ESMO Congress 2023 | OncologyPRO

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.