Case study

Toronto Clinical Research Group (TCRG)

Eliminating duplicate data entry in a Phase 3 mental health trial.

Clinical research staff supporting a patient during a mental health study visit

Overview

Toronto Clinical Research Group (TCRG), a mid-sized research site located in downtown Toronto, participated in a Phase 3 clinical trial evaluating an adjunctive therapy for Major Depressive Disorder (MDD). The protocol required extensive clinician-rated scales (MADRS, HAM-D, CGI-S/I), daily ePRO diaries, multiple lab panels, and ECG assessments.

Despite using modern systems ™ EMR, ePRO, ClinCard, and the sponsor's EDC ™ coordinators were still performing large volumes of duplicate data entry, slowing operations and increasing the risk of transcription errors.

TCRG partnered with Nexa Trials to automate the eSource ? EDC data flow and eliminate redundant manual transcription.

The challenge

High-volume duplicate data entry across multiple systems

Before Nexa Trials, coordinators manually re-entered:

  • Clinician scale scores from paper worksheets ? EDC
  • Vitals and ECG results from EMR ? EDC
  • Lab values from PDF reports ? EDC
  • ePRO diary summaries ? EDC
  • Dosing timestamps ? EDC

On average, each MDD participant generated:

  • ~1,450 data points over the 12-week study
  • ~900 of those were duplicate entries
  • 3.5 hours of manual transcription per visit

This resulted in:

  • Frequent transcription errors
  • High CRA query volume
  • Delayed data entry completion
  • Staff fatigue and overtime
  • Slower database lock timelines

The site director estimated that 30™40% of coordinator time was spent on redundant data entry.

The Nexa Trials solution

Automating eSource ? EDC for all major data streams

Nexa Trials deployed its automation layer across TCRG's existing systems:

  • eSource Integration
  • EMR-to-EDC Mapping
  • Lab Report Parsing
  • Clinician Scale Digitization
  • ePRO Summary Automation

Key automations included:

  1. Clinician scales automation ™ MADRS, HAM-D, and CGI scores were captured digitally and auto-populated into the EDC with full audit trails.
  2. EMR ? EDC sync ™ Vitals, ECG timestamps, and medical history fields were mapped and pushed directly into the EDC.
  3. Lab report extraction ™ PDF lab reports were parsed automatically, preserving reference ranges, units, and abnormal flags.
  4. ePRO summary automation ™ Daily mood diaries and adherence logs were summarized and synced without coordinator involvement.
  5. Real-time query prevention ™ Nexa validated ranges, units, and required fields before data reached the EDC, preventing downstream queries.

Implementation

Timeline: 14 days

  • Days 1™3: Workflow mapping, system access, and data dictionary alignment
  • Days 4™7: Automation buildout for scales, vitals, and labs
  • Days 8™10: EDC integration and validation
  • Days 11™14: Staff training and go-live

No system replacement was required ™ Nexa layered onto TCRG's existing tools.

Results

Massive reduction in duplicate data entry

After implementing Nexa Trials:

  • 92% of duplicate data entry eliminated
  • 3.5 hours ? 18 minutes average data entry time per visit
  • 78% reduction in transcription errors
  • 61% fewer CRA queries
  • Data entry backlog cleared within 2 weeks
  • Database lock achieved 9 days faster than previous MDD studies at the site

Coordinator feedback

“This is the first study where I didn't spend my evenings catching up on EDC entry. Nexa removed the most painful part of my job.”

™ Lead Coordinator, TCRG

Sponsor feedback

“The clean data and low query volume were noticeable from week one. This site became our top performer.”

™ Lead CRA, Phase 3 MDD Program

Conclusion

By automating duplicate data entry across scales, labs, EMR, and ePRO, Nexa Trials transformed TCRG's operational efficiency. The site completed the Phase 3 MDD study with:

  • Faster data entry
  • Fewer errors
  • Happier staff
  • A reputation for clean, timely data

TCRG has since made plans to expand Nexa Trials automation to all other new studies including neurology, metabolic, and oncology trials.

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