When it comes to conducting clinical trials, aside from the participants who dedicate their time, effort and bodies to advancing medicine, there is no more important stakeholder than the research site. They are the heart of a trial.

From Greenphire’s perspective, our core goal is to build solutions that remove burdens for research sites and participants. We aim to streamline traditionally manual and time-consuming administrative workflows, enabling sites to focus on research and patient care to get treatments to market faster.

But how do we know what solutions to build or processes to improve to better support sites?

There is no better approach than garnering feedback directly from sites themselves. The Society for Clinical Research Sites (SCRS) has been a vital partner to Greenphire and the industry, helping to understand the evolving challenges and needs of research sites around the world.

With that, I recently interviewed Jimmy Bechtel, Vice President, Site Engagement at SCRS to glean deeper insights as he discussed the findings from the 2022 Site Landscape Survey.

Some of the key survey topics and discoveries examined included:

Staff Turnover

58% of sites noted having a higher turnover rate over the past two years.

Staffing challenges impact a site’s ability to conduct and complete trials – from enrolling participants to facilitating visits and patient care. As such, there is a heightened emphasis on training to develop talent, reduce skill gaps and retain staff. So this task doesn’t get left to already burdened site staff, Greenphire employs a global team which offers live site training as well as in-application resources.

Payment Terms & Operating Cash

Regarding payment terms, 56% of sites noted negotiating monthly terms (up from 45% in 2021) and 27% noted negotiating quarterly terms (down from 35% in 2021).

This depicts a trend towards more frequent payments. Paying sites on a preferred timeline is critical to ensuring they have the enough operating cash to conduct a trial.

With 58% of sites indicating that they have 3 months or less operating cash on hand, not only are preferred payment terms essential but timely execution of payments based on the contracted frequency as well. This phenomenon was confirmed in a recent Greenphire survey where sites, sponsors and CROs cited “streamlining site payments and invoicing” as the leading way to foster enhanced relationships with sites.

Hybrid Trials & Technology

76% of sites indicated participating in completely virtual trials in 2021 vs. 59% in 2022.

During the pandemic, the industry adapted quickly, turning to technology to keep as many trials operational as possible. In many cases, this meant conducting trials 100% virtually.

As we move forward and stabilize, we are seeing a more hybrid trial model emerge- activity is returning to the site while paired with and supported by the flexibility that technology can offer, driving operational efficiency and an optimal participant experience. In fact, “benefit to the participant population” was the top ranked reason among sites for participating in hybrid trials.


We are seeing a greater emphasis on diversity within clinical trials. In fact, 54% of sites noted being asked to participate in a clinical study with diverse patient population targets.

This effort has been supported for years by patient advocacy groups and other industry organizations, including SCRS and Greenphire. More recently, regulatory mandates from the FDA have continued to further advance diversity in clinical research.

The industry is making fantastic steps forward, however, there is still work to be done. This includes the need to assist and provide resources to sites around this initiative with 25% of sites saying they could benefit from support in diversity enrollment planning.

Top Site Needs from Sponsors and CROs

When asked “what does your site need/want as far as support from Sponsors and CROs, the top three responses were:

  • Stronger and more robust budgets
    • 40% of sites declined initial contracts during negotiation
    • 43% of sites said that startup costs are underfunded
  • Integrated & consistent tech
    • Sites are willing use and learn new technology. In fact, a top response when asked how sites are planning for hybrid trials was “actively updating knowledge of technology”
    • There are often numerous technologies used throughout a trial and as such, a solution’s usefulness, intuitiveness, and interoperability with other technologies are crucial to site success
  • Thorough site personnel training
    • Trials are getting more complex and more time-consuming for sites and participants
    • With new technologies, evolving processes, and staff turnover, sites have a greater need for comprehensive training programs

As this survey revealed, the industry continues to make significant advancements. There are, however, clear challenges that sites continue to face. For organizations like Greenphire and SCRS, we view this as a call-to-action to continue advocating for and listening to global research sites. With this site direct feedback, we can work towards improving processes and enhancing solutions that ultimately reduce these hurdles and help the industry execute more efficient, successful trials.

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