Abstract 1717P
Background
Digitalisation of healthcare delivery enhances security, efficiency, and cost-effectiveness. The challenges of transitioning to a modern electronic healthcare system with multiple workflows remain poorly described, especially for early phase trial units. We present our recommendations for digital healthcare transition based on our experiences and outcomes. The Royal Marsden (RM) and Institute of Cancer Research (ICR) Drug Development Unit (DDU) is one of the largest early phase centres in Europe, enrolling ∼300 patients across >60 trials per year, with a dedicated ward, day unit and outpatient clinic.
Methods
In March 2023, RM transitioned to a new healthcare system. DDU adopted a patient centric approach, as per table, with emphasis on safe treatment delivery for patients within the dose-limiting toxicity (DLT) period. Table: 1717P
Planning aims
| a) Virtual walk-through trial pathways from referral to discharge b) Patient visits planning and forecast for first 4 weeks. For Week 1, targeted reduction in planned patient attendance by 10% with no patients starting on trial and on-site attendance is prioritised for those within DLT period. c) Staff training < 8 weeks in advance and absences minimised during the transition period d) Managing expectations of patients, staff, and partners e) Daily team meetings to feedback and escalate issues |
Results
All planned trial activities were completed during weeks 1-4; though late IMP dosing up to 21:00 were experienced. Over these weeks, 36 patients were treated within the DLT period, and no safety issues raised. Adaptation pace among staff varied, with reports of fatigue from learning new workflows, improving from Week 4. From Week 5, the number of attendances returned to pre-transition levels.
Conclusions
Major digital transformation projects can be undertaken safely within a phase I trial setting whilst maintaining service delivery, with investments in implementation beyond the technology itself. Staff digital literacy assessments, training, pathway walkthrough, interface familiarisation, managing staff morale are critical for managing such transitions. Extensive planning and focus on the end users are vital in ensuring both short-term delivery and long-term benefits of digital transformation.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The Institute of Cancer Research and The Royal Marsden Hospital.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
2375P - Neoadjuvant sintilimab combined with gemcitabine and cisplatin (GP) for muscle-invasive bladder cancer (MIBC) patients followed by selective bladder sparing surgery
Presenter: Zhou Tong
Session: Poster session 23
2376P - Pembrolizumab monotherapy following tri-modality treatment for selected patients with muscle-invasive bladder cancer
Presenter: Shang Bin Qin
Session: Poster session 23
2378P - Efficacy and safety outcomes with pembrolizumab (pembro) rechallenge for patients (pts) with advanced/metastatic urothelial cancer (UC) who responded to first-course treatment
Presenter: Vadim Koshkin
Session: Poster session 23
2379P - AVENANCE: Subgroup analysis of patients (pts) with advanced urothelial carcinoma (aUC) with histological variants from a real-world (RW) study of avelumab first-line maintenance (1LM)
Presenter: Philippe Barthélémy
Session: Poster session 23