In part one of this series, I proposed the value of a clinical trials partner in the move to accountable care, providing benefits to all stakeholders in health care, especially patients. In part two, I’ll share the key elements of success for doing so. Having a clinical trials management team that eases the administrative burden of physician investigators, sub-investigators and referrers is pivotal. Improved quality and cost can’t be achieved if physicians aren’t able to practice at the top of their license. In a recent project, my client had the administrative structure in place but utilized only three main investigators. We already demonstrated improved patient experience, engagement, and outcomes in a previous project so we knew it would be beneficial to expand the research program across more of the other 150 providers in the group. While study protocols seem extremely detailed, they don’t address how best to incorporate the study into the flow of our healthcare system and how physicians practice medicine each day.
There were four components to the project:
interviews of providers and trials management team
analysis of clinical, operational and financial processes
creation of a new operations and communication plan
We knew that if we were going to expand the program we had to truly understand the current state of physician perception so the survey and interviews were key. The respondents to the electronic, confidential survey were categorized into three groups: champions, targets and protestors. This allowed us to not only understand who fell into each group but why, and how to move targets to champions. Physician feedback made it clear that while they knew clinical research could be beneficial, the lack of clinical integration and communication about patient enrollment and status updates were standing in the way. Many felt research was often a barrier to quality care and some were threatened that they would “lose” patients. With a drive to be accountable for outcomes, that was simply unacceptable.
The end result of the project was a new operational plan that included:
process map for improved operations
enhanced education of providers
refined patient recruitment process
improved clinical communication throughout every trial
creation of an internal “IRB” (to make trial selection an organizational decision, not one made by an individual investigator)
establishment of a physician engagement leadership team
In the end, the medical group and trials management partner were able to expand the number of investigators and improve patient recruitment success. These outcomes allow all stakeholders to reap greater benefits. More providers can advance their clinical expertise through involvement with research and they can help their patients’ access cutting edge treatments that advance quality outcomes and patient experience. For many, that means a chance at life.