Karen Hultberg was frustrated. The administrator of the New York Hospital Queens' Lang Research Center was trying to do more studies. But there was a big obstacle: for each research subject's check, she had make a separate request to the hospital's finance department.

Each check—typically for $25 or $50—took one to three months to obtain and mail. So if a study participant had to come in for 16 visits, that meant 16 check requests, then 16 checks mailed to the subject. Eventually. Long after the visit. That's a lot of time, paper, frustration and embarrassment.

“It's just so large here, and checks had to go through layers and layers of people,” Hultberg explains. “Sometimes patients had been seen three times and they'd still be waiting for the check from their first visit.”

Red Tape

It was beyond cumbersome and inconvenient, and it was no way to engender good word of mouth in the community of potential subjects while the research site was trying to grow. Cash? Not safe. “That would have been way too much of a risk; people around here get their offices broken into,” she says.

The answer? Hultberg found it while wandering around the Site Solutions Summit, an annual meeting for principal investigators and other high-level stakeholders at sites. She spotted a booth touting a debit card. Each time the patient came back for another visit, more money could be electronically loaded on their card. Hultberg was ready to try anything.

Flash forward a few months. Now, things are greatly sped up at the Lang Research Center, where the number of studies done each year has doubled and so has the number of subjects coming through the doors. Every quarter or so, Hultberg or her staff estimates how many patient visits are expected. Then they estimate the total amount of patient stipends and request a check for that amount. Say, $5,000 maybe. When it comes, they route the money to Payoneer, which puts it into the center's account.

When a study patient completes a trial visit, a Lang Center staff member goes online, types in the code number on the subject's card, and voila!—payment is automatically loaded onto the subject's debit card.

Audit Trail

“It's a lot less paper, a lot fewer phone calls and begging and pleading and waiting,” says Hultberg. “It saves us time and aggravation and it's a real selling point to the participants. It's helping with retention. It's just not good faith to say, 'Can you wait for a few months to be paid?'” Plus, it leaves a nice paper trail—well, a digital record—that pleases the hospital's finance department.

Hultberg says the Lang Center has also been using the cards when it takes too long to get checks cut for study marketing materials. “Instead of having to wait a month to start doing marketing for a study, we'll issue ourselves a card, put $600 on it, go to Kinko's and get all the materials made, then send the receipt to the sponsor,” she says.

Payoneer's system has worked without any glitches. No patients have ever claimed promised funds were missing from a card. The cards are far more convenient for patients, too. Many are sick and/or elderly, and had reported that taking their checks to the bank was, at the very least, a hassle, and at most, painful. “They are now loving that they can just take their card and go to the market and buy groceries,” says Hultberg.

She views the cards as way to attract and retain patients. At times, the center will issue cards to people participating in a study that doesn't stipulate that patients get a stipend. But if the research participants have come from long distances, or parts of New York poorly served by mass transit, Hultberg will give them one anyway.

'One Less Thing'

Payoneer was founded in 2005, and provides pre-paid cards to many companies that work with independent contractors, freelancers or anyone who's not on an official payroll. Other Payoneer clients in the clinical research world are United BioSource, Bradenton Research and RXTrials.

“There are a lot of different aspects to clinical research," says Hultberg. "When you first get started, you don't understand all the regulatory, the shipping. Getting the stipend to the patient is another aspect. Now, for us, it's streamlined, and for that I'm grateful. It's one less thing I have to worry about.” Another financial firm with clinical trial payment solutions is Greenphire, which ClinPage profiled in this 2009 article.

by Suz Redfearn