Clinical Informatics Research Unit Update

We would like to take this opportunity to give you all an update on what is happening here at the Clinical Informatics Research Unit (CIRU). 

We would like to warmly welcome Dr Mike Head and Dr Rebecca Brown into the department. They are both Research Fellows at the University of Southampton and are currently running the ResIn study.

The Research Investments in Global Health study (ResIn) is funded by the Bill & Melinda Gates Foundation. The project previously focused on the UK research landscape and published widely on the strengths and gaps in the UK research portfolio for both infectious diseases and oncology. Levels of investment have been compared to global and national burdens of disease to gain an insight into relative levels of spend and inform priority-setting initiatives. Now, ResIn is building a global dataset and analysing funding trends and disease burdens for infectious disease research across the G20 nations and will report findings in 2018. The study, and results to date, have been presented multiple times to many high-level global health stakeholders including the World Health Organisation, European Commission and the Wellcome Trust. Findings have also been cited by others in numerous documents including journal publications and government reports.

See http://researchinvestments.org/ for more about the project.

A trip to the EDGE office by Viswin Mallayan

We had Viswin Mallayan, Research and Innovation Information Manager at University Hospitals of Leicester NHS Trust join us in the EDGE office a few months back and we thought we would share his story with you:

"I had the great honour of working with the EDGE team in Southampton last month, where I spent my time sharing and gaining knowledge reporting in EDGE and Microsoft Power BI, as well as presenting two webinars on “'Using EDGE and Microsoft Power BI to provide intelligent reports and improved business decisions” to a Canadian Team and all the UK NHS trusts.

I have been an EDGE user for over 18 months and use the system to capture recruitment data and prepare reports for senior management and clinical management groups. I utilise EDGE in conjunction with Microsoft Power BI to provide intelligent reports and help shape and inform clinical management groups’ decisions.

EDGE is one of the best tools with greater flexibility for the end user. This means we are benefiting as we can use the system as an intelligent data management tool to fully integrate information from all departments to produce meaningful and quality data for outcome analysis.

Leicester’s Hospitals uses Microsoft Power BI as a primary reporting tool for research data and we are working with the EDGE team to make common Microsoft Power BI dashboards where any Trust using Edge can see their performance (similar to open data platform).

Since the EDGE Accelerate conference in March of this year, my colleague Carolyn Maloney has guided around 20 NHS trusts in the UK on how to use EDGE for Clinical Research." 

EDGE Case Study by Helene Jones

The Lincolnshire Clinical Research Facility facilitates the implementation and management of clinical research for the United Lincolnshire Hospitals Trust across its multiple hospital sites within the large rural county of Lincolnshire in the East Midlands. The research undertaken within the trust encompasses a wide range of therapeutic areas including oncology, haematology, stroke, cardiology, paediatric, dermatology, diabetes, midwifery, ophthalmology, respiratory, anaesthesia, gastroenterology, renal and orthopaedics. The breadth of research disciplines managed by the research facility and the diversity of hospital sites within the trust called for a flexible clinical trials management system to support its continued growth and build upon operational processes. In April 2016 ULHT implemented EDGE across all of its sites providing a fully-integrated data platform for the benefit of clinicians, research nurses, radiologists, pharmacists and other research professionals, supporting their clinical research and providing real-time trial data and business intelligence.

The nature of research in the region is influenced by the diverse needs of a population and healthcare system in the large rural county of Lincolnshire, and Lincoln as one of the fastest growing cities in the UK. The trust needed a system to provide the flexibility to manage differing scales of operations and the requirements of individual units within its organisation but maximise communication, and provide consistent metrics and reporting. One of EDGE’s greatest qualities is its adaptability which makes it so flexible in managing the complexities of clinical trials and the range of contexts in which they are conducted. 

EDGE is an application which is logical and scalable. During the implementation of the CTMS within the organisation we were able to train and roll out the application around the busy work schedules of the research teams and do this in a stepped process by site. The software is user-friendly yet provides powerful functionality and the option to adapt the application, at multiple levels, to meet the needs of the organisation. A core strength of the system is its flexibility for end-user process adaption, allowing individuals and trusts to creatively develop their particular instance. This in turn contributes to the evolution of EDGE through the perspective of sites and researchers who understand evolving operational needs the most and builds benefits for the EDGE community. The developers have cleverly, through the provision of an attribute based system, created an application which is future-proofed and keeps pace with evolving processes. We can build on the global knowledge of users across the UK and beyond in how we can better use data and systems in the delivery of efficient clinical trials. The role out of the system within our Trust has also provided the unanticipated yet immeasurable benefit of engagement with the wider community of EDGE users in delivering research and in sharing best practices, both in terms of the application itself and sharing research ideas in general. 

Within the United Lincolnshire Hospitals Trust we use EDGE to support the setup, feasibility and approval process for studies, track recruitment, manage patient visits, record resource, interventions and inter-disciplinary departmental involvement such as logging studies requiring ECGs, RECIST criteria, all blood sciences requirements etc. We also use EDGE for substantive reporting and monitoring of metrics by maximising the use of core EDGE reports alongside bespoke attribute reporting at a study level, site level and patient level. We are also seeking to develop the system as a trial evaluation tool and workforce management application. 

