The COVID-19 pandemic has had a huge impact on the acceleration of digital tools used within health, social care and clinical research. A government report ‘The Future of Clinical Research Delivery: 2022 to 2025 implementation plan’ (Department of Health and Social Care, June 2022) sets out a future vision of delivery which includes research enabled data and digital tools.

In collaboration with NIHR CRN West Midlands a team of academic researchers at WMG at the University of Warwick have explored the adoption and use of digital tools within clinical research, and people’s experiences of using them. The study investigated the following questions: Which digital tools are are clinical research teams using? Which digital tools were considered to be effective (and ineffective)? Are there any barriers to digital tool use?

The research was conducted over two phases. Firstly, a comparative report on findings of three separate online surveys with the following participant groups within the CRN West Midlands region:

1) Researchers and related staff

2) Research and development staff

Secondly, those participants also had the opportunity to take part in a qualitative interview which was analysed and summarised into 10 themes.

Participants agreed that digital tools were defined as an online device that could connect to the internet andused to make research more efficient. Digital tools have been adopted across all stages of clinical research including management, recruitment, and data collection. Impact of the COVID-19 pandemic rapidly increased the use of digital tools and the attitudes towards the implementation of this is one of acceptance amongst staff. The benefits of using digital tools included convenience, accounting for individual differences, efficient use of time and easy connectivity between colleagues. However, the drawbacks of using digital tools included, technical issues, difficulty reading interactions over digital means (compared to face-to-face), learning how to use the system and a lack of clarity on which digital tools worked best on a task-by-task basis.

There was little choice in selecting which digital tool they used, mostly because the tools would be used across the organisation such as MS Teams or SharePoint; however, some participants stated that they used a bespoke system. Staff would often find out about other recommended tools through word-of-mouth and suggested creating a standardisation process which helps outline the tool’s use and selecting the appropriate from a list of suggestions.

There were several identified barriers to using digital tools which included: attitudes towards using them, conflict between carrying out a patient-centred job and finding time to learn to use new digital tools, and resources (such as budget and expertise). To overcome some of the barriers, some organisations used a hybrid approach using both paper and digital. However, this increased workload for some staff due to data management requirements. Participants explained training can help staff to feel more comfortable using digital tools, however, a flexible approach is needed to understand individuals’ barriers to using them. Training was provided on some of the tools using different methods, however, training wasn’t always specific for digital tools use within research.

The cost and effectiveness of the digital tools in comparison to paper is very little researched but participants expressed an interest and recognised that this would be important for making a case for using digital tools in the future.

Participants agreed that digital tools would be increasingly used in the future, however, there was concern around excess pressure on nurses, need for collaboration and digital expertise when developing the tools. Some of the participants in the study were conducting their own research to evaluate effectiveness of the digital tools.

Conclusions

Key findings were that the use of digital tools is becoming increasingly essential within clinical research, with the pandemic accelerating the need for these tools. Adoption was observed across management, recruitment, consent, data collection, retention, and intervention. Tools which were favoured by the staff were ones which increase efficiency. However, digital exclusion remains a concern for participants and whilst training can overcome this, delivery of training needs to be flexible to avoid excessive extra workload on staff. Currently, there is concern about limited resources available to support the rapid adoption of digital and online methods for clinical research. In particular, there is a need for individuals or groups who can deliver expertise to organisations and research teams in terms of selecting the best tool for the job and deliver relevant training. This could be in the form of regional networks or user groups. Finally, the study was unable to recruit a suitable sample of patients/carers who had previously participated in clinical research studies and experienced the use of digital approaches in the context of trial participation. The research team therefore recommend future research should focus on gaining further insight from participant groups.

Read the full report below.

Preprint: click here for the preprint

Full Report: click here for the full online report