# Remote consent and tele-screening so the first trial visit is a video call

Source: https://onco.cc/ideas/idea-tr1-remote-consent-tele-screening/  
OnCo record `idea-tr1-remote-consent-tele-screening` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Much of trial screening is paperwork, questions and reviewing scans that already exist. Doing this by video and electronic consent before any travel would let patients decide without a wasted trip.

## Summary

Sites adopt electronic consent with teach-back, tele-screening visits reviewing existing imaging and pathology via central read, and remote collection of history and performance status, so in-person attendance is needed only for procedures the protocol genuinely requires. Regulators in the US and EU accept eConsent; adoption in oncology remains low.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Sites offering remote consent and screening will convert a higher fraction of referred patients into enrolled patients and shorten the interval from referral to cycle 1 day 1.
- Rationale: Screen failure after travel is demoralising and expensive; many failures could be identified from existing records. Remote consent lets patients involve family and take time, which improves comprehension.
- Proposed test: Stepped-wedge rollout across a cooperative group's sites; measure referral-to-enrolment conversion and time to first dose before and after.
- Maturity: early-clinical
- Actor: clinic

## Sources

- Bottleneck evidence (Trials enrol too few, too slowly): Unger et al., Systematic review of barriers to cancer trial participation (JNCI 2019): https://doi.org/10.1093/jnci/djy221

## Connected records

- institutions: [National Cancer Institute (NIH)](https://onco.cc/institutions/nci/)
- bottlenecks: [Trials enrol too few, too slowly](https://onco.cc/bottlenecks/b-trial-enrolment/)
- key papers: [Unger: most patients never get the chance to join a cancer trial, and when offered, half say yes](https://onco.cc/key-papers/paper-unger-trial-participation-barriers-jnci-2019/)
- roadmaps: [Trial modernisation roadmap: the randomised trial → platforms and adaptive designs → decentralised, pragmatic and always-on](https://onco.cc/roadmaps/trial-modernisation-roadmap/)

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