Unresponsive Clinical Trial Sites: Why Ghosting Happens (and How to Fix It)

It’s a familiar story in clinical research: a referral comes through, the patient looks like a strong candidate, the sponsor is excited...and then things stall. The patient waits for a call, the site gets buried in competing priorities, and the opportunity quietly fades away. In the world of trials, this kind of “ghosting” isn’t just awkward, it’s costly. 

When I was a CRC at a research site, I saw this time and time again. News flash: it’s not because they are lazy or incompetent. So why does it happen, and more importantly, what can we do about it? 

Why Sites Go Quiet

1. Staff Overload 

Coordinators often juggle multiple studies, hundreds of emails, and too many administrative tasks. Even with the best intentions, patient outreach can fall to the bottom of the list. 

2. Communication Gaps 

Important emails may land in spam folders. The rest get buried into the flow of all other emails. Phone tag is a killer. Staff, CRO and Sponsor turnover create wild goose chases. Responsibilities between site staff aren’t always crystal clear. It’s easy for a small gap to quickly snowball into a missed connection. 

3. Screening Roadblocks 

When prescreening turns into an obstacle course, outreach gets stuck at the starting line. Sites wait for a “perfect time” to jump in... but spoiler: it never shows up. 

 What are the most common roadblocks? 

• Manual tracker overload: Too many separate spreadsheets, platforms, and trackers cause delays and confusion. 
• The passing of the baton: When it is unclear who should make the first move and where the handoffs are, teams stall and outreach is left in limbo. 
• Data bottlenecks: Coordinators wait for complete labs or medical records before engaging, causing missed opportunities to start early conversations with participants. (This can be automated, by the way!) 

4. Competing Studies 

With several trials running at once, sites always focus on the ones that feel more manageable, pressing or profitable. Pro tip: Highly organized studies are more profitable to sites as they are about to run each visit and manage the study overall with greater efficiency. 

The Ripple Effects

When sites go unresponsive, it impacts everyone: 

• Patients disengage when they don’t hear back promptly or don’t have control over scheduling a future touchpoint. 
• Recruitment milestones slip, putting trials behind schedule and creating even more work to get things back on track. 
• Site-Sponsor-CRO relationships strain, as follow-up emails pile up and the blame game begins. 

Think of it this way: silence is like putting your trial in airplane mode and then later having it blow up with all sorts of pings and alerts when you land. 

A Lesson from the Outside: Pitching a Friend 

It all starts with the protocol. Recently, I pitched a friend at a pitch-a-friend event, where the challenge was to make them “marketable” to a wider audience. Think Shark Tank, but for dating. The task was simple: show the crowd why my friend is a “catch” and make everyone want to meet him. I didn’t do that by writing a 10,000-word biography and reading it word for word. I made the presentation simple and easy to understand. 

It turns out, making a clinical trial appealing to sites is not that different. If you hand a site a confusing, 200-page protocol with half a dozen other manuals, 12 prescreening steps and a partridge in a pear tree, you’re basically saying: “Trust me, they’re great once you get to know them.” Not exactly a winning pitch. 

But when you simplify the complex by highlighting the benefits, organizing the information and 3rd party tech, and putting it all into a one stop shop platform, it makes the “ask” easy and sites are far more likely to engage. In other words: less awkward dating profile, more polished LinkedIn intro. 

Practical Fixes that Work

The good news? Unresponsiveness doesn’t have to be part of the process. With the right support, sites can eliminate delays and relax into smooth, reliable workflows. 

1. Scheduling Support 

Automating or outsourcing first outreach to Site Scheduling Services keeps referrals from falling through the cracks. Confirm eligibility, establish availability, and effortlessly hand off patients who are ready for the next step. 

2. Streamlined Communication Tools 

Referral dashboards, automated alerts, and real-time updates keep everyone on the same page and prevent important leads from getting lost. 

3. Smarter Prescreening, Pay for Performance 

When critical eligibility checks happen earlier, and central campaigns are under a pay for performance model, site staff only receive patients who are a much better match, saving time and effort. 

4. Ongoing Engagement 

Automate regular check-ins and feedback. Setting clear expectations, measuring engagement, and recognizing site performance can create accountability without adding pressure. 

Turning Silence into Success

Just like pitching a friend, site engagement is all about the packaging: When you highlight the good stuff, simplify the overwhelming details, and deliver a well-organized study, you make it easy for the site to say “yes,” which translates to the patient. 

By reducing the noise, lightening the load, and making the “pitch” to sites compelling, everyone wins: patients get connected to care faster, sites stay engaged, and trials move forward on schedule. 

At ProofPilot, we are here to help make sure your trial isn’t the one left on “read.”