From IVRS to IWRS: Evolution of Interactive Response Technology

Interactive Voice Response Systems (IVRS) and Interactive Web Response Systems (IWRS) are key to running a clinical trial, from enrolling patients to administering the study drugs. The tools, collectively referred to as Interactive Response Technology (IRT), have come a long way from when staff simply entered patient information over the phone, and now include many more modern features to help your trial run smoothly.

Today's technology is better able to anticipate your trial's supply needs, keep your trial data clean, and accomodate more complex study designs. To understand how far it's come, here is a brief history of IRT and how it's evolved over the last 20 years or so.

Generation 1: Interactive Voice Response Systems (IVRS)

The earliest IVR systems date back to the 1970s, when phones with keypads were developed. The technology allowed users to enter information that corresponded with different numbers on the keypad in response to voice prompts. Using a keypad allowed users to enter patient information and randomize a patient into a trial while keeping the patient's identity blinded. In the 1980s, touchpad IVR systems became more affordable for most sites.

At first, IVRS was only used to randomize patients into a clinical trial. It later became the central place for drug supply chain management, too.

Generation 2: Interactive Web Response Systems (IWRS)

In the last decade or so, IVRS has largely disappeared – and it's safe to say few people are mourning its loss. "The [IVRS] user experience is a bit negative in most cases,” Justin Jaeschke, Senior Director of Client Engagement at IRT company YPrime, told Antidote. IVRS has been replaced with Interactive Web Response Systems (IWRS), the next generation of IRT.

Like the name suggests, IWRS works in a similar way to IVRS, only information is entered through a computer instead of over the phone. These systems also connect with other technologies more easily, allowing better communication and data sharing.

Generation 3: IRT features today

One key feature of modern IRTs involves predictive supply chain management. In a blinded trial, sites aren't able to order a certain number of study drugs, so IWR systems do the work automatically. Modern systems are also able to recalculate study drug needs when patients drop out, for example, and use an algorithm to predict changes before they happen.

Today's IWRS can also work with more modern study designs. For example, Jaeschke said that his company has seen more requests for studies with direct-to-patient drug shipping for patients who aren't able to leave home to attend doctor's visits. Modern systems are able to accommodate those kinds of study designs.

It's also important for your IRT to be able to communicate with your site's other systems. Today, it's considered standard for IRTs to integrate with an electronic data capture (EDC) system. For example, "It's important for IRTs to be able to communicate with lab systems, with different distribution centers to make sure your drug orders are electronically sent,” said Jaeschke. Different IWRS offer integration with different technologies, so when you're deciding on which is the right choice for you, consider your existing setup and how you would like data to be shared.

Some companies offer IRTs that communicate easily with other systems because they also provide those other systems. YPrime's system uses the same technology as the company's eCOA (electronic clinical outcomes assessments), for example, which allows the system to share patient data in real time.

The more integration you have in your systems, the more time you potentially save during data reconciliation, Jaeschke said.

"IRT in general I think now more than ever is such an important of a clinical trial ecosystem,” said Jaeschke. "We're seeing a lot more need for data integration and sharing of data between IRT and many systems.”

If you're looking for an IWRS vendor, we've compiled a list along with a guide on smart questions to ask when you're making your decision. And when you're ready to start finding the right patients for your trial, Antidote is here to help.