How eCOA/ePRO is transforming clinical trials

eCOA making life easier for patients, sites and sponsors.
eCOA making life easier for patients, sites and sponsors. (Getty Images)

A conversation with Steve Rosenberg, CEO of uMotif electronic clinical outcome assessment (eCOA) - collecting data electronically.

eCOA and ePRO (electronic patient-reported outcome) technology are transforming clinical trials, offering streamlined processes for patients, sites, and sponsors. In this Q&A, Steve shares how user-centric design, emerging trends, and collaboration are shaping the future of clinical research.

The clinical trial landscape continues to evolve rapidly, and eCOA and ePRO are at the forefront of this transformation. Steve also shares his insights on the changing needs of patients and sites, the role of technology, and what the future might hold for these vital tools.

Steve  Rosenberg
Steve Rosenberg (uMotif)

Q: Steve, 15 years ago, the focus of eCOA/ePRO was relatively straightforward. How has the landscape changed, and why is there now a need for evolution?

SR: When eCOA/ePRO first emerged, the objective was pretty straightforward — move paper forms onto mobile or provisioned devices. It was a big leap forward at the time, but the environment has become much more complex since then.

Clinical trial protocols today are far more intricate, involving multi-layered designs that can feel overwhelming for both patients and sites. The definition of a “device” has also expanded — now, it’s not just mobile phones or tablets but also wearables and apps. And let’s not forget the patients themselves: they’re more tech-savvy than ever and expect trial technology to mirror the intuitive, seamless experiences they encounter in their everyday lives.

Meanwhile, sites face increasing administrative burdens. It’s no longer enough for eCOA/ePRO tools to just ensure compliance. They must enhance the patient journey and empower sites with tools to manage complex trials efficiently.

Q: Patients now expect clinical trial tech to rival consumer-grade apps. How can the industry meet these expectations?

SR: That’s a critical point. Patients are no longer passive participants; they’re informed, tech-literate, and they demand high-quality experiences. As they should!

To meet these expectations, we need to adopt a user-centric approach to design. Every interaction with trial technology should feel as simple and intuitive as opening your favorite app. Features like customizable reminders, gamified compliance tracking, and even conversational interfaces can make the trial process feel less daunting.

It’s also about creating clarity—patients should always know what’s expected of them, where they are in the process, and what’s next. The easier and more engaging the experience, the better the outcomes, both in terms of data quality and patient retention.

Q: Sites are under significant strain. How can eCOA/ePRO solutions better support them?

SR: Sites are juggling so much already, from compliance tracking to patient support to reporting requirements. eCOA/ePRO tools should simplify their workload, not add to it.

For instance, centralized dashboards can provide real-time insights into patient compliance, flag potential dropouts, and streamline data collection. Training modules built into the platform can help site staff get up to speed quickly. Ultimately, these systems need to act as a one-stop shop — integrating patient management, compliance monitoring, and data capture seamlessly.

When we give sites better tools, we improve the overall efficiency and accuracy of trials. That benefits everyone: the sites, the sponsors, and, most importantly, the patients.

Q: Stakeholder collaboration is essential in clinical trials. How does uMotif ensure its technology supports all parties—patients, sites, and sponsors alike?

SR: Collaboration is absolutely key. We start by listening to all stakeholders — patients, sites, and sponsors. Each brings a unique perspective.

Patients might highlight features that make technology less intimidating or time-consuming. Sites often point out operational inefficiencies or training gaps. Sponsors provide a high-level view of trial goals and regulatory requirements.

By synthesizing these insights, we can develop technology that balances the needs of all stakeholders. At uMotif, we constantly iterate based on feedback to ensure our tools remain user-friendly and effective.

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(Image: Getty/Spainter_vfx)

Q: What trends do you see shaping eCOA/ePRO in the next year?

SR: Personalization and adaptability are big ones. Patients want tailored experiences, so platforms will need to adapt to individual needs — whether that’s through language options, integration with personal devices, or customized notifications.

AI and machine learning are also set to play a bigger role. These technologies can predict patient dropouts, optimize trial designs, and even flag anomalies in real time.

Another major trend is the continued rise of decentralized trials. These models demand robust eCOA/ePRO systems to maintain data integrity and participant engagement across diverse and remote locations.

Q: What would you like to see happen in the next five years for eCOA/ePRO?

SR: I’d like to see the technology become even more accessible and universally adopted. Right now, there are still too many trials relying on outdated methods, which limits the data quality and patient experience.

In five years, I hope we’ll have a much more integrated ecosystem where eCOA/ePRO tools are standard, not optional. These tools should be part of a broader, patient-centric trial framework that prioritizes engagement, simplicity, and inclusivity.

From a tech standpoint, I’d love to see advancements in AI that make trial management even more proactive. Imagine systems that can predict issues before they occur or suggest personalized interventions to keep patients engaged.

Ultimately, the goal is to make clinical trials as seamless and rewarding as possible for everyone involved.

Q: You’ve had a long career in software. Why does this space in particular resonate with you?

SR: Of all the software I’ve worked on, this is the one that sticks with me the most. It’s hard to put into words, but there’s something incredibly fulfilling about knowing our work contributes to the greater good.

We’re not just building software; we’re helping improve lives, accelerate treatments, and make health care more accessible. It’s a small piece of the puzzle, but it feels meaningful in a way that’s hard to match.

Q: Finally, if you could give one piece of advice to those in the industry looking to adopt or improve their eCOA/ePRO systems, what would it be?

SR: Start with the end users in mind — whether that’s the patients or the site staff. Technology is only as good as its adoption. If it’s too complicated or doesn’t address their real needs, it won’t succeed.

Focus on simplicity, adaptability, and clear communication. When we make technology easy and engaging, we open the door to better compliance, better data, and, ultimately, better outcomes.