storytelling, and communications for mission-driven companies in healthcare and technology. She previously served as an associate director on FGS Global’s Health team, where she advised biopharma, health tech, and nonprofit clients on complex communications challenges.

Earlier in her career, Naomi was a senior communications associate at Luminary Labs, leading digital strategy and risk management projects for federal agencies — including ARPA-H, CDC, U.S. Department of Education, HHS, and VA — as well as for pharmaceutical clients, such as Pfizer and Roche. Naomi holds an MBA from the Quantic School of Business & Technology, an MPH from George Washington University, and dual undergraduate degrees in biology and English.