We have seen a digital revolution sweep across clinical practice, driven by the extraordinary circumstances of the coronavirus.
Areas that have typically been very slow to move to digital solutions have been transformed almost overnight.
For example, in primary care in the UK, less than 1 in every 100 GP appointments were carried out by online video consultation in 2019, and nearly 4 in 10 people had no access to online consultations at all. Fast forward a few months into 2020, and GPs are seeing only 7 in every 100 patients face to face. For additional insights from the U.S., please see Telehealth comes to the forefront
Much of the change is being led by low-tech digital services such as text message communication and video consultations. These simple solutions have proven popular partly because they are so quick and easy to adopt. Solutions to previous challenges around the secure delivery of patient documents and remote patient monitoring are also seeing increased adoption rates.
COVID-19 has been the catalyst needed to overcome barriers, or at least perceived barriers, that previously slowed the adoption of digital in many areas. This transformation has been borne out of urgent necessity, a burning platform that required immediate action. But will it transfer to the design of clinical trials, the engine of innovation in clinical practice, and therefore lead to a sustained change?
Once the immediate pressure has passed, it is unlikely we will see the same scale of all-encompassing digitization in the design and implementation of clinical trials for a number of reasons, including the following:
While regulatory bodies have been quick to provide advice and guidance on how to continue running trials while reducing face-to-face contact, such as taking appointments over the phone, these simplification measures are currently only planned to apply while the COVID-19 outbreak is ongoing.
Additionally, many of the practices that have seen widespread adoption are relatively small changes, tinkering at the edge of digitalization. A radical step change in progress will only come from sustained pressure forcing a change from the status quo of existing clinical trial design, but it seems unlikely that these existing lockdown measures will last long enough for this huge impact to be seen. Currently, the essence of most advice is to avoid starting new clinical trials if possible. This is due, correctly, to the need to hold patient safety paramount. However, we will only see innovation in this area if we are forced to work within this new environment.
Only with this sustained pressure will we see the investment in the infrastructure and the methods we need to make the broad-scale change. We are still lacking confidence in the reliability and security of digital methods and data collection, concerns around user-error in self-monitoring devices still need to be addressed and technology improvements are required to open up the range of data that can be collected out of the clinic.
However, if a digital transformation does occur, we would reap the benefits well into the future. Trials could become more convenient for participants aiding retention rates, they could become available to people who were previously logistically out of reach as well as providing an opportunity for more regular data collection, ultimately making trials more efficient and more effective.
There are many, many priorities for the healthcare industry in leading the world through this pandemic and digitalization isn’t a quick fix. However, disruption is also the spark of innovation and any improvements in best practice should be celebrated and helped to survive once we are out the other side.
Policy teams may want to consider asking regulatory bodies to extend the positive steps they have taken in this area so they apply post-COVID. There may also be opportunities for internal teams to work together to consider the increased role that telemedicine and digitalization can play in both clinical trial design, real-world evidence gathering and recommendations for best practices for healthcare providers in a real-world setting.
Are you interested in more information on how to help support greater adoption of digitalization? Please contact us.