Patient enrollment is the number one reason clinical trials fail to meet their timelines. Eighty percent of trials are delayed by at least one month due to recruitment challenges. Thirty percent of enrolled patients drop out before the trial concludes. And for every day a clinical trial runs behind schedule, sponsors lose an estimated $600,000 to $8 million in unrealized revenue.

The conventional model — requiring patients to travel to academic medical centers every few weeks for blood draws, assessments, and monitoring visits — was already straining before the pandemic. COVID-19 proved that another way was possible. Decentralized and hybrid trials, remote monitoring, digital biomarkers, and AI-powered patient matching went from experimental concepts to operational necessities in a matter of months.

Now those technologies are not going back in the box. They are becoming the default infrastructure for how clinical trials run.

This guide profiles the 25 digital health platforms reshaping clinical trial design, execution, and data capture in 2026. These are the companies building the technology layer between sponsors and patients — the platforms that determine whether a trial enrolls on time, retains its participants, generates clean data, and ultimately gets a drug approved.

This guide is updated quarterly. Platforms are evaluated on clinical adoption, technology differentiation, regulatory acceptance, and sponsor feedback. Suggest a platform for review.

The Digital Trial Landscape in 2026

The shift is no longer theoretical. Regulatory agencies have formally embraced digital health technologies in clinical development. The FDA published its Framework for the Use of Digital Health Technologies in Drug Development and issued final guidance on remote data acquisition. The EU AI Act’s high-risk provisions take effect in August 2026, creating new compliance requirements for AI applications in clinical trials. And the ICH is actively working on harmonization frameworks expected by 2027 to 2029.

For sponsors, the question is no longer whether to use digital health technology in clinical trials. It is which platforms to use, how to integrate them, and how to ensure the data they generate meets regulatory standards.

Layer 1: Decentralized Trial Platforms

These platforms provide the core technology infrastructure for running clinical trials with reduced site dependency — enabling remote consent, virtual visits, home-based data collection, and hybrid trial designs.

1. Medable

Headquarters: Palo Alto, CA | Founded: 2015

Medable has emerged as the leading decentralized clinical trial platform, providing an end-to-end system that integrates eCOA (electronic clinical outcome assessments), eConsent, remote data collection, telemedicine, and connected device management. Their platform powers hybrid and fully decentralized trials for major pharmaceutical companies including several top-20 pharma sponsors. In 2026, Medable launched Agent Studio — described as the industry’s first agentic AI platform for clinical development — designed to automate routine clinical trial processes and reduce the unproductive “white space” caused by manual workflows. Medable’s extensive partner network includes retail pharmacy networks, home health providers, and connected sensor companies.

Best for: Sponsors implementing decentralized or hybrid trial designs who need a comprehensive, AI-enabled platform with broad partner integrations.

2. Science 37

Headquarters: Research Triangle Park, NC | Founded: 2014

Science 37 was one of the original pioneers of virtual clinical trials and continues to innovate in decentralized trial operations. Their platform enables fully remote or hybrid trial execution through telemedicine, connected devices, and mobile health technologies. With experience across hundreds of decentralized studies, Science 37 has built operational knowledge that newer entrants cannot easily replicate. Their network of telemedicine investigators and mobile nurses provides the human layer that technology alone cannot deliver.

Best for: Sponsors running fully decentralized or predominantly virtual clinical trials who need both technology and operational execution support.

3. ObvioHealth

Headquarters: Orlando, FL | Founded: 2017

ObvioHealth operates as a virtual research organization, combining an enterprise digital platform — ObvioGo — with clinical science expertise to deliver end-to-end hybrid and decentralized trials. Their no-code, drag-and-drop study builder allows protocol development and adaptation in a fraction of the time traditional systems require. ObvioHealth has conducted trials across 16 therapeutic areas in 28 countries. Their recent partnership with Oracle Life Sciences adds decentralized trial capabilities to Oracle’s Clinical One platform.

Best for: Sponsors and CROs seeking a fully integrated virtual research platform with rapid study build capabilities and proven global execution.

