Washington's MultiCare Health System is using a technology platform positioned above the EHR to match patients with clinical trials run by its Institute for Research & Innovation.
For busy clinicians, determining whether a patient makes a good candidate for a clinical trial is often low on the list of things to do during a healthcare visit. But AI technology is making that process much easier, and opening the door to potential life-changing health outcomes.
The MultiCare Health System, a Washington-based network of 12 hospitals, has been offering a robust slate of clinical trials through its MultiCare Institute for Research & Innovation for almost 40 years, but the process of matching patients to trials isn't easy. Clinicians have to be on top of all the trials underway and each program's inclusion criteria, then they have to comb through a patient's medical records to see if the patient would make a good candidate.
Recently, the health system launched a digital health app for oncology and pediatric practices that does the hard work for clinicians. It sits above the EHR, pulling out patient data to match patients to ongoing clinical studies, then sending alerts to care providers on those matches.
"When a physician introduces a clinical trial opportunity to a patient … we have a lot more success in engaging that patient in a clinical trial, and that increases the chances" of a meaningful outcome, says Annie Reedy, CRA, MBA, MultiCare's chief research and education officer. "When you’re nudging the physicians [with an app that says] this patient may be a good candidate, that's a much better way of working it into their workflows."
Annie Reedy, CRA, MBA, chief research and education officer, MultiCare Health System. Photo courtesy MultiCare Health System.
Clinical trials have long existed in a different orbit than clinical treatment, with few opportunities to bridge the gap unless the provider is personally involved in the clinical trial. Surveys have found that about 90% of doctors would feel comfortable referring a patient to an appropriate clinical trial, but less than 1% are doing it, often because they're just too busy to keep track of all the available trials.
This, in turn, has affected how these trials are conducted. If clinical trials aren't gaining access to the best candidates, only those who've been able to register, the chances of meaningful results diminish. And if a trial doesn't have a diverse and equitable patient base, especially underserved populations, there's a less of a chance of creating a treatment that will help patients who need it the most.
Reedy points out that many therapeutic clinical trials also have strict inclusion and exclusion criteria, making it difficult to find the right candidates. In addition, research tends to be focused on research institutions, rather than health systems with diverse patient populations.
"Access to many of these trials is very, very tough," she says. "That's why you need tools to make that process easier."
MultiCare is partnering with Alabama-based IllumiCare to deploy the company's Trials App, part of the company's Smart Ribbon platform. The technology sits above the health system's Epic EHR, pulling out and analyzing the necessary information and sending alerts to providers.
Reedy says MultiCare's Institute for Research & Innovation is currently involved in about 120 clinical trials, including new trials recently launched to address pediatric migraines and adult diabetes. The health system enters inclusion and exclusion criteria for each of those trials into the platform, which then sifts through the health system's patient base for candidates.
That, she adds, is much more efficient than the old process, in which trial coordinators combed through medical records looking for the right matches. That process was time-consuming and labor-intensive and not always accurate.
"This saves a lot of time and effort," she says, and is much more comprehensive.
Aside from picking the right patients, the process is set up so that the patient's care provider can recommend the clinical trial, which is important. Reedy notes that patients are much more likely to heed their doctor's advice on taking part in a clinical trial, and are much more likely to engage in the trial and stay motivated. This, in turn, improves the effectiveness of the trial.
MultiCare Health is one of the front-runners in adopting IllumiCare's technology, but there are several vendors in the space with different platforms—and plenty of room for expansion. Reedy says the health system is currently set up to screen and recommend only its own clinical trials, and a natural expansion of the platform would take in other clinical trials. That, like any health information exchange program, will take time and involve more sophisticated technology.
Closer to home, Reedy would like to expand MultiCare's platform so that it could not only link patients to clinical trials, but other care management education and resources, especially for patients who opt out of clinical trials.
“Access to many of these trials is very, very tough. That's why you need tools to make that process easier.”
— Annie Reedy, CRA, MBA, chief research and education officer, MultiCare Health System
Eric Wicklund is the associate content manager and senior editor for Innovation, Technology, Telehealth, Supply Chain and Pharma for HealthLeaders.
Healthcare organizations are now using AI technology to comb through patient records and match patients to clinical trials, improving on the old process of sorting manually through patient records.
The process not only reduces time and workload issues, but ensures that clinical trials are recruiting the right patients, including from underserved populations.
As the technology becomes more sophisticated, health systems will be able to expand the reach of clinical trials, thus improving the chances of positive outcomes and valuable new treatments.