REDMOND, Wash., October 5, 1998 — Dr. Jay Benear, an oncologist in Tulsa, Okla., used to sift through stacks of books, each one up to six inches thick, trying to match his cancer patients with clinical drug trials that could save their lives. Not only was the process time consuming, but the books also were out of date, and the studies they listed were often “closed,” meaning researchers already had enlisted all of the cancer patients needed to complete the study.
Benear recently abandoned the laborious book-searching process and now enters information about his patients onto SecureNet, a new Web site built using Microsoft technology. Developed by American Oncology Resources, Inc. (AOR), the Web site enables Benear to match more of his cancer patients with leading-edge drug treatments that could help them beat cancer when traditional cancer therapies have failed.
“The most frustrating thing for a doctor is to go tell a patient that we have a study that you’re eligible for and then go back and find out that it’s been closed,” said Benear, president of Cancer Care Associates in Oklahoma. “SecureNet has helped me to streamline the process of identifying who’s available for trial and proactively knowing what trial a patient’s eligible for.”
Using Microsoft technologies ranging from SQL Server to Internet Information Server and Microsoft Site Server, AOR has developed the first national Web site that allows physicians like Benear to match their cancer patients with clinical drug trials. A national cancer management company that focuses on oncology, AOR this week plans to finish rolling out the Web site to its physicians, who treat 8 percent of all cancer patients in the U.S.
The Web site could reduce the time it takes pharmaceutical companies to bring their drugs to market by making it easier for them to find the right cancer patients needed to conduct their trials. It is also expected to make it easier for cancer patients to receive access to cutting-edge drugs that have yet to be approved by the Food and Drug Administration. Cancer patients sometimes turn to drug trials after their tumors stop responding to traditional cancer therapies, because the drugs offered through these trials can provide the best cancer treatments two or more years before they become standard.
“Most of the time in a research trial, the treatment eventually becomes standard treatment,” Benear said. “So the smart thing is to get as many of our patients as we can into trials.”
SecureNet is an example of how healthcare organizations are using Microsoft technology to improve the services they offer to medical patients. To date, Microsoft’s software partners have developed more than 400 healthcare applications for all segments of the healthcare industry.
“Our goal is to provide healthcare organizations with the technology tools they need to create integrated information systems,” said John D. Carpenter, worldwide healthcare industry manager at Microsoft. “SecureNet is an excellent example of how Microsoft technologies can be used to connect healthcare providers with the information they need quickly and reliably, to provide the best possible care for their patients.”
Physicians currently have had no automated way to keep up with cancer drug trials. As a result, cancer patients typically learn of drug trials on a hit-or-miss basis, depending on how up to date their physician is on the latest research.
“Depending on where your physician has been trained, depending on how much they care about clinical research or how well they’ve kept up with it, a patient may or may not be presented with clinical research alternatives,” said Bill McKeon, vice president of marketing at AOR. “There’s no automated way of guaranteeing that you’re going to be considered for all these potential therapies.”
Once cancer patients are selected for a drug trial, a clinical research coordinator must fill out numerous case report forms that record each patient’s detailed reactions to the drug. The research coordinator faxes these forms to a data management collector, who enters the information into a central database. The paper-based system slows down the time it takes to complete drug trials and leaves a lot of room for error since forms are sometimes completed inaccurately and have to be re-entered by a central data management employee, McKeon said.
“There are more new drugs for cancer patients available through clinical research now than in the last 10 years combined,” McKeon said. “The problem we are faced with is keeping pace with the genetic revolution when we are relying on a system that is still manual, labor intensive, slow and prone to human error and data inaccuracy?”
AOR SecureNet solves these problems by providing an automated database that offers physicians up-to-the-minute information about clinical drug trials. AOR’s 340 physicians, who see 90,000 new patients every year, enter basic information about their patients into a database, including the patient’s name, gender, date of birth, and site and stage of the cancer. The Web site searches for possible drug trials and sends e-mail to the physician within seconds when a match is found. Any time a new trial is added, SecureNet searches for potential patients, and any time a new patient is added, the Web site searches for upcoming trials. Once a trial is under way, the SecureNet Web site allows physicians to enter patient information directly into the database, eliminating the need to re-enter data and reducing the chance of human error.
Currently, less than 5 percent of cancer patients participate in clinical drug trails, McKeon said. Increasing this number to 10 percent would make it possible for pharmaceutical companies to bring their drugs to market in one year compared to the three to five years it now takes them. “If you’re a cancer patient, or your mom’s a cancer patient, three to five years is everything,” McKeon said.
McKeon, who has created other Web sites for the medical community, said the idea of an online drug trial matching system simply occurred to him one day. “I was running one day and realized that technology could automate the patient-trial matching process and replace the current hit-or-miss fashion that is in place,” he said. “It really depends on whether the physician has read the latest information. And the sad fact is that often patients fall through the cracks.”
After researching the options, McKeon decided to base the Web site on Microsoft technology because of its seamless integration among applications as well as the company’s “proven track record of being innovative and inventive.” He also went with Microsoft technology because protecting patients’ confidentiality was a top priority, and Microsoft offered the highest level of security.
“We chose a platform that allowed us several layers of security,” McKeon said. “That was a number one concern to us, to have something that would really work well in this area. That’s why this has been a perfect fit for us.”
McKeon worked with TVisions, a Microsoft certified solution provider, to build the application. A Boston-based company that specializes in developing on-line business solutions for the Web, TVisions has had the Web site up and running since May, and AOR has spent the last few months testing the application and deploying it to its physicians.
SecureNet runs in a complete Microsoft environment using SQL Server, Internet Information Server and Microsoft Site Server Commerce Edition 3.0. Microsoft Site Server Commerce Edition gives AOR the ability to connect physicians and their patients to the clinical trial information in a secure environment that provides both scalability and close integration with other systems. Physicians need Windows 95 and Internet Explorer 4.0 on their desktops to use SecureNet.
While the drug-trial matching system is considered the most innovative aspect of SecureNet, the Web site also includes other features including a medical library that allows physicians to research cancer studies and a chat room that enables doctors to share information about cancer therapies. AOR plans to expand the Web site to include a chat room that will allow patients to exchange information about their treatments.
“When it comes down to having cancer, you want to have every weapon available. The more alternatives, the better,” McKeon said. “Our goal is to leapfrog the status quo by using technology to help our physicians identify the most effective therapy for their patients. We want to streamline clinical research in this country.”