Live Virtual Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2020

Translating ideas into action: Lessons from the COSA Tele-Trial project  (#4)

Sabe Sabesan 1
  1. Department of Medical Oncology, Townsville Cancer Centre, Townsville Hospital and Health Services, Townsville, QLD, Australia

The Australasian Tele-Trial Model, developed by the Clinical Oncology Society of Australia (COSA), outlines key considerations for increasing access to clinical trials for people with cancer living in rural and remote locations and the contribution of tele-health models to facilitate study activity across rural and remote locations.  The Model connects larger clinical trial centres with smaller satellite sites using telehealth so that patients from smaller sites can take part in some or all aspects of clinical trials closer to home1. These sites can be metro sites or regional and rural sites; depending on the nature of trials. This Model is now regarded as a solution for decreasing the disparity in access to regional and rural and patients with rare diseases. COVID has also enabled larger sites to connect with each other; thus, triggering a reform of the trial industry. The journey from “idea to implementation” has taken an implementation science approach that includes evidence, context, facilitation and successful implementation. 

Evidence for the Tele-Trial Model came from the literature on existing models of teleoncology including tele-chemotherapy, consensus among senior leaders and industry bodies and the COSA teleoncology guidelines2. In terms of context, this required the involvement of state governments, trial groups, industry, and cancer centres. Each sector had a significant part to play in developing the policy framework, incorporation into trial protocols and implementation. This type of national reform involving complex socio-political considerations requires facilitation. In effecting new reforms, we require not only an influential body to bring stakeholders together; but also one that has the credibility and necessary clinician-levers to navigate the system through negotiation and advocacy. An example of such a body is COSA Council where 30 disciplines and interest groups, and over 20 organisations are represented, including COSA’s partnership with Cancer Council Australia. COSA is now completing a three-year pilot implementation project of the Tele-Trial Model. As a result of the Tele-Trial funding consortium and with support from COSA Council, this pilot implementation has been very successful and paved the pathway for national adoption at scale3. Clinician-levers can help the clinical leaders to progress national projects through successful negotiations4.  In summary, a sound idea supported by evidence and colleagues, the involvement of stakeholders at organisational levels, and peak-bodies as credible influencers are the basic foundations of system implementation.

  1. Australasian Teletrial model: A National guide for implementation, Clinical Oncology Society of Australia, Sydney, 2016.
  2. COSA Clinical practice guidelines for teleoncology. Viewed 13 August 2020.
  3. Sabe Sabesan, John Zalcberg, Craig Underhill et al, Implementation of the Australasian Teletrial Model: Lessons from practice, Asia-Pacific Journal of Clinical Oncology 2019;15(58):3-14
  4. Sabesan S, Senko C, Schmidt A. Enhancing Chemotherapy Capabilities in Rural Hospitals: Implementation of a Tele-chemotherapy Model (QReCS) in North Queensland, Australia, Journal of Oncology Practice 2018,14(7): e429-e437 (DOI: 10.1200/JOP.18.00110)