4. Thread (by Labcorp)

Headquarters: Cary, NC

Thread’s clinical trial technology platform enables decentralized trial activities including eConsent, ePRO, telemedicine visits, and connected device integration. As part of Labcorp, Thread benefits from integration with Labcorp’s massive diagnostic network and drug development services. This combination of digital trial technology and diagnostic/laboratory infrastructure creates a differentiated offering for sponsors who need both virtual patient interactions and laboratory-based endpoints.

Best for: Sponsors requiring decentralized trial capabilities integrated with laboratory and diagnostic services.

Layer 2: Patient Engagement, Recruitment & Retention

Patient enrollment and retention are the operational lifeblood of every clinical trial. These platforms use data, AI, and novel approaches to find patients, match them to trials, and keep them engaged throughout the study.

5. TriNetX

Headquarters: Cambridge, MA | Founded: 2014

TriNetX operates the world’s largest federated clinical data network, providing real-time access to over 150 million electronic health records across 137 healthcare organizations in 17 countries. Pharmaceutical companies use TriNetX to test the feasibility of trial inclusion/exclusion criteria, identify sites with the highest patient density for specific conditions, and optimize trial design before a single patient is enrolled. The federated architecture means patient data never leaves the healthcare organization — TriNetX queries the data in place, providing privacy-compliant analytics at massive scale.

Best for: Sponsors optimizing trial design feasibility, site selection, and patient population analysis before trial activation.

6. Deep 6 AI

Headquarters: Pasadena, CA | Founded: 2015

Deep 6 AI uses artificial intelligence to read and interpret unstructured clinical data — physician notes, lab results, pathology reports, radiology findings — to identify patients who match clinical trial criteria. Traditional patient matching relies on structured database queries that miss the majority of eligible patients because their relevant information is buried in free-text medical records. Deep 6’s AI reads through that unstructured data, dramatically expanding the pool of identifiable patients and accelerating enrollment.

Best for: Sponsors and sites struggling with patient identification for trials with complex eligibility criteria, particularly in oncology and rare disease.

7. Inato

Headquarters: Paris / New York | Founded: 2016

Inato’s marketplace platform connects pharmaceutical sponsors with community-based research sites that are typically overlooked by traditional CRO site selection processes. By expanding the available site network beyond the same overcommitted academic medical centers, Inato helps sponsors accelerate enrollment, improve patient diversity, and reach populations that conventional trials miss. Their model directly addresses the structural problem that most clinical trials recruit from a narrow base of high-volume sites.

Best for: Sponsors seeking to expand their site network, improve enrollment diversity, and access community-based patient populations.

8. Antidote Technologies

Headquarters: New York, NY | Founded: 2014

Antidote connects patients directly to clinical trials through digital matching technology. Their platform analyzes clinical trial criteria and matches them against patient profiles, making it easier for both patients and physicians to find relevant trials. Antidote’s partnerships with patient advocacy organizations and health information websites extend their reach into disease communities where trial awareness is typically low.

Best for: Sponsors seeking direct-to-patient recruitment channels and partnerships with patient advocacy communities.

9. Trialbee

Headquarters: Lund, Sweden | Founded: 2015

Trialbee uses AI to match patients to clinical trials using data from electronic health records, insurance claims, and other real-world data sources. Their platform provides sponsors with analytics on patient availability, geographic distribution, and competitive trial activity — enabling data-driven decisions about where and how to recruit. Trialbee’s European roots give them strong capabilities in EU data privacy compliance.

Best for: Sponsors seeking AI-powered patient-trial matching with strong European and global data privacy compliance.

Layer 3: Endpoint Data Capture & Clinical Outcome Assessments

These platforms capture the data that determines whether a drug works — from patient-reported outcomes and cardiac safety to medical imaging and digital biomarkers. The quality of endpoint data directly determines regulatory success or failure.

10. Clario (Thermo Fisher Scientific)

Headquarters: Philadelphia, PA | Estimated 2025 Revenue: ~$1.25 billion | Acquired by: Thermo Fisher for $8.9 billion

Clario’s $8.9 billion acquisition by Thermo Fisher was one of the landmark deals in clinical trial technology. Clario is the only company that combines eCOA, cardiac safety assessment, medical imaging, precision motion analysis, and respiratory endpoint technology on a single platform. Their technology has supported over 19,000 clinical trials and contributed to more than 870 regulatory approvals across 120 countries. Integration into Thermo Fisher’s ecosystem — alongside PPD’s CRO services and Patheon’s manufacturing — creates the most comprehensive clinical development services stack in the industry.

