Clinical trial recruitment is notoriously difficult, and nowhere is this more acute than at the referral stage. When a participant who looks potentially eligible is referred by a patient advocacy group, HCP, or site, it is not uncommon for them to fall out of touch before enrolling. Manual handoffs, fragmented systems, and limited visibility into referral status are the structural drivers of this attrition. This matters because the majority of clinical trials already fail to meet their enrollment targets on time. Referral drop-off is one of the least visible but most consequential contributors to that pattern.
Clinical trial teams know that when a participant is referred, that can be powerful – but it’s no guarantee of enrollment. One study showed that only 11% of patients flagged as potentially eligible were ever referred to study teams, and just 4% were ultimately enrolled. Why? Time-strapped providers, manual communication, and no clear workflow for following up.
Despite efforts to patch this gap with spreadsheets, emails, and legacy IRT tools, the problem persists. These workarounds create blind spots where referred participants go dark and coordinators lose track. The downstream effects are well documented: a significant proportion of sites under-enroll, timelines extend, milestones are missed, and recruitment spend is consumed without proportional return.
The underlying issue is structural: referral workflows lack a single system to capture, match, and track participants from the point of referral through to enrollment. Solving this requires replacing fragmented handoffs with a coordinated, visible process.
Sano's Referral Manager addresses this directly. The feature reduces referral dropout by tracking every referred participant through a structured, centralized workflow, replacing manual handoffs with automated status updates.
“The centers most successful at clinical trial enrollment are those that prioritize inviting every single patient who might be eligible.”
- Karen Winkfield, MD, PhD, Wake Forest Baptist Medical Center
The Referral Manager is a purpose-built capability within the Sano platform that gives sponsors and their partners a single, transparent view of every referral, from capture through enrollment.
Sano's Referral Manager captures, matches, and tracks externally referred participants in a single transparent workflow. Rather than leaving referrals in a black box, the feature enables teams to:
This gives teams complete visibility into the referral pathway and reduces the attrition risk introduced by fragmented handoffs.
Because the Referral Manager integrates with Sano's digital prescreen and eConsent tools, referred participants move through a connected workflow rather than across separate systems.
| Metric | Before Referral Manager | With Referral Manager |
|---|---|---|
| Manual Follow-up Time | ~2 Weeks | A few days |
| Visibility | "Black box" / Spreadsheets | Single transparent workflow |
And the pattern is consistent across the industry: referral workflows that rely on email chains and phone calls introduce friction at every handoff. Each delay increases the chance that a referred participant disengages before reaching a site. By automating matching, notifications, and status tracking within a single workflow, the Referral Manager compresses the time between referral and action, reducing the window in which participants are lost.
In early feedback from beta users, coordinators reported that centralized referral tracking reduced the time spent managing follow-up communications across disconnected tools.
To explore how Referral Manager can be configured for your program's referral sources, eligibility criteria, and site workflows, get in touch with the Sano team.
Full visibility into every referral, from capture through enrollment, with the operational controls to act on each one consistently and on time.