Key Points
Paying research participants is a major administrative burden.
Integrating study data collection with payment processing eliminates the administrative burden, fosters greater participant engagement, and enhances the overall participant experience.
Centralizing participant payment facilitates federal reporting and lays the groundwork for other operational efficiencies.
Summary
Paying research participants for their time and effort is a common practice, traditionally handled using cash, checks, or gift cards. However, these methods often involve labor-intensive, error-prone, and inefficient processes that can lead to delays and significant administrative burden. By integrating participant payments directly into the study data management system, these issues can effectively be eliminated. Scaling these operations to the organizational level introduces even greater efficiencies, improves coordination across all research activities, and simplifies federal reporting requirements.
Participant Payments
Compensating research participants for their time and effort is a well-established practice, traditionally managed through three tangible forms of payment:
Cash
Check
Gift Card
However, unlike advances in other research areas, the participant payment process has been slow to adopt more efficient methods. Traditional payment options remain burdened by their physical form and require significant labor-intensive, administrative overhead and practices including:
Documentation and Tracking: All three methods require detailed documentation of receipts and disbursements. Additionally, tracking events such as the completion of study visits is required to determine the correct amount and timing of payments. Once determined, this process often involves data entry into a separate, disconnected accounting resulting in redundant work and risk of errors.
Security and Management: Cash and gift cards require physically secure storage (e.g., lock box and cabinet), as well as detailed policies and procedures for access. Staff must be trained to follow the procedures, including documentation of disbursements. Moreover, theft is an ever-present risk requiring monitoring and frequent replenishment since the amount on-hand is often kept low to minimize risk of loss.
Check-Specific Issues: Paper checks may have delivery delays, leading to participant inquiries about payment status, which consumes staff time. Electronic checks require participants to provide sensitive bank account information, which some might resist due to privacy concerns.
While widely used, these traditional payment methods are clearly in need of a more streamlined, secure, and efficient approach to compensating participants.
Payments Plus
Study data management systems, which already integrate design information, event tracking, and data collection capabilities, are naturally suited to handle participant payments with substantially increased efficiency and effectiveness. However, viewing participant payment merely as about efficient transactions misses the broader, more important aim.
The most effective strategy is to view participant payments as one component within a comprehensive set of features designed to engage and enrich the experience of research participants, ultimately driving increased participation, retention, response rates, and overall satisfaction. Merely fulfilling the requirement of participant payments without this comprehensive engagement strategy narrows the mindset and creativity of feature development, and risks the resulting participant experience being mechanical, impersonal, and detached from the scientific disease discovery process. Such an oversight not only poorly reflects on an organization's reputation, but also severely hampers the ability to cultivate enduring, multi-study relationships with participants, effectively undermining the foundation for sustained research collaboration.
The broader set of participant engagement tools (e.g., communication, education) has been discussed elsewhere (e.g., here), the focus here is on how best to leverage and integrate participant payments into the research process. The model is an incentive-based points rewards system, where participants earn points by completing various research activities (e.g., completing a form). These points can then be redeemed for gift or debit cards of their choice. With this integration, study execution and participant payments are managed simultaneously.
Incentives System
The key features of this rewards system are as follows:
Supply a ‘Why’: Provide easily accessible, multi-media information that clearly communicates how participation contributes to scientific knowledge and actionable results, beyond just the payment. For example, a welcome video describing what to expect during the study and the importance of the findings, with links, images, audio, etc. to related information as applicable.
Flexible Incentives: Ability to allocate any quantity of points to events, including the same event over time. For instance, completion of a symptom questionnaire earns 100 points at first visit, but 500 points at the ‘Month 12’ visit.
Immediate Feedback: Deliver instant feedback when reward points are earned.
Independent Exchange: Enable participants to independently exchange points for rewards at any time, as well as view their reward history.
Reward Personalization: Allow participants to choose their form of reward (e.g., gift / debit card, charity donation, event tickets, etc.).
Together, these features completely automate the Participant Payment process, relying solely on the execution of the research protocol. As a result, numerous labor-intensive tasks are eliminated such as monitoring events, managing physical cards, documenting transactions, addressing payment inquiries, and calculating payment amounts. Additionally, total participant payments can be automatically aggregated at the organizational level for federal 1099 generation (or 1042 for Foreign Nationals, subject to 30% withholding) when annual payments exceed $600 (in 2023).
Scaling Operations
Given the clear advantages of Participant Payments facilitated by the study data management system, nearly all organizations scale up these operations. Although additional IT infrastructure costs are incurred to coordinate activities, these costs are far outweighed by the gains in labor efficiency, security, documentation, and ease of federal reporting. The scope of additional infrastructure varies depending on organizational objectives, but the main task involves connecting data about research protocols, participants, and the financial aspects of Participant Payments.
What’s New About ‘New’ Infrastructure?
