Guides

eCOA, AI, and Agentic AI: A practical overview and guide

eCOA
6 min

Combining artificial intelligence (AI) and agentic AI with electronic Clinical Outcome Assessment (eCOA) systems fundamentally enhances how clinical trial data is collected, interpreted, and acted upon. At its core, eCOA captures structured data directly from patients, clinicians, or observers, such as symptom severity, quality of life, or functional outcomes. Modern platforms expand this further by supporting a full range of assessment types, including electronic patient-reported outcomes (ePRO), clinician-reported outcomes (eClinRO), observer-reported outcomes (eObsRO), and performance outcomes (ePerfO).

By Asad KhanThere's a particular kind of energy at the World Vaccine Congress that's hard to describe unless you've been in it. Hundreds of scientists, executives, policymakers, pharma leaders, CRO teams, and site networks, all in one convention centre, all sitting with the same fundamental tension. We know how to make vaccines that save lives. So why does getting them to patients still take so long?I spent three days in Washington this week as part of the Medable team. Washington in late March meant that the cherry blossoms were just past their peak but still stunning, and catching them along the Tidal Basin between sessions was one of those small, unexpected gifts that a busy conference week doesn't always make room for.For the conference, I came in with a clear intention. I wanted to reconnect with partners I respect, listen more than I talk, and have honest conversations about where this industry is and where it needs to go. What I didn't fully anticipate was how much the week would reinforce something I already believed but needed reminding of.The urgency is real. And it's shared.The mood in the roomThe congress opened with a keynote from senior US government leadership on federal strategy for public health and pandemic preparedness. The fact that the speaker lineup was still being confirmed close to the event said something in itself. The policy ground under the vaccine industry is shifting, and nobody in that opening session pretended otherwise.Nicole Lurie from CEPI was direct about it during the pandemic preparedness plenary. "We have a long way to go to rebuild trust, not just in the US but globally." That landed with weight in the room. Because the trust deficit isn't just about public perception of vaccines. It runs deeper, into data sharing, into international cooperation, into whether countries will report surveillance information when there are real social and economic consequences for doing so. No platform fixes that. It's a human problem before it's a technology problem.What I kept noticing alongside all of that was a stubborn determination to keep going. Scientists presenting new data, site networks sharing what's working, regulatory specialists wrestling with AI governance frameworks in real time. Nobody was waiting for the policy environment to sort itself out. That resilience is one of the things I find most compelling about this community.The AI conversation nobody's fully figured out yetThomas Waite, Deputy Chief Medical Officer at the UK Department of Health, said something that hasn't left me. "Maintaining public trust when deploying AI surveillance agents is challenging." He also raised the point that if you're training AI on datasets where certain populations are over or underrepresented, you risk making existing inequalities worse. It's not just about what AI can do. It's about how you do it and who it serves.In almost every conversation I had at the congress, excitement about AI's potential existed right alongside genuine uncertainty about whether it can be trusted and governed responsibly. I think both of those things are true at the same time. The potential is real. So is the responsibility. The companies that'll matter in five years are the ones holding both of those thoughts without letting one crowd out the other.The question the whole congress was really askingCristina Cassetti from CEPI and WHO framed something that stuck with me. "How do we weave all responsibilities into one unit? When there's an outbreak, it's always chaotic." The argument from the main stage was that you can't build rapid response infrastructure in the middle of a crisis. It has to already exist.That felt directly relevant to everything I think about in my day job. The systems, processes, and partnerships that let trials move at the speed the science demands have to be in place before the pressure arrives. You can't retrofit speed into something built that is slow.COVID proved that when urgency is real and barriers are genuinely removed, trials can move at a pace nobody thought possible. The question I came to Medable to work on is why that should require a global emergency to unlock. Every unnecessary delay in trial startup or enrollment or conduct is a delay in patient access to therapies that could genuinely change or save lives. That's not a commercial point. It's a human one.What we shared over dinnerOn Tuesday evening Medable hosted an intimate dinner at Ocean Prime for a group of vaccine development leaders. There were small tables, honest exchanges, no polished presentation competing with the actual conversation.Our guests came from right across the clinical trial ecosystem, pharma, biotech, site networks, and CROs. Chief executives, chief medical officers, regulatory leaders, portfolio directors, and clinical operations specialists. People who design trials and people who run them at scale and people who are responsible for the vaccines themselves. The whole ecosystem around one table.I shared Medable's 1:1:1 vision, one day to start a study, one day to open enrollment, one year to complete study conduct. Not as a pitch. As an honest articulation of what we're genuinely building toward and why it matters.What surprised me was how it landed. The response wasn't just polite interest. It was recognition. Immediate and consistent, regardless of where people sat in the ecosystem. Every person in that room had felt that friction from their own angle.My colleague Toai then gave a live demonstration of some of the technology behind that vision. Watching the room engage with it, the questions people asked, the connections they drew to their own programmes, reminded me why showing something real matters so much more than describing it. One result I shared made that concrete in a way no slide ever could. A recent vaccine megatrial we supported delivered 100% cohort enrollment within five days, at a scale where weeks or months would've been completely normal. That study became a blueprint, that blueprint became a programme, and three additional vaccine trials launched immediately after. Nobody needed me to explain what that meant. They'd all lived the alternative.The conversation that mattered mostHowever, the most memorable part of the evening came up naturally around the table and it's stayed with me more than anything else from the week.The people in that room care deeply about what they do. They're genuinely invested in vaccine development, they live the science,and they want to get safe and effective vaccines to the people who need them. That passion was unmistakable.Yet, almost every person there described being held back by the same things. Manual processes. Paper. Operational friction that really shouldn't exist in 2026. Systems designed around how trials used to run rather than how they need to run now.What came through just as strongly was a real fatigue with vendors. Not with technology. With a particular kind of vendor relationship where someone sells you a solution without ever truly understanding your problem, where the pitch is confident but the partnership is thin. Where you end up feeling like a number rather than a partner.That hit me hard, because I think it's the most honest thing the industry is trying to communicate to technology companies right now. Better tools aren't enough on their own. Real partnership combined with the right technology is what'll actually shift the status quo. You can't have one without the other. It's also the standard I try to hold myself to, and a conversation like that one is a reminder of why it matters.What I'm taking awayThe policy environment is genuinely uncertain and the congress didn't try to dress that up. The questions around AI governance and trust are real and unresolved. But what I felt most strongly across the whole week was something much simpler. The people in this industry are committed to getting it right. The challenge isn't will or capability. It's the infrastructure and the processes and the weight of how things have always been done.The work is urgent. The community doing it is serious. And what'll move it forward isn't technology on its own. It's technology in the hands of people who've taken the time to genuinely understand the problem they're there to solve.That's why I do this. A week in Washington reminded me not to take it for granted.‍‍
Blog posts

