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Historical information and analytical foundations for RBM are important, but, in my view, RBM is about proactively managing each individual trial to quality and efficiency goals. Prospective considerations based on timely information are more important to RBM success than the historical record. Effectively managing the current trial involves far more than having a central analytical staff identify KPIs and determine triggers for monitoring visits. Central staff should be managing the study in real time, continuously addressing issues in the field and resolving many issues without the need for site visits. Properly implemented, RBM is not a discrete activity but an integral component of proactive trial management.