Physicians are unable to give an accurate feasibility count or actively search for eligible patients for a clinical trial. Since most valuable patient information is archived as text (clinical notes, transfer notes, multi-disciplinary meeting notes, discharge letters, etc.) into the EHR system, it is not possible to search these criteria except perhaps for a broad diagnosis category such as pulmonary carcinoma, while patient disease profiles are way more complex. CTcue has the state-of-the-art technology that the healthcare institutes are missing. Our matching engine can match these factors with detailed in- and exclusion criteria.
The first roadblock concerns patient privacy. Since we only access the pseudonymised data within the hospitals firewall, no patient data leaves the hospital, ensuring that our processes are in line with the privacy laws. Providing the EHR data is the second obstacle. We consider the EHR to be a collection of medical terminologies and we search this for medical terms, sentences and relevant text snippets to reach a conclusion about the patient profile. Our system does not need exact mapping to the patient database. Access to pseudonymised data at the hospitals remains a priority and challenge, which we overcome by increasing adoption.
We focus on at least doubling the accrual rates. Based on research using just an alert showed an improvement of 2.5 fold compared to conventional methods. As mentioned before this process is far from being an optimal solution. Many physicians find the task of patient recruitment very cumbersome and are unable to find and recruit all eligible patients. We aim to reduce the clinician’s workload, by allowing continuous insights to eligible patients, thereby improving the patient recruitment process. Of note, clinicians will be able to assess the effectiveness of our solution from the instance CTcue is integrated into their system.
We will continue to focus on making a faster and simpler selection process of eligible patients. The accrual rates will increase over time, since it heavily relies on adoption rate at hospitals worldwide.
Privacy and security of patient data is an important issue, and we have done our utmost to overcome such hurdles. It remains a challenge to obtain a unified consensus on patient record privacy and big data use in clinical medicine. From the start CTcue has been working with an experienced legal team on the topic of privacy and security of patient data.
Improved accrual rates are very important to the industry. Physicians focus on optimizing patient care, and improving the accrual rates is not on the priority list of most hospitals. EHR vendors provide search functionality on structured data, and IBM's Watson has shown promising results on stratification of unstructured data. However, these partial solutions require financial investments by hospitals and a substantial effort in integrating them with hospitals local systems. By providing a free “Google for Electronic Health Records” which facilitates physicians and the medical industry it plays a key role in establishing a healthy ecosystem in the medical industry.
