Technical challenges in leveraging distributed clinical data

As the digital age progresses the amount of clinical data that is being gathered and stored in electronic format is increasing rapidly. Much of this data is stored in isolated repositories, separated by administrative boundaries, large geographical distances and different standards of maintenance. However, there is great potential in unifying these data stores together and harnessing the collective information that they possess. One area that stands to benefit greatly from such an initiative in the unification of such data is that of clinical trials and studies. Grid technology is a computing paradigm that attempts to find solutions to exactly this type of problem: how to federate data from wide-scale distributed sources on a time-scale useful to the typical end-user. As such, the VOTES project (Virtual Organisations for Trials and Epidemiological Studies) is a pilot-project, collaborative between seven UK institutions and funded by the UK Medical Research Council (MRC) to investigate how to implement a solution that draws distributed clinical data together in real time to enhance the primary trial processes -- patient recruitment, data collection and study management. This paper outlines the solution that has been implemented in the VOTES project, and the technical challenges that have arisen, focusing in particular on the security and usability of the back-end technologies used to perform the data federation.