Researchers Using EHRs To Conduct 'Point-of-Care' Clinical Studies

Physicians and biostatisticians at Veterans Affairs Boston Healthcare System and Stanford University are piloting "point-of-care" clinical trials, which leverage electronic health records to compare the effectiveness of different approved treatments, Fierce Biotech IT reports.

The researchers published an article about their pilot project in the journal Clinical Trials. The pilot, which began in October 2010, compared the efficacy of two standard insulin treatments for hospitalized patients with diabetes. The best treatment was defined as the one leading to shorter hospital stays (McBride, Fierce Biotech IT, 4/11).

How Point-of-Care Trials Work

For the pilot project, specialists programmed Boston VA's EHR system to assist in clinical trial recruitment. When a physician submits an order for insulin treatment, the system recommends two standard regimens and a third option, labeled "no preference."

If the physician chooses "no preference," the patient is given information about the clinical trial. If the patient agrees to participate in the trial, the EHR system randomly assigns the patient to one of the two treatment options.

The physician then uses the EHR to record the patient's clinical data during the treatment course. Researchers can use the EHR system to track which treatment is associated with the best patient outcomes.

Advantages of Point-of-Care Trials

Researchers say point-of-care trials offer some benefits over traditional clinical trials because they:

  • Allow researchers to quickly compare treatments for a specific patient population;
  • Enable doctors to immediately implement more effective treatment regimens; and
  • Eliminate delays involved in the peer-review process.
Louis Fiore, lead author of the Clinical Trials article, said the pilot project "has been successful so far, and we plan on rolling it out to other VA hospitals nationwide over the coming months" (Mansell, Pharma Times, 4/12).

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