What has to happen in a room for an idea to leave it and change how we work?
Turning ideas into practice is central to the Innovation Network Gathering (ING), which returned to West Chester, Pennsylvania, this year. For its fifth gathering, ING brought together people who sponsor, run, support, and participate in clinical trials, filling the town’s historic downtown venues with conversations about how clinical development could work better.
The format is deliberate: no exhibit hall, no booths, no selling. Main-stage talks sit alongside small-group discussions, with an invited audience drawn from across life sciences. Sponsors, contract research organizations, sites, patient advocates, patients, and technology providers have opportunities to work through problems together.
This year, I had the pleasure and privilege of leading content strategy for the small-group discussions, known as Dive Teams, and introducing that segment on stage. The challenge was to make room for conversations that could lead to changes in practice—and continue after everyone went home.
Inside ING’s Dive Teams: Rethinking Clinical Trial Operations and AI
Dive Teams are small breakout groups, each working through one hard question. Their name draws on the explorers who descended into the Mariana Trench: an invitation to move beyond familiar talking points and examine what lies beneath them.
This year’s questions fell into three broad areas.
The first was how clinical trials operate. Teams examined what it would take to measure quality consistently across site networks, test improvements in trial delivery, and rethink familiar formats such as investigator meetings.
The second was how to put AI to responsible use. Where are AI agents delivering value, and where are pilots stalling? What evidence makes a system ready to deploy, and who should produce it? These discussions also considered the people expected to work with new technology: how leaders can build trust, communicate honestly through disruption, and support the judgment and knowledge their teams bring.
The third was the experience of participating in research. Teams explored how patients find trials, what helps them stay engaged, and how physicians who are not investigators can support their participation. They also asked what it would mean for organizations to treat patient trust as something they must earn, sustain, and measure.
ING creates space for people with different responsibilities to focus on a problem they share. The absence of a sales floor helps, but the willingness to examine established ways of working matters just as much. Two three-hour sessions cannot resolve the industry’s greatest challenges. And even a productive conversation can fade once everyone returns to their daily responsibilities. One speaker captured that risk with a story about coffee beans. After the previous year’s ING, he took a bag home, stored it carefully in his fridge, and never brewed it. Ideas can meet the same fate: brought home with good intentions, then put away.
This year’s presentations offered reasons for optimism. Speakers returned with accounts of work on data interoperability, agentic AI, leadership during AI adoption, and standards for measuring quality in clinical trials. These were opportunities to hear what had happened between gatherings, beyond the initial conversation. For me, that is the test of ING’s value: what participants take into practice, what they learn, and what they bring back for others to build on.
Why Clinical Development Needs a “Yes” Culture
The main-stage talks gave those working sessions a wider context. Speakers addressed the habits, incentives, and institutional barriers that make change difficult, even when people agree it is needed.
Morgan Hanger, executive director of the Clinical Trials Transformation Initiative (CTTI), opened the gathering by holding up a mirror to the industry. We are, she suggested, an industry of A students. We learn the rules and complete the assignment. We begin a protocol by editing the previous one, reuse the consent template, and check every data point twice. Yet individual diligence can still add up to what she called “a collective C for the system.”
Her challenge exposed a problem that effort alone cannot solve. People can perform their assigned roles well while the system continues to impose delays, costs, and burdens on the patients it is meant to serve.
Morgan also named a habit behind that result: it is easier to say “no” than to say “yes.”
Over the next two days, speakers explored the consequences of that habit, and the conditions that could make a responsible “yes” possible.
Patient Access to Clinical Trials: Where the Barriers Become Personal
Irfan Khan’s account made the question of access painfully concrete. A cardiologist from a family of physicians, he described his father’s experience with Alzheimer’s and Parkinson’s. When standard therapy failed, his father could not get into a clinical trial in time to help, despite having two sons working in healthcare.
On the regulatory panel, Christine Lee described another family living close to a major academic medical center whose care team had never mentioned a trial.
Both stories challenged the assumption that proximity to medical expertise translates into access to research. A trial can exist, and a patient can need it, without a path ever connecting them.
Jeff Coller brought that gap into the discussion of gene therapies. He described the extraordinary effort behind baby KJ’s personalized gene-editing treatment and asked what it would take to make such care available more widely. A treatment developed through exceptional coordination raises a difficult next question: how do institutions make that work repeatable and accessible?
Other speakers examined what happens once someone joins a trial.
Sylvia Baedorf Kassis shared the story of a Parkinson’s trial participant who was left without an answer about whether she had received the investigational drug or a placebo. Regina Holliday described bringing patients’ experiences into conference halls and boardrooms through paintings on the backs of jackets. Lloryn Hubbard showed how ordinary operational decisions shape participation. An additional blood draw may require another visit. An eligibility requirement may carry a cost for the patient. A site selected for its ability to start quickly may be far from the people who need the trial. Alicia Staley, Chief Patient Officer at Medidata Solutions and a four-time cancer survivor, closed her keynote by saying, “For industry, time is money. For patients, time is life.”
These examples made patient experience tangible. Participants give their time, their bodies, their data, and their lives. The decisions made around a protocol determine how much that participation asks of them, and what they receive in return.
Data, Quality, and Shared Learning in Clinical Trials
Saying “yes” responsibly requires clarity about what is possible, what must be protected, and who can make the decision.
Rohit Nambisan approached that problem through data. Organizations may hold datasets without being able to establish quickly where they came from, how they may be used, or whether they are suitable for a particular purpose. He described a data passport: a verifiable credential checked when someone seeks to use the data. The broader point extends beyond technology. Capabilities become useful when people have the information, processes, and authority to act on them.
Morgan offered a related approach to trial operations: identify what is critical to quality, protect it, and create room to experiment elsewhere. Irfan asked feasibility teams to reconsider how they respond to physicians who have not run a trial before. Instead of treating inexperience as the end of the conversation, what would it take to help a new investigator participate?
Learning together was another recurring theme. Morgan called for sponsors to embed small experiments in their trials and publish what they learn. Jeff described the value of centers sharing experience as new procedures develop. Lloryn discussed the community engagement work behind Moderna’s COVID-19 vaccine trial, showing how trust must be built through relationships and practical decisions.
These proposals make change more specific. They ask people to define the safeguards, support, and shared learning that allow a different course of action. They also offer a useful way to judge progress: Are we making it easier for patients to reach research? Are we reducing unnecessary burdens? Are we learning from the work and making that learning available to others?
Putting Collaboration into Practice in Clinical Development
One of the most memorable moments at ING involved the whole auditorium singing.
Ben Landsverk, who leads a community chorale in Portland, invited us to add our voices and listen to what happened as they came together. He described the chorusing effect and the richness that emerges from imperfect individual voices.
Singing together means contributing and listening at the same time. You adjust to what you hear. You become part of something you cannot produce alone.
That experience gave physical form to what the gathering was asking of us throughout the two days. Collaboration requires people to offer an idea before it is fully formed, listen closely to a different perspective, and allow the work to change through that exchange.
ING makes room for those encounters. But its lasting value depends on what we do with them. In the rooms where it happens, ideas get tested, people try things out loud, and those who will carry the work forward find each other. The rest happens after we go home, in the trials we design and run.