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This case study highlights the approach taken by the Direction de la Recherche Clinique et de l'Innovation (DRCI) of the Assistance Publique Hôpitaux de Paris (AP-HP) to dematerialize and automate its processes.
To help and support it in this task, the AP-HP DRCI chose TimeTonic, a secure French NoCode platform for process management, collaboration and automation.
TimeTonic enabled the APHP to rapidly deploy digital solutions tailored to its specific needs, thanks to its secure platform offering advanced functionalities such as user rights management, data centralization, form digitization, cloud and natively mobile application creation, workflow visualization, report generation and task automation, while retaining the flexibility of a spreadsheet.
Find out how TimeTonic and AP-HP's DRCI successfully integrated NoCode into Europe's largest university hospital!
Assistance Publique - Hôpitaux de Paris, more commonly known as AP-HP, is a French public health establishment and the university hospital centre (CHU) for the Île-de-France region. The AP-HP is responsible for healthcare, teaching and research, and comprises 38 hospitals in Paris, the inner suburbs and the provinces. Every year, its 38 hospitals receive more than 8 million patients for consultation, emergency treatment, scheduled hospitalisation or home hospitalisation. The AP-HP has 100,00 professionals working at its head office and in the 6 University Hospital Groups (GHU), to enable decision-making to be taken closer to the teams and departments, and to strengthen links with universities, regions and partners, thereby enhancing the quality of care and research for all patients.
In 2022, the AP-HP will have a budget of almost 9 billion euros and numerous cooperation agreements in Europe, Asia, the Middle East, Africa and Latin America for medical and research projects.
The AP-HP is Europe's leading university hospital centre, as well as the leading sponsor of clinical trials in France and Europe. The Department of Clinical Research and Innovation (DRCI) is responsible for managing all research and innovation projects and allocating the resources needed to implement them. It promotes and supports the development of research activities and relies on more than 1,200 highly qualified professionals specifically dedicated to the design, implementation and monitoring of projects. These projects involve close cooperation with health and research establishments, industrial and academic partners, and players in the pharmaceutical, medical device and digital health sectors. The DRCI is in contact with the research departments of the 6 GHUs, support structures (Clinical Investigation Centres, Clinical Research Centres, Biological Resource Centres) and universities and research bodies.
The AP-HP's Clinical Research and Innovation Department is organised into 8 distinct divisions, 12 clinical research units, a clinical trials department, a medical device evaluation centre and a pharmaco-epidemiology centre, as well as several cross-functional structures. The AP-HP DRCI manages more than 4,000 projects, and AP-HP clinicians publish more than 10,000 scientific papers every year. The Strategic Steering Unit, headed by Quentin Demanet and to which André Desproges reports, is more specifically responsible for managing and developing the Research and Innovation Information System.
The AP-HP DRCI is made up of a large number of healthcare professionals, each with defined roles (researchers, external partners, directors, etc.) and interacting with each other. It manages a large number of research projects each year, working with health establishments and industrial and academic partners all over the world. Such a structure is therefore subject to a large number of complex internal processes involving many different players. These processes meet important regulatory obligations and must guarantee compliance with good clinical practice and patient safety.
Prior to the dematerialisation of their research processes, DRCI staff were using a large number of manual processes, even though strict deadlines apply. For example, when a clinical study was launched between an industrial company and the AP-HP, the mandatory contractualisation process was carried out using a generic e-mail box, which received the requests and all the necessary documents (grids of additional research costs, etc.) within a strict 45-day timeframe (between submission of the application and signature of the contract). The result of this approach was a lack of responses, reporting errors and very long delays.
In order to improve its operations, the AP-HP's DRCI launched an initiative to map all the internal clinical research processes in order to formalise the research circuits and processes. A request was then made to the Digital Services Department (DSN via its Customer Relations Department) for a digital tool that would integrate the research and innovation information system, which would be simple and unique for all units in order to harmonise practices between sites. This tool should make it possible to dematerialise the various clinical research processes and to link them to a workflow for automating tasks to monitor and manage projects in the context of research data security issues.
