Cloud-Based Technology in Clinical Trials
Technology has transformed industries, from music to medicine. Advances in data availability and the analytical tools to manage it are growing exponentially. With the addition of cloud technology, the benefits expand. But what does all this mean to data management in clinical trials? And what IS the Cloud?
What is Cloud Computing?
From the NIST (National Institute of Standards and Technology)
‘Cloud computing is a model for enabling ubiquitous, convenient, on-demand network access to a shared pool of configurable computing resources (e.g., networks, servers, storage, applications, and services) that can be rapidly provisioned and released with minimal management effort or service provider interaction. This cloud model is composed of five essential characteristics, three service models, and four deployment models‘
To find out more about how the NIST defines the characteristics, service models, and deployment models, you can read their publication ‘The NIST Definition of Cloud Computing’.
A more approachable definition comes from the Oxford dictionary:
“The practice of using a network of remote servers hosted on the Internet to store, manage, and process data, rather than a local server or a personal computer.”
If you want to know more about how the internet works, you can read more about it at HowStuffWorks.com, which is a great resource describing even the most technical tools in terms that are easily understood.
Benefits of Cloud Computing:
On Demand Self Service: there is never a need to request more storage space, additional time on the server or any other needs. The service is responsive to your needs.
Always Available, Everywhere: Anything stored in the cloud is available on any device that has a web browser – smartphone, tablet, computer, and now, even a watch or Fitbit.
Dynamic Resources: The cloud enables services to many customers simultaneously with the same virtual physical resources. Server location doesn’t matter: as long as you have good internet access, you have full use of the product.
Rapid Elasticity & Scalability: The cloud simply scales with you – processing and memory capacity responds to your needs, up and down.
Measured Service: Usage can be monitored, controlled and reported, so you can better manage your cost. You only pay for the storage space used.
The cloud provides limitless access to the software, data, and tools for analysis that have been contracted to you with a vendor. All the data and the software to support it are provided to you anywhere you are, on any connected device, from anywhere in the world, all in real time. And that comes in handy with the expansion of global sites and trials.
There are many benefits of using Cloud-Deployed eClinical Solutions.
Greater Study Control: The clinical trial manager can independently turn site enrollment on or off, and manage individual access. User views and permissions can be managed at each trial location and each site. You can proactively review and manage entry professional as well as monitor requirements in real-time; giving you the information you need to make decisions faster.
Real-Time Reporting: Data is always available in real-time.
Information is generated directly from the system itself; no need to supplement system reports due to data transfer lag time. That means the system automatically triggers inventory changes, provides immediate notification of Serious Adverse Events, and gives you the information you need to make decisions, faster. Quickly make decisions, and provide the highest quality data for risk based monitoring.
Access Data from any Device: Mobile, Tablet, Laptop and Workstation: As long as the device has reliable access to the internet, all data can be accessed from anywhere, at any time. The physical location of the study team and the actual storage site of the information are irrelevant.
Saves Money: With lower IT costs because you don’t need to purchase or rent storage space for the use of the product, you reduce your IT spend. You automatically earn economies of scale, as the software provider has already negotiated these low costs.
Saves Time: You completely eliminate time requirements needed to install licensed software. You receive your logon access and you begin. There are no software updates to install or track. The software is always up-to-date, ready to respond.
Data Security
Trial managers should always be concerned about data security, regardless if paper or technology based. Enterprise Class Security supports current standards including PCI DSS, HIPAA, HITECH and SCO2. When determining your eClinical solution, you must ensure the highest possible data security and compliancy with regulatory agencies.
Disaster recovery and business continuity plans must also be in place, including the use of redundant sites, hardware and networks with a verified business continuity plan provided to you by your eClinical partner. Look for redundant sites that vary in location and geography and outline time requirements to activate stored data.
Selecting a Cloud-Based eClinical Provider
When determining your cloud-based eClinical application, validation of on-going performance, security, and integrity of stored and managed data is a must. Availability of the system and uptime should also be verified, to minimize or eliminate downtime for upgrades and mid-study changes. A unified software platform delivered through the cloud should virtually eliminate downtime for any reason, providing the clinical trial with the recovery of lost productivity.
Service Level Agreement
Service Level Agreements allow you to manage the cloud-based vendor appropriately. Be sure to measure what matters, including:
Verify System Availability Definition: Your eClinical provider should define the system availability of the application in the cloud. It is important to note that some providers try to specify availability outside of scheduled downtime. A true cloud application should not require downtime to perform maintenance so it is important to evaluate how the provider reports availability.
Support Services Agreements: Available resources to provide assistance when issues arise within a cloud based application are as important as system availability. It is important to define the expected support on-staff to address issues as they arise in any application. eClinical application support is even more relevant when patient safety is at risk. It is important to define the on call staff and the expected support during off hours.
Response Time Requirements: It is important to define the expected response times when support issues do arise. Ensuring that the clinical teams as well as the eClinical vendor have the same expectation on response times ensures you have the optimal experience when issues do arise.
Service Level Credits: Ensuring that from the beginning the SLA defines what credits you receive when the eClinical vendor does not meet the SLA is very important. Having expectations set form the front and the repercussions that the vendor will experience if those expectations are not met help ensure when issues do arise there is a defined path for resolution.
Reporting Availability, Standard & Ad-Hoc
Your eClinical provider should deliver functionality that empowers users with insightful data, including reporting flexibility. The availability of standard and ad-hoc reports, status reports on data entry and cleaning, and the ability to see average times to task, for example, will provide added insight so the trial can stay on track. Reports on time between visit date and data entry for EDC, time from query response to query close in EDC, and time between data received and entered in CTMS, eTMF, Safety, and Labs can be measured to ensure timelines are supported and response time requirements are met.
Remediation Requirements
When finalizing agreements, ensure allowances are made for remediation if agreements are not maintained, with escalating consequences if issues are not handled in a timely matter. It is important to include in any agreement the frequency and the format of the reporting of the SLA requirements to ensure the vendor and client are reviewing and reporting on the same information. Within the SLA, ensure the channel and structure of the escalation are clearly defined to ensure quick response on issues.
Industry & Regulatory Archival Records
Your provider should offer industry and regulatory required archival records, with clearly defined responsibilities, response time, and fees.
Look for solutions that minimize or eliminate data migration or manipulation, streamlining the data management process and mitigating trial risk.
Verify the supported browsers and trial data accessibility on mobile and tablet browsers. Ask about routine maintenance and any related down time. With the expansion of global sites, confirm which languages are supported and what typesets are available (Chinese, Japanese, etc.) and any related additional fees.
Contracting with Partners
If you are selecting sites or contracting with a CRO, be sure to negotiate enforceable expectations for clinical data entry into your chosen cloud eClinical application. Negotiate specific requirements, such as data entry within 48 hours of patient visit, and establish payments based on data quality, such as no queries or open issues with data, including data cleaning activities. Cloud eClinical applications allow you to move away from time based unit of measurements to activity or task based measurement and dearly define responsibilities and tasks associated with the study.
Look for software that activates the benefits of the Cloud.
Although cloud technology enables many benefits, it all starts with the software. Regardless of the delivery system, via Cloud or not, the capability of the technology to optimize clinical trial data management is key.
Software that does not require data migration or manipulation optimizes the benefits of the cloud. Some solutions may require data to be transferred from one product to another, or require access to tools external to the core system to complete data entry or classification. These software offerings do not maximize the benefits of the cloud as down time and lost productivity are introduced.
Software products that are not delivered in the cloud require additional resources to manage the software upgrades, server maintenance, and active user maintenance. Whether the provider manages the product or the clinical trial team, additional resources and time are required, extending the timeline of the trial.
Summary
Technology advances have created the opportunity for companies to redefine their services. The cloud is a real benefit to the clinical trials industry, responsive to the growth of global sites and round the clock access requirements, safely accelerating the development of meaningful treatment for the people who need it and supporting efforts to reduce the cost of development. But knowing how to manage the cloud, finding a provider that actively supports advancing technology and delivers software that optimizes the power of cloud technology will create an optimized clinical trial.
*Fountayn Formerly known as Datatrak