The trial as a paper trail
- Site staff retype EHR notes into eCRFs by hand
- AE coding takes days; queries take weeks
- Safety signals surface only in monthly aggregate reports
- Sponsor, CRO and site each work from their own copy of the truth
- Human bias and transcription errors pervade manual adverse event reporting
- Trial activity schedules are built by hand from protocol documents, prone to omission
- Regulatory filings are assembled in a panic at the 7- or 15-day deadline











