Joe Dustin: Sites Are Driving Clinical Tech Evolution
By Dan Schell, Chief Editor, Clinical Leader
At the SCOPE Summit in Orlando, I sat down with Joe Dustin, who is currently self-employed as a consultant for Dauntless Clinical Strategies, but who is also a longtime clinical research technology leader. This was his tenth SCOPE, and what stood out most in our conversation was not a single technology, but his focus on a shift in power and momentum toward clinical trial sites. He believes the industry is entering a new phase of transformation — one driven not by sponsors or CROs, but by sites themselves.
Sites Are Driving the Next Wave of Change
Dustin has spent most of his career building technology for sponsors, but he now sees the innovation curve bending toward sites. Increasingly, they are digitizing operations out of necessity, not because sponsors require it. As he put it, sites are adopting systems to run their businesses more effectively — from CTMS platforms and eConsent tools to eSource, recruitment tools, and financial management systems. “There’s a whole eClinical stack growing for sites,” he said.
Private equity investment, site network consolidation, and operational pressure are accelerating that shift. According to Dustin, sites are redesigning workflows to improve efficiency and reduce administrative overload. Essentially, they are trying to make it so that site staffers “don’t hate their jobs or feel just like data entry clerks,” he said. In this contect, there’s no surprise that AI is beginning to play a role, helping automate repetitive work and streamlining processes that have historically required manual duplication.
The Technology Burden — And the Breaking Point
Despite the promise of digitization, the burden of technology remains one of the most persistent frustrations for sites. Dustin summarized the current hierarchy of site concerns in plain terms:
- They need more trials.
- They need to be paid on time.
- They are overwhelmed by the volume of technology required per study.
Sponsors often deploy 15–20 systems per protocol, forcing coordinators to navigate multiple logins, workflows, and duplicate data entry requirements. Dustin emphasized that transcription and data transfer remain core pain points, driving sites to adopt creative — sometimes unauthorized — automation solutions just to keep up with sponsor timelines.
“We should be solving the right problem,” he said, arguing that the issue is not productivity but process design.
He pointed to a legacy issue that dates back to the early adoption of EDC systems. When EDC first took hold, sponsors told sites they didn’t need to change their workflows, just copy what they were already doing into the new system. That compromise never evolved. “The technology got better, but the process never changed,” Dustin said. The result is 20 years of layered duplication.
Bring Your Own Technology
Dustin is helping lead a “bring your own technology” (BYOT) workstream through the Decentralized Trials & Research Alliance (DTRA), an effort aimed at allowing sites to use their own systems while securely transmitting data to sponsors.
“If the site says, ‘I’d rather use my tech than yours and connect it so I don’t have to learn a new system,’ you get data much faster and eliminate manual work,” he explained.
This concept aligns with broader digital data flow initiatives across the industry. Dustin believes seamless integration between eSource systems and sponsor platforms will be one of the clearest signs that progress is real. Instead of forcing sites into sponsor-designed workflows, studies could deploy standardized configuration files that allow sites to stand up systems quickly, auto-map data back to sponsors, and still preserve flexibility for standard-of-care procedures. That shift, he argues, would reduce startup timelines, lower data friction, and make life easier for coordinators without compromising oversight.
Signs Of Recovery And Consolidation
Looking ahead, Dustin sees continued momentum around digital protocols, electronic medical record retrieval, patient matching, and recruitment infrastructure. He predicts that sponsors will begin centralizing recruitment platforms rather than rebuilding vendor relationships study by study. He also anticipates consolidation among long-standing technology providers, particularly in the ePRO and eSource space.
After a sluggish funding environment last year, Dustin believes budgets are starting to loosen. “Budgets were locked up last year. They’re unlocked now, and people’s plans are being put into place,” he said.
Whether that translates into job growth and sustained stability remains to be seen, but from Dustin’s vantage point, the industry is moving again.
If his assessment is right, the next meaningful transformation in clinical research will not come from another sponsor-mandated system rollout. It will come from empowering sites to use the tools that actually fit how they work — and connecting those tools in a way that finally eliminates the duplication we have tolerated for far too long.