Feature|Articles|September 22, 2026

Is Decentralization Actually Reducing Site Burden, or Just Moving It?

Decentralized trial models have demonstrated real gains in enrollment performance and patient access, but operational switching costs, fragmented technology stacks, and unresolved gaps in the patient-site relationship raise a question the industry has been slow to confront directly.

Decentralization has reshaped the conversation around clinical trial access and efficiency, but the question of what it actually does to site burden has received far less scrutiny than what it does for patients. Three distinct voices, arriving at the same unresolved question across the course of a year, suggest the industry may be optimizing for the wrong metric.

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