The rise of electronic health records (EHR) was heralded as a step toward the merging of patient care and research, a scenario in which data from the day-to-day of healthcare is gathered to inform treatment and drug development. But a study in the United Kingdom suggests that while technology can now facilitate this vision, the path is blocked by another barrier: red tape.
PMLiVE reports on the U.K. study, which looked at two attempts to use EHRs for research. One of the trials asked general practitioners (GPs) at healthcare practices to recruit patients with high cardiovascular risk, while the other asked the same physicians to enroll people with chronic obstructive pulmonary disease (COPD) exacerbation. While the GPs had some reservations about talking to their patients about the trial during routine consultations, they were generally in favor of the model of research.
However, GP enthusiasm waned as they learned about the paperwork they had to complete to join the study. "We found that GPs were required to fill in many forms, which took considerable time and effort, before being allowed to ask patients to take part in the trials. As a result, only about 5 out of 100 GPs completed all of the paperwork," the authors wrote. The number of healthcare practices interested in taking part in the trials fell at each step in the governance process. GP participation in both trials was less than 7%.
The difficulty recruiting sites had had knock-on effects on the enrollment of patients. While the heart disease trial hit its patient recruitment target, the COPD study fell well short. The good news is the shortfall isn't indicative of technical failings or resistance from GPs or patients, but--in the U.K. at least--other barriers remain. "The real challenge is not the technical infrastructure to implement electronic point-of-care trials, but a wider appreciation that clinical research is essential to inform patient-centered clinical practice," the authors conclude.