ABSTRACT
Background: The COSA Teletrial framework was piloted in 2017 and recently adopted as the national principles for teletrials (1). The Monash-Gippsland (MG) Teletrial project was initiated in 2019, funded by the Victorian Cancer Agency, aiming to increase clinical trials access for regional patients. The project was impacted by the COVID-19 pandemic lockdowns and recommenced in April 2021. Key learnings from the project are presented here. Aims: To report on the barriers and enablers found within the MG Teletrial project. Methods : A review of project meeting minutes was undertaken alongside informal discussions with participants and key stakeholders. Challenges affecting Latrobe Regional Hospital (LRH) in adopting open trials at Monash Health (MH) were itemised below. Results : Governance processes are lengthy and complex despite the adoption of COSA model by both health services with existing central ethics approval. Infrastructure and partnerships: Outsourcing of LRH pathology and radiology to private providers requires additional contracting and costs. Lack of cancer prescribing software at MH and common Electronic Medical Record pose difficulties with source documents management. The funding from collaborative partnerships allows LRH to successfully join the Regional Trials with critical research resources. Regular communications via teleconferencing has greatly facilitated progress. Staffing: The nature of appointments with fractional oncologist at LRH present challenges in clinical trials development. Access to the project funded full-timeMH Teletrial fellow working alongside the Trials Hub funded consultant and LRH study coordinator was essential. Logistics: Staff exchanges for training have been repeatedly thwarted by sudden lockdowns. Technical issues including a major malware attack on LRH email significantly impacted communications for months in 2019. Conclusions : The establishment of Teletrial at a greenfield site is complex and requires significant, longer term infrastructure support, including human and non-human resources.