From the Congress floor to the dinner table: A Week in Washington that reminded me why this work matters

There's a particular kind of energy at the World Vaccine Congress that's hard to describe unless you've been in it. Hundreds of scientists, executives, policymakers, pharma leaders, CRO teams, and site networks, all in one convention centre, all sitting with the same fundamental tension. We know how to make vaccines that save lives. So why does getting them to patients still take so long?

I spent three days in Washington this week as part of the Medable team. Washington in late March meant that the cherry blossoms were just past their peak but still stunning, and catching them along the Tidal Basin between sessions was one of those small, unexpected gifts that a busy conference week doesn't always make room for.

For the conference, I came in with a clear intention. I wanted to reconnect with partners I respect, listen more than I talk, and have honest conversations about where this industry is and where it needs to go. What I didn't fully anticipate was how much the week would reinforce something I already believed but needed reminding of.

The urgency is real. And it's shared.

Webinar cover image for Harnessing AI for more efficient clinical trials
Webinars

Harnessing AI for more efficient clinical trials

AI
6 min

Explore how AI is transforming clinical trials, from accelerating data analysis to predicting trial outcomes.

Blog posts

Everest analysis: How Medable eCOA solves speed, patient experience, and customer needs

eCOA has moved from a supporting tool to a foundational pillar of modern clinical trials, and Everest Group agrees. In its inaugural eCOA Products PEAK Matrix Assessment, Everest named Medable a Leader, citing strong market impact, accelerated timelines, and a platform built for real-world trial complexity. As the eCOA market surges toward nearly $1B in value, this recognition underscores how speed, patient experience, and AI-driven innovation are reshaping how trials are designed, launched, and scaled globally.

Blog posts

What happened at JPM 2026?

JPM
6 min

Each January, the J.P. Morgan Healthcare Conference sets the tone for the life sciences industry, serving as the year’s most influential gathering of biotech, pharma, investors, and dealmakers. 

This year was no different. 

Thus, we checked in with our conference attendees, booth visitors, and more to see what they thought were this year’s trend-setting takeaways.

Blog posts

How Agentic AI is transforming life sciences discovery and operations

The numbers are in, and they spell change for life sciences. 

That’s because nearly three-quarters (73%) of global pharmaceutical organizations are actively planning, piloting, or deploying agentic AI initiatives

This widespread means agentic AI is no longer a futuristic concept, but a present-day imperative for staying competitive and delivering life-changing medicines faster.