Choosing and implementing an external solution in an entity as large and complex as the AP-HP's DRCI is a major challenge, with major repercussions for all the players involved in this decision, both internal to the structure and external.
The DRCI and the DSN of the AP-HP therefore embarked on a search for the most appropriate solution to meet their needs, and identified 3 solution publishers with the capacity and characteristics to successfully carry out this project to dematerialise clinical research processes.
The final decision was made in favour of the French NoCode management and collaboration platform, TimeTonic. For the decision-makers at the AP-HP, TimeTonic stood out for its ease of implementation, its adaptability to the current ecosystem and its high level of data protection in the cloud.
TimeTonic is a French platform for process management, collaboration and automation that meets the need to help companies, hospitals and regions replace or complete what is missing in a traditional IT system.
It allows you to digitize & harmonize processes, automate workflows, centralize data associated with projects, and thus create your own applications and workflows without code.
Based on a so-called data first approach, this corresponds to a mix between the classic database (the back), where data is simply stored, and a visual interface (the front) that will enable you to visualize and manage said data, and then create an entire application ecosystem around it (workflows, automations, forms, etc.).
The idea of this data-first approach is to give the same autonomy and flexibility as a spreadsheet, while adding a clear visualization (numerous views are available: Table, Kanban, Gantt, Timeline, Cartographic, Fiche), secure (data hosting in France and RGPD) and mobile (through the native mobile application). Learning to use the platform is very quick, so users already familiar with Excel-type spreadsheets can quickly and easily create the applications they need.
As part of the process of contracting a research project with an industrial or academic sponsor, the French government has introduced a single agreement describing the type of contract to be adapted and signed between the hospital and the external sponsor (industrial or academic).
This contractualisation process, which is very important at the AP-HP due to the number of research projects it handles, is quite cumbersome and requires the iterative sending and receiving of around fifteen documents.
Before TimeTonic was deployed, the process was carried out using a generic e-mail box to which industrial and academic sponsors sent their dossiers, which were then followed up using Excel spreadsheets.
There were several problems with this method:
These 4 problems were then transformed by André Desproges and his teams into clear, defined needs:
In a structure as imposing as the AP-HP, changing some of the processes and tools used can have consequences, and the issues are varied.
The first major challenge for the DRCI teams was financial. When a patient is admitted to hospital, the costs are standard, but when he or she is part of a clinical trial, there are additional costs, because the costs of research cannot be separated from those of treatment. All the examinations that the patient undergoes as part of a clinical trial will be considered as "additional costs". These additional costs are the responsibility of the industrial or academic sponsor and are listed by the sponsor for negotiation between the sponsor and the doctors in charge of carrying out the trial in the hospital. As the contractual deadline between submission of the application and signature of the contract is 45 days, negotiations take place during this period, and it is essential for the AP-HP to have a rapid processing procedure that allows a high degree of flexibility in negotiations.
In addition to the financial stakes involved, with a project processing and execution deadline that must not exceed 45 days, the doctors must validate the project's admissibility within a maximum of 5 days of receipt of the file. This time constraint is inherent in the single agreement introduced by the government. This short timeframe means that AP-HP teams have to be highly responsive, relying on a fast, reliable solution.
Once TimeTonic had been selected and validated by DRCI and DSN, the NoCode solution was implemented through a test on 2 pilot sites at AP-HP.
The first stage in the implementation of TimeTonic for this process was the dematerialisation of the monitoring table for manufacturers' dossiers and the creation of the submission form. From now on, manufacturers will be able to submit their applications and all the supporting documents using a TimeTonic online form, which will automatically check that the application is complete.
Once the application has been received and validated by the doctors, they simply click on a button which, using TimeTonic automation, sends them e-mails indicating the status of their application and the next steps to be taken, thanks to a Timeline generated directly by TimeTonic.
