How Decentralized Clinical Trials Are Affecting Sites and What They Can Do About It

Decentralized or site-less trials are becoming more and more common. According to ZS’s DCT database, site-less trials experienced a 77% compound annual growth rate between the second half of 2019 and 2020.1 While this initial growth is due in part to the COVID-19 pandemic, the number of site-less trials is still going up. As reported by Clinical Trials Arena, we can expect a 28% increase in site-less and/or virtual clinical trials in 2022 compared to 2021.2

Site-less trials do offer potential benefits for patients, such as reducing the burden of in-person visits and facilitating larger access to participation, especially in underrepresented or rural communities. But the increase in site-less trials has downsides for patients, too. For example, in site-less trials, a patient’s first contact with the study or investigators is often virtual, which makes managing the patient’s experience challenging. Virtual study designs also require participants to navigate complex platforms and use unfamiliar or intimidating technology, leading to further challenges with overall experience as well as an increased dropout rate.

But what about sites?

The Downsides of Site-Less Trials for Clinical Trial Sites

The increase in site-less trials isn’t ideal for research sites as it removes them almost entirely from the research process. A decrease in the volume of on-site studies being conducted can lead to lower earning potential because, without site-based studies, sites don’t have research revenue. Fewer site-based studies also means reduced access to research as care for a site’s patients as well as a loss in research site status and the ability to participate in the advancement of healthcare.

Even if traditional research sites can transition to virtual or hybrid trial models, such trials add complexity to an already complex process. Virtual and hybrid trials necessitate time, funds, and flexibility. Sites must spend time teaching staff and patients how to navigate new technologies and processes and must also invest large amounts of money on technology infrastructure for connectivity — wasting precious resources in an already overstretched system.

Since site-less trials seem to be here to stay, what can sites do to hold onto revenue and resources?

Conduct Clinical Trials With the Elligo Research Network

The Elligo Research Network is designed to maximize your potential as a research site. Our unique solutions, consisting of a study pipeline and supportive services, help you increase your revenue in the face of site-less trials, build your pipeline, and streamline your operations.

As an Elligo Research Network partner, you gain access to exclusive, site-based studies tailored to physician research interests and patient needs. This pipeline of high-interest studies, built on our strong partnerships with top pharmaceutical companies and contract research organizations, expands your therapeutic opportunities, increases your revenue, and brings widespread research as care to your patients.

The Elligo Research Network also gives you access to our PatientSelect trial model, a healthcare-centered program built on the philosophy that the physician-patient relationship is crucial to successful trials. PatientSelect supplies trials only available through Elligo, further boosting your study pipeline, as well as robust infrastructure that alleviates many of the administrative and operational burdens traditionally associated with conducting research.

Finally, we offer our clinical research partners customizable support. Whether you need assistance in patient recruitment and enrollment or financial management and reimbursement analysis, our services reduce your administrative burden and overhead, lower costs, improve the quality of your trials, and allow more focus on your patients and ultimately higher enrollment in each trial.

Only Elligo Expands Your Clinical Research Capabilities

Site-less trials are becoming more common, but by joining the Elligo Research Network, we will protect your revenue and ensure your patients retain access to research as care.

Contact us today to learn more about the Elligo Research Network.


  1. Gao Fan, Solomon Maurice, Roy Arnab, Chaplin William. Why Decentralized Clinical Trials Are The Way of the Future. Applied Clinical Trials. Published April 5, 2021.
  2. Parkins Kezia, Hillman Andrew. 2022 forecast: decentralised trials to reach new heights with 28% jump. Clinical Trials Arena. Published December 14, 2021.

When you need direct access to physicians and their known patients or research practice management solutions to accelerate your clinical trials, there’s Only Elligo.

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