Best for: Sponsors running complex trials requiring multiple endpoint modalities (cardiac, respiratory, imaging, eCOA) under one technology partner.

11. Signant Health

Headquarters: Blue Bell, PA | Founded: 2019

Signant Health addresses two critical operational needs: patient engagement technology and clinical supply management. Their eCOA, eConsent, and RTSM (randomization and trial supply management) platforms are used by many of the world’s largest pharmaceutical companies. Signant’s ability to manage both the patient experience and the drug supply chain — ensuring the right therapy reaches the right patient at the right site — makes them a uniquely positioned partner for complex global trials.

Best for: Sponsors needing integrated patient engagement technology (eCOA, eConsent) with randomization and clinical supply chain management.

12. Viedoc

Headquarters: Uppsala, Sweden | Founded: 2003

Viedoc provides a comprehensive eClinical platform encompassing EDC, eConsent, ePRO/eCOA, and supply/logistics management within a single integrated system. Their modular form creation and multilingual interfaces are designed for rapid deployment across international sites. Viedoc’s focus on usability and speed of study build has made it a preferred platform for mid-to-large global trials, particularly for sponsors who need fast protocol amendments without operational disruption.

Best for: Sponsors running global trials who need rapid study setup, multilingual support, and integrated eClinical capabilities in one platform.

13. YPrime

Headquarters: Malvern, PA | Founded: 2010

YPrime provides eCOA, IRT (interactive response technology), and eConsent solutions with an emphasis on configurability and customer service. Their platform supports complex trial designs including adaptive studies, multi-arm protocols, and trials requiring sophisticated randomization schemes. YPrime’s modular approach allows sponsors to deploy individual solutions or a full integrated suite.

Best for: Sponsors with complex trial designs requiring sophisticated randomization, flexible eCOA, and responsive support.

Layer 4: Real-World Evidence & Clinical Data Intelligence

These platforms turn real-world clinical data — from electronic health records, claims databases, genomic registries, and post-market surveillance — into evidence that supports regulatory submissions, trial design, and commercial strategy.

14. Tempus AI

Headquarters: Chicago, IL | Founded: 2015 | Data: 350+ petabytes

Tempus operates the largest multimodal clinical and molecular data platform in oncology, with over 350 petabytes of de-identified clinical and molecular data. Their AI-powered platform connects clinical data (treatment histories, outcomes), molecular data (genomic sequencing, RNA expression), and imaging data to help physicians personalize treatment and help pharma companies design smarter trials. Tempus is increasingly used by pharmaceutical companies as an R&D platform — identifying novel targets, designing biomarker-driven trials, and stratifying patient populations. Their IPO in 2024 valued the company at over $6 billion.

Best for: Pharmaceutical companies seeking oncology-focused real-world data and AI-driven insights for drug development, clinical trial design, and precision medicine.

15. Flatiron Health (Roche)

Headquarters: New York, NY | Founded: 2012 | Acquired by: Roche (2018)

Flatiron Health has built the most comprehensive real-world oncology data platform in the industry. Their data covers millions of cancer patients across hundreds of U.S. oncology clinics, providing longitudinal records of diagnoses, treatments, and outcomes. The FDA has used Flatiron data to support regulatory decisions, establishing a precedent for real-world evidence in drug approval. As a Roche subsidiary, Flatiron’s data and analytics capabilities are deeply integrated into one of the world’s largest pharmaceutical companies while continuing to serve the broader industry.

Best for: Oncology-focused sponsors needing real-world evidence for regulatory submissions, clinical trial design, or commercial strategy.

16. Aetion

Headquarters: New York, NY | Founded: 2013

Aetion’s Evidence Platform transforms real-world data into regulatory-grade evidence. Their platform is used by pharmaceutical companies, regulatory agencies, and payers to evaluate drug safety, effectiveness, and value using data from electronic health records, claims databases, and registries. Aetion’s technology has been validated through collaborations with the FDA and is designed to meet the evidentiary standards required for regulatory submissions and health technology assessments.

