Why Clinical Trials Need Mobile Health Tools: Can CROs be Replaced?


I have previously written why mobile technologies need clinical trials.  I would now like to discuss why clinical trials need mobile technology.

For readers not familiar with clinical research, a CRO (clinical  research organization)  is “…an organization that provides support to the pharmaceutical and biotechnology  industries in the form of research services outsourced on a contract basis. A CRO may provide such services as biopharmaceutical development, biologic assay development, commercialization, preclinical researchclinical research, clinical trials management, and pharmacovigilance. (Wiki)”    CROs as we know them today started in the late 1970s and early 1980s and have grown as a part of Pharma R&D budgets from 4% in the 1990s to close to 50% in the mid 2000s.  In a previous post on why Pharma needs mobile apps, I briefly mention their potential role in clinical trials.  I would like to discuss this in more detail now.  The cost of performing clinical trials is increasing significantly. Technology including mobile technology and analytics can decrease these costs, but the challenge is for both business models and the research processes to adapt around them. This presupposes that the technologies can perform trials well.

In an excellent paper Transforming the Economics of Clinical Trials, the authors discuss the introduction of technology in clinical trials: “Over the last decade, electronic data capture (EDC) has made some progress in transforming this [business] model. In an EDC-enabled environment, paper forms are replaced by electronic forms, whereby sites enter their data into an electronic database. This technology has produced some efficiency gains as edit-checks reduce the cost of the manual data-query process. However, the EDC platform was largely embedded in the traditional clinical research business model, with legacy concepts around site monitoring and validation. New opportunities for central statistical monitoring of data in these systems were not widely embraced)…Patient screening and recruitment costs remained largely unchanged.”  They then suggest the mining of EHRs for data for the screening and recruitment of patient research subjects, and mobile technologies for direct data collection. What is also keenly pointed out is the current absence for a technology-based business model. The report goes on to discuss monitoring of trial sites. Both the European Medicines Agency and the FDA have endorsed centralized monitoring of trials via technology on a real-time basis.

One company providing mobile tools for clinical trials is exco intouchInVentiv Health is a CRO which has recently become active in the mobile side of clinical trials. InVentiv bought a stake in Mytrus, a company that has mobile technology which facilitates obtaining informed consent for clinical trials.

Recruitment of patients is another aspect of digital technology in clinical trials. Pfizer used social media to recruit patients for a clinical trial of Detrol  One company hosting 200,000 patients in online communities which gather data on 150,000 disease states, PatientsLikeMe  has signed agreements with pharmaceutical companies to match patients with trials using its clinical trial search tool.

Other advantages of mobile clinical trials, as I see them, include less biased recruitment via crowdsourcing, a dramatic reduction in costs, better medication tracking via pill sensor technology (Proteus Digital Health), and faster reporting of adverse events (which can potentially save lives and stop negative studies earlier via transmission to the Data Safety Monitoring Board),  and more timely analytics and trial reporting. In addition, they might lend themselves to more comprehensive or efficient audits, and will strengthen the assistance of caregivers (who can receive and transmit data with/for the patient) in the trial. 

     While I do not believe that mobile technology will replace CROs, I do believe that it will significantly reduce costs and improve procedural inefficiencies and accuracy. The digitalization of clinical trial data represented a significant step in improving process and quality of trials. Making it mobile will take it to an even more higher level. 

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About davidleescher

David Lee Scher, MD is Founder and Director at DLS HEALTHCARE CONSULTING, LLC, which specializes in advising digital health technology companies, their partners, investors, and clients. As a cardiac electrophysiologist and pioneer adopter of remote patient monitoring, he understood early on the challenges that the culture and landscape of healthcare present to the development and adoption of digital technologies. He is a well-respected thought leader in mobile and other digital health technologies. Scher lectures worldwide on relevant industry topics including the role of tech in Pharma, patient advocacy, standards for development and adoption, and impact on patients and healthcare systems from clinical, risk management, operational and marketing standpoints. He is a Clinical Associate Professor of Medicine at Penn State College of Medicine.
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One Response to Why Clinical Trials Need Mobile Health Tools: Can CROs be Replaced?

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