| Summary: | BackgroundClinical trial accrual monitoring is a critical component of trial operations, influencing feasibility, timeliness, and scientific validity. Despite its importance, many National Cancer Institute–designated cancer centers continue to rely on static spreadsheets or manually generated reports that provide delayed and incomplete insight for study teams. These limitations hinder timely identification of recruitment challenges, reduce transparency across stakeholders, and constrain proactive operational decision‑making. Scalable, institution‑wide systems that support near–real‑time accrual oversight remain uncommon in academic settings.
ObjectiveThis study aimed to design, implement, and operationalize a near–real‑time clinical trial accrual dashboard within a National Cancer Institute–designated cancer center, and to evaluate its use, adoption, and early operational impact on accrual monitoring workflows.
MethodsWe developed an enterprise accrual dashboard integrating daily extracts from the institutional clinical trial management system with automated data quality validation and time series accrual forecasting. The system supported multiple stakeholder roles through role‑based access and was deployed within existing governance and oversight workflows. Implementation and evaluation were guided by the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework and the Guidelines and Checklist for the Reporting on Digital Health Implementations framework, with system logs used to assess reach and adoption, and qualitative operational feedback used to characterize use in practice.
Implementation (Results)From May 2022 to May 2026, the dashboard was used institution wide for monitoring therapeutic and nontherapeutic trials, logging 1605 unique user sessions across investigators, coordinators, data managers, and leaders. Automated daily validation enabled earlier detection and correction of missing or invalid accrual data, improving the reliability of institutional reporting over time. The dashboard replaced manual monthly reports with continuous monitoring and was incorporated into routine operational and leadership reviews, enabling earlier identification of lagging studies and more timely discussions regarding resource allocation and recruitment strategies. Accrual forecasting models demonstrated stable in sample and out of sample performance and were used to support anticipatory planning rather than prescriptive decision making. Initial increases in data correction workload and user resistance decreased as workflows matured and data transparency became normalized.
ConclusionsImplementation of a near–real‑time accrual dashboard within an academic cancer center is feasible and sustainable and can meaningfully improve accrual oversight by strengthening data quality, transparency, and integration into routine workflows. The primary value of such systems lies not only in visualization or analytics but in their ability to shift accrual monitoring from retrospective reporting to proactive, institution‑wide operational review. With appropriate governance and clinical trial management system infrastructure, similar dashboards are transferable to other research centers seeking to modernize trial oversight.
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