Shared-Task Worklists Improve Clinical Trial Recruitment Workflow in an Academic Emergency Department

Abstract

Background Clinical trials performed in our emergency department at Barnes-Jewish Hospital utilize a centralized infrastructure for alerting, screening, and enrollment with rule-based alerts sent to clinical research coordinators. Previously, all alerts were delivered as text messages via dedicated cellular phones. As the number of ongoing clinical trials increased, the volume of alerts grew to an unmanageable level. Therefore, we have changed our primary notification delivery method to study-specific, shared-task worklists integrated with our pre-existing web-based screening documentation system. Objective To evaluate the effects on screening and recruitment workflow of replacing text-message delivery of clinical trial alerts with study-specific shared-task worklists in a high-volume academic emergency department supporting multiple concurrent clinical trials. Methods We analyzed retrospective data on alerting, screening, and enrollment for 10 active clinical trials pre- and postimplementation of shared-task worklists. Results Notifications signaling the presence of potentially eligible subjects for clinical trials were more likely to result in a screen (p < 0.001) with the implementation of shared-task worklists compared with notifications delivered as text messages for 8/10 clinical trials. The change in workflow did not alter the likelihood of a notification resulting in an enrollment (p = 0.473). The Director of Research reported a substantial reduction in the amount of time spent redirecting clinical research coordinator screening activities. Conclusion Shared-task worklists, with the functionalities we have described, offer a viable alternative to delivery of clinical trial alerts via text message directly to clinical research coordinators recruiting for multiple concurrent clinical trials in a high-volume academic emergency department.

Searching of Clinical Trials Made Easier in cBioPortal Using Patients' Genetic and Clinical Profiles

“…Studies in the field of recruitment support often tackle different aspects than searching fitting trials for a specific patients, for example, optimize eligibility criteria 34 or assess trial population representativeness, 35 supporting data collection 36 or helping to find patients for screening. 37,38 A key factor in enrollment of MTB patients in clinical trials are matching genomic alterations of the patient's tumor and the study's inclusion criteria, yet these alterations are not specified in a well-structured matter and often only found study's descriptive text. 39 Therefore, several attempts have been made to curate precision cancer studies from trial regis-tries like ClinicalTrials.gov or institution-specific registries to generate a structured database to query.…”

“…Studies in the field of recruitment support often tackle different aspects than searching fitting trials for a specific patients, for example, optimize eligibility criteria 34 or assess trial population representativeness, 35 supporting data collection 36 or helping to find patients for screening. 37 38 …”

Selecting EHR-driven recruitment strategies: An evidence-based decision guide

“…These may take the form of push notifications or a refreshable task list. 21 If adopted, a recruitment site would need to invest up-front resources to ensure that queries necessary to identify eligible patients are embedded into workflows which can rapidly communicate patient lists to researchers or recruitment coordinators. This approach can leverage pre-built querying infrastructure which exists in most commercially available EHR platforms or draw insight from queries written against a health system's enterprise data warehouse.…”

“…A direct to researcher alert to facilitate recruitment is a more targeted approach for recruitment which takes place in the clinical setting. These may take the form of push notifications or a refreshable task list [21]. If adopted, a recruitment site would need to invest upfront resources to ensure that queries necessary to identify eligible patients are embedded into workflows which can rapidly communicate patient lists to researchers or recruitment coordinators.…”