In short, very little. However, this shouldn’t be viewed pessimistically about the likelihood of success. Instead, it’s an optimistic realization that the costs incurred for new IT infrastructure are typically small since much of the work involves connecting existing systems. However, there are two sides to what is needed, one is solvable and the other is unlikely to ever be solved.
Counterintuitively, the solvable part is what most organizations do poorly, and thus must be designed and built. Leaving the additional factor of foreign nationals out of the picture to help clarify the issues, note all organizations are required to issue 1099s to participants paid above a specified annual dollar amount (e.g., $600 in 2023) to comply with federal reporting. There are two standard approaches taken, or a combination of both, that aggregate data based on Social Security Number (SSN) and payment date information.
The first aggregates data from a patchwork of systems ranging from study specific spreadsheets, departmental level databases, individual study data management systems, vendor tools, accounting systems, etc. The second approach involves an organization policy that forces all research participant payments through a disconnected accounting system for single study payments greater than some specified amount (e.g., $100). Below the specified amount, cash / cash equivalent is used with no participant tracking. The risks of inaccurate annual, per participant totals using either of these approaches are readily apparent.
To minimize the risk of inaccuracies and maximize the efficiency of federal reporting, what’s needed is an organization database application (ODA) that standardizes how participants are identified, and tracks enrollment and payments across research projects. This is precisely the new IT infrastructure needed to coordinate participant payments. The ODA does require other functionality related to comprehensive capture of participant payments that is beyond the scope of this discussion but is related to the ‘unsolvable’ side of the equation.
More specifically, there isn’t a study data management system that can accommodate all study designs. Nor will there ever be. The aim of the study data management system is to accommodate an increasing proportion of research designs but will always be a step behind cutting edge data management needs. Thus, a manual participant payment process is needed to cover all scenarios. If this is done in the ODA, the development scope expands to include a participant portal, thus best done through an accounting system (e.g., check sent to participant as ‘vendor’) or the study data management system using a single visit study proxy since it has a portal and hosts other studies in which the participant may be enrolled.
The Design
Since most data elements are present in other systems, the ODA primarily consists of ID fields (i.e., foreign keys) used to retrieve data for reporting purposes. The basic data definition and requirements are as follows:
Connections
Research Protocols (Often from IRB system)
Protocol ID: Field that links to information about a given research protocol
Accounting
Funding Source ID:
Primary Account: Account ID of research project (e.g., grant)
Payment Account: Account ID from which funds are drawn for participant payments, often a separate service (e.g., Tango).
Research Data Management System (RDMS)
RDMS Protocol ID: Field that links to information about a given research protocol.
Research Participants
Functionality
Global Unique Identifier (GUID):
Generate a participant GUID, based on small set of demographics (e.g., here).
Information Stored
Demographics:
GUID and associated demographics
Federal Reporting Information:
Social Security Number (SSN): Or an equivalent identifier for foreign nationals.
Foreign National Indicator: Flag for foreign national participants.
Contact Information: Address to send 1099 (1042 foreign nationals)
Research Participation:
Protocol ID: Research projects enrolled.
Annual Disbursement: Total annual payments.
How It Works
There are two primary aims of the ODA:
Standardize the process of identifying participants and recording their enrollment and compensation across research projects.
Provide a participant payment service with hooks for SDMSs.
This is done by orchestrating the activities of three systems:
Research Protocol Management
Accounting
Study Data Management
A case example will help illustrate the basics of how these systems work together. The main steps and associated system actions of a participant in a research project are as follows:
Study Setup - Prior to enrollment, configuring the SDMS
ODA
Provides SDMS with payment account ID
Links SDMS protocol ID to institutional research protocol ID
Enrollment – participant is enrolled in a study
ODA / SDMS exchange demographic information
If new participant, ODA generates GUID and stores associated demographics
Study Participation – participant completes research protocol activities
SDMS – engages and incentivizes participant, ideally using multiple methods besides payment (e.g., secure communication, personalized information, simple data entry, etc.)
Manages progress through research protocol
Tracks activity completion associated with payment (e.g., form completion)
Provides participant portal for payment feedback and receipt
For example, portal showing points earned for completing tasks that can be exchanged for gift cards
Annual Total Payments – Determine total annual participant payments
ODA / SDMS communicate
SDMS sends participant’s total annual payments for each project enrolled to ODA.
ODA sums total payments for each participant across research projects
Submits total on federal 1099 (1042) form
Using the ODA to link together related systems and leveraging the SDMS to automate participant payment, organizations can markedly reduce labor costs on both sides of the process. On the payment side, automation transforms participant compensation into a seamless component of a rewards system, which boosts retention, improves data completion rates, and enhances participants' overall experience—making them more likely to have a positive impression of the organization and engage in future research. On the federal reporting side, this automated approach dramatically improves accuracy and efficiency, while the enhanced coordination of research activities offers substantial additional opportunities for organizational optimization and growth.
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