Browse your email, attend a conference or read a journal and you are bound to see terms like ‘digital health’, ‘virtual’, and ‘decentralized clinical trials’. What is all the buzz? Recruitment, retention, diversity, efficiency, safety and accuracy are all factors driving the need for radical innovation. This need is painfully apparent during the current COVID-19 pandemic. We can no longer ‘do the same thing and expect a different result’; it is time to take some giant steps forward.