Applied Clinical Trials
The session started with a short address from James P. Kremidas the Global Head of Patient Recruitment at Quintiles Inc. The session chair stated that electronic medical records (EMRs) "are very useful. But the challenge is in the implementation. EMRs are evolving and we are at an interesting state of that evolution." The ability to tap into EMRs for patient recruitment—although not quite the Holy Grail the session's title implies—has untold potential, and could potentially change the way recruitment is conducted in the future.
After Kremidas's remarks, Jaime Lucove a Scientist at AllScripts spoke. Lucove gave an overview of the market and the types of data available. She said that EMR presents longitudinal patient data to a provider at the point of care. Data can flow into the EMR from different sources. There are currently around 400 different EMR systems in place today. EMR utilization is increasing: 50% of providers in 2010 used some form of EMR system, compared to 18% in 2001. Lucove finished her talk by discussing the consideration of when to use EMR data for research.
Following Lucove to the microphone was Gary Mallow, Director of HIT for Clinical Research at Merck Research Labs. He discussed what is happening in the life sciences sector with regard to healthcare trends: digitization of the healthcare records, connection of data sources, larger population stores, and the exchange of information driven by meaningful use. According to Mallow, Health Information Exchange (HIE) initiatives have increased from just nine in 2004 to 73 in 2010—illustrating an increase in the use of electronic records in the life sciences.
Next up to the podium was Global Head of Patient Recruitment at Genentech, Inc., Jane Myles. Myles discussed the operational use of EMR and EMR-enabled clinical research processes. "Perhaps there is a way to harvest data that already exists and leverage it to decrease the burden on patients," Myles said. According to Myles, the key stakeholders in the rising reliance on EMR are: contracts, legal, regulatory, clinical science, epidemiology/biostats, and clinical operations. Myles stated that teams need both time and training in order to utilize the full power of EMR; currently effective planning stages are missing, decreasing the ability to use the process to its full extent.
The final panel member to take the stage was Gary Lubin, the President and CEO of Centerphase Solutions. Lubin warned the crowd that although EMR systems can be very effective, they require a huge commitment. If EMR is used correctly it can offer a great advantage, unfortunately many large companies are misusing the technology. According to Lubin, 15% of ICD-9 codes were inconsistent with diagnosis in a recent study of EMR, a dangerous trend. Lubin was not all doom and gloom however, he ended his talk with a positive: the amount of charts that need to be reviewed when using an Electronic Health Records system can be reduced by more that 75%.
Following Lubin's presentation, the floor was opened up to question and answer.