Clinical research has entered a defining decade. Technology isn’t just supporting trials; it’s reshaping how research is planned, executed, and experienced by every stakeholder involved. For Academic Medical Centers (AMCs), hospitals, health systems, and site networks, 2026 will be about moving from adoption to deeper integration of unified, enterprise-grade eClinical ecosystems that connect every operational workflow. The most successful organizations will be those that connect their technology, people, and processes into one cohesive ecosystem.
The year will be the year of site empowerment, where interoperability, automation, and site-led innovation finally replace outdated, sponsor-driven silos.
Here are the trends that we predict will shape how high-performing research organizations operate in 2026 and beyond.
1. The Rise of the eClinical Command Center
The days of managing trials through a patchwork of disconnected systems are fading. Sites that once relied on individual modules will now demand centralized command centers, purpose-built platforms that unify site-based clinical trial operations, financials, and performance metrics in real time. This mirrors the shift seen across AMCs and health systems: consolidating dozens of fragmented tools into a single Site Operations Management System (SOMS).
SOMS connects CTMS, eSource, eReg/eISF, participant engagement, payments, and Devana into a single operational hub. It becomes the organization’s total eClinical command center, giving research leadership unified oversight of study performance, financial health, and compliance across the entire portfolio.
In a world where AMCs and health systems oversee dozens, or even hundreds of active studies, visibility is everything. Fragmented systems create blind spots; unified operations create momentum.
With SOMS, clinical trial leaders can monitor:
- Enrollment progress in real time
- Revenue performance at the study, department, or enterprise level
- Protocol compliance and emerging risks
- Staffing workload and visit forecasting
- Operational bottlenecks before they derail timelines
By 2026, the most competitive clinical trial institutions will have:
- Better project oversight across departments, teams, and sites
- Unified dashboards for study timelines, revenue, and enrollment
- Real-time monitoring of protocol deviations and queries
- Automated KPI reports for sponsors and leadership teams
What it means for sites:
Visibility will equal value. Organizations that can see their performance in real time will make faster decisions, prevent delays, and position themselves as preferred research partners.
With SOMS, data silos are eliminated. Coordinators, regulatory teams, and leadership operate from a shared source of truth, allowing them to anticipate risks before they surface, allocate resources with precision, and execute trials with greater predictability.
The institutions that embrace an eClinical command center will set the pace for site-based research in 2026 and beyond.
“At RealTime, our vision is to become the true nerve center for clinical trial operations, from start to finish. Administrators at large health networks and academic medical centers need a complete, real-time picture of their research activity across every department and site. RealTime is ready to deliver exactly that.”
Graeme Hennessy, Chief Commercial Officer
2. The End of Duplicate Data Entry
We caught up with Nathan Levens, Vice President of Product & Head of Quality at RealTime, who predicts that 2026 will mark the beginning of the end for one of clinical research’s biggest inefficiencies: eSource to EDC data transcription.
The 2025 RealTime Reports eSource Survey found:
- 72% of sites still manually transfer data between systems
- Transcription errors occur in nearly 70% of cases
It’s a staggering amount of wasted time, effort, and accuracy, especially in modern clinical trials where interoperability should be the norm, not the exception.
For decades, duplicate entry has been treated as an unavoidable step in the clinical data lifecycle. This persistent interoperability gap will finally close in 2026.
With the launch of RealTime’s EDC Connect, sites can seamlessly map and export data from eSource into any Operational Data Model (ODM)–compatible sponsor EDC platform, significantly reducing errors and reclaiming hours previously lost to manual transcription.
Built on validated EDC capabilities using the CDISC ODM standard, EDC Connect requires no custom integration to implement, making true, scalable interoperability finally accessible for every site, regardless of size, infrastructure, or EDC vendor preferences.
What it means for sites:
With EDC Connect, sites finally escape the costly, time-draining cycle of duplicate data entry between eSource and EDC systems. Instead of manually re-entering and reconciling data across platforms, electronic source information flows securely and consistently into sponsor systems, eliminating unnecessary work and reducing risk. This translates into:
- Faster study start-up and close-out, removing a key operational bottleneck.
- Cleaner, audit-ready data, with fewer mismatches and reconciliation issues.
- A significant reduction in site workload, giving coordinators back time previously spent on redundant documentation.
“Our mission has always been to make research more efficient and more human. EDC Connect gives sites more time to focus on patients, not platforms. It’s a leap forward for interoperability, and for the people who make trials possible.”
Nathan Levens, Vice President of Product & Head of Quality
3. Bring Your Own Technology (BYOT) Goes Mainstream
In 2025, BYOT moved from idea to industry initiative, led by the Decentralized Trials & Research Alliance (DTRA) and co-authored by RealTime’s Rick Greenfield alongside leaders from GSK, Mayo Clinic, and others. By 2026, BYOT will become a defining feature of sponsor-site collaboration.
BYOT empowers sites, AMCs, and health systems to use their own validated eClinical systems, like eSource, eReg/eISF, and eConsent, within sponsor-funded studies. Instead of forcing new tools on site staff, sponsors will rely on interoperability standards (like CDISC ODM, FHIR, and USDM) to maintain visibility without compromising data quality.
What it means for sites:
Choice becomes a competitive advantage. BYOT shifts power back to the organizations doing the operational heavy lifting. Instead of adapting to a different technology stack for every study, sites, AMCs, and health systems can standardize on their validated systems, systems they know, trust, and have already trained their teams on. This means:
- Greater operational consistency across all trials, regardless of sponsor.
- Higher staff productivity, as coordinators and regulatory teams no longer relearn tools for every protocol.
- Faster startup timelines, since existing workflows, templates, and configurations can be leveraged from day one.
