Closing Communication Gaps During Study Startup

In a recent video interview with Applied Clinical Trials, Brian Mallon, Executive Vice President, Site and Patient Solutions at ICON, discussed why site activation timelines continue to lag across the industry and what operational changes could help reverse the trend. Drawing on findings from a recent global survey, Mallon outlined how prolonged contract and budget negotiations, communication gaps, and increasing protocol complexity are contributing to startup delays. He explained how greater standardization, earlier and more meaningful site engagement, and the thoughtful application of AI and automation—particularly to reduce administrative burden—can accelerate activation without adding complexity for sites. Mallon also emphasized the importance of maintaining momentum during startup, adopting more site-centric practices, and strengthening bi-directional communication to better support site staff while improving overall study efficiency.

The below interview transcript was lightly edited for clarity.

ACT: With 92% of sites citing communication gaps and contract delays as key pain points, how can sponsors and CROs improve collaboration during study startup?

Mallon: I think it was really interesting to see that 92% citing communication gaps. It’s self-evident, but worth repeating, that clear and consistent communication is absolutely critical. Nearly half of the sites within our survey rated sponsor and CRO communication as average or poor, and that highlights a real opportunity for industry-level improvement.

Being Irish, and the fact that every breakout room in this building is named after an Irish playwright or poet, I think George Bernard Shaw put it better than I ever could: “The single biggest problem with communication is the illusion that it has taken place.”

The fundamental issue is the misconception that simply speaking or exchanging information guarantees understanding. I would go one step further and say that, at an industry level, the communication pathways we have prioritized—particularly through tech platforms—are somewhat extractive. By that I mean: what information do we, as sponsors or CROs, need from the site, versus what does the site need from us?

At ICON, we’re acutely aware of that dynamic and the necessity for communication to be bi-directional. Over the last number of years, we’ve thought deeply about this and, in some cases, rethought and retooled our tech platforms, such as FIRECREST, and our operating models to focus not just on what we need, but what information and communication the site needs.

Personally, owning and running our own site network has really helped solidify that this bi-directional exchange is absolutely necessary. Sites cannot be left in a vacuum. Information must be provided based on what they need; it cannot be purely extractive. That communication gap doesn’t surprise me.