The following is a guest article by Katrina Rice, Chief Delivery Officer at eClinical Solutions
There’s a growing imperative to address social determinants of health (SDoH), particularly to combat health disparities, ensure safe treatments across populations, and improve patient outcomes. Diversity, equity, and inclusion (DEI) initiatives have emerged as a catalyst for positive change and addressing SDoH, yet over the past year, regulations – including executive orders focused on ending DEI programs and advancements – have led to growing scrutiny and shifting priorities.
January will mark one year since these orders and policies ignited conversations around DEI, and as we look to 2026, it’s worth revisiting the missteps of the past in order to not repeat history. In the next year, DEI must be strategically implemented within the heart of the organization, across all operations, from patient recruitment, leadership, and research and development (R&D). By viewing DEI as a business imperative and strategic priority, rather than an optional initiative driven or removed by policy, organizations can more effectively drive improved treatment outcomes and patient health across populations.
Why DEI in Clinical Trials Matters
Clinical trials offer a clear example of how DEI can directly impact health outcomes.
Historically, clinical trial participants have primarily been white males, risking underrepresentation of minority patients and adverse reactions or less efficacy. Unique genetics and DNA bring a different set of outcomes, and a lack of representation across gender, race, and ethnicity makes it difficult to assess side effects or drug effectiveness across populations. Not knowing how diverse groups will react to these drugs in the real world limits the impact of these life-saving treatments.
Until we can ensure safety and efficacy across communities by ensuring representation in trials, the industry must prevail in charting a path forward for diversity, ensuring trial data is reflective of the population.
2025: Headwinds for Clinical Trial Diversity
The executive order issued in January 2025, “Ending Radical And Wasteful Government DEI Programs And Preferencing,” caused major setbacks for the healthcare industry as some agencies dismantled or quietly rolled back initiatives. A key example for the life science sector was the U.S. Food and Drug Administration’s draft guidance on clinical trial diversity, which was removed from the agency’s website immediately following the executive order. This guidance, originally issued in June 2024, outlined diversity action plans to improve the strength and generalizability of evidence from clinical trials, as well as the enrollment of participants from underrepresented populations. After removing the guidance in January, the industry saw major pushback from industry leaders and organizations, including a lawsuit from Doctors for America, and 19 days later, the removal was reversed.
However, the webpage still reads “this page does not reflect reality, and therefore the Administration and this Department reject it.” The initial removal and reversal, paired with the conflicting information, continues to prove challenging for organizations looking for clear steps on how to implement DEI initiatives in practice.
Achieving Meaningful Diversity with Patient Trust and Engagement
To achieve meaningful diversity in 2026, inclusivity must be ingrained across all levels of an organization. At the patient level, trust must be built and earned within communities to increase engagement and participation. For clinical trials, trust begins by understanding the potential barriers or hesitations individuals may face with participation, and addressing them openly.
A central challenge many patients face is a lack of clear, accessible information. Clinical trial outreach is often centered on larger urban medical centers, leaving smaller or rural communities–both at the provider and patient level–uninformed. When clinicians lack clear instructions about how to engage patients in clinical trials, there is no pipeline of information being shared with potential participants.
Building engagement from the ground up starts with educating and encouraging communities on the impact of their participation and meeting patients where they are. This includes attending local health fairs or community events and partnering with trusted organizations to bridge information gaps. By taking a patient-centric approach and conducting boots-on-the-ground outreach, clinical trials have the potential to better engage and reflect a more representative population.
Championing DEI From the Top-Down
Equally important to building patient trust through ground-up initiatives is championing DEI initiatives through a top-down leadership approach. Leadership sets a clear tone and standard for a company, both internally to employees and externally to stakeholders. Embedding the underlying values of DEI within an organization’s business goals and corporate culture sets the tone of accountability and commitment.
Senior management can lead by example by clearly setting expectations and supporting equity-focused initiatives. Whether it’s by equitable decision-making related to hiring and programs, allocating funds and staffing to address SDoH, reinforcing accountability with training and education, or ensuring plans and goals have equity metrics, there are a myriad of actions to take. When leadership actively integrates these principles into both decision-making and daily culture, they create the conditions for sustained equity practices. This leadership commitment strengthens trust, ensures accountability, and enables the organization to more effectively identify and address the social determinants of health that impact the communities it serves.
Reducing Health Disparities Through R&D
Just as recruiting diverse patients is essential for better, more representative treatment, healthcare organizations have an opportunity – and a responsibility – to consider DEI in their R&D initiatives. To guide more inclusive development, data analytics can be used to assess outcomes for any gaps in population data.
For clinical trials, analyzing data sources and assessing what trial sites are being used to collect data can help identify gaps. These insights can help researchers pivot to include broader populations and focus areas, guiding more inclusive, comprehensive, and effective research outcomes.
Strategic Implementation of DEI Across Operations
Looking back at 2025, administrative changes in DEI and regulatory rollbacks caused uncertainty and potential deprioritization of incentives for patient recruitment.
Moving forward, rather than labeling programs explicitly as DEI, companies should embed the principles of DEI at all levels of an organization across patient engagement, leadership, and research. In doing so, organizations can more effectively address health disparities, using R&D to assess any gaps in population data and guide more inclusive research outcomes. These efforts must be seen as core operational priorities if health outcomes are to be truly reflective of the real-world population.
When the healthcare system actually reflects the communities it serves, we can effectively develop life-saving treatments that work across populations. For me, clinical trial diversity is imperative because I want my community to be saved–that’s my future, and our collective future.
About Katrina Rice
Katrina Rice is an accomplished Chief Delivery Officer with an impressive career that spans over 25 years and includes advancement into increasingly demanding leadership roles. With a solid history of leading business transformations and managing global portfolios, she is as much at home scaling operations as she is in developing strategies that drive revenue growth. At eClinical Solutions, Katrina was recently promoted from Executive Vice President of Professional Services to Chief Delivery Officer. In her free time, Katrina is an active participant of Chief, a private network for women in senior leadership roles, Treasurer in her church, where she oversees all financial aspects, and a Member of the Delta Sigma Theta Sorority Incorporated, a not-for-profit organization dedicated to public service with an emphasis on programs that assist the African American community.
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