Transforming Clinical Trials with Patient-Finding Technology

Gary White, the Senior Director with EMEA Strategic Site Solutions at IQVIA explores the evolution of patient-finding technology. In this episode, discover how IQVIA's digital solutions are reshaping traditional data collection methods, unlocking new possibilities for research sites and patients. Uncover the transformative impact of digital patient-finding technology on research site operations. Join us as we discuss the challenges, benefits, and future prospects of integrating these technologies into clinical trials.

Transcript

Jimmy Bechtel: 0:00

Greetings and thank you for being part of the Society for Clinical Research Sites on SCRS Talks. I'm your host, Jimmy Bechtel, the Vice President of Site Engagement with the Society. Get ready to dive into a space where we discuss pressing clinical research industry issues, celebrate noteworthy achievements, and foster a deeper connection within the research community. This is a space to amplify voices and perspectives that shape the landscape of clinical research. Today, we have Gary White, the Senior Director with EMEA Strategic Site Solutions at IQVIA, here to share a little bit more about what IQVIA is doing with digital patient facing technology. Gary, it's great to have you with us today. Really excited to talk about this topic because we know how important patient facing technology is as well as how vital its usability is for patients and sites, of course. So if you wouldn't mind, I'd love to start off with learning a little bit more about you and your role at IQVIA.

Gary White: 1:02

Fantastic. Thank you very much indeed, Jimmy. And thank you for having me on. So as Jimmy said, my name is Gary White. I'm a Senior Director of Strategic Site Solutions for the EMEA region. I'm based in Glasgow in Scotland. And we are part of a group of four regional teams with our colleagues in the U. S. LATAM and APAC, whose remit is really to act as that interface between IQVIA and our investigators sites and to ensure that collectively we meet our responsibility of delivering accelerated innovation and improved outcomes for our patients. So my role more specifically surrounds IQVIA's relationships with two pivotal groups. Firstly, our external site networks, with whom we partner in trial delivery and process alignment. And secondly, our academic researchers and our academic research networks, who really sit at the fulcrum of medical and scientific innovation, which is the lifeblood of what drives healthcare forward, and is the reason we all come to work every day, right? So I've been in clinical R&D for around 25 years, the last 16 years with IQVIA, starting out in our central laboratory function in 2008, and I've moved through various strategic roles in the organization before joining the Strategic Site Solutions team in 2018. Outside of IQVIA, I'm also the vice chair of the Scottish Life Sciences Industry Leadership Group, which is a group of key stakeholders from across the clinical, pharmaceutical and wider life sciences sector in Scotland who are work with the Scottish Government in devising policy and creating new policies and adaptations of existing policies related to research, healthcare and life sciences. I'm also part of the Scottish Government's Ministerial Trade Board, which again is focused from a life science perspective on really maximizing the impact of what we as an industry do for our patients.

Jimmy Bechtel: 3:00

That's excellent, Gary. Thank you for that detailed introduction. I'm really excited to speak with you specifically on this topic because it's squarely in your wheelhouse. And I know it's been something that IQVIA has been intimately focused on for a long time now. And you all recently shared a case study on digital patient finding technology. So that's where I'd like to start. Can you tell our listeners a little bit about the challenges that this technology has worked to overcome? And kind of how it came to be and, and really why it exists and was brought to the forefront of our conversation today.

Gary White: 3:35

Absolutely. First of all, we're delighted to have published that article with SCRS. I think it's so important for us to spread knowledge and awareness of these types of technologies. So this case study was important for us. So we wanted to take a look at how the proliferation of digital technology and research and healthcare space is really transforming the way in which we approach some of the traditional challenges. But in the real world, we realize that innovation is not always necessarily seen as a good thing in this dynamic and high pressure environment where clinical care and research is the all consuming focus. So the pain of changing to a new technology is something that's seen particularly in the public hospital setting as being prohibitively complex, time consuming, and something that's a real bother. Sometimes the IT architecture or the IT infrastructure is limiting. For digital solutions, there's also always the problem of data governance and privacy to consider. That's the top priority, meaning that sometimes the pure cost of deployment is just too high or it's too complex, or the return on investment in terms of time and cost simply isn't enough to truly justify the investment in these innovations. So in this particular case study, we wanted to look at a technology with which IQVIA have seen significant value added to site operations and then provide some insights as to what challenges this technology can address. What are some of the benefits and the true value that these types of technologies can bring to site operations? So we took. This example, it's of a multi centre observational cohort study, which involved examining the extant data from 19 different hospital centres who specialised in prostate cancer. The database itself was designed primarily to capture the outcomes from the patient and also the patient's healthcare utilization through extensive chart review and looking at the data in detail from all 19 of those sites. Manual chart review, as you know, of patient data is time consuming, it's error prone, it's resource intensive, and most concerningly, it provides only an instant snapshot of the data set at that time time when the analysis happens. For this study, we worked with the sites and we calculated that this manual process would take about six years to gather the data together for 3600 patients and would require almost 10 full time employees working constantly on this, which was calculated from around about five hours per patient to actually do that manual chart examination. So hugely labor intensive, hugely challenging. So these types of challenges are typical when we're querying even electronic structured medical data sets, and traditionally, this represents a real pain point for sites where the large data sets have to be explored and queried in search of those meaningful insights that we look for in these types of studies.