Best for: Sponsors needing real-world evidence that meets regulatory standards for FDA/EMA submissions, HTA evaluations, and post-marketing studies.

17. Veradigm (formerly Allscripts)

Headquarters: Chicago, IL

Veradigm provides a real-world data platform built on electronic health record data from one of the largest ambulatory EHR networks in the United States. Their life sciences solutions include patient identification for clinical trials, real-world evidence generation, and targeted physician engagement. Veradigm’s EHR-embedded capabilities allow sponsors to reach patients and physicians at the point of care.

Best for: Sponsors seeking EHR-integrated real-world data and point-of-care clinical trial solutions.

Layer 5: Wearables, Sensors & Digital Biomarkers

These platforms capture continuous physiological data from patients outside of clinical sites — transforming how endpoints are measured, how safety is monitored, and how patient behavior is understood.

18. Koneksa

Headquarters: New York, NY | Founded: 2017

Koneksa’s platform integrates data from wearable devices and digital sensors into clinical trial workflows, enabling continuous, real-time measurement of patient activity, sleep, gait, heart rate, and other physiological parameters. Their digital biomarker analytics convert raw sensor data into clinically meaningful endpoints that can support regulatory submissions. Koneksa has worked with pharmaceutical companies across neurology, cardiology, and respiratory therapeutic areas.

Best for: Sponsors incorporating wearable-based or sensor-based digital endpoints into clinical trial designs, particularly in neurology and movement disorders.

19. ActiGraph

Headquarters: Pensacola, FL | Founded: 2003

ActiGraph has been providing research-grade wearable devices and analytics for clinical research for over two decades. Their CentrePoint platform captures, manages, and analyzes objective physical activity data from wearable accelerometers — data that is increasingly used as a clinical trial endpoint in therapeutic areas including oncology, rare disease, and CNS disorders. ActiGraph devices have been used in FDA-reviewed clinical trial submissions.

Best for: Sponsors needing validated, research-grade physical activity monitoring with a regulatory track record.

20. Evidation

Headquarters: San Mateo, CA | Founded: 2012

Evidation’s platform captures health data directly from individuals through connected devices and apps, then applies machine learning to generate health insights and digital biomarkers. Their approach enables large-scale, real-world data collection from diverse populations. Evidation has partnered with major pharmaceutical companies to develop novel digital endpoints and to recruit participants for virtual studies.

Best for: Sponsors exploring novel digital biomarkers, large-scale real-world data collection from consumer devices, and virtual study designs.

Layer 6: AI-Powered Trial Design & Operations

These platforms apply artificial intelligence to optimize how clinical trials are designed, how sites are selected, how protocols are written, and how risks are monitored during execution.

21. Unlearn.AI

Headquarters: San Francisco, CA | Founded: 2017

Unlearn.AI creates digital twins of clinical trial participants — computational models that predict how individual patients would have fared without treatment. These digital twins can serve as prognostic controls, potentially reducing the number of patients required in control arms and accelerating trial timelines. The FDA has provided positive feedback on the approach, and Unlearn has published validation studies demonstrating the accuracy of their models. If broadly adopted, digital twins could fundamentally change clinical trial economics.

Best for: Sponsors looking to reduce control arm sizes, accelerate trials, and incorporate AI-generated prognostic controls into their study designs.

22. Saama Technologies

Headquarters: Campbell, CA | Founded: 2000

Saama’s AI-powered clinical data analytics platform — Life Science Analytics Cloud — helps pharmaceutical companies accelerate data cleaning, signal detection, and regulatory submission preparation. Their technology automates many of the data management tasks that traditionally consume months of clinical operations time, including automated query generation, risk-based monitoring, and real-time data surveillance.

Best for: Sponsors and CROs seeking AI-powered clinical data management, automated query generation, and accelerated database lock.

23. Medidata AI (Dassault Systèmes)

Headquarters: New York, NY

Medidata has embedded AI capabilities across its Clinical Cloud platform, including AI-powered trial feasibility prediction, synthetic control arm generation, and protocol design optimization. Their Acorn AI division focuses on applying machine learning to the massive datasets generated across Medidata’s clinical trial network — one of the largest in the world. In 2026, Medidata is integrating AI-based trial feasibility predictions and AI-assisted protocol design into its core study planning workflow.

