Point of Care Clinical Trials (POC CT)
Mass. Veterans Epidemiology Research and Information Center (MAVERIC)
VA Boston Healthcare System
Ryan.Ferguson@va.gov, Louis.Fiore@va.gov, Leonard.Davolio@va.gov
Point of Care Clinical Trials (POC-CT) is an effort to embed a clinical trial into the routine course of care through integration with CPRS / VistA, the VA's electronic medical record system. In this way, we plan to derive evidence from 'real world' conditions and outcomes and, using the same medical record system, present that evidence as decision support at the point of care.
A pilot study is just beginning in the VA Boston to evaluate the comparative effectiveness of weight-based versus sliding scale insulin regimens. To ensure that our approach will scale to other VA sites, the POC protocol is implemented using existing functionalities within CPRS / VistA such as Health Factors and Clinical Reminders with data collected automatically from existing data elements.
The image below describes the POC-CT workflow. The grey boxes indicate what would normally be activities of the study team which are handled by the EMR in POC clinical trials.