Enhancing Participation in Certificates of Diagnosis (COD) for Market Research Studies

Rob Ramirez - Chief Strategy Officer, Manifest Health

Are You Considering CODs?

As Certificates of Diagnosis become part of the normal data collection process for market research studies, it is important to begin discussions on best practices.  This is not only critical to enhance participation, but we must also remain empathetic with patients when requesting personal health information.  This paper shares some of the best practice Manifest Health has observed related to CODs.     

Background

Certificates of diagnosis (CODs) serve as crucial documentation that validates the treatment or diagnosis of a patient's condition.  In recent years, the demand for CODs has surged among study sponsors seeking to ensure that data is collected from specific patient populations. However, many individuals encounter obstacles when asked to upload their personal health information. The primary reasons for pausing or dropping out of the study process include:

1. Inability to Provide Information: Some participants may not have immediate access to the required documentation.

2. Reluctance to Share Sensitive Information: Many individuals are hesitant to disclose personal health details to third parties due to privacy concerns.

Study Overview

To better understand the factors influencing participation in COD studies, Manifest Health conducted a comprehensive analysis of studies conducted in 2025.  Our objective was to identify key drivers that could maximize patient participation in uploading their health information.

Results

Our analysis revealed four best practices that can significantly enhance participation rates in COD submissions:

1. Clarify the Need for CODs

It is essential to articulate the reasons why COD is required for participation in the study. Clearly communicating the purpose and benefits can alleviate participants' concerns and motivate them to provide the necessary documentation.  This transparency helps build trust and reinforces the importance of their contribution to research.

2. Offer Multiple COD Proof Options

Providing participants with a variety of options for submitting their CODs can increase compliance.  Acceptable forms of proof may include:

• Insurance Bills: These are often readily available and can serve as valid documentation.

• Patient Portals: Many patients have access to online platforms where they can retrieve their health information quickly.

• Doctor's Notes: Allowing participants to submit a note from their healthcare provider can offer flexibility.

• Telehealth Records: As telehealth becomes more prevalent, including digital records from virtual appointments can broaden options.

Offering diverse submission methods caters to varying patient preferences, thereby reducing barriers to participation.

3. Streamline the Upload Process

An intuitive and mobile-friendly upload process is crucial, as research indicates that approximately 85% of participants upload their CODs via mobile devices.  Simplifying the upload experience involves:

• Minimizing Steps: Reducing the number of steps required to submit a COD can significantly enhance user experience.

• Providing Clear Instructions: Ensuring that participants have easy-to-follow guidelines can prevent confusion.

• Implementing User-Friendly Interfaces: Adopting responsive design principles can facilitate a seamless experience across devices.

By prioritizing ease of use, sponsors can encourage higher participation rates.

4. Foster Relationships between the recruiting partner and Patients

Establishing and nurturing a relationship between the recruiting partner and the patients is paramount. This relationship fosters trust in the recruiting partner and can encourage participants to share sensitive information. Key strategies for patient recruiting partners include:

• Regular Communication: Keeping participants informed about news on their disease and their role can reinforce their commitment.

• Providing Support: Offering 24/7 assistance with any queries or concerns regarding the COD submission process can enhance confidence.

Building Trust through Transparency: Clearly explaining how their information will be used and safeguarded can alleviate privacy concerns.

Conclusion

To maximize participation in COD studies, it is vital to address the barriers that prevent patients from uploading their health information.  By implementing best practices such as clarifying the need for CODs, offering multiple submission options, streamlining the upload process, and fostering trusting relationships, study sponsors can enhance patient engagement and data collection efforts.