Everest notes, eCOA and Medable have become foundational to trials Late last year, Medable was proud to be named as a “Leader” in their new “eCOA Products PEAK Matrix Assessment.”
“The report profiles 19 leading eCOA product providers, classifying them as Leaders, Major Contenders, and Aspirants,” according to Everest.
This marks Medable’s fifth recognition from the Everest Group in just five years and comes at a time where the eCOA market is experiencing huge growth. Currently, the market is valued at $800 million and is expected to reach $950 million by 2027, according to Everest’s report.
Everest notes that growth in eCOA adoption is being driven by the need for real-time patient data, stronger patient engagement, and higher data quality. Sponsors and sites increasingly rely on immediate access to patient-reported outcomes to support faster, data-informed decisions, while intuitive, patient-friendly interfaces improve participation and compliance. At the same time, built-in validation, automation, and AI-driven analytics reduce manual effort, improve data reliability, and shorten study timelines.
In short, the report highlights the fact that eCOA platforms have become an essential foundation for conducting modern digital and decentralized clinical trials.
Everest named Medable a leader in clinical trial eCOA
What Everest analyzed in their rankings Traditionally, the Everest Group evaluates clinical trial technology platforms and companies using a comprehensive, end-to-end lens. Their aim is to look beyond featuresets and instead assess how well platforms support the full lifecycle of a clinical trial. Specifically, they break an organization’s capabilities into three areas:
Sponsor- and site-facing capabilities , such as study configuration, workflow automation, real-time reporting, predictive analytics, and compliance-ready audit trails.Patient-facing experiences , including data capture modalities, engagement tools, reminders, communication with physicians, and usability features that directly impact patient adherence and trial quality.Broader platform readiness , encompassing scalability, interoperability with the clinical trial ecosystem, security, regulatory compliance, and enterprise-grade data management.Beyond technology, the Everest Group evaluates the services ecosystem surrounding each platform. This is because they understand that successful clinical trials depend as much on implementation, validation, translation, training, and ongoing support as they do on technology.
An eCOA leader in speed, patient experience, and customer needs In 2020, Medable released its first TeleCOA product to the industry. Just five years later, Everest Group has named Medable a “Leader” in its newly launched eCOA Products PEAK Matrix Assessment .
Much like the founding of Medable itself, the company’s eCOA offering was born out of firsthand frustration with the challenges of conducting clinical trials. In designing its eCOA, Medable set out to address three core priorities simultaneously: speed, patient experience, and the diverse needs of its customers.
eCOA speed exemplified Everest Group positioned Medable as a Leader, citing strong market impact and ability to accelerate trial timelines through automation, multimodal data capture, and AI-driven innovation.
However, what sets Medable apart is how we can repeatedly prove that speed can be designed, scaled, and sustained. Across multiple real-world deployments, we have demonstrated the ability to compress timelines that traditionally take weeks or months into days. Using AI-powered study build generation, we reduced eCOA build timelines from weeks to a single day, enabling kickoff and client signoff within 24 hours and requiring only one round of UAT due to minimal defects.
At portfolio scale, sponsors and CROs cut study setup time by up to 50%, launching multiple trials in parallel without adding operational overhead. Speed at global scale is often constrained by localization and translation, but new translation technologies enable us to address this bottleneck head-on. By applying AI-enabled translation and migration workflows, Medable reduced global translation timelines by 43% , shortened review cycles by more than half, and enabled parallel language builds across regions. This allowed studies to move forward without waiting on sequential handoffs. You can read more about this process in the innovation section below.
Even in highly complex markets, our speed has remained consistent. For instance, in Japan, Medable partnered directly with local study teams, procured compliant devices in-country, and delivered fully localized training ahead of launch. This resulted in the study achieving “first patient in” well ahead of forecast, all while still maintaining a 99.27% eCOA adherence rate.
Together, these outcomes reinforce Everest Group’s view that “Leaders” in eCOA are defined not just by technology, but by their ability to execute faster across geographies, study designs, and portfolios.
Elevating the eCOA patient experience Medable was founded based on the frustrating experiences found while conducting clinical trials. As a result, our eCOA is designed to offer a human-designed, consumer-grade UX, complete with notifications, reports, and submission-ready data. This experience is vetted and refined by our Patient Caregiver Network (PCN), a cross-functional team of patients from former and current trials.
Standardized, familiar designs across studies lower cognitive burden, while real-time feedback and progress tracking keep participants engaged throughout the trial journey. These design choices translate into measurable outcomes.
In large, multi-study portfolios, sponsors reported improved site and patient satisfaction driven by consistent eCOA experiences and reduced retraining. In highly complex markets such as Japan, Medable’s localized approach delivered fully-translated materials, culturally aligned training, and direct regional support. This resulted in an extremely high 99.27% eCOA adherence rate, with sites and patients reporting they felt well supported from onboarding through execution.
eCOA that’s flexible enough to meet varying customer needs Medable’s eCOA is built as part of a unified clinical trial platform, not a standalone tool. This foundation enables seamless integration with core systems such as eConsent, EDC, CTMS, IRT, wearables, and sensors. The benefit is that sponsors and CROs gain a single source of truth across their studies through the elimination of data silos, as opposed to the standard, fragmented views that many organizations have. Additionally, this interoperability reduces reconciliation effort, improves oversight, and supports real-time decision-making across the trial lifecycle.
