How eCOA Can Improve Patient-Provider Communication in Clinical Trials

One of the most significant challenges in clinical research today is engaging patients — and keeping them engaged. Patient engagement is the key to a successful study, as it not only ensures that the study reaches completion, but that the data collected is accurate and the patient experience is a positive one.

While there are many factors that influence patient engagement, communication with providers and study researchers is one of the most important. Patients often report being confused by jargon, feeling “in the dark” about the results of their study, or unsure about what they need to share with providers in terms of their experience with the trial and the treatments. Patients want to build rapport and trust with their providers in any healthcare situation, but it’s especially important during clinical trials.

With the stakes so high, researchers are committed to finding new ways of improving patient engagement and patient-provider communication. One method that is showing a great deal of promise is the implementation of electronic clinical outcomes assessments (eCOA). By using eCOA technology solutions to capture patient data electronically using a smartphone, secure website, or other interface, researchers are collecting higher quality data more efficiently, while simultaneously improving how patients and providers communicate with each other.

The Key Communication Benefits of eCOA

When eCOA was initially introduced, there were some who were concerned that an electronic interface would create an unnecessary barrier to communication between patients and providers. They feared that instead of building a relationship with a provider and sharing information during visits, information would only be shared online without further discussion.

As it turns out, those concerns were unfounded. Collecting data electronically has actually improved communication in several key ways:

1. Symptoms are now more likely to be discussed. Because most eCOA protocols require patients to enter information in real time, as opposed to paper assessments which were often filled out just before appointments and based on recollection, patients are more likely to note specific symptoms or changes. In fact, in one study, nearly 50 percent of the symptoms that were reported electronically were addressed during a visit to the provider, as opposed to only about 24 percent of the symptoms that were recorded on paper.

2. eCOA can automatically flag issues to discuss. Researchers can develop eCOA systems to automatically flag specific issues for discussion during visits. Using a paper system, a provider would have to interpret reports to identify problems, assuming that the patient reported them. This not only improves communication, but also the safety of the study.
3. eCOA ensures consistency. When using an eCOA solution, all patients are asked the same questions in the same order, in the same way. When providers talk with patients, there are so many things that can influence the conversation, including tone, mood, the order of the questions, the halo effect, and more. This can have the effect of influencing results, and whether specific issues are addressed. By remaining consistent, though, not only is the study integrity maintained, but patients and providers have a more honest relationship.

Building Patient Relationships

While eCOA can significantly improve patient-provider communication within clinical trials, there are still human factors to consider as well. How providers relate to patients can influence patient reporting of their conditions; for instance, providers who come across as especially caring and nurturing may inadvertently skew patients toward feeling better than they actually do, whereas more neutral providers can spur more honest reporting. It’s important for research designers to provide training in a standard methodology and how to properly engage with patients to ensure accurate results.

Much of the discussion about the benefits of eCOA have focused on increased patient compliance and improved data accuracy. These are certainly the important consideration, but it’s also useful to consider the effect that electronic data collection can have on the patient-provider relationship. By all accounts, implementing electronic tools has a positive effect, opening the lines of communication for more honest and accurate reporting. Not only are patients more willing to share their experiences, but providers are also learning more information that they may not have otherwise, creating safer studies for all patients. Given these benefits, it’s reasonable to assume that in the not too distant future, all clinical research will use eCOA tools.