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Submitted on May 22, 2006
Accepted on May 6, 2007
Affiliation of the authors: 1 The Clinical Data Interchange Standards Consortium, Austin, TX; 2 Alschuler Associates, LLC, East Thetford, VT; 3 Microsoft Corporation, New York, NY; 4 Lincoln Technologies, Wellesley, MA; 5 Digital Infuzion, Gaithersburg, MD; 6 Topsail Technologies, Durham, NC; 7 Duke University Medical Center, Durham, NC; 8 Columbia University, New York, NY; 9 Duke Clinical Research Institute and Duke Translational Medicine Institute, Durham, NC
* To whom correspondence should be addressed.
Objective Inefficiencies in clinical trial data collection cause delays, increase costs, and may reduce clinician participation in medical research. In this proof-of-concept study, we examine the feasibility of using point-of-care data capture for both the medical record and clinical research in the setting of a working clinical trial. We hypothesized that by doing so, we could increase reuse of patient data, and eliminate redundant data entry, and minimize disruption to clinic workflow.
Design We developed and used a point-of-care electronic data capture system to record data during patient visits. The standards based system was used for clinical research and to generate the clinic note for the medical record. The system worked in parallel with data collection procedures already in place for an ongoing multicenter clinical trial. Our system was iteratively designed after analyzing case report forms and clinic notes, and observing clinic workflow patterns and business procedures. Existing data standards from CDISC and HL7 were used for database insertion and clinical document exchange.
Results Our system was successfully integrated into the clinic environment and used in two live test cases without disrupting existing workflow. Analyses performed during system design yielded detailed information on practical issues affecting implementation of systems that automatically extract, store, and reuse healthcare data.
Conclusion Although subject to the limitations of a small feasibility study, our study demonstrates that electronic patient data can be reused for prospective multicenter clinical research and patient care, and demonstrates a need for further development of therapeutic area standards that can facilitate researcher-use of healthcare data.
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