Jimmy Bechtel: 6:44

That's interesting, Gary, and it's cool to hear about the kind of the background and how that was formed because that transition from this really intense manual data capture to trying to solve the need around that to make it more efficient and effective at the site level on behalf of patients, I think is a really important aspect and driver for why we do some of the work that we do. So I appreciate, I guess, IQVIA's emphasis on that aspect of it, right? We identified this as a clear problem. We listened to the sites. And therefore we're trying to implement a solution to make that a little bit less burdensome at the site level and therefore, serving the patients all that more effectively.

Gary White: 7:23

I mean, ultimately what we're trying to do is, help the sites to free up that resource so that they can focus on patient care, because ultimately, that's that's what these people should be focusing on, right? They should be focusing on the patient experience, the patient journey. You don't want people having to sit for hours and hours just trawling through data when they could be sitting with patients, reassuring them. Making sure they're comfortable, making sure their experience is pain free and trauma free as possible.

Jimmy Bechtel: 7:52

Well, that's a great transition then, Gary. I think to my next question. Getting into benefits, right? Talk a little bit more about what some of the outcomes and benefits are for utilizing this technology. You mentioned being able to potentially spend more time bedside and doing what they want to do with patients, what they need to be doing with patients. But also I'd love for you to talk about the implications then for the study's speed and scope as well.

Gary White: 8:18

Absolutely. So this specific example, as I said, we were using IQVIA's own patient finder tool. So we deployed that in situ at the 19 sites, meaning that the technology was sitting behind the hospital firewall. The patient data was at no point going outside of that safe haven of the hospital's EMR system. So that kind of made sure there was no concerns from a privacy and data confidentiality perspective. So it was sitting in there in the hospital. What we then did was to supply each of the hospitals with a programmed query, which was entered in the platform each of the sites and allowed the system then to automatically examine both the structured and unstructured electronic patient data in the hospital's own EMR system. As such, the patient finder was then able to identify almost instantly about 50,000 potential patients who appeared on the surface to be meeting the basic inclusion criteria for this particular study and it quickly and efficiently gathered those 50, 000 patients from the hospital medical records. So crucially, out of that 50, 000 patients, the system was able to automatically exclude over 50 percent of those patients using the programmed inclusion exclusion criteria algorithm, which would have previously had to have been done manually and involved that exhaustive chart review that we talked about, which would have had to rely on the site staff to do. So for the remaining cohort we had left. 10, 000 patients were identified and included in the study in less than two years, and if you compare that with the 36, 000 patients that we spoke about taking six years to do manually, that's a real increase in efficiency and effectiveness and a really much more significant utilization of site resources. So the calculations that we've done in collaboration with the hospitals that were involved have estimated that the resource savings and the cost avoidance were around about 32, 500 hours of work being saved and avoided in collecting that 10, 000 patients. data set. That equates to 17. 4 full time employees, which represents a cost saving of over 1 million for this one study alone. Now, this technology, once it's in place, can be utilized on any study, any type of patient data set and patient cohort that you're looking to identify. So if you extrapolate that out to the 20, 30, 40, 50 studies that a department are doing at any one time, then the cost savings start to become really, really significant.

Jimmy Bechtel: 11:02

Yeah, you're not kidding Gary. A million dollars is no insignificant amount of money for anybody regardless of the size of your organization. That's really, really great to hear, and it's great to dive into and hear some of the benefits for the sites as well, and I think anytime we can more effectively and efficiently identify patients and get them engaged in the clinical trial process and not spend so much time in that space, everyone's better off. And it's oftentimes, like you had alluded to, the rate limiting factor for a lot of our clinical trials. So moving through that, moving past that, and actually getting into the bulk of the trial and, and those main visits there. It's a win win for everybody.

