Copyright © 2011 Allscripts Healthcare Solutions, Inc.

Applied Informatics Inc

Team Members:

Yaseen, Aamir, Shahid, Sharib and Chintan 1

Matching Patients to Clinical

trials using EHR Data

| Copyright © 2011 Allscripts Healthcare Solutions, Inc. A Connected Community of Health

Solution Overview

Ø  The TrialX Allscript EHR application is designed for two

important use cases

•  Automatically match a given patient to a database of

ongoing clinical trials, so as to facilitate recruitment at the point of care during an office visit

•  Enable the provider to run a cross patient query on the

EHR to find patients that may be eligible for a specific clinical trial

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| Copyright © 2011 Allscripts Healthcare Solutions, Inc. A Connected Community of Health

Problem – Finding Patients for Clinical trials

Ø  Clinical Trials are a critical step in the drug development

pipeline

Ø Approximately 50,000 trials are conducted annually

Ø  Finding eligible participants is a major hurdle in timely

completion of clinical trials

Ø  80% of clinical trials get delayed

Ø  Each days delay on average is $1-3million in lost revenue

for pharmaceutical companies

| Copyright © 2011 Allscripts Healthcare Solutions, Inc. A Connected Community of Health

Problem – Lack of Information Ø Most physicians (68%) are not aware of which clinical trials

are suitable for their patients and are unable to provide this

information during a clinic visit

Ø  EHRs have the potential to help identify eligible patients and

to alert physicians if patients match a trial

Ø  However, few EHRs have any, easy-to-use application to •  Find which trials maybe suitable for a given patient •  Refer the patient to the matching trial sites •  Or queries to find a cohort of patients that may qualify for a given study and

inform them about it

| Copyright © 2011 Allscripts Healthcare Solutions, Inc. A Connected Community of Health

Use Case 1: Matching Patients to Clinical Trials Ø  The application automatically matches a given patient record

to clinical trials

Ø Allows the provider to refer the patient to the matching site

in one click via email

Ø  Saves a note in the patient’s EHR for future reference

| Copyright © 2011 Allscripts Healthcare Solutions, Inc. A Connected Community of Health

Use Case 2: Find Patients for a Given Trial Ø Allows providers to run query to find suitable matches for a

given trial •  Age •  Gender •  Location •  Condition •  Medication

Ø  Send a voice message to all matching patients informing

them of the study

| Copyright © 2011 Allscripts Healthcare Solutions, Inc. A Connected Community of Health

Matching Patient to a Trial

Step 2: The application queries the AllScripts EHR to

access patient information

Step 1: The Provider accesses the application from

within the Allscripts EEHR, say during a patient

encounter

| Copyright © 2011 Allscripts Healthcare Solutions, Inc. A Connected Community of Health

Matching Patient to a Trial

Step 3: list of matching trials are displayed, sorted by

nearest distance to patient zip code. Additional filters

like Phase are provided to narrow down results.

“Refer Now” button is provided

Step 4: Patient is referred by provider to research

site by email and the patients complete CDA is

attached for the investigators to review

| Copyright © 2011 Allscripts Healthcare Solutions, Inc. A Connected Community of Health

Use Case 2: Find Patients Matching a Trial Step 1. Provider has a Breast Cancer trial. He can

enter the criteria to find patients with that Condition

entered

Step 2: The application queries the AllScripts EEHR,

using GetPatientsbyICD9 code to retrieve patient

CDA and then match against other criteria

| Copyright © 2011 Allscripts Healthcare Solutions, Inc. A Connected Community of Health

Find Patients Matching a Trial

Step 3: Provider can then enter a message

that will be broadcast to the patient as an

automated Phone Call

Step 5: Provider can see number of calls

completed and responses entered by the patients

Step 4: The System Dials all the matching

patients, pulling their phone number from the

EHR and the message entered by the provider is

spoken out to the patient.

| Copyright © 2011 Allscripts Healthcare Solutions, Inc. A Connected Community of Health

Technical Details

Ø  The TrialX App is integrated with the AllScripts EHR using the API

and can run across any browser

Ø  The app uses several API calls to both read and push data to the

EHR

Ø  App works for a specific patient and also performs cross patient

queries

Ø  Integrated with a cloud-service to make automated calls

Ø  Built as a Django/Python application that works across browsers

Ø  Runs as a Windows 8 Application as well

| Copyright © 2011 Allscripts Healthcare Solutions, Inc. A Connected Community of Health

Development Details Ø  TrialX is currently live across 5 major academic medical

centers and used by over 1.5 million patient visitors on

trialx.com every month

Ø Allscripts API calls used Ø  TrialX uses EEHR/Unity API to fetch provider and patient information. Ø  API Calls Used

Ø GetPatientFull

Ø GetPatientsByICD

Ø GetPatientSections

Ø  SearchDiagnosesCodes

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| Copyright © 2011 Allscripts Healthcare Solutions, Inc. A Connected Community of Health

App Info

Ø  http://ehr2trials.trialx.com:8001/erecord/?patientID=90

Ø  Video link

Ø  Video shows the doctor accessing the application to find trials

matching a given patient and then referring the patient to the

site. It also shows the provider running a query on their

database to find patients matching a study criteria and then

sending them an automated voice message

| Copyright © 2011 Allscripts Healthcare Solutions, Inc. A Connected Community of Health

Next Steps

Ø NewYork-Presbyterian Hospital, one of our current TrialX

clients, would be an important site to pilot the application as

the hospital uses Allscripts EHR

Ø  Perform full-clinical record semantic matching using

laboratory values, procedures to find more specific matches