Reduce clinical trial site burden through better workflows

Ryan Muise — Host, XTalks
Good day to everyone joining us, and welcome to today's Xtalks webinar. Today's talk is entitled "Reduce Clinical Trial Site Burden Through Better Workflows and Fewer Delays." My name is Ryan Muise, and I'll be your Xtalks host for today. This webinar will run for approximately sixty minutes and includes a Q&A session with our speakers.

Ryan Muise — Host, XTalks
The webinar is designed to be interactive and works best when you're involved. Please feel free to submit your questions and comments for our speakers throughout the presentation using the questions chat box, located in the control panel on the right-hand side of your screen. If you require any assistance, you can contact me at any time using the same chat panel. I'd also like to welcome our attendees viewing via LinkedIn Live — please submit your questions via the comments tab. All participants are in listen-only mode, and the event will be recorded and made available for streaming to those who have registered on xtalks.com.

Ryan Muise — Host, XTalks
I'd like to thank Suvoda, who developed the content for this presentation. Suvoda is a global clinical trial technology company with a market-leading real-time software platform that empowers sponsors and CROs to make confident decisions and sites and patients to take calm, controlled action. Suvoda delivers interconnected, action-driven software solutions and industry-leading services and support so that even in the most time-sensitive, mission-critical moments, life-changing studies keep moving forward.

Ryan Muise — Host, XTalks
Now I'd like to introduce our speakers. Daniela leads Suvoda's global eClinical Solutions consulting team and is based in the Barcelona office. She works closely with clients and prospects, delivering presentations and demonstrations while serving as a subject matter expert on Suvoda's solutions. Daniela joined Suvoda eight years ago in the services delivery organization, where she worked in project management and gained deep hands-on experience in IRT solution delivery.

Ryan Muise — Host, XTalks
Andrés has twenty years of experience in the eCOA industry and is Vice President of eCOA Solution Strategy at Suvoda. Since 2024, he has led Suvoda's product and commercial strategy for eCOA, driving innovation and industry alignment. Previously, as Vice President of eCOA Practice, he built Suvoda's eCOA service operations, establishing key teams and extending capabilities. And as VP of Customer Success at Suvoda, Kathy is responsible for driving adoption, value realization, and long-term success across Suvoda's global client base. She leads cross-functional teams spanning consulting, training, and customer success, aligning stakeholders and orchestrating execution to ensure clients achieve measurable outcomes and maximize the impact of Suvoda's platform. Without further ado, I'll hand the mic over to our moderator, Daniela. You may begin when you're ready.

Daniela Duffet — Global eClinical Solutions Consulting, Suvoda
Thank you, Ryan. And thank you, Kathy and Andrés, for joining me today, along with all of our audience. Welcome to our webinar. We're really excited to be chatting with you today about the site experience and how simpler tech can drive faster and better trials. We're focusing, as the title suggests, on reducing clinical trial site burden through better workflows and fewer delays. Let's dive right in.

Daniela Duffet — Global eClinical Solutions Consulting, Suvoda
We're all here because we really care about the site experience and can see how central it is to the success of clinical trials. One of the realities we've seen is that sites aren't struggling with complexity — they're absorbing it. Most trial designs assume that complexity can be managed centrally, but in reality it's pushed downstream to sites, where it shows up as delay, rework, staff burnout, and a lot of other problems we'll be discussing today. To get us started, let's look at the landscape as it is now and some of the key pain points sites experience. Andrés, I'll ask you to go first.

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
First and foremost, thank you to everyone for taking the time to engage in this very important discussion. As Daniela just mentioned, sites have an incredibly tough job — that goes without saying. And sites absorb a lot of the challenges around the complexities of trials that sponsors are pushing on them.

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
We've been working with Everest Group as they look to evaluate the IRT landscape, and as part of that work they surveyed key stakeholders across sites, sponsors, and CROs. Some of the feedback we obtained — primarily from sites — was about what sites expect from sponsors when selecting technologies. At the end of the day, it's what you or I would expect from anything: things that work. They want reliable systems, systems that make sense together, that speak to one another, that intuitively understand where a participant is in a trial, or perhaps systems that anticipate their needs.

