Key findings from the Tufts CSDD site technology survey
- 75%+ of sites have experience using digital and remote trial solutions.
- 93% say remote monitoring tools are essential for adherence and patient data capture.
- 36% of sites have invested in their own digital solutions—often to expand research capabilities.
- Data quality is the top benefit reported (29%), followed by faster access to patient health data.
- 64% see no financial impact, but 22% report losses tied to tech coordination, troubleshooting, and training burdens.
Much has been written about investigative site challenges with clinical trial technologies, particularly those supporting decentralized clinical trial (DCT) models. Over the past several years, the dominant narrative has suggested that clinical sites feel both overburdened by and resistant to the expanding use of digital tools in study design. Sites recognize the potential operating efficiencies to be gained, and the benefits to patients achieved, by using digital tools, but what many sites report struggling with are the fragmented and poorly coordinated number of solutions required by sponsors and contract research organizations (CROs).
Moreover, a growing number of investigative sites have invested in their own validated technology solutions, some that are well-integrated into their health system’s electronic health records and clinical practices. Yet many sponsors and CROs have limited familiarity with these site capabilities. Initiatives such as the Site Readiness Practices Framework for Decentralized Trials and Bring Your Own Technology (BYOT) Playbook are helping sponsors better assess site preparedness and technology capabilities.
To add to these efforts to inform industry understanding of investigative site preparedness and experience with remote and virtual solutions, the Tufts Center for the Study of Drug Development (CSDD) recently conducted a global survey of investigative sites. The aims of the study were to assess when, where and why investigative sites have invested in virtual and remote solutions supporting patient visit convenience and data collection and the primary value proposition that these solutions offer.
Assessing the value proposition
The study was conducted in collaboration with, and support from, Evinova, a separate health-tech business within the AstraZeneca group delivering digital solutions to accelerate clinical development. Tufts CSDD launched an online global survey among investigative sites between April and May 2025. Invitations were emailed to approximately 5,000 investigative sites. Data cleaning and analysis were performed in RStudio. Tufts CSDD conducted descriptive statistics and subgroup analyses. Responses from a total of 387 investigative site professionals—representing approximately 275 distinct investigative sites—were analyzed. Table 1 presents the digital tools assessed as these are the primary digital solutions used by investigative sites.
Clinical and administrative personnel from a broad cross-section of mature (10+ years conducting clinical trials) global investigative sites completed the survey (see Table 2). Six out of ten sites operate in North America and 22% in Europe. Approximately half of respondents are based within an academic research setting; half within an independent community-based research setting. Most respondents (70%) reported having more than eleven years of experience at their current organization. Survey respondents reported having experience with a broad mix of therapeutic areas.
Site receptivity, preparedness and experience
More than three-out-of-four respondents reports having experience using digital solutions.This finding is consistent with other industry reports affirming that the deployment of digital solutions in clinical trials is becoming more commonplace. In addition, nearly all respondents (>93%) believe that solutions supporting remote patient monitoring and/or management are playing an essential role in ensuring patient adherence with the protocol; collecting quality-of-life information; and gathering biometric and physiological data. The majority of respondents (82%) perceive that study participants are ‘very’ or ‘somewhat’ receptive to the use of remote data collection and patient monitoring solutions.
Slightly more than one-third (36%) of respondents indicated that their site has made dedicated investments in digital solutions; 64% have not yet made an investment (see Figure 1). Nearly half of respondents (47%) indicated that the primary reason for making an investment was to support and expand their clinical research offerings and capabilities.About one-third of investigative sites indicated that the primary reason was to enhance clinical care (30%). Approximately one-out-of-four investigative sites (22%) reported that that their primary reason for investing in digital solutions was to improve operating efficiencies.
In addition to investments in operational-support systems such as clinical trial management systems, electronic regulatory and operating documentation and electronic data collection, the results of this study reveal that sites are investing in a much broader range of digital tools (see Table 3).
The most common digital data collection investments include eDiaries or clinical outcome assessments platforms (ePROs), medical devices including wearable devices for self-collection of biovital data, remote data collection and patient monitoring. The most common investments supporting remote site visits focus on operational and logistics convenience-enhancement services including telehealth or secure video visit technologies, eConsent systems, and patient payment solutions. A smaller relative percentage of sites report investing in local and home-based clinical services including local lab facilities used for specimen collection, home nursing visits and investigational medical treatments shipped directly to patients’ homes.
