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Operations · The Myrtle Magazine

More efficiency, more fragmentation: why oversight is the missing piece

The industry is getting more efficient and more fragmented at once. Coordination is not control, and coordination breaks at scale.

By Hadas Nachmanson, founder of Myrtle Clinical · June 2026

The clinical trials industry is becoming more efficient, but also more fragmented.

The FDA aligned ICH M15 guideline on Model Informed Drug Development is accelerating faster, data driven development in pharma and medical device companies. More efficiency means more programs, more trials, and more outsourcing to CROs and vendors. Not less complexity, more of it.

The direction is clear: more parallel development, more global execution networks, and more distributed responsibility. Accountability, however, stays with the company developing the product.

Execution is now split across multiple CROs, vendors and service providers. Each optimizes its own part. No one owns the full system.

This is why structured CRO and vendor oversight is the missing piece in most clinical programs. Not reporting. Not dashboards. Real operational control: quality, data integrity, protocol adherence, and alignment across every vendor.

Without it, there is no control. Only coordination. And coordination breaks at scale.

By Hadas Nachmanson, Founder of Myrtle Clinical · LinkedIn

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