Ari Bousbib
Analyst · