Presentation Authors: Anobel Odisho*, Robert Krumm, Imelda Tenggara, John Kim, Clarence So, Peter Carroll, Matthew Coopberberg, San Francisco, CA
Introduction: Clinical trials are a key tool in evaluating interventions; however, fewer than 3% of patients with new cancer diagnosis enroll in a trial and a majority of all trials fail to meet enrollment targets. We developed a clinical trials screening and enrollment platform integrated with the electronic health record to enable efficient screening and enrollment of patients into trials and improve team communication.
Methods: We deployed a cloud-based relationship management software (Salesforce CRM) with customizations for clinical data elements such as diagnoses, cancer staging, pathology results, and lab results. Data were populated from our Urology Data Warehouse, a SQL database which integrates manually abstracted data with nightly data extracts from various automated data streams: natural language processing of free text documents, SmartData Elements entered by clinicians during routine clinical care, patient reported outcomes, and demographic, clinical, and appointment data from the EHR (Epic). Data are populated into Salesforce using its Application Programming Interface (API). The platform is accessible to Clinical Research Coordinators (CRCs) on desktops and mobile devices.
Results: Our clinical trials enrollment system, named Streamforce, was launched on 5/7/18. To date, demographic, clinical, appointment, and current trial enrollment data for 116,180 patients has been loaded into Streamforce. CRCs use interactive reports and data visualizations to identify patients that have not been screened, are ineligible, eligible, interested, or enrolled in any of the 11 trials currently actively enrolling through the platform. As of 10/30/18, 15,365 patients have been actively screened, including 3,867 deemed eligible for at least one trial. Only 12 patients have requested they not be contacted for future research. 4,167 comments have been exchanged between CRCs regarding patient screening and enrollment. CRCs use real-time reports showing numbers of patients by trial and filter by eligibility status and appointment times, allowing them to focus enrollment efforts on eligible patients with upcoming appointments. They can also filter by clinical characteristics, such as stage, grade, labs (over 143,000 PSA results loaded), and treatment dates.
Conclusions: Cloud-based CRM software can be customized for clinical trial enrollment and integrated with the EHR and clinical data warehouse, allowing for real-time reporting and more effective clinical trial eligibility screening and enrollment.
Source of Funding: This project was supported in part by Salesforce and the Goldberg-Benioff Program in Translational Cancer Biology.