How Community Sites Can Stay Competitive Under Growing Efficiency Pressures

In a recent video interview with Applied Clinical Trials, Liz Beatty, co-founder and chief strategy officer at Inato, discussed how sponsors can balance efficiency pressures with patient access as competition for sites and patients intensifies. Beatty explained that while AI-driven tools are accelerating protocol design, feasibility, and trial operations, overreliance on a small pool of familiar sites can create bottlenecks that undermine those gains. She highlighted a shift away from historical site performance data toward real-time patient eligibility insights, enabling more accurate trial planning and inclusive site selection. Beatty also outlined how community research sites can remain competitive by using technology to demonstrate verified patient access and readiness. Looking ahead to 2026, she emphasized that sponsors able to move beyond isolated AI pilots—by redesigning underlying processes and committing to scaled change management—will be best positioned to shorten timelines and expand access to clinical trials.

The interview transcript was lightly edited for clarity.

ACT: With efficiency pressures rising, how can community research sites stay competitive and secure trial opportunities this year?

Beatty: This has been a real challenge for community research sites. Historically, it has been difficult for them to break through. Sponsors continue to rely heavily on a very small subset of sites. Roughly 5% of sites run the majority of trials, which makes it challenging for newer or less experienced sites to get selected, even when they serve the right patients.

Community sites often tell us how hard it is to make the list, especially in competitive disease areas where sponsors default to sites they already know. But this dynamic is starting to shift. Sponsor pipelines are growing, competition at large academic and legacy sites is increasing, and this creates an opening for community sites that can demonstrate readiness.

There are two primary ways community sites can stand out. First, investing in AI and technology. Many sponsors are prioritizing data-driven or tech-enabled sites, especially those using AI to improve efficiency in challenging areas like patient identification and enrollment. Second, community sites can prove access that sponsors cannot get elsewhere. Sponsors are often hesitant to work with unfamiliar sites, but community sites can mitigate this risk by using AI to show verified, real-time access to eligible patients, particularly those underrepresented in research.

In 2026, the community sites that win trials will not be the biggest or most well known. They will be the ones that can credibly prove readiness, performance, and patient access, and AI gives them the tool to do that.