Exemplar 1: Clinical Trials Innovations for Rural Areas

People who reside in rural areas have higher incidence of cancer, limited access to timely high-quality cancer care, and worse survival. Limited clinical trials access for rural residents with cancer exemplifies the challenge of rural cancer care. As clinical trials become more deeply integrated into high quality routine cancer care delivery, finding innovative ways to expand access to rural residents has become a high priority. The fundamental solution is to bring clinical trials to where rural residents routinely receive their care, ideally as close to home as safely possible. We provide examples of innovative solutions to achieve this fundamental goal, including: The NCI Community Oncology Research Program (NCORP) which has sought to integrate National Clinical Trials Network infrastructure into community and rural healthcare delivery infrastructure; support policy changes promoting decentralized clinical trials processes; telehealth strategies to decentralize key clinical trials processes and create virtual clinical trials infrastructure with a centralized research workforce; and to promote pragmatic approaches to engage administrators and clinicians in community and rural healthcare systems who traditionally have not adopted the clinical trials mission.