First-patient-in to last-patient-in, with every site's funnel in view

What does a day of enrollment delay cost a sponsor?

Tufts CSDD re-estimated the value of a delay day in an August 2024 white paper, in 2023 dollars, and called the long-quoted $4 to 5 million a day a gross misestimation.^⁠[1]

Tufts CSDD reported in 2013 that 89% of trials eventually met their enrollment goals, typically by nearly doubling the original timeline.^⁠[2] Of 2,579 Phase 2 and 3 trials closed in 2011, 19% were terminated for failed accrual or finished below 85% of their enrollment target.^⁠[3]

How unevenly do selected sites enroll?

In that 2013 Tufts CSDD analysis of more than 150 studies and nearly 16,000 sites, 11% of sites in a typical trial enrolled no patients, 37% under-enrolled, 39% met their target and 13% exceeded it.^⁠[2] Presenting Tufts CSDD data at the 2024 SCOPE Summit, Ken Getz said about 40% of the North American sites a sponsor looks to engage will not activate, with contracting, budgets and IRB approval among the reasons.^⁠[4]

In WCG's 2025 survey of 611 sites, 28% named recruitment and retention a top challenge, down from 36% in 2024, and 41% said expanded recruitment and retention services were a top priority for sponsors to address.^⁠[5] Bond does not fix contracting or activation delays. At an active site, it takes on the chart search and first contact that compete for coordinator time. After enrollment, the same voice and SMS agents send visit reminders, book transportation, collect symptoms and diaries, run side-effect check-ins and flag participants at risk of dropping out.^⁠[13]

Can EHR data check a site's feasibility estimate?

Site feasibility usually means a questionnaire and often a site visit, and sites are typically not paid for the work. A 2024 task force paper, extrapolating from an ASCO oncology survey, put the industry-wide scale of feasibility burden and inefficiency at $1.6 billion.^⁠[6]

At a site already connected to Bond, Identify runs the protocol's criteria over structured and unstructured records and shows the chart evidence for each match.^⁠[11] Bond runs feasibility from the same EHR screening, giving eligible-patient counts for a protocol backed by the chart evidence behind each match.^⁠[13] The count comes from the chart, not from a coordinator's estimate. Diagnosis codes alone map little of the language criteria use. In Bond's own analysis of 51,055 eligibility criteria from ClinicalTrials.gov, ICD-10-CM alone resolved at least one exact multi-token concept in 5.7% of criteria, against 82.0% for Bond's terminology graph.^⁠[12]

• Same logic at every site. Each site runs the same configured criteria, so differences in matched counts are less likely to come from how each site counted.
• Known limits. Counts exist only where Bond is connected to the EHR, depend on what each site documents, and miss criteria that are not in the chart, such as willingness to take part. The feasibility questionnaire template and the guide to how sponsors choose sites cover the rest.

What changes at each site day to day?

Site staff keep the decisions: they review matches, take escalations and obtain consent.^⁠[11]

1. 1

   Identify

   LLM-based screening reads structured fields and notes against each criterion, ranks candidates and shows the evidence behind each decision. Coordinators review a ranked list instead of building one by hand.

2. 2

   Engage

   Engage runs voice and text outreach, pre-screening and scheduling with scripts configured per site and study. Patients are told AI assistance is used and can reach a person at any time: the agent transfers the call live to a coordinator or books a human callback, whichever the site prefers.^⁠[11],[13]

3. 3

   Consent

   Consent support explains the study in plain language, answers patient questions, supports comprehension and escalates to staff. The investigator and delegated staff still obtain consent.

Bond can also set up Meta and Google ad campaigns for your study across the sites it supports.^⁠[13] Leads from those ads flow straight into the same voice and text agents that pre-screen and schedule patients found in each site's EHR.^⁠[13]

How does EHR screening relate to a Diversity Action Plan?

FDORA, enacted in December 2022, requires sponsors to submit a Diversity Action Plan for Phase 3 and other pivotal drug studies and certain device studies, with enrollment goals broken down by race, ethnicity, sex and age group. The requirement applies to studies that begin enrollment more than 180 days after FDA publishes final guidance.^⁠[7] As of September 2026, FDA's guidance page still lists the June 2024 guidance as a draft.^⁠[8]

Who gets asked shapes who enrolls. In the 2020 HINTS survey, 9% of US adults had ever been invited to join a clinical trial, and 47% of those invited took part. Rural adults had about a third of the odds of urban adults of being invited.^⁠[9]

Bond screens the connected EHR population against the criteria, not only referrals, but which populations get screened still depends on the sites you select. See Bond for FQHCs and community sites.

What will you see reported across your sites?

Bond reports the same funnel at every site: patients matched, contacted, pre-screened, consented and randomized, plus time to enrollment, matching accuracy, screen-failure signals and coordinator hours saved.^⁠[11] Bond counts a patient as enrolled once randomized, the count that sets last-patient-in.

Stage counts show where a site is stuck: few matches point at the criteria or population, matches without contacts at review or outreach, pre-screens without consents at scheduling or the consent discussion, and consents without randomizations at screen failures.

What does deployment ask of the sponsor and its sites?

Bond deploys at the sites you select. Each site signs a business associate agreement, completes a security review, connects its EHR, configures criteria and scripts with Bond, and submits outreach scripts to its IRB where required. Full EHR integration typically takes 48 hours per site, depending on the EHR, IT review and interface method.^⁠[11] See implementation and security.

• Pick the first studies and sites, starting where enrollment risk is highest.
• Share how your medical team reads ambiguous criteria, such as lookback windows and lab cutoffs, so every site configures them the same way.
• Agree funnel definitions and a reporting cadence before the first site goes live.
• Start Bond setup during site start-up, not after activation.

Activation is not enrollment. In CRIO's July 2026 start-up benchmarks, measured by study, the median time from site activation to first patient visit screened was 20 days, with quartile values of 8 and 34 days.^⁠[10] Configuring screening during start-up lets it begin at activation.

Engage connects to the site's calendar, CTMS or a Google Sheet for scheduling and hand-off, and Bond is a CRIO Certified Partner.^⁠[11]

How does pricing line up with what a sponsor pays for?

Bond uses two-part pricing. A volume-based platform fee covers EHR integration, implementation and ongoing operation: the EHR connection, security review and audit logging setup, workflow configuration and ongoing support. There is no separate integration fee. A success fee is charged per enrolled patient, meaning randomized, and per-visit milestones can be added.^⁠[11] The variable part tracks the same randomized count your reports show, not calls placed or leads passed. Pricing is custom; see pricing.