Best for: Sponsors already using the Medidata ecosystem who want AI-enhanced trial design, synthetic controls, and integrated analytics.

24. Trials.ai

Headquarters: Various | Focus: AI protocol optimization

Trials.ai represents the emerging category of pure-play AI companies focused specifically on clinical trial protocol optimization. These platforms analyze historical trial data, real-world evidence, and competitive intelligence to recommend protocol designs that maximize enrollment probability, minimize amendments, and optimize endpoint selection. While many are early-stage, their potential to reduce one of the biggest sources of trial delay — protocol amendments — makes them strategically important.

Best for: Sponsors seeking data-driven protocol optimization to reduce amendments and improve enrollment feasibility.

25. Huma

Headquarters: London, UK | Founded: 2011

Huma’s digital health platform combines remote patient monitoring, digital biomarkers, and AI-powered analytics to support both clinical trials and real-world clinical care. Their platform has been deployed across multiple therapeutic areas and has received CE marking as a medical device in Europe. Huma’s dual focus on clinical trials and clinical care positions them uniquely — the same platform that monitors patients during a trial can continue monitoring them in real-world practice after approval.

Best for: Sponsors seeking a platform that bridges clinical trial monitoring and post-approval real-world patient monitoring, particularly for European and global programs.

How These Layers Work Together

No single platform solves the clinical trial technology challenge. The most effective digital trial strategies combine platforms across multiple layers:

A sponsor designing a hybrid oncology trial might use TriNetX for feasibility analysis and site selection, Medable for decentralized patient visits and eConsent, Clario for cardiac safety and imaging endpoints, ActiGraph for wearable activity monitoring, and Tempus for real-world evidence generation after approval.

The challenge — and the opportunity — is integration. Platforms that interoperate seamlessly with each other and with core clinical systems (EDC, CTMS, eTMF) will win disproportionate market share. Those that create data silos will be replaced.

What Sponsors Should Ask Before Choosing

Has the platform generated data that was accepted by regulators? Regulatory acceptance is the ultimate validation. Ask for specific examples of FDA or EMA submissions supported by the platform’s data.

How does the platform handle data privacy across jurisdictions? GDPR, HIPAA, and emerging data regulations in Asia create a complex compliance landscape. Your digital health partner needs to navigate all of them.

What is the patient experience? Technology that frustrates patients increases dropout. Ask for patient satisfaction data and usability testing results.

How does the platform integrate with existing clinical systems? If your CRO uses Medidata Rave and your eTMF is in Veeva Vault, your digital health platform needs to work with both without manual data reconciliation.

What is the evidence for clinical validity? For digital biomarkers and wearable endpoints specifically, ask for published validation studies and any regulatory feedback on the endpoint’s acceptability.

What’s Next

Agentic AI enters clinical operations. Medable’s Agent Studio launch signals a new phase where AI agents autonomously handle trial management tasks — from document processing to site communication to safety signal detection. By 2027, most major clinical trial platforms will incorporate agentic AI capabilities.

Digital endpoints become primary endpoints. Wearable-derived and sensor-derived endpoints are moving from exploratory to primary status in trial protocols. The first drug approval supported by a digital primary endpoint is likely within the next two to three years.

Regulatory convergence accelerates. The FDA, EMA, and PMDA are actively aligning their approaches to digital health technologies in clinical trials. ICH harmonization expected by 2027 to 2029 will create a more predictable global framework.

Platform consolidation reshapes the landscape. Thermo Fisher’s $8.9 billion Clario acquisition is the most visible example, but expect more M&A as larger clinical technology companies acquire specialized digital health platforms to build integrated offerings.

Methodology

Platforms included in this guide were selected based on clinical adoption by pharmaceutical sponsors, regulatory acceptance of platform-generated data, technology differentiation, therapeutic area breadth, and 2026 market activity. This guide focuses on technology platforms rather than full-service CROs, though some platforms offer operational services alongside their technology.

Is your platform transforming clinical trials? We update this guide quarterly and welcome submissions. Contact our editorial team with your company details for consideration in the next update.

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Last updated: March 2026. Next update: June 2026.