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
Over the last twenty-plus years in my career, technology has done a great job of moving things forward and growing with the ever-changing landscape. But one thing that has fallen short is that sites have been asked not just to absorb a lot of this complexity — they've been asked to be resilient and adapt to it. So when we think about the problems that technology platforms are meant to solve, one of the big questions that keeps coming to mind is: what challenges is technology actually introducing while it's solving older ones? Are we just kicking the can down the road by creating new solutions that introduce new problems?

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
Part of that burden around executing increasingly complex studies is then passed down to the participant. When that happens, it becomes very difficult to keep participants engaged, and then sites have to work across myriad systems, multiple logins, fragmented systems that don't speak to one another. That's some of the top concern expressed today in the field, and it's why solution providers like Suvoda are asked time and again to find new ways to solve these problems.

Daniela Duffet — Global eClinical Solutions Consulting, Suvoda
That's a really good point. Kathy, anything to add?

Kathy Kohler — VP, Customer Success, Suvoda
I agree with everything Andrés said, and I'd add that another burden we often hear sites talk about is the amount of work required just to help patients successfully navigate the trial and remain in it. Patients are balancing work and family obligations, and within clinical trials they face additional challenges like transportation or financial considerations — all on top of the realities and stress of living with a medical condition. Sites spend a significant amount of their time supporting patients with this, whether it's answering travel questions or managing schedule changes. And one thing I find particularly interesting is that much of this work isn't formally assigned to anyone, so it's not accounted for.

Kathy Kohler — VP, Customer Success, Suvoda
When questions arise, when processes aren't clear, or when a participant needs help navigating the experience, the site often becomes the default coordinator — trying to connect participants to the right resources, helping them understand their challenges, and figuring out how to navigate the process. That's an operational gap that exists across the study experience, and the sites are absorbing it. As studies become more complex and patient expectations continue to evolve, that responsibility is only growing. That's why we're seeing so much more interest in solutions that not only improve the patient experience but also provide clearer support models, better visibility, and more connected workflows, so sites aren't left acting as the coordinator for every issue that arises.

Daniela Duffet — Global eClinical Solutions Consulting, Suvoda
Absolutely. Sites aren't just struggling with complexity — they're absorbing it. And we're expecting them to absorb it with a level of resilience that is becoming unsustainable. With the rise of technologies like AI, we'll be able to capture and analyze more data, but ultimately it's going to come down to sites having to execute that and capture it. That's a good bridge to my next question: how are we seeing sponsors approach the site experience, and what are they doing to alleviate some of these burdens? Kathy, do you want to go first?

Kathy Kohler — VP, Customer Success, Suvoda
One of the shifts we're seeing is that sponsors are paying more attention to everything surrounding participation. Historically, they tended to focus on solving an individual challenge — like travel or payments. But what we're seeing now is sponsors taking a broader view and looking at the overall site experience, trying to understand where burden exists across the study and what they can do to make participation and study execution easier.

Kathy Kohler — VP, Customer Success, Suvoda
Travel is a good example. The challenge isn't just getting a participant to a visit — it's everything that happens around the visit: scheduling transportation, managing changes, coordinating a caregiver, and all the questions that arise when something doesn't go as expected. Sponsors are recognizing those needs and understanding they can differ from patient to patient, so being flexible in the solutions they provide is really important. A rideshare solution might be perfectly appropriate for one study, while a rare disease study with complex logistics might require full concierge support involving flights and hotels.

Kathy Kohler — VP, Customer Success, Suvoda
Another area receiving significant attention is site payments. We hear repeatedly that the issue isn't just about whether a payment was made, but that the site doesn't know where it stands in the process. Sites can spend a lot of time researching payment status or trying to answer a question for the patient. What we've found is that simply providing visibility removes a significant amount of administrative effort. Sponsors are recognizing that the operational experience matters — sites know which studies are easy to work on and which aren't, and that experience can influence future engagement.

Daniela Duffet — Global eClinical Solutions Consulting, Suvoda
Thanks for sharing. So flexibility and visibility — those are the two key themes across travel and site payments. Andrés, anything to add?

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
Everything Kathy mentioned covers a lot of the known challenges that service providers like us learn about through our engagement with sponsors and sites — that's why these solutions exist. But one thing I've seen sponsors do is take far more care about engaging sites and participants to get their feedback — establishing site boards, reaching out to patient advocacy groups, really wanting input on what's challenging, what's working, what's not working. We ourselves at Suvoda have undertaken this in the last few years, and for me it's been incredibly eye-opening. In many ways it's validated what we as an organization are trying to solve for.

