Clinical Trials: The Future Hinges On Orchestration, Not More Tools

Forbes

19 hours ago

Rahul Saluja, Managing Partner & Board Advisor at Cognizant, driving growth in Life Sciences, Digital Transformation & Smart Manufacturing.
Over the past few years, we've seen a wave of digital innovation in clinical trials: decentralized models, eConsent, real-time monitoring and direct-to-patient logistics. We've digitized nearly every touchpoint. But here's the problem: Digitization doesn't equal transformation.
In many cases, we've simply layered new tools onto an outdated operating model. The structure beneath—the way clinical trials are orchestrated across functions—has barely evolved. We're running modern trials with legacy assumptions, and it's showing.
Sponsors are still dealing with mid-trial surprises, delayed shipments, inconsistent patient engagement and misaligned teams. And patients, who now live in a world of real-time apps and same-day delivery, are losing patience with trial timelines and broken communication loops. We don't have a technology gap; we have a coordination gap.
The Illusion Of Progress
There's a difference between having digital capabilities and knowing how to use them to drive outcomes.
Today, different teams manage different parts of the trial:
• Clinical ops oversee protocol execution.
• Supply manages depots and packaging.
• Commercial stays focused on engagement and growth.
• Digital leads the platform strategy.
Each function is doing its job, but in isolation. The challenge is no longer about building new platforms. It's about aligning those platforms around a common operational framework. That's where most organizations are falling short—and where real transformation needs to happen.
Borrowing From Industries That Got It Right
In complex industries like aviation and logistics, orchestration isn't optional. It's built in. These industries rely on control towers—centralized command centers that bring data, systems and decision making together in real time.
Life sciences needs something similar—a clinical control tower. Think of it as a strategic layer that connects your decentralized trial ecosystem, where supply chain, protocol changes, site performance and patient data all speak to each other. This isn't a dashboard. It's an orchestration engine—one that allows your teams to anticipate disruptions, coordinate faster and act with clarity.
What It Looks Like In Practice
A clinical control tower connects:
• Randomization and trial supply management (RTSM) and supply planning tools.
• Real-time site feedback and patient insights.
• Protocol changes with operational impact modeling.
• AI and analytics to identify risk signals before they escalate.
The impact?
• Fewer surprises
• Smoother amendments
• Faster delivery
• Better sponsor experience
• Higher patient retention
And perhaps most importantly, it builds trust—with internal teams, external partners and the patients we're ultimately serving.
The Leadership Shift That's Needed
Transformation at this level doesn't happen from the bottom up. It requires leadership that understands how strategy, operations and execution intersect.
Life sciences leaders—especially across clinical, digital and commercial domains—need to ask tougher questions:
• Are our systems integrated, or are they simply adjacent?
• Do our teams operate from the same data and timelines?
• Can we course-correct mid-trial in real time?
• Are we building toward speed and scale or stuck in reaction mode?
The organizations that can confidently answer these questions will be the ones that define the next era of clinical development.
What's At Stake
It's not just about efficiency. It's about resilience and the ability to adapt quickly, maintain compliance, protect timelines and ensure quality—all while keeping the patient at the center.
In the next five years, life sciences companies will be judged not just by innovation, but by execution. Those most successful won't necessarily have the most tools, but those that know how to connect them.
Final Thought
The future of clinical trials won't be defined by technology alone. It will be defined by how well we orchestrate that technology across teams, systems and time zones.
Patients are living in 2025. They expect seamless, smart and responsive experiences. It's time our trial infrastructure caught up. To get there, we don't need more dashboards. We need alignment. We need orchestration. And most of all, we need leadership bold enough to rethink how trials are truly run.
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