Clinical Researcher—June 2026 (Volume 40, Issue 3)
PATIENTS & PRACTITIONERS
Natalia Elias Calles, MPH
As disease complexity grows and the pace of therapeutic innovation accelerates, the most forward-thinking health systems are deepening the connections between research and care, and improving patient outcomes in the process.
There is a version of clinical research that lives apart from care—down a different hallway, run by a different team, governed by a different calendar. And then there is the version that many of us are actively building: research as a living part of how patients move through a health system, from first diagnosis through long-term follow-up.
The momentum toward that second model is real and growing, driven not by ideology, but by the practical demands of caring for increasingly complex patients in a landscape where new therapies are arriving faster than any single institution can track through standard channels alone.
When research is woven into the fabric of care, it transforms from an external process patients endure into a partnership that empowers them.
Reframing the Old Paradox
The question of whether research and care truly coexist is one the field has asked for decades. Today, leading health systems are answering it not with debate, but with results. Patients cared for at institutions actively conducting clinical trials benefit from more coordinated touchpoints, more rigorous monitoring, and deeper multidisciplinary engagement.
Research consistently shows this extends to patients across disease areas, even for patients not personally enrolled in a trial.{1,2} The research environment, it turns out, is a variable in the outcome. The question is no longer whether research and care belong together; it is how quickly we can make that the standard.
Four Pillars of a Connected Model
- Research as a care pathway option—Trial eligibility screening is embedded at the point of diagnosis, a standard step in the clinical decision-making process, as routine as any other care pathway option. Only 2% to 8% of adult cancer patients enroll in clinical trials, often not because they are ineligible, but because no suitable trial is available at their treatment site.{3} Embedding research into care delivery directly addresses this gap.
- Unified data infrastructure—Electronic health record-to-electronic data capture integration is leveraged to reduce dual documentation burden, improve data accuracy and reliability, and support real-world evidence generation.
- Workforce aligned to both missions—Research nurses, coordinators, and navigators are embedded directly within the clinical team, present in the same conversations, and contributing to the same goals.
- Governance that reflects complexity—Portfolio-level oversight is maintained to balance scientific opportunity, operational capacity, financial sustainability, and health equity.
The Policy and Management Moment We Are In
The funding environment is shifting, and health system leaders are navigating that reality with real innovation. The organizations best positioned to do so are those that have built research deeply into their care operations, because the value research generates is visible not just in grant revenue, but in the quality of care delivered, the talent it attracts, and the partnerships it enables.
At the same time, the therapeutic pipeline has never been more active. The U.S. Food and Drug Administration approved 55 novel therapies in 2023, 50 in 2024, and 46 in 2025, averaging 47 per year over the past decade, well above the historic norm of 36 annually. At that pace, health systems without embedded research infrastructure are not just behind the curve. They risk being unable to offer their patients access to the most current options in care.{4–6}
Cell and gene therapies, GLP-1 agonists reshaping metabolic disease management, artificial intelligence–assisted diagnostics entering clinical validation—each of these represents a category where institutions with strong research infrastructure are shaping outcomes rather than waiting for them. For executive leaders, that represents both a responsibility and an opportunity.
Health systems deepening their research-care connection are not just preparing for the future of medicine—they are already practicing it.
What This Asks of Leadership
Integration at this level requires intentional structures that bring research operations into executive strategy conversations alongside finance, quality, and operations. It also requires incentive models that recognize clinicians for research engagement alongside clinical productivity, and leadership willing to see the full picture of what research-active institutions actually generate.
Studies consistently link research activity with lower mortality, stronger care quality ratings, and better staff and patient experience.{2} The value extends well beyond direct sponsor dollars. Research-active institutions see expanded patient volume from individuals actively seeking access to investigational options, along with increased adherence visits and in-house testing that strengthens both data integrity and operational revenue.
A site experienced in delivering a therapy during its trial phase is uniquely positioned to offer it the moment it transitions to standard of care. When a trial therapy becomes an approved treatment, the institutions that ran the trial do not start from scratch. They carry forward the clinical experience, the trained team, and the patient relationship that no institution encountering the therapy for the first time has yet built.
Such integration also asks us to evolve how we talk with patients about research participation. Informed consent, at its best, is an ongoing conversation—one in which patients understand that research participation is a genuine care option, not a separate track. When that conversation happens naturally within the clinical encounter rather than as a standalone administrative step, patients engage as partners in both their own care and the broader progress of medicine.
Patients facing complex or treatment-resistant conditions are actively seeking access to investigational options. The system that makes that access clear, navigable, and compassionate will earn a level of trust that cannot be manufactured any other way.
The Opportunity Ahead
This integrated model is not the exclusive domain of large academic medical centers. It is the organizational philosophy that allows health systems of every size and type to remain closely connected to innovation as the pace of medical progress continues to accelerate. The leaders building this connection today—structuring their teams, their governance, and their patient conversations around it—are defining what excellent, future-ready care delivery looks like.
This is transformative leadership in action, and it is already well underway across leading health systems.
References
- Majumdar SR, Roe MT, Peterson ED, Chen AY, Gibler WB, Armstrong PW. 2008. Better outcomes for patients treated at hospitals that participate in clinical trials. Arch Intern Med 168(6):657–62. doi:10.1001/archinternmed.2007.124. PMID:18362259.
- Jonker L, et al. 2020. Patients admitted to more research-active hospitals have more confidence in staff and are better informed about their condition and medication: Results from a retrospective cross-sectional study. Journal of Evaluation in Clinical Practice26(1):203–8. doi:10.1111/jep.13118
- Chen J, et al. 2023. Increasing patient participation in oncology clinical trials. Cancer Medicine 12(3):2219–26. doi:10.1002/cam4.5150
- U.S. Food and Drug Administration. Novel Drug Approvals for 2023. https://www.fda.gov/drugs/novel-drug-approvals-fda/novel-drug-approvals-2023
- U.S. Food and Drug Administration. Novel Drug Approvals for 2024. https://www.fda.gov/drugs/novel-drug-approvals-fda/novel-drug-approvals-2024
- U.S. Food and Drug Administration. Novel Drug Approvals for 2025. https://www.fda.gov/drugs/novel-drug-approvals-fda/novel-drug-approvals-2025
Natalia Elias Calles, MPH, is Director of Clinical Research at TMC Health, a DrPH Student at the Johns Hopkins Bloomberg School of Public Health, and a member of the Board of Trustees with the Association of Clinical Research Professionals.
