Reframing Efficiency to Protect Patient Access in 2026

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: As sponsors push harder on efficiency, how can they recalibrate in 2026 to avoid restricting patient access to clinical trials?

Beatty: Efficiency has been the top priority for sponsors over the past year. Clinical teams are actively using AI and technologies to rethink processes like feasibility, site selection, and enrollment, just to name a few. All of this is with the shared goal of accelerating timelines and getting new medicines to patients faster. I do not see any sign of this focus slowing down in 2026.

That said, some efficiency measures can have unintended consequences, and I think a great example of this is narrowing trials to a smaller group of familiar research sites to streamline selection, contracting, and even startup. While this can look really efficient on paper, it further concentrates trials in a few locations, ultimately restricting patient access and limiting who can participate.

In 2026, I expect sponsors to intentionally recalibrate, not by abandoning efficiency, but by redefining it. We will see sponsors prioritize partnering with community sites, especially in underrepresented populations, embed research more directly at the point of care, and show up differently in communities to meet patients where they are, like we are already seeing today with mobile clinics. This does not have to be a tradeoff. When sponsors are intentional about access, they can actually improve enrollment speed, reduce bottlenecks, and shorten overall timelines.