Sites Under Pressure: What Clinical Research Sites Need to Operate, Compete, and Deliver

Clinical trials have spent decades perfecting data capture, but the execution layer underneath it, including decision workflows, data collection design, and lab connectivity, remains fragmented in ways that limit what AI can realistically deliver and that quietly compromise the scientific validity of the data itself.

In this Q&A, John Worden, chief commercial officer at Javara, discusses why clinical trial recruitment has remained stubbornly one-size-fits-all, how AI can identify patients at scale without displacing the clinician relationships that drive trust, and what care-integrated research engagement needs to look like for health systems, sponsors, and sites.

Why clinical development’s next AI bottleneck is not the model, but the system around it.

In this Q&A, Patrick Mizer, chief technology officer at Ledger Run, discusses how payment reliability has become a competitive differentiator in site selection, why decades of disconnected workflows have made payment inconsistency a structural problem, and where AI is delivering real value in the high-friction parts of clinical trial payments.

As sponsors push for faster, more representative studies, AI-enabled matching and EHR integration are emerging as operational levers, but bias, explainability, and governance will determine whether the technology scales.

Participant engagement depends more on clarity and understanding than on gamification or incentives, requiring engagement embedded into trial workflows as a core design component rather than a peripheral consideration

A platform-based approach connects AI across workflows, data and governance, helping life sciences organizations move from isolated wins to real scale.

The clinical research industry talks about patient-centeredness constantly but embeds it too late, too narrowly, and without clear ownership, and the cost shows up in enrollment failures, protocol deviations, and outcomes that don't reflect what patients actually care about.