Breaking the Site Barrier: How Digital Innovation Is Fundamentally Reimagining Oncology Clinical Trials

Clinical trials in oncology face a paradoxical challenge: while cancer care increasingly moves into community settings, trial participation remains concentrated in academic centers. Only 7.1% of adult cancer patients participate in trials, with those who do rarely reflecting the diversity of the broader patient population. This fundamental mismatch between where patients receive care and where trials are conducted creates significant barriers to enrollment, diversity, and ultimately, speed to market.

The traditional site-centric model of clinical research faces mounting pressure from increasing trial complexity. IQVIA data shows every measure of complexity has risen since 2010—more sites, more countries, more endpoints, and more eligibility criteria. This complexity comes with a cost: longer development timelines and participant pools that poorly represent real-world patients.

Digital approaches are beginning to bridge this gap with practical, implementable solutions. Participants at a recent Executive Roundtable highlighted how site-agnostic screening tools that analyze EHR data across healthcare networks can identify eligible patients regardless of where they receive care. Organizations implementing these tools have reduced screening time by 60-85% while significantly diversifying their participant pools.

Our experience with health systems and pharmaceutical companies reveals that the true transformation isn't simply about finding more patients—it's about fundamentally rethinking how trials operate. The most innovative companies are shifting from asking "How do we find patients for our trial?" to "How do we bring our trial to where patients already are?"

Decentralized trial components enable participation without requiring frequent visits to academic centers. One pharmaceutical company we worked with reimagined their Phase 2 lung cancer study to incorporate remote consent, digital symptom reporting, and local imaging—eliminating over half of the required site visits. The result wasn't just faster enrollment but also a participant population that better reflected real-world demographics.

Implementation of digital tools in a COPD trial reduced treatment duration and in-person visits by 50%, decreased overall trial duration by 15%, cut costs by 32%, and improved the patient experience index by 68%. This isn't just convenient—it fundamentally changes who can participate by removing geographic barriers.

For R&D leaders, these innovations create strategic imperatives to redefine site selection strategy based on patient population distribution rather than academic prestige. Every required on-site visit exponentially decreases the potential participant pool—especially for underrepresented populations. The hub-and-spoke model allows pharmaceutical companies to centrally organize research coordination and data management at academic centers while extending trial access to community hospitals.

How would your development timelines change if you could reduce screening time by 80% through digital patient identification? What if your clinical trial data better represented the patients who will actually use your therapy once approved? How would your protocol design change if you started with the constraint that participants cannot travel more than 10 miles for trial participation?

The most effective acceleration strategies don't simply digitize existing processes—they fundamentally rethink who can participate and how. This perspective shift represents the true promise of digital innovation in clinical trials, with the potential to deliver therapies to market faster while generating more representative and applicable data that could reduce post-approval surprises and support stronger market uptake.

Interested in how digital innovations can reduce screening time by 80% while increasing participant diversity? Let’s continue the conversation, what are your trial acceleration challenges?