Waste Not?

The longer I spend in the clinical trials industry, the more I am baffled by the amount of waste in the field. Unfortunately I am not just talking about wasted dollars for studies that never get off the ground or studies that never enroll at various sites. The physical waste produced by the industry is absolutely ridiculous and there really seems to be very little being done to rectify it.

Exhibit A: Lab reports. Why are lab reports still faxed (and sometimes mailed in addition) to sites? Some labs have recently developed the capacity to have sites log on to secure sites to retrieve lab reports, which can then be downloaded and printed at the site. One may say that this still uses paper, but in this scenario there is no cover page to the lab reports. Just think about how much paper would be saved by simply eliminating the cover page along with any summary pages at the end of the report. For large research sites, this would be a crazy amount of paper per year.

Exhibit B: Lab Kits. Most sponsors send lab kits in small boxes that are often discarded after the actual phlebotomy materials are used. The lab samples themselves are then sent in entirely different shipment boxes that usually do not use the original packaging. Add in the myriad kits that must be destroyed when they are either unused or expire over the course of the study and you end up with a nimiety of waste. While community recycling campaigns are more prevalent then ever before, I would wager that most sites could care less what happens to the unused kits, just so long as they are out of the way. I could see a couple possible solutions. The first would be to streamline the entire process: 1 kit for 1 shipper or multiple shippers for a large batch of lab draw supplies. The main downside to this second suggestion is that it would put a lot of responsibility on the site to make sure that the proper supplies are used at each visit....one of the primary reasons that lab kits are packaged individually currently.

Exhibit C: Emails/Paper Diaries/Questionnaires. Sites are required to keep copies of all correspondence between the sponsor/CRO/vendor and themselves. What would be so difficult about saving all emails, burning them to a CD and filing them with the regulatory documents at the end of the study? Or even burning them prior to monitoring visits for the CRA to review periodically? I think either scenario would save countless amounts of paper and help push the industry towards a more paperless functionality. Along the same vein, there is no reason why paper diaries and questionnaires should continue to exist. Most people have computers or are at least familiar with using a computer/PDA, so sponsors should be willing to pay the extra fee for electronic data capture systems. I would think the overall savings in capturing information electronically and in real-time would easily trump paper documentation in a short period of time.

There are countless more examples of situations in clinical research where wastefulness still exists in a society where recycling and reducing usage is strongly encouraged (I would love to have more suggestions and ideas). Unfortunately I don't see this trend changing unless there is significant pressure from not only the sites, but also the sponsors. I am thinking of starting an initiative to promote less wasteful practices not only at the site level, but also from the sponsors...please let me know if you are interested in participating!