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Optimizing Resource Utilization in Healthcare and Clinical Trials
What is resource utilization in healthcare?
Resource utilization in healthcare refers to the efficient and effective allocation and management of resources in order to provide quality care to patients while keeping costs down and avoiding wasted resources. Resource utilization can also refer to the angle of assessing the degree to which the population uses healthcare resources, which can provide insights into disease burden, healthcare affordability, etc. Healthcare resources include human, material, technological, and financial resources.
Effective resource utilization is crucial in healthcare and in clinical research, as it ensures that limited resources are allocated appropriately, supporting optimal patient outcomes as well as cost-effectiveness and operational efficiency. Through thorough planning for optimizing resource utilization, healthcare providers and research sites can enhance access to care, reduce wait times for patients, minimize waste and unnecessary expenses, limit staff burden, and improve patient satisfaction.
Factors such as population demographics, disease prevalence, treatment guidelines, insurance and reimbursement models, available technologies, and financial constraints all shape resource utilization patterns in healthcare systems. In clinical research in particular, resource utilization is closely related to the specific design of the trial, the trial budget, the therapeutic area, and the patient demographic.
Types of healthcare resources
In general, healthcare resources include anything that is required for effective delivery of patient care or clinical research protocols, and thus includes different components:
1. Human resources: Physicians, nurses, pharmacists, investigators, administrative staff, study coordinators, clinical research associates, data managers, statisticians – anyone who performs an essential function in the delivery of patient care or the execution of clinical trials.
2. Material resources: Generic and study-specific medical supplies (excluding technological equipment), which includes the investigational product, placebos, home testing kits, syringes, vials, disinfectants, documentation, gloves, bandages, etc.
3. Technological resources: Imaging equipment like MRI or CT scanners, laboratory instruments for diagnostic tests and procedures, information systems (electronic health records, eClinical software tools, etc.).
4. Financial resources: Research budgets and healthcare funding, which could come from various sources, both internal and external, public and private, represent major constraints since essentially all of the aforementioned resources are paid for with money! Specific resources considered in this category include equipment, operating expenses, per-patient expenses, one-off costs, staff payroll costs, audits and monitoring costs, insurance reimbursements, research & development expenses, and the list can go on.
Measuring resource utilization in clinical research
In order to improve the effectiveness of resource utilization in clinical research, it first needs to be measured and tracked in order for the sponsoring organization to understand their resource flows. This information could come from a variety of places:
- Monitoring activities, tracking resource usage across study sites
- Tracking administrative and regulatory submission timelines
- Detailed study budgets
- Post-trial/retrospective analyses of successes, failures, and strong and weak points
- Surveys/questionnaires distributed to study sites and patients to get their feedback on efficiency and suggestions for improvement
- Health economics and outcomes research (HEOR) conducted at the organizational level to understand the cost-benefit ratio of trials conducted
- Adding an additional layer to a future study, capturing real-time measurements of resource use using software tools, logbooks, activity trackers, etc.
Specific metrics that a sponsor might wish to track can vary widely depending on objectives, study designs, and suspected or identified problem areas, but could include aspects such as the following (although the potential metrics are essentially unlimited):
- Number of participants in the study
- Number of in-person visits to study sites
- Procedures/tests performed, per patient and in total
- Cost-per-patient for a given trial
- Costs of the investigational product, in total or for each stage from manufacturing through to distribution and administration
- Operating costs for facilities
- Software subscription or purchasing costs
- Costs related to training
- Number of research associates, investigators, and other personnel involved in the study
- Labor hours
- Staff payroll costs
- Sources of delays and non-compliance
Challenges in resource utilization in clinical trials
Because clinical studies involve complex collaborations between various teams and providers, optimizing resource allocation and utilization is no small feat. Right from the beginning, formulating a strong clinical trial budget represents a challenge due to the number of variables involved and the unpredictability of many aspects of trial operations. Specific challenges related to resource utilization in clinical research include:
1. Budgeting and forecasting
As we already stated above, preparing a clinical trial budget is a daunting task. The complex and interconnected nature of trial operations makes it very hard to predict expenses with precision. In our article about the idea of starting with a clinical trial budget template, we explain why it’s a smart move to approach budgeting with some degree of flexibility and leave room for unexpected costs so they don’t cause more severe setbacks.