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
At conferences, you hear all the time about wanting the patient's voice or the site's voice. But you don't always see the fruits of that. If you're going to engage site boards or patient boards, it's so important not only to listen but to take action and demonstrate that action. You can want to hear from somebody, but unless you're actually going to do something about it, nothing changes. More recently — and especially this year — I've seen so many more sponsors being mindful about incorporating site and participant voice in the design of their protocols.

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
Think about an oncology study that's also a rare disease — you're trying to find participants who may be hours or even a flight away from the site. How are we designing a study that makes it easy for them to receive the care they need, participate in the study, and help advance science? When you listen to site feedback, it's about helping coordinators answer those real questions: How is this patient getting to the site? They have to take time off work — is that okay? Can they move their visit? The industry as a whole can always do better, but it's great to see sponsors taking intentional steps. That message from sites is loud and clear for everyone across the industry.

Daniela Duffet — Global eClinical Solutions Consulting, Suvoda
It's a really good point. Listening is great, but if you're not acting on it, it's not meaningful. It's a two-step approach. Now I'd like to steer us into the role of technology. We've spoken about complexity in clinical trials, and we know that new technologies and services are often introduced to support those more complex trials. But one of the messages we keep hearing from sites is that the introduction of new technology can itself be a burden — extra logins, new devices, new training, new processes. How can we make sure technology becomes an asset rather than a burden? Kathy?

Kathy Kohler — VP, Customer Success, Suvoda
I don't think most sites are resistant to technology. What they struggle with is when a new solution requires additional training or changes how they work day to day, and it's not clear to them what the payoff of that change is. So it's important to focus on how technology is being applied to ensure it's truly an asset. We've seen that sites often develop workarounds that become part of their normal routine — a spreadsheet they maintain, a tracking process — something they've created because they don't fully trust the system or it doesn't fully meet their needs. And sites don't always mention these things because they've become so ingrained in how they work.

Kathy Kohler — VP, Customer Success, Suvoda
To me, purpose-built technology is about understanding where coordinators are spending their time, where delays occur, where errors tend to happen, and where the workarounds are — and then designing solutions that eliminate that effort rather than simply shifting it somewhere else. What I hear consistently from sites is that they don't need vendors to hand them another system. What they really want is partners who understand the operational realities they're dealing with and can help them successfully incorporate technology into their day-to-day workflows.

Kathy Kohler — VP, Customer Success, Suvoda
Successful technology adoption is less about the technology itself and really is about everything surrounding it — how it's implemented, how sites are trained, how quickly issues are addressed. Those things often determine whether a solution is viewed as helpful or burdensome. Implementation is important, but adoption is where the value is realized. Organizations that focus on enablement and change management as much as the technology itself are the ones that will be successful. Sites aren't evaluating technology based on how sophisticated it is — they're evaluating it based on whether it saves them time, reduces their effort, and ultimately helps them focus more on patients.

Daniela Duffet — Global eClinical Solutions Consulting, Suvoda
And ultimately, sites are people. We all know change is hard. I like the emphasis you put on being partners with them — it ties back well to what Andrés was saying about listening and gaining feedback. Andrés, anything to add?

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
Something Kathy mentioned reminded me of an anecdote a sponsor shared at a recent conference. This sponsor was visiting a site — either for a feasibility visit or something similar — and the thing that actually stood out wasn't how organized the site was, but that the lead coordinator showed up with a spiral-bound notebook under her arm. When the sponsor asked what it was, it turned out to be all of her cheat sheets, logins, and participant tracking — that was how this coordinator did her job. Just at that one site.

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
When you think about how differently sites operate — site networks, academic centers, small individual sites, large sites — they all have different institutional processes and policies to adapt to, which means technology can't be one-size-fits-all. But to me, it still feels like all of these solutions are putting sites on rails and forcing them to carry a notebook of cheat sheets for each study. Think about all the studies they're running, all the participants they're seeing. In 2026, someone is walking around with a handwritten guide to how to do their job every day. Technology should be more intentional about solving that. How do we take that notebook out of the coordinator's hand and have them trust that the system is going to guide them and tell them what they need to do?

