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Welcome to The Trial Signal! It's a place to explore some of the questions our industry is wrestling with, challenge a few assumptions, and hopefully make complicated things a little easier to see.
First up: Are You Planning 2027 With Yesterday's Tools—and Yesterday's Data?
I’ve never met a leader who didn’t want to bring the most qualified and talented people onto their team. (The 2011 NFL “Suck for Luck” campaign may be the rare exception—and, as we know, that story didn’t exactly end as planned.) So why do organizations spend thousands of dollars and hundreds of hours finding, training and positioning talented people, only to ask them to make a similar investment of their time using the modern-day equivalent of an abacus?
I previously shared that my husband underwent a liver transplant in 2025. Following the transplant, he joined a clinical trial evaluating how patients adopt new habits to support better post-transplant outcomes. On our first clinic visit, we were handed a stack of paper roughly half an inch thick: the informed consent document.
My conversation with the coordinator went something like this:
Me: “Whoa—that’s a lot of paper!”
Coordinator: “Don’t worry, we’ll go through it together.”
Me: “You know this can be done on an iPad, where the patient can watch a video, flag questions, and then you spend five minutes with us instead of thirty?”
Coordinator: “Oh wow—are you serious?”
Me: “Imagine what else you could get done with that time. Tell your boss to reach out to me. I know people!”
You can imagine my reaction when she then pulled out a checkbook and wrote my husband a paper check.
In clinical finance, the number of metaphorical paper checks can be astounding. One of the biggest contributors is the siloed way our organizations work. And this isn’t limited to sponsors. CROs and technology providers can have the same problem: data lives in different systems, formats and functions, and it is not always easy to extract, connect or reconcile.
Something that sounds as straightforward as a monthly accrual can become a significant manual undertaking. During budgeting and planning season—now underway for many organizations—the impact becomes even more visible.
Somewhere right now, a very smart person your organization invested significant time and money to hire is spending a meaningful part of the day copying numbers from one spreadsheet into another in the name of 2027 planning.
Another is pulling information from disparate systems. Someone else is reconciling different versions of what should be the same data. And somewhere, an important assumption is sitting in a file the person building the forecast doesn’t even know exists.
There’s nothing inherently wrong with a spreadsheet. There was nothing inherently wrong with a paper check or an abacus, either.
Tools aren’t replaced because they suddenly stop working. They evolve because the questions we ask become more sophisticated—and because we find better ways to use both our data and our time.
But sophisticated tools alone don’t solve the problem if protocol assumptions are in one place, investigator grant data is in another, actuals live somewhere else, operational forecasts sit in another system, and Finance has yet another view.
2027 planning shouldn’t be an exercise in assembling information. It should be an exercise in using it.
Technology is increasingly capable of taking on more of the lower-value work: bringing information together, applying methodologies consistently, automating calculations, surfacing variances and making data more accessible.
That doesn’t make people less important. It makes their judgment more important. And isn’t that why you hired them in the first place?
Instead of spending Tuesday figuring out where the numbers came from, your clinical finance professional can spend Tuesday asking:
Does this assumption make sense? Where is our exposure? What changed? What scenario haven’t we modeled? Where does experience tell me the data may be misleading? What decision should we make because of what we’re seeing?
Better tools change where we spend our time.
If this sounds like your team, I feel your pain – let’s talk!
About the author
Holly Leslie is Vice President, Investigator Grants Solutions at Auxilius, with more than 20 years of experience across clinical trial financial management, investigator grants and payments, life sciences technology, and product and commercial strategy. The Clarity Edit explores the intersection of clinical finance, technology, data and the decisions that move the industry forward.
