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Potential Clinical Research Profits Elude Community Hospitals



By Maxine Bookbinder 
 
January 8, 2014 | Clinical research trials are flourishing in community hospitals nationwide; however, many hospitals fail to generate a profit or develop a research infrastructure. Still others remain on the research sidelines, resulting in missed opportunities for enhanced revenue, community prestige, and retaining prominent physicians.
 
HutchinsAgainA 2013 survey of 183 healthcare industry professionals revealed that community hospitals often lack essential resources, structure, or experience necessary to conduct trials. “Our results show that community hospitals have largely remained on the sidelines when it comes to trials,” says Kristin Hutchins, president and CEO of GuideStar Clinical Trials Management, who commissioned the survey.
 
 “We wanted to learn why these hospitals have been slow or unable to participate in this growth opportunity. If they realized what a clinical research program brings to a hospital, why aren’t they doing it?” 
 
A majority of executives do realize this. In the survey, 92% of respondents said that clinical research contributes to medical science; 86% said it offers progressive medical therapy to the community; 73% said it enhances a hospital’s image in the community; 63% noted physician satisfaction; and 49% cited competitive advantages for hospitals. 
 
 When hospital executives were asked to rate the key attributes of a clinical program and their impact on hospitals, 57% cited “overall impact on hospital service quality.”
 
Twenty years ago, approximately 70% of industry-sponsored research and clinical trials took place in academic medical centers.  Today, almost 70% are conducted in community healthcare settings. Because clinical trials are still relatively new to community hospitals, administrators often don’t approach research in a focused way or as a commitment.  
 
In fact, Hutchins found that more than 50% of hospitals that incorporated medical research did so in a “disjointed, decentralized” manner. For example, says Hutchins, a hospital’s cardiology and oncology departments might simultaneously conduct research, write their own contracts, and negotiate their own budgets, without knowing the other department is also doing so, resulting in redundant inefficiencies. 
 
Research is noble and altruistic; it is also a business that must focus on funds and compliance to succeed.  “Research is not often run like a business,” says Hutchins. In fact, the survey revealed that almost 50% of hospital administrators didn’t “have a grasp” on how their research was performing financially.  “Money needs to be a focus today. Hospital margins are tight. A clinical trial that makes a profit can pay for another trial that just breaks even or loses money.”  
 
Other obstacles include insufficient resources, staffing, financial support, and internal clinical research program awareness. Often times, executives can find needed talent inside their own hospitals. Otherwise, they must hire from outside. “The right support today,” says Hutchins, “can lead to a lifetime of success.” 
 
A research administrative structure and a keen awareness of research finances should be in place at the beginning for research projects to be successful, but too often were missing, according to hospital executives. Other absent elements cited in the survey include: an understanding of how to run a trial; experienced administrative staff who can collect and process data; skilled staff who can negotiate budgets and manage contracts; and a physician principal interested in pursuing research.  
The first step to a successful research business is to find a physician champion willing to bring medical liaisons and study sponsors together. Such candidates include physicians attracted to offering innovative and pioneering medicines and therapies, publishing their research finds, and being involved in non-traditional patient care. 
 
Then, make clinical research a priority.  “Hospitals need to make it a commitment,” says Hutchins. “Research has to be part of their strategic planning. There needs to be a cultural shift to support research.” 
 
Finally, a successful and profitable clinical research program needs staff that understand infrastructure requirements and expenses. It also requires a balanced trial portfolio—a balance of industry-funded versus cooperative group studies—and aggressive contract and budget negotiations. Of course, a trial can’t succeed without the right patient population.
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