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
Instead of thinking about how systems integrate with one another, we should be talking about how systems unify and create a singular experience. That could mean competitors working with each other and finding solutions that make sense for sites. At the end of the day, those are our customers. We are trying to get trials executed cheaper, faster, and better, getting drugs approved — that's the mission. So we should be intentional about building solutions that attack these paradigms. When you think about solving a problem, certain vendors can go out there and try to solve one big thing, but they're not necessarily thinking about how that ties into an ecosystem or following user-centered design — thinking about all the different individuals, all the different users: participant, site, site manager, PI, CRA, and how each one engages with the system.

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
You have to be intentional about solving the problem for the community, not just the individual. At Suvoda, whenever we think about how to solve a problem, we try to do it in the simplest way and bring our expertise together with what the technology can do. It comes back to adaptation. We shouldn't just be asking sites to adapt. Technology should be adapting to sites. How is the solution flexible so that it is not a general, one-size-fits-all solution, but one that's adaptable to the different scenarios and lived experiences at a site?

Daniela Duffet — Global eClinical Solutions Consulting, Suvoda
And a lot of that can be gained through the feedback we get from sites — listening, communicating, partnering, as Kathy said. I actually have a follow-up question for you, Andrés. You were talking about implementing solutions that might be applicable to one site but not another. I'd love to hear more about what it takes to successfully build and roll out new technology across really diverse global sites.

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
It starts with being adaptable. When you think beyond a one-size-fits-all solution and different kinds of sites, the outer layer is different countries, different agencies, different regulatory environments, different cultural expectations. As an industry we've generally been slow to evolve with not just technology, but the growing cultural changes in the world. COVID was a watershed moment — we began figuring out how to get to participants where they are and how to be more accessible. We needed to engage participants more broadly and address underserved populations. But when you think about that from a global standpoint, your solution has to adapt to fit the needs of sometimes an individual country within the scope of the entire trial.

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
eConsent is a great example because of how differently countries approach privacy, the rights of the participant, and the consenting process. Even within the United States, individual states have different perspectives. Your system shouldn't be deploying a solution where only a fraction of sites can use it. If you don't do this intentionally, you're missing the point. Your solution needs to scale.

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
One thing we get asked by sponsors all the time is: can you roll out a protocol amendment gradually, so that as different countries or sites are approved, you can do it incrementally rather than waiting until everyone is approved? I can't believe we're still having that conversation in 2026. That should be a hard requirement for any system — it's been a reality in clinical research for a very long time. It goes back to simplicity and thinking about everyone involved, and not forcing a sponsor, site, or CRO to adapt to how they run the trial because the solution requires it. It has to be the other way around.

Daniela Duffet — Global eClinical Solutions Consulting, Suvoda
Especially as we all live in a world increasingly governed by technology — it's in everyone's day-to-day life, so our expectations are shifting. The protocol amendment rollout example is such a good illustration of flexibility, and also of the reality that different sites may be at different points in the same trial. Kathy, anything to add on the global site aspect?

Kathy Kohler — VP, Customer Success, Suvoda
Andrés nailed it. I'd add that beyond just the technology, sometimes the harder challenge is understanding how sites actually work in different parts of the world and recognizing that there isn't a single global site experience. A large academic medical center is very different from a smaller research site — in staffing levels, in how comfortable they are with technology, in how patients engage with research, and even in their expectations around technology. And that extends beyond the technology to training and support, which can vary significantly across regions.

Kathy Kohler — VP, Customer Success, Suvoda
It's not enough to just build the technology — you have to understand the surrounding processes and workflows sites are using across the globe. Looking at how training is delivered, how support is provided, what documentation is needed. We've seen situations where one region strongly prefers short video-based learning, while another wants detailed written documentation. You might assume nobody wants lengthy written documentation anymore — they want something fast — but when you actually talk to different regions and different sites, you might find you were wrong. You have to be flexible enough to provide whatever's needed so sites can get the true benefits and adopt the system. The technology matters, but the surrounding experience often determines whether adoption succeeds.

Daniela Duffet — Global eClinical Solutions Consulting, Suvoda
Thank you both. We've covered the site experience, how sponsors are helping, and the role of technology. Now I'd like to move into some real-life scenarios to highlight specific workflow unification examples. The first scenario I'd like to discuss is eCOA and patient payments. These tools sometimes work alongside each other but not necessarily together. How can these work together to ease site burden and improve the patient experience? Andrés, I'll ask you to start.