EDGE has provided ULHT with an IT platform to support its strategic planning and growth, enhancing its reporting, communication and trial management to support enhanced participant engagement and patient outcomes. All this supports the delivery of efficient clinical trials. The following principles demonstrate the benefit of EDGE for individuals, trusts, networks and the NHS.  

EDGE provides; 

1. Complete flexibility to support specific needs of trusts, sites and individuals in managing clinical trials.
2. Creative power for trusts and sites to develop their own instances to meet local needs.
3. an EDGE community who collaborate to collectively evolve the system.
4. a system which is developed through the perspective of the end users who understand their individual needs the most.
5. a robust and secure integrated system and data set for enhancing operational delivery at trust, regional and national levels.

Post by Helene Jones, Research Support Officer
United Lincolnshire Hospitals NHS Foundation Trust
Helene.Jones@ULH.nhs.uk

Using EDGE to manage a complex primary care study

My name is Randeep Basra and I am a Clinical Studies Officer for the Clinical Research Network in North West London. I am part of the delivery team that helps with the setup and support at primary care sites and recruitment of participants for research projects that I am assigned to work on.

One of the projects currently in progress is iHealth-T2D, a multicentre, cluster randomised clinic trial on type 2 diabetes in the South Asian population. The study looks to provide evidence that the implementation of lifestyle modifications and health promotion is clinically effective in reducing the onset of type 2 diabetes in South Asians with central obesity or pre-diabetes compared to usual care. Managing the study has brought on some complex and challenging situations in terms of project management, where communication, organisation and team work has been key to the success we have experienced so far.

This has been helped significantly by the use of EDGE. In the early stages, large amounts of information about the study was kept in a number of places that were not so easy to access and were becoming difficult to manage by the team as a whole. An example of such information was the staff involved and their contact details, information about clinics being run at GP practices and patients recruited, just to name a few. When hearing about EDGE, we felt it could work to solve these issues.

Since then, we haven’t looked back. Once the process of uploading all the information to EDGE had taken place, we found it straightforward to access and the layout easy to navigate. We are able to effortlessly store different pieces of information about the project or primary care sites in one place that everyone can see. For example, I can find a particular recruiting site in a couple of clicks and can access information on how many patients were contacted from a particular site and on what date, when screening clinics are running and how many participants have been recruited so far. The outcome is that everyone is able to look at and maintain up-to-date information about the study from a single place from almost any location at any time.

Knowing that I can add users and have the contact details of any member of staff from any of the 50+ GP practices taking part is reassuring and allows a smooth stream of communication with everyone involved. Personally, the “notes” section is a highlight for me, as being able to communicate updates about an individual site for everyone to see in a free-text box saves time on administration and permits flexibility depending on what information can be stored here. Although it is not necessary to upload patient information to EDGE for our team, I have found using anonymous codes for each patient recruited at GP practices has been a safe and fool-proof way for me to keep an accurate record of how many participants are engaged with the study. Last, but certainly not least, the “project attribute reports” have been wonderful when requiring a snapshot of the study for team meetings and to assess data quality.

This hasn’t just been useful for me the delivery team – other staff who support the delivery team have found it a great way to pull off information from the system when it comes to arranging financial payments or tracking recruitment. In fact, this study was the first we have tried to store financial information on and while this is work in progress, it has been very useful so far. In this way, the whole team can be singing from the same hymn sheet without the need for endless spreadsheets and hard-to-follow email trails.

We would like to give a special thanks to Kaatje and Sean for all the support we have had in making this system work well for the project. We feel the adaptability and brains of the system, as well as the people behind it, are what make it work for us.

Here is a shot of the team who have all been involved in delivering the study.

Post by Randeep Basra, Clinical Studies Officer
CRN North West London
randeep.basra@nihr.ac.uk

Read an article from us

You can find an article from our director James Batchelor in this months International Clinical Trials magazine. The title of the article is 'Strength through Collaboration', where James promotes research teams coordinating both nationally and internationally, in safely changing routine standards of clinical care to improve patient quality of life. 

This piece can be found here and has been taken from International Clinical Trials May 2017, pages 24-26 © Samedan Ltd

Visit the contents page of the current issue of PMPS here

Global Cyber Attack- advice for our users

As you may all be aware, there was a global cyber attack on Friday causing problems across the NHS.

EDGE is hosted at a secure Tier 4 centre at Carelink, one of the highest level of secure centres available. The EDGE service was not impacted by the attack however, as a precaution we decided to temporarily stop access to the EDGE service on Friday evening to allow time for the threat to be better understood and reduce the risk of any impact to the EDGE service. On Saturday morning after further assurances, access to EDGE was resumed.

This was done purely as a precautionary measure.

We would advise that all NHS staff follow the guidance given by their organisation regarding security patches, run windows updates on all machines and continue to keep all computer systems up to date with anti-virus software releases. Further to this we recommend for those trusts who are running Windows XP to contact their IT department to update to Windows 10 as an extra safety precaution.

In general please can all users be extra vigilant when opening emails and do not open any attachments or click on any links if you are not expecting communication from the sender. Malicious emails may appear to come from other NHS employees, so even if you recognise the sender please do not assume that the contents are safe. If you think your computer has been infected by a virus we advise that you immediately disconnect it from the network or shut it down and contact your IT department.

This is also good advice for your personal computers to limit the impact of these cyber attacks.

We will continue to monitor the situation and react appropriately to continue to provide a safe and reliable service.