A WCG study conducted in the years following the pandemic identified staffing shortages, rising trial complexity, and declining physician capacity as the three biggest strains on clinical trial enrollment. Each one compounds the others: fewer staff means less bandwidth for complex protocols, and fewer available investigators means less capacity to run the trials sponsors need. Mobile, point-of-need care addresses all three directly, whether the study involves ophthalmic endpoints specifically or non-ophthalmic protocols that require ocular assessments.
Why Are Clinical Research Sites Facing Staffing Shortages?
WCG's research found staffing was the number one challenge reported by clinical research sites, with a turnover rate between 16% and 30%. Pandemic-era site shutdowns created a backlog of studies that hasn't fully cleared, adding tension between sponsors and site staff over which studies get prioritized. That delay has a trickle-down effect that eventually reaches every part of clinical research, including patients waiting to enroll.
How Can 20/20 Onsite Help Increase Site Staffing Capacity?
20/20 Onsite eases enrollment burdens tied to site capacity or staffing shortages by bringing a Mobile Vision Clinic on-site, functioning as an extension of the site team, essentially another exam room, just one with wheels. Each clinic can be staffed with any combination of pre-screened, licensed, and GCP-certified technicians or other care providers, backed by an experienced patient management team that has helped maintain consistently above-average patient satisfaction ratings. Having that team on-site as additional support relieves pressure a stretched clinic or research center is already carrying.
How Do Trial Complexities Limit the Eligible Patient Pool?
The same WCG research found sites reporting a 70% increase in Phase III trial procedures over the prior decade, alongside a 300% increase in data collection points. The more complex a protocol, the more strain it puts on sites already following a more comprehensive endpoint collection schedule, a poor match for a workforce that's often been forced to backfill with more junior staff less experienced with complex protocols.
Increased complexity also means more stringent eligibility criteria, tightening inclusion and exclusion requirements in ways that shrink the eligible patient pool. This hits rare disease studies especially hard, since eligible patients may be scattered across the country and unable to participate simply because of the distance from a research site. The result: sponsors and CROs miss enrollment timelines not because interest is lacking, but because too few qualified patients live close enough to enroll.
How Can 20/20 Onsite Help Reach a Wider, More Diverse Patient Population?
As a site or vendor on wheels, 20/20 Onsite can go wherever patients or potential participants already are, reaching more diverse communities with individuals who are often better matches for a trial's specific requirements and who may receive potentially life-altering care they otherwise wouldn't have access to.
That reach also creates direct feedback loops with community patient groups on how to build more patient-centered, less burdensome protocols. In previous trials, 20/20 Onsite's team has proposed protocol changes based on direct patient feedback that were ultimately approved, meaningfully improving the patient experience, particularly for visually impaired participants.
Pre-screening patients before they arrive at a clinical research site is another direct lever: confirming eligibility criteria ahead of time reduces logistics strain for complex protocols and spares site staff from ineligible patients and avoidable screen failures, which positively affects both cost and enrollment speed. On data quality, 20/20 Onsite completed an observational study assessing subjective refraction, autorefraction, and keratometry measurements collected on board a Mobile Vision Clinic versus a traditional setting, and found no statistically significant difference between the two.
Why Is Physician and Investigator Capacity Declining?
WCG's study also flagged physician capacity as a growing concern. Trial starts have stayed relatively consistent over recent years, but the number of active U.S. investigators has been steadily declining, with 40% of investigators involved in only one trial, a sign of shrinking interest and availability for physicians to take on this work as the volume of trials needing investigators keeps growing.
How Can 20/20 Onsite Help Increase Principal Investigator Capacity?
If a study needs an additional site or Principal Investigator, one of 20/20 Onsite's doctors can serve as PI, using the mobile clinic as one of the study's sites: scheduling patients, conducting activities per the assessment schedule, and entering data into the EDC the same way any other site would.
Mobile Vision Clinics also enable physicians to expand their patient capacity into traditionally underserved communities where specialists aren't readily accessible. In one assessment, 20/20 Onsite's research found 36 New England counties at high risk for age-related macular degeneration (AMD) that were more than 100 miles from a specialist, a gap that closely tracks access barriers documented in ophthalmic assessments for non-ophthalmic trials more broadly. Point-of-need clinics can bridge exactly that gap between hard-to-find patients and clinical trial participation, expanding access to testing nationwide rather than only where a specialist already practices.
20/20 Onsite: Your Solution for Clinical Trial Enrollment Challenges
If your study is at risk from staffing shortages, trial complexity, or shrinking investigator capacity, request an enrollment risk consultation to see how point-of-need mobile care can bring convenience, efficiency, and a top-rated participant experience to your study before enrollment timelines slip.
Frequently Asked Questions
What are the biggest challenges facing clinical trial enrollment today? Site staffing shortages, rising trial protocol complexity, and declining physician or investigator capacity are three of the most significant structural challenges, according to WCG research. Each compounds the others, since fewer staff and fewer available investigators both reduce a site's capacity to run increasingly complex protocols.
How does a mobile vision clinic help with clinical research site staffing shortages? A mobile vision clinic can function as an extension of a site's existing team, bringing pre-screened, licensed, and GCP-certified technicians and an experienced patient management team on-site. This adds capacity without requiring the site to hire and train additional staff directly.
Why do more complex trial protocols shrink the eligible patient pool? More complex protocols typically come with more stringent inclusion and exclusion criteria, which narrows who qualifies to participate. This is especially difficult in rare disease studies, where qualified patients may already be geographically scattered and unable to reach a limited number of research sites.
Is data collected on a mobile vision clinic as reliable as data collected in a traditional clinical setting? Yes. An observational study comparing subjective refraction, autorefraction, and keratometry measurements collected on board a Mobile Vision Clinic against a traditional setting found no statistically significant difference between the two.
Can a mobile vision clinic serve as an official clinical trial site with its own Principal Investigator? Yes. A 20/20 Onsite physician can serve as Principal Investigator on a study, using the mobile clinic as one of the trial's sites, handling scheduling, assessments, and EDC data entry the same way a traditional site would.
How does point-of-need care help address declining investigator capacity? By extending an existing physician's reach into underserved communities where specialists aren't easily accessible, mobile clinics let a smaller pool of available investigators support more patients across more locations than a single fixed site could reach on its own.
How does 20/20 Onsite help sponsors reach patients in underserved or specialist-scarce areas? 20/20 Onsite's research has identified specific access gaps, including 36 New England counties at high risk for age-related macular degeneration that were more than 100 miles from a specialist, and deploys Mobile Vision Clinics to close exactly that kind of distance-based access barrier.