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
With my background in eCOA, the last twenty years has been very focused on patient diaries, compliance, and creating systems that make sense. When Suvoda and Greenphire merged, I had the opportunity to learn a lot more about patient payments. For a very long time, I had considered patient compliance really tied into routine and habit — I still believe that — but I had completely missed the point of compensation in keeping participants engaged. We partnered with Citescript towards the end of last year, and they did a survey in 2025 around patient engagement with a lot of feedback around payments in particular. Kathy, I'm actually curious what you've heard from the Greenphire side.

Kathy Kohler — VP, Customer Success, Suvoda
One of the things that stood out from the Citescript discussion on micropayments was that participants weren't really talking about the payment amount — they were talking about the experience. What they appreciated was the immediacy and transparency of the payments, and the recognition that their effort had been acknowledged. We focus so much on making sure payment occurs and happens timely, but what we're finding is that through the integration of eCOA and patient payments, we create a much more predictable experience, and that is really appreciated.

Kathy Kohler — VP, Customer Success, Suvoda
Patients complete an activity and can clearly see what happens next. They don't have to wonder whether something was received or whether they're eligible for a payment. And sites don't have to sit in the middle of those routine interactions because it's all visible. So the opportunity isn't just about automating payments — it's about eliminating that uncertainty, creating predictability, and removing the administrative effort that often surrounds those payments.

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
When we talk about unifying systems, and as our legacy systems have been combined into a single app experience for participants, having that same transparency for the participant is incredibly valuable. Part of it is knowing: am I getting paid? Am I getting reimbursed for this trip? I completed something — my compliance is high, and I'm getting a micropayment as a result. But it also aligns very much with the everyday expectation people have of technology. Our expectations have gotten smaller and smaller — fifteen seconds for something to load, and you put your phone down.

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
Think about it from a patient's perspective — especially when we're trying to reach more underserved populations or people with multiple jobs who have to take time off work and for whom reimbursement is the reason they stay in the study. Having visibility into payment status within the same app experience that's also prompting them to complete their daily diary is what people expect today. Everything is in the same place. Connecting payments with the eClinical elements of completing diaries or being in a routine — these are solutions that just make sense together. And when the app is answering those questions, you're taking burden off the coordinator. They're not having to call the coordinator to ask where their reimbursement is. The system should just take care of it.

Daniela Duffet — Global eClinical Solutions Consulting, Suvoda
Great points. Immediacy and transparency are things we expect in all aspects of technology. And giving patients a better experience ultimately gives sites a better experience, because sites are the ones patients will call if there's an issue. This is also removing work from them — if a patient can submit a reimbursement request through an app, they're not going to show up at a site with a receipt. It makes it easier for the site as well.

Kathy Kohler — VP, Customer Success, Suvoda
Creating predictability and visibility gives trust to both sites and patients. That's such an important piece — it's not just about the expectation. It's about making sure we're building that trust and keeping them engaged so that they want to continue in the trial and help us gain the data we need.

Daniela Duffet — Global eClinical Solutions Consulting, Suvoda
Exactly. Now I'd like to move to another scenario — one that Andrés, I think is better suited for you, though Kathy, please chime in. I want to talk about having eCOA and IRT together. How do these solutions working together help optimize the patient and site experience throughout the screening, randomization, and drug dispensation workflow? And are there any risks in tying these two systems together?

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
When I joined Suvoda, I knew very little about IRT and drug supply — I knew it was very complex and nuanced, but it was always "that other system." I had my blinders on around what a coordinator goes through when they're needing to enroll a participant, assign them a diary, and then send that participant on their way to complete their diaries or questionnaires in clinic.

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
As I began to learn more about the platform, one thing that became evident to me was the strength Suvoda had in creating a system that guided the site — instead of prompting the site to identify what visit they're at and what activities are required, the system intuitively presents that to the coordinator. That makes perfect sense, because you're in one place, you click one button, and the system does these things for you. The old workflow was: go here, do this, create your participant, get your ID, then go into the eCOA system and create the participant there using that ID. That was the way of the world.

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
When I started seeing the strength of combining participant creation with the clinical workflow — so that the system prompted eCOA task completion — that clicked for me. Our founder and CEO preaches about time-sensitive, mission-critical moments in the trial, and that's been burned into my mind. When you think about solutions that make sense together, it's about unification. The system needs to do what it needs to do for that visit, and I as a coordinator shouldn't have to tell the system what I'm there for. It should be telling me. And the more it does that, the better the downstream impacts are.

