Making NHS technology more trial friendly

Like the rest of the health sector the pharmaceutical industry has been famously (or infamously) conservative about embracing new technology. IT companies have found themselves being eyed with suspicion and their solutions treated with great caution.

However, according to one of the leaders in software for research trials, this is changing and the NHS should also be aware of opportunities that are opening up. The key development to which they refer is the increasing adoption of electronic data management for clinical trials.

Stephen Powell, vice-president and general manager of international operations for Phase Forward believes those driving IT modernisation should take a close look at the potential for turning the new NHS into a superior setting for running clinical trials.

“The NHS can come forward and create benefits and ask ‘What do we get in return?’ I think there’s a discussion point there,” he says.

Powell reels off three things the NHS could do without pausing for breath. “First, look at the IT infrastructure from a holistic view, not just the track information follows between primary care and secondary care, but also other information exchanges.”

Second, he says there could be a discussion around creating certain types of locations with staff specialising in commercial and academic trials and the infrastructure to support the work.

Third, Powell suggests that those creating electronic records could work with clinical trial software developers to move towards single data input.

In the longer run, he says such collaboration could give the UK a competitive edge over other countries in attracting pharmaceutical research. The NHS’s “closed market”, which delivers the vast majority of care and treatment to a whole population, is already attractive to researchers, but research-friendly IT could make it even better.

“Infrastructure has the main impact,” says Powell. “The critical thing is the networks they’ve got and their ability to get to the outside world.” Phase Forward was found that its software works better in China and Eastern Europe than in the UK and France which, Powell believes, suffer from bad government infrastructure.

He may be pushing at an open door. Speaking the International e-Health Conference held in London on 16-17 October, NHS IT director-general Richard Granger dismissed arguments for reprocuring a closed network like the current NHSnet.

While adequate controls were needed around information passing over the new network, much of it would be across public switch equipment, said Granger. “I can see no rational reason for not doing this.”

Will the public stand for closer collaboration with the pharmaceutical companies? Powell agrees that there is a communication job to do with the public on the benefits of allowing the transfer of anonymised data for research. The output based specification (OBS) for the NHS’s new Integrated Care Record Service includes specifications for the pseudonomisation and anonymisation of data that suppliers will have to provide, but a recent
survey for the Consumers Association and the NHS National Programme for IT (NPfIT) found that a mere 6% of respondents felt some part of their electronic record should be shared with pharmaceutical companies.

In contrast, 13% thought their employers should be able to access some part of their record. More positively, 39% thought that “making good information available quickly for medical research” was an important benefit of electronic records.

Phase Forward are bullish about their growth prospects. The company dominates the market in electronic data capture with revenues of $60m in 2002, compared to figures they give for their nearest rival of $4.5m.

They work in 85 countries and count 11 of the top 15 pharmaceutical companies among their clients. More importantly, Powell, believes the company has overcome the innate conservatism of the industry by demonstrating its stability and living up to its claims for reducing the time and costs associated with clinical trials and improving data quality.

”Now they can give us the tick in the box and say, ‘We don’t have to worry that in three years’ time, having locked our processes around you, you will disappear,’” he explains.

One of the next big challenges would seem to lie with the research community and the NHS.