Development and implementation of cancer clinical trial patient screening using an electronic medical record-integrated trial matching system

Abstract

Objectives Clinical trial enrolment is critical for the development and approval of novel cancer therapeutics, but patient identification and recruitment to clinical trials remains low and multiple trials accrue slowly or fail to meet accrual goals. Informatics solutions may facilitate clinical trial screening, ideally improving patient engagement and enrolment. Our objective is to develop and implement a system to efficiently screen queried patients for available clinical trials. Methods At Stanford, we designed and implemented a personalised clinical trial matching system, integrating our electronic medical record, clinical trials management system and a third-party software-based solution to directly connect providers with clinical research coordinators and appropriate trials. Results Over 3 years of a staged rollout, significant increases in clinical trial screening requests and subsequent enrolment have been observed. The total number of screening referrals increased from 20 in the first year to 236 in the third year. Enrolment related to screening referrals, the € conversion rate', ranged from 16% to 26% of referred patients. Conclusion Clinical trial matching systems can increase awareness of available trials and provide a mechanism to increase clinical trial accrual, especially when implemented at the point of care for easy access at treatment decision points. Here, we describe the process of creating and implementing a bespoke clinical trial matching software integrated into the electronic medical record. Having validated the utility of the platform, we will focus on further efforts to drive utilisation through software features.