Gary White: 11:40

It is. It is. And like you said earlier, Jimmy, that increase in availability of staff for bedside time is the intangible there. I mean, it's hugely important. And not just for the patient perspective as well, for a staff engagement perspective. You want to retain your staff. You want to make your staff feel as if they're doing something that's important and impactful. Sitting in front of a computer or doing manual chart review possibly doesn't feel like that for everyone. I'm sure a lot of nurses would rather be sitting beside a patient actually talking to them and being with them rather than trawling through their EMR to try and find the next available patient to bring in. So that that kind of staff engagement. Employee engagement and and hopefully staff happiness and satisfaction of what they do is enhanced by this technology as well, which is a little bit less obvious and less tangible than the cost savings or the time savings.

Jimmy Bechtel: 12:35

Yeah, I couldn't agree more. Gary, let's talk a little bit about then as we begin to conclude our conversation here, the future, right? What's next for this? So how does IQVIA envision the future of this technology? And what's really next then for IQVIA in working with and partnering with the clinical research community,

Gary White: 12:54

so we still have significant ground to cover before this becomes the accepted norm or or standard practice across the health care and research landscape. But I would think that the natural progress for the future of this type of digital enablement would be at the population and country level deployment by health care payers, health care providers and governments essentially having a unified and comprehensive population health data set would be a massive asset for any country, so not just impacting health care and delivery of health care, but also the economy in general for inward investment and the attractiveness of those countries as a destination for biopharma to run clinical trials, but also for the health and well being of that entire population and the enablement of large public health initiatives, which are enabled by and driven by technology, by AI, and by ML. That's where we see the future going. If we look, for example, at pharmacogenomics and medication management as a focus point of that. Genomic data does, as we all know, provide physicians with the ability to effectively manage prescribing, ensuring right drugs are prescribed to the right patients based on the genomic characteristics of the individual. So with the size and scale of these data sets and the subsequent clinical decision support systems that are required to enable the physicians to optimize those prescribing practices. There's no doubt that we require these types of digital and tech enabled practices to allow us to deliver on our commitment to our patient's health and well being. We do that best together, right? We do that best by the collaboration of industry, of academia, and of healthcare providers. And that's what we at IQVIA remain focused on for the months and the years that lie ahead. Now, as part of this, we continue to invest significant time and efforts in what we call our connected research community program. This is where we've brought together a core group of around 15 stakeholders from our prime and partner sites that represent that broad spectrum of commercial, public hospital and academic research sites. So we meet regularly to discuss key themes in research and healthcare and collectively look for potential solutions where we can address the challenges, optimize our day to day interactions. And once again, as I alluded to at the beginning, accelerate innovation and improve the outcomes for our patients. That's really the intention that we intend to take forward, Jimmy.

Jimmy Bechtel: 15:33

Well, it's a noble intention, Gary, and I think is reflected in a lot of the recent work that IQVIA has done with and on behalf of the sites. And this patient facing technology is a great example of that. One of those things. So it's great to hear about this and hear about that commitment, but it will also be really great to see what other innovations and developments come out of that focus as an organization. I know there's probably a lot of sites that will be listening to this that are also very hopeful that that focus continues to play itself out into developments. For and on behalf of better relationships and better partnerships so we can make more efficient and speed along the execution of these clinical trials. So I think it's a great place for us to end our conversation today. Gary really want to say thank you to you for being here with us, but also thank you to IQVIA for the focus on patients and sites and for technologies like this and for future technologies that again are made with sites and patients in mind.

Gary White: 16:35

Great. Thank you very much indeed, Jimmy. And if any of the listeners would like to find out more, there's a link within the information related to the podcast where you can reach out to us. And we're always delighted to have an additional conversation, explore further possibilities, and see what we can do together. So thank you for giving us the opportunity, Jimmy.

Jimmy Bechtel: 16:54

You're very welcome. Thanks again, Gary. Don't forget to explore more site focused resources on our website as well, in addition to that link that Gary had mentioned. myscrs.org. You'll find a wealth of content and publications, plus the opportunity to save your spot for upcoming webinars and SCRS summits held throughout the year. Thank you for tuning in and we can't wait to have you back for more enriching content. Until next time.