For those not yet in the know, agentic AI is a sophisticated form of AI designed not just to analyze data, but to act autonomously, plan, reason, and execute complex, multi-step tasks. This goes far beyond traditional automation. Instead, agentic AI is about creating intelligent systems that can drive innovation, accelerate drug development, and optimize operations like never before.

So, which companies are leading the charge, and how exactly are these intelligent agents reshaping the pharma landscape? Let's dive into the specifics.

Blog posts

Shaping intelligence: How a “human in the loop” keeps AI anchored

It’s been said that the only constant in the world is change. 

For decades, clinical trials have been a human only endeavor, with teams of clinicians, study teams, and patients working hand in hand to bring the latest molecules to market. Now, a new central actor has entered the clinical paradigm, agentic artificial intelligence. 

Only three years after OpenAI kicked off the artificial intelligence arms race, AI has gone from requiring users to prompt it, to pre-emptively identifying bottlenecks, safety risks, and more, thanks to agentic AI. 

Agentic AI is an autonomous, goal-oriented system that uses reasoning and external tools to independently plan, execute, and adapt multi-step actions with minimal human intervention to achieve complex objectives. 

Sponsors and CROs have begun using AI agents across their workforces to improve trials in ways that humans have traditionally struggled to accomplish. For instance, organizations have been creating AI agents to analyze prior trial protocols, benefiting from lessons learned across prior trials and real-world outcomes, enabling teams to anticipate risks and automating elements of submission drafting. Anomaly detection has helped teams better identify outliers in operational metrics or safety signals, prompting early interventions. Document intelligence accelerates medical writing by grounding generative outputs in verified data, which reduces cycle time without sacrificing accuracy. 

However, in each of these use cases, humans remain squarely “in the loop.” Or rather, the decision making isn’t left entirely to AI. Instead, the objective is to augment clinical, regulatory, and legal teams with tools that surface the right information at the right time.

This core concept, keeping a human in the loop, is essential to clinical decision making and operations as agentic AIs, while powerful, are not inherently suited to fully autonomous operation in all regulated contexts.

Blog posts

What happened at ESMO AI & Digital 2025

The 2025 ESMO AI & Digital Oncology Congress, held in Berlin from November 12 to 14, highlighted the accelerating role of artificial intelligence across the oncology care continuum. Although imaging and pathology remain the most established fields for AI adoption, this year’s programming revealed a decisive shift toward workflow-integrated AI that enhances clinical operations, supports trial efficiency, and addresses the realities of patient monitoring. 

Across three days of sessions, side-room conversations, and industry demonstrations, one theme was clear. AI is evolving from experimental add-on technology into a practical clinical teammate, but scaling its impact will require robust validation, seamless integration, and a sustained focus on clinician trust.

White Papers, Case Studies, Reports

Medable oncology solutions

Discover how Medable’s AI-powered oncology platform simplifies complex cancer trials by integrating eCOA, ePRO, and eConsent solutions—reducing trial time, improving patient retention, and enhancing data quality for faster, more efficient research.

Blog posts

Sponsors talk AI: Sanofi's take on the evolving role of AI in clinical trials

AI
6 min

Artificial intelligence continues to move from experimentation to execution across the life sciences industry. On a recent episode of the AI in Business podcast, Matthew Peruhakal, Global Head of Data Architecture, Utilization, and AI Engineering at Sanofi, offered a deep look at how the pharmaceutical giant is integrating AI to transform clinical trials. From intelligent data workflows to proactive risk detection and regulatory alignment, Peruhakal described an organization reshaping its research and development operations around a new digital core. 

His message was clear: AI cannot remain a side project. To make a meaningful impact, it must be embedded as a strategic capability that connects people, systems, and data across the enterprise.

Blog posts

Sponsors talk AI: Novartis’ take on the evolving role of AI in clinical trials

AI
6 min

Artificial intelligence is shifting from promise to practice in biopharma, and few domains feel the impact more than clinical development. In a recent conversation on the AI in Business podcast, Zhong Lu, director of data science and AI at Novartis, outlined how AI is evolving the clinical trials process end to end. His perspective centered on building internal platforms that unite structured and unstructured data, deploying document intelligence to remove process friction, and using responsible generative AI to support scientific decision making without compromising compliance. While the regulatory bar remains high and patient trust is paramount, Novartis’s approach shows how targeted applications of AI can streamline data operations, strengthen regulatory readiness, and make both traditional and decentralized trials faster and more resilient.

Guides

Building blocks: The ultimate guide to AI in clinical trials

Explore how artificial intelligence (AI) is fundamentally transforming every facet of clinical trials, from initial protocol design and patient recruitment to data management and regulatory approval. This comprehensive guide provides an authoritative, in-depth look at AI's role in accelerating drug development and improving patient outcomes, with special focus on emerging agentic AI technologies.

See how Agent Studio can transform your trials.