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
We've noticed this over the last few years — how important that element is across everything that happens in a trial behind the scenes. If I have to go and randomize a participant today, and they're supposed to have been doing diaries for the last three weeks, I shouldn't need to go to another system to check that first. The system should know exactly where that participant is. If they're going to be non-compliant as they arrive, I should be notified so I can follow up with that participant, and then when I do randomize them, the system takes all of that information into consideration with a single click.

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
Pushing that down to the randomization visit: the coordinator just clicks randomize. The system says the participant has completed seven of the last ten diaries — they are compliant from an eCOA perspective. Here is their lot number. Here are the drug units to assign. One click. Think about all the time they now have to address the questions that every participant is going to have, instead of spending ten, fifteen, maybe thirty minutes signing into one system, doing a few things, going into another system, doing more. And if they make a mistake, now they have to call the help desk. We all know these scenarios.

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
What excites me most about what we're doing is that the system intentionally tries to remove that burden from the site. Other systems are catching up and everyone is thinking about this — but it's almost a no-brainer moment. Like, of course this action should lead into the next one. The system should intuitively know to guide the user, the coordinator, to help the participant move through the study and know exactly what needs to happen next. When you have a system that is truly unified — not integrated, not multiple solutions bolted together, but one architected from the ground up to work as a single solution — it really does begin to solve those problems. It's not perfect, but it begins to solve them.

Daniela Duffet — Global eClinical Solutions Consulting, Suvoda
The themes keep coming through — flexibility, immediacy, transparency, building trust. It applies at the site level just as much as at the patient level. Thanks, Andrés. Kathy, I have a scenario for you — travel. You have more experience on the patient travel side. How does that fit into a broader platform and help the site experience we've been talking about today?

Kathy Kohler — VP, Customer Success, Suvoda
Travel is one of the clearest examples of why the connected experience really matters. What I like about combining it into the broader platform is that travel can become part of the patient journey from the very beginning rather than something managed separately. At study startup, when participant profiles are being established and assessment and payment requirements are being configured, travel needs can also be incorporated into that same experience. That means sites don't have to figure out where to go when a patient needs support — the information is already there, connected to the broader study workflow.

Kathy Kohler — VP, Customer Success, Suvoda
Travel needs vary significantly from patient to patient. The support model can scale based on those needs. For some studies, the patient may simply need transportation, while others are far more complex — a caregiver, documentation support, special accommodations, coordination across multiple visits. For straightforward needs, sites or patients can request transportation directly through the technology. For more complex scenarios, we have a travel team that can take over the entire experience — booking flights, hotels, ground transportation, caregiver arrangements, and any other logistics.

Kathy Kohler — VP, Customer Success, Suvoda
And what's important is that everybody has visibility into what's happening. We hear this so often — there's so much additional burden that comes from simply not knowing. Things may be taken care of, but if that's not visible, questions come into the site from patients, and it takes more time away from the higher-impact things sites should be doing. The patient can see their travel details, the site has visibility into the arrangements, and the study team doesn't have to rely on emails, spreadsheets, or a separate system to understand what's happening. It's all right there. That's where the real value comes in — not just the travel support, but having it all work together as part of a connected experience rather than a collection of separate processes.

Daniela Duffet — Global eClinical Solutions Consulting, Suvoda
Visibility keeps coming up, and I think these are the important themes we want our audience to take away. If there's not visibility, it creates uncertainty, and that does the opposite of what we're trying to get to today — building trust. Thank you both. Now, to close out before we open up for Q&A: we've covered a lot of ground today. Sites are under pressure from complexity and fragmentation. Technology helps in many ways, but we have to be very thoughtful about making sure it reduces rather than adds to site burden. Unification — not just integration — is key: technology working with sites in the way that sites want to work, informed by their feedback. And we've discussed specific scenarios — IRT, eCOA, patient payments, travel, the patient-facing app — and how all of these working together and unified can help reduce effort for sites while delivering visibility, transparency, and immediacy, which ultimately builds trust. So for my final question: one sentence from each of you — what are your aspirations or predictions for site realities in the next three to five years? Kathy, do you want to go first?