Enterprise readiness is often dependent on organization’s trust of another. Medable’s platform incorporates robust security controls, audit trails, and regulatory compliance safeguards to support requirements such as 21 CFR Part 11, GDPR, and global data privacy standards. Centralized data management, automated metadata capture, and transparent QA processes ensure data integrity while simplifying inspection readiness and governance.
As clinical trials grow more complex, many eCOA solutions begin to show their limits. What works for simple studies often breaks down when protocols introduce adaptive designs, overlapping cohorts, high-volume enrollment windows, or frequent amendments. Medable’s eCOA was purpose-built for these realities, enabling sponsors to confidently support complex study logic, dynamic schedules, and large-scale data demands without compromising speed or data quality
At the core of this flexibility is Medable’s ability to support complex study designs through adaptive diaries, dynamic branching logic, and parallel execution across multiple cohorts. Study teams can visualize visit schedules, questionnaires, and patient workflows upfront, allowing feedback and refinement early, before issues surface in UAT. This approach ensures that even highly customized studies remain predictable, testable, and operationally manageable from day one
Complex trials rarely remain static, and Medable’s eCOA is designed to evolve alongside them. Rapid, no-code amendments (including mid-study updates and re-consent) can be deployed without disrupting timelines or increasing validation risk. Built-in guardrails, audit-ready workflows, and linked configurations allow teams to adapt quickly while maintaining compliance and data integrity, even as protocols change
Lastly, scalability is equally critical in complex programs, particularly in vaccines, oncology, and other high-stakes therapeutic areas. Medable’s eCOA reliably supports high-volume enrollment windows, daily data transfers at scale, and global, single-day go-lives across dozens of countries and languages. By combining reusable libraries, standardized workflows, and AI-enabled automation, Medable enables sponsors and CROs to move complexity off the critical path.
Innovation that’s solving traditional eCOA problems AI is transforming eCOA implementation limitations While eCOA has improved data capture and patient experience compared to paper, many delivery models still rely on sequential workflows, heavy manual effort, and late-stage discovery. This often creates delays that ripple into site readiness, global activation, and downstream data access.
A major reason eCOA becomes a rate limiter is that traditional implementations can take 16 to 20 weeks for a base English go-live, with additional time required to support global rollout. Much of that time is consumed by repeated design meetings, customizations, manual validation, and UAT cycles that stretch into weeks because teams often encounter the “real” experience for the first time during testing.
When stakeholders can’t clearly visualize what they’re approving early on, UAT becomes both validation and discovery, and issues surface late.
AI-enabled eCOA is changing that delivery paradigm by collapsing timelines and reducing manual work without compromising rigor. By shifting key work earlier, standardizing decisions, and enabling stakeholders to see the end-user experience from day one, AI-enabled platforms can reduce the typical go-live window from 16 to 20 weeks down to 4 to 8 weeks or less. Kickoff becomes a moment of alignment and confirmation rather than first-time exploration, and UAT compresses because study teams are no longer surprised by what they’re testing. Automated testing, standardized scripts, and more predictable build patterns reduce variability and move activities that used to be on the critical path into a controlled, repeatable workflow.
How AI is collapsing eCOA translation timelines One of the biggest historical bottlenecks in global studies has been translation. The traditional model often requires batching languages, meaning that even after an English go-live, countries can wait 10 to 20 additional weeks before they’re fully patient ready.
AI-enabled translation and localization shifts this work from sequential to parallel by generating clinical-grade contextual first-pass translations across more than 120 locales and enabling reuse of translated assets through libraries. This approach reduces the back-and-forth typically required with translation partners, keeps translations off the critical path, and allows teams to prepare language packages earlier for ethics committee submissions, accelerating readiness to recruit globally from the start.
Standardization and reusability help foster speed and consistency A key enabler behind eCOA efficiency gains is the move from building each study from scratch to a reusable “build once, deploy many” model. Centralized libraries allow organizations to store reusable questionnaires and diaries alongside their data structures and translations, so teams can standardize how endpoints are defined and collected across a program or portfolio. This improves both speed and consistency, reducing the need for customization while strengthening data harmonization across studies. Governance controls such as versioning and “ready for use” status help ensure only approved assets are deployed, supporting quality and compliance while still accelerating execution.
AI in removing manual bottlenecks AI also removes bottlenecks in the most tactical, time-consuming parts of eCOA work, such as digitizing paper instruments and responding to protocol amendments. Instead of manually copying and pasting content screen by screen, a process that can require hundreds of clicks and introduce numerous error opportunities, teams can upload Word or PDF instruments and use AI to generate eCOA screens and underlying data structures in seconds.
This reduces manual effort, improves quality by eliminating common points of human error, and adds flexibility when changes occur late in the process. Because screenshots can be exported quickly for ethics committees, license holders, or subject matter review, amendments no longer have to derail timelines the way they often did in traditional models.
Looking ahead: Everest sees eCOA and Medable as catalysts for faster, better, more human trials Everest Group’s recognition of Medable as a Leader in the inaugural eCOA Products PEAK Matrix underscores a broader shift underway in clinical research. Nearly two decades since its initial release, eCOA is no longer a supporting technology. Instead, it is a strategic foundation for how modern trials are designed, launched, and executed.
As sponsors and CROs face growing pressure to move faster, engage patients more effectively, and generate higher-quality data, platforms that combine speed, scalability, and human-centered design will define the next era of clinical development.
