CRAs are trained to protect patient safety, ensure protocol compliance, and support sites. But in reality, much of their time is spent on manual coordination work.

Florence’s 2026 State of Clinical Trial Technology report shows that clinical trial workflows are still heavily dependent on email, paper, and disconnected systems, limiting real-time visibility and slowing execution. And when that happens, CRA time shifts away from oversight and into administration.

Here are the five biggest areas where CRAs lost time today.

Document Handling Across Systems

Following Up on Missing or Incomplete Documents

CRAs act as the coordination layer between sites and sponsors when documents are missing or incomplete.

What this looks like:

• Sending reminder emails
• Tracking outstanding documents
• Following up multiple times
• Escalating delays to site staff or PIs

Why it matters:
95% of the industry still relies on email for document exchange, even when other systems are available, which creates constant back-and-forth and delays.

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Reviewing Site Document Quality (Without Real-Time Visibility)

CRAs are responsible for ensuring site documentation is complete and inspection-ready—but they’re typically doing it after the fact, without continuous visibility.

What this looks like:

• Reviewing documents only during scheduled visits (or delayed remote access)
• Identifying missing or poor-quality documents after issues have already occurred
• Manually piecing together document status across email, portals, and trackers
• Following up with sites to correct issues that could have been caught earlier
• Re-reviewing the same documents multiple times as updates come in

Why it’s inefficient:
This is high-value work, but the workflow is reactive. Without real-time access to site documents, CRAs are often finding problems late instead of preventing them early.

CRAs report that when they have continuous access to site documents, they can identify and resolve issues faster and reduce rework.

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Maintaining Trackers and Status Reports

Because systems are not connected, CRAs often maintain their own trackers to understand study status at each of their sites.

What this looks like:

• Updating Excel trackers for startup readiness and activation progress
• Tracking personnel training and system access
• Compiling updates from multiple systems
• Preparing reports for internal teams

Why it matters:
Most organizations still lack real-time visibility into site operations, forcing CRAs to manually piece together status updates.

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Monitoring Visit Prep, Documentation, and Follow-Up

Monitoring visits are core to the CRA role—but a significant portion of time is spent preparing for, documenting, and following up on visits, rather than the visit itself.

What this looks like:

• Preparing for visits by determining required elements for each monitoring visit 
• Reviewing site data and documents across multiple systems manually before each visit
• Sending the agenda and any document requests to sites in advance 
• Documenting findings and observations in the monitoring visit report after the visit
• Following up with sites on action items and outstanding issues
• Re-checking documentation to confirm resolution

Why it’s inefficient:
This work is essential, but much of it is manual and repetitive. The underlying work—like document review and status tracking—can be partially automated or surfaced in real time, reducing the need for repeated prep and follow-up, leaving more time available for higher-value site support and risk identification.

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What Changes When You Remove the Friction?

These tasks have always been essential parts of the CRA role, but they are:

• Manual instead of automated
• Fragmented across systems
• Dependent on email and trackers

With the complexity and volume of today’s studies, this manual coordination turns into a full-time job. 

By leveraging AI and eClinical solutions designed to make site documents and workflows connected and visible in real time, CRAs can shift their focus back to:

• Identifying risks earlier
• Supporting sites proactively
• Improving protocol adherence
• Increasing monitoring efficiency

In other words, they can do the work they were trained to do.