- Improved negotiating position, as sites with mature technology ecosystems (eSource, eReg/eISF, eConsent, payments, participant engagement, and more) become more attractive partners for sponsors seeking efficiency and data quality.
Most importantly, BYOT establishes a new norm: sponsors bring the protocol, sites bring the systems. And everyone benefits from smoother operations, clearer oversight, and data that flows through standardized interoperability (CDISC ODM, FHIR, USDM) instead of fragmented, one-off integrations.
“Sites are already investing in high-quality technology that integrates with their workflows,” said Greenfield. “The BYOT approach recognizes that letting sites leverage these systems doesn’t just make their work easier – it accelerates trials and benefits sponsors.”
Rick Greenfield, Founder & Chief Strategy Officer
4. Study & eSource Templates Become the ROI Multiplier
As studies grow in complexity and volume, study and eSource templates give teams a structured, protocol-aligned foundation that reduces variability and helps coordinators work with clarity. Instead of rebuilding forms for every study or relying on paper CRFs as a blueprint, sites are moving toward standardized, electronic templates that support both speed and quality.
Templates will become a cornerstone of site ROI in 2026 because they meaningfully reduce the time and variability built into study start-up and execution.
According to the RealTime Reports: eSource ROI Survey Summary findings:
- 63% of sites reported improved protocol compliance after adopting eSource
- Standardized templates ranked as the #1 compliance driver (39%), even above audit trails and version control
Internal analysis of RealTime’s study template and eSource build documentation shows that study builds, which often require 2–10 hours of staff effort, are significantly shortened when teams rely on standardized templates.
Likewise, production-ready eSource builds are completed in 2–6 weeks, with expedited timelines as fast as two weeks. By reducing build time to just a few weeks, sites can activate sooner and begin on a stronger, audit-ready foundation from day one.
Beyond speed, templates introduce a level of consistency and data quality that is difficult to achieve with one-off builds. They offer:
- Stronger data integrity and protocol fidelity through standardized structures that behave consistently across users and departments.
- Higher data quality at the point of capture with smart logic, intuitive visit flow, and QA-reviewed designs that reduce queries and deviations.
- Faster adoption and training because templates mirror real coordinator workflows, making systems easier to learn and use.
What it means for sites:
Templates won’t replace good processes, but they will strengthen them. In research environments defined by tight timelines, complex protocols, and staffing pressures, templates offer a quiet but powerful return: greater accuracy, smoother execution, and a scalable foundation for every study.
In 2026, sites that leverage templates can expect:
- Faster study activation, with hours of build work already done
- More reliable, audit-ready data with fewer corrections downstream
- Quicker onboarding for staff using familiar, structured workflows
- Greater cross-department consistency, especially in large AMCs
“Our Professional Services team is dedicated to going into deep dives with our customers to help them learn about how to get even more return on investment from RealTime’s entire suite of eClinical solutions. ”
Alicia Gearhart, Director, Professional Services
5. AI Moves from Buzzword to Business Skillset (Without Replacing Site Technology)
AI will dominate 2026 headlines, but not in the way the industry hype suggests. While some vendors rush to promise “AI-built workflows,” the most successful research organizations will focus on AI literacy, not AI features.
In 2026, expect sites, AMCs, and health systems to adopt AI tools outside of regulated study workflows to support:
- SOP and template drafting
- Protocol summary and comprehension
- Internal training materials and checklists
- Non-regulated administrative tasks (scheduling, prep, communication)
- Summaries of large documents for internal review
Success won’t hinge on who has AI tools, but on who has AI-skilled teams capable of using them well.
What it means for sites:
AI won’t run clinical trials, but it will give research teams meaningful time back to focus on patient care, data integrity, and operational oversight. As AI literacy becomes a core competency, sites that intentionally upskill their staff will see measurable gains in efficiency and decision quality.
For site networks, AMCs, hospitals, and health systems, this means:
- Administrative burden drops. AI handles summaries, documentation prep, and routine communication so teams can focus on higher-complexity tasks.
- Training accelerates. Coordinators, regulatory specialists, and new hires get faster, clearer onboarding through AI-assisted learning materials.
- Protocol understanding improves. AI-generated summaries help teams align quickly and reduce avoidable errors across visits.
- Staff feel more supported. Instead of AI replacing jobs, it becomes a force multiplier that removes friction from daily workflows.
Ultimately, organizations that treat AI as a team skillset, not just a tech feature, will operate with greater agility and confidence in 2026. The differentiator won’t be the presence of AI. It will be the capability to use it responsibly and effectively.
The 2026 Outlook: Smarter Systems, Stronger Sites
By 2026, the question won’t be who uses technology. It will be whoever uses it best. Clinical research is moving beyond a patchwork of disconnected tools and into a unified ecosystem powered by interoperability, automation, and true site autonomy. The organizations that excel will be those that modernize not just their technology, but the way their people and processes work together.
Sites, AMCs, hospitals, and health systems now have the chance to build an operational foundation that strengthens every part of the research lifecycle. They can take control of their workflows through BYOT, eliminate long-standing burdens like duplicate data entry from eSource to EDC, and centralize all operations within a unified command center. They can scale quality using standardized templates and sharpen team capability with AI-assisted skills that remove friction from daily work.
The future belongs to organizations that see technology not as a collection of tools, but as an integrated ecosystem, one that empowers their teams to work smarter, faster, and with greater confidence. Those that embrace this shift will prevent delays, strengthen sponsor relationships, and ultimately deliver better research outcomes.
Advice for 2026? Own your systems, leverage your data, elevate your teams, and let technology finally serve the science, and the people at the center of every trial.
Read More: 2025 Year in Review: Redefining What’s Possible in Clinical Trial Technology