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
1757P - A real-world evaluation of the effectiveness of thermogram along with clinical breast examination in community-based breast cancer screening program
Presenter: Rahul Ravind
Session: Poster session 23
1758P - Body composition meets precision medicine: The prognostic value of sarcopenia in patients (pt) treated with Molecularly Targeted Agents (MTA)
Presenter: Cinta Hierro
Session: Poster session 23
1760P - Systematic review of quality of life (QoL) inclusion among endpoints, reporting and impact of QoL results in phase III non-inferiority trials of systemic treatments in oncology
Presenter: Jessica Paparo
Session: Poster session 23
1761P - Incidence of herpes zoster in cancer patients in Europe: A systematic review
Presenter: Inga Posiuniene
Session: Poster session 23
1762P - Are published data up-to-date? Analysis of time to publication in major oncological journals
Presenter: Pawel Sobczuk
Session: Poster session 23
1763P - The challenge for Cancer Trials Ireland (CTI) to sponsor NCI and non-EU sponsored trials in the EU
Presenter: Eibhlin Mulroe
Session: Poster session 23
1886P - Pembrolizumab and denosumab in clear cell renal cell carcinoma (ccRCC): A phase II trial (KeyPAD, ANZUP1601)
Presenter: Craig Gedye
Session: Poster session 23
1887P - Adjuvant everolimus (EVE) in patients (pts) with completely resected very high-risk renal cell cancer (RCC) and clear cell histology: Results from the phase III SWOG S0931 (EVEREST) trial
Presenter: Primo Lara
Session: Poster session 23
1888P - 24-month follow up of durvalumab and savolitinib combination in MET-driven clear cell and non-clear cell renal cancer
Presenter: Francesca Jackson-Spence
Session: Poster session 23