2. Waste and inefficiencies
Effective resource utilization can be hampered by various forms of inefficiency and waste: ineffective coordination and communication among stakeholders; accidental duplication of tests or procedures; delays caused by human error; poor query management and resolution practices; non-compliance; unused study drugs due to drop-outs, poor handling/storage, expiry, etc.; unnecessary spending; activation of low-performing sites; etc... Operational inefficiencies and wasted resources should be identified as one of the first steps in addressing resource utilization issues.
3. Distribution of resources across sites
Different sites will have access to different patient populations, and it usually won’t be possible to accurately predict enrolment rates at each site unless it has a strong and up-to-date patient database in a similar therapeutic area. Distributing study resources across sites then requires adjustments on-the-fly as the enrollment picture becomes clearer.
Strategies for improving resource utilization
Beyond thorough planning and budgeting steps before beginning a new trial, as well as tracking resource utilization in order to support future improvements and decision-making, here are three more ideas for improving resource utilization in the context of clinical trials:
1. Use technology to increase efficiency of resource allocation and tracking: The huge variety of eClinical systems available to trial sponsors enables new levels of oversight and tracking of resource flows. Perhaps not the primary function of many of these systems, they can be used to assist with clinical trial supply management, logging visits, tracking expenses, and many other factors that can help sponsors gain higher-resolution insights into resource utilization. Data can be collected and aggregated over multiple studies to make improvements at the organizational level, or the data can be used in real-time to improve operations in an ongoing trial.
2. Adopt patient-centric and outcomes-based research approaches: Since drug development is resource-intensive and resources are limited, it makes sense to focus on avenues that are more likely to lead to elicit relevant, tangible benefits for patients. Considering the patients’ real needs as well as their experience as a research participant can help narrow down research questions and designs to those that are more likely to succeed in terms of actual patient health outcomes. In the long-run, this strategy is likely to improve the cost-benefit ratio of clinical research efforts for an organization and improve the effectiveness of resource utilization overall.
3. Consider outsourcing: While some organizations certainly can do it all, the truth is that in some cases it will be more resource-efficient to outsource certain operations to professionals with strong expertise in that aspect. Almost any aspect of clinical research can be outsourced, beginning with drug discovery and development and manufacturing (i.e., to a CMO/CDMO), through to patient recruitment (i.e., clinical research recruiters, or our platform as Power) and any other aspect of trial operations (i.e., a CRO offering comprehensive services). In general, it might help to think about the long-term goals of the organization. If the idea is to one day be fully equipped to conduct multiple trials end-to-end entirely internally, it could be a better bet to develop dedicated and skilled internal teams/departments or even establish new facilities. In other cases, such as when the focus is on completing an individual trial as quickly as possible or for organizations with less experience and smaller teams, outsourcing may often work out to be more effective and efficient in terms of both time and money.
Conclusion
Optimizing resource utilization in healthcare is essential for ensuring the delivery of high-quality care, while simultaneously balancing cost-effectiveness and operational efficiency. In clinical research, efficient resource allocation and utilization is key for adhering to study timelines and budgets, in addition to optimizing patient experience and care. Thorough planning and budgeting, purposeful tracking of resource flows, and leveraging technology are all strategies that can be used to enhance resource utilization within a trial and make organizational improvements over time. The ultimate goal of enhancing resource utilization in healthcare is improving patient outcomes and driving sustainability in healthcare systems, although there are many other beneficial effects that can be experienced immediately such as streamlined operations and reduced trial costs.