Kathy Kohler — VP, Customer Success, Suvoda
What I'm hoping to see is that sites spend less time managing logistics and more time on the high-value activities they should be doing — supporting patients and delivering care. That's why we're doing all of this. I don't think the future will be defined by more technology. I think it will be defined by technology that becomes less visible, so that sites don't have to see all these different systems, things flow through, and they don't have to log in to as many places. That connectivity is incredibly important, and everyone is starting to tune in to that — whether it's technology Suvoda can offer ourselves or whether we need to work with other companies. People are starting to realize that we should be working together, because behind all of this is the patient experience. We want to make sure we're doing right by patients and sites so they can be focused on that patient experience.

Daniela Duffet — Global eClinical Solutions Consulting, Suvoda
Not more technology, but better technology. Andrés?

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
I see a change in how sites engage with technology. We're in the age of agentic AI, and the most exciting thing about that for me is the ability to engage conversationally with the system. You have ten participants you're seeing that day, and you can just say: "A participant is here — what do I do?" And the system just tells you. Sites don't want to leaf through two hundred pages to figure out what button to click next. If we can embrace that — and at Suvoda we are — I think we're going to see this more and more. First it was chatbots, now it's AI agents that have access to information and can ask: "Do you want me to handle that for you?" So you can go and talk to your participant while the system handles what it needs to. To Kathy's point: better tech, not more tech. It's how the tech is actually improving things, not just what else it's solving for — because some of these problems technology has inherently introduced. What are we doing to actually change the way those problems are handled?

Daniela Duffet — Global eClinical Solutions Consulting, Suvoda
Ultimately, we're all trying to eliminate the scenario Andrés described — someone at a site with a paper notebook that their entire operation depends on. We're trying to provide better tools to tackle that. Kathy, Andrés, thank you so much for your insights. This has been hugely educational, and I'd like to open it up to audience questions. Ryan, back to you.

Ryan Muise — Host, XTalks
Thank you for this insightful discussion. As we move into Q&A, I'd like to direct the audience to the handouts module for additional documentation related to today's presentation. Please keep sending in your questions. I'll get us started with what's already come in.

Ryan Muise — Host, XTalks
First question: are sites generally open to utilizing technology for patient engagement?

Andrés Escallón — VP, eCOA Solution Strategy, Suvoda
Yes. It's a misconception that sites are adverse to tech. They actually want solutions that make sense and are reliable. There is a huge appetite to do more to engage with their participants. Ultimately, sites care most about their participants, and we as solution providers need to make sure we're not creating more problems for them in how they engage.

Ryan Muise — Host, XTalks
Next question: you talked about flexible deployment — what are some examples of configuring deployment across different study needs?

Kathy Kohler — VP, Customer Success, Suvoda
Flexibility isn't just about giving every study more options — it's aligning the level of support, technology, and operational processes to what the study actually requires. One of the challenges our industry has faced historically is trying to apply the same approach to very different studies. A rare disease study has very different needs than a large phase three trial. An oncology study may require a very different participant support model than a study where most activities occur from home.

Kathy Kohler — VP, Customer Success, Suvoda
From a travel perspective, thinking about the different needs of patients — the human element behind what they're going through — is so important. Someone coordinating their travel is one thing; a mother traveling to another country with a very sick child has very different needs. Does she need a companion? Does she need special accommodations? Being able to offer a concierge model with people trained on the complexities of the trial and on being empathetic to the patient's situation — that kind of flexible deployment is incredibly important.

Ryan Muise — Host, XTalks
Thank you. Another common question: how are travel costs handled — are patients reimbursed, or are costs covered upfront?

Kathy Kohler — VP, Customer Success, Suvoda
In most cases, travel costs are covered upfront rather than reimbursed after the fact. The travel is funded by the sponsor and managed through the travel program, so patients aren't expected to pay out of pocket and wait to be reimbursed later. That's a really important distinction, because reimbursement assumes a patient has the ability to absorb that cost upfront — and for some patients, particularly those traveling long distances requiring flights, that can become a barrier to participation. The goal is to remove that barrier before it becomes an issue, so that patients can focus on their health rather than worrying about finances.

Ryan Muise — Host, XTalks
Thank you all for your wonderful contributions today. We have reached the end of our time. For those interested in hearing more from Suvoda, you can register for their next webinar discussing the Everest study findings — scheduled for September 22nd — by visiting xtalks.com. If we couldn't attend to your questions, the team at Suvoda will follow up with you. Thank you to our speakers, and have a great day, everyone.

Daniela Duffet, Andrés Escallón & Kathy Kohler — Suvoda
Thanks, everyone.