André and his teams then imported the request tracking tables from Excel into the new TimeTonic workspace. In addition to these tables, they also imported large databases, also stored in Excel, corresponding to different hospitals and different manufacturers (files containing between 130 and 135,000 lines).
Each of these databases is now visible on TimeTonic via different tables, and are linked to the submission form, enabling external promoters (industry and academia) to select the relevant information for the project themselves (hospitals, doctors, departments, etc.).
These files are then automatically transferred to the hospitals and doctors for whom they are intended.
The project monitoring section for managers has also undergone a major overhaul, featuring interactive dashboards integrated into TimeTonic for real-time viewing of a wide range of indicators (number of files in progress, incoming files, validated files, non-validated files, priority files, etc.).
The implementation of this new solution within the AP-HP was a great success, both on the user side (doctors, industrialists, controllers) and on the decision-maker side (hospital directors, DSN).
Getting to grips with TimeTonic was a quick process, with 1 month elapsing between the signing of the test and the deployment of the first TimeTonic process. This month included training the teams on the tool and setting up tests with ersatz data.
The processing of the incoming data flow worked perfectly. In around 3 months, the AP-HP teams received no fewer than 170 requests from external promoters and 250 requests for amendments (each year the AP-HP receives around 800 requests).
Secondly, a significant amount of time has been saved. Numerous repetitive and time-consuming tasks have been modified or eliminated, not only by means of the submission form but also by the automated processes implemented.
The form makes it possible to eliminate the human stage of completing files, the stage of assigning files to the right elements and also the errors inherent in using email (typing errors, spam, etc.).
Automation also eliminates human steps such as sending e-mails announcing the admissibility of the project to industrialists and allocating applications to the right people.
The conditional visibility applied to the different views in TimeTonic ensures that the data available is only visible to the right people, reducing the time needed to find the right information.
Finally, user rights allow access to workspace architecture to be partitioned, reducing the risk of human error.
External promoters are delighted to have this platform for sending files, as well as the various tools at their disposal for monitoring project progress (e-mails, Timeline) in a secure environment.
Last but not least, the solution's scalability also means that users can create new applications whenever they want, without the need for costly in-house development, saving both time and money.
Following this first deployment, and thanks to its success, the AP-HP is starting to roll out TimeTonic to all its different sites and the 100,000 professionals who work on them.
Priority processes have been identified in order to gradually implement the solution and test its various functions.
Following the enthusiasm of the teams and the validation of their interest in extending the coverage of TimeTonic's uses, several other university hospitals have already expressed an interest in benefiting from the AP-HP's expertise and replicating the eco-system within their own organisations.
This case study highlighted the challenges faced by Assistance Publique - Hôpitaux de Paris (AP-HP) in terms of managing clinical research processes. As Europe's largest university hospital centre (CHU), AP-HP manages a large number of clinical research projects, with challenges in dematerialising processes, monitoring and managing clinical trials, and coordinating international collaborations.
To meet these challenges, AP-HP chose TimeTonic, a French platform for process management, collaboration and automation. TimeTonic enabled the AP-HP to rapidly deploy digital solutions tailored to its specific needs, offering flexibility similar to that of traditional spreadsheets, but with advanced features such as data centralisation and management, form creation, emailing, visualisation and management of projects and workflows in Kanban or Gantt view, report generation and task automation.
TimeTonic's roll-out has been a success, with rapid implementation and the first applications submitted in less than a month. Feedback on the use of TimeTonic has been very positive, with the system being quick to learn and easy to adapt to the specific needs of the AP-HP, with concrete results such as improved visibility and management of clinical research projects.
In conclusion, the case study of the AP-HP and TimeTonic demonstrates how a French NoCode platform like TimeTonic has made it possible to respond effectively to the complex needs of managing clinical research processes, by offering a flexible solution that is quick to deploy and adapted to the specific requirements of the healthcare sector.
