Clinical Trial Sites and Technology Overload

In a recent video interview with Applied Clinical Trials, Jimmy Bechtel, vice president, site engagement, SCRS, discussed key challenges and initiatives at the site-level. AI's impact on sites is significant, with uncertainty around its implementation. Diversity requirements pose challenges, and technology overload is a major issue due to inconsistent tech stacks and financial burdens on sites. Bechtel also highlighted some initiatives that SCRS is currently working on and gave an overview of the most recent Global Site Solutions Summit.

A transcript of Bechtel’s conversation with ACT can be found below.

ACT: One thing we hear a lot about is sites experiencing a technology overload recently. Why do you think sites are expressing this?

Bechtel: Yeah, I think a lot has to do with the sheer amount and variety of technology that sites are being asked to implement on their clinical trials, coupled with the fact that there isn't any sort of standardization or consistency around it. You could have one trial from one organization use one tech stack, and then another trial from the same organization use a completely different tech stack, and that just repeats itself and compounds upon itself for all the different sponsors and CROs that a site is working with, so it's that lack of consistency and lack of interoperability and integration that has a lot to do with the challenges that the sites see. Every time they see a new technology is used in a new or different way, they have to start from scratch with the training and the knowledge and the education and how to use it and educating their patients. There's just a lot of inefficiencies that comes with this pilot-phase that we're in still with a lot of these technologies. I think we're moving in the right direction. It sounds like a lot of sponsors and CROs and professional service providers and these technology companies hear that, the dust is settling, and they're starting to understand which ones they want to use, and they're starting to build in some consistency. By now, a lot of sites have seen a lot of the solutions in one way, shape, or form, so they're starting to realize those things. It's kind of been a rough couple of years that we've tried to work through some of that.

I would also say that the financial aspect of utilizing and implementing these technologies, operationalizing them at the site level is a real challenge for sites, because there's, as you can imagine, when you have to train and implement and, again, operationalize these technologies at the site and patient level, that takes a lot of time and effort and training and coordination into parts of the site that sponsors and CROs probably never even think about. IT, and integrating that when you have a system that might be pulling data or data might be moving over that site's network and its patient data, there's a whole a bunch of cybersecurity, and IT questions that we have. It’s just one example of ways in which the dollars can start to build up in ways that we don't expect, so approaching a clinical trial with a traditional budget doesn't really work in the case of implementing technologies. Sites are seeing themselves bear a lot of these costs because they don't necessarily know either approaching some of these technologies. It's not until we're well into the clinical trial and well into that implementation phase of these technologies that we start to realize and recognize some of those true and real costs, but by then, unfortunately, sponsors and CROs say it's too late to renegotiate the budget, so the sites are stuck bearing those costs as a result of implementing that clinical trial. It’s learning the lesson the hard way, unfortunately, but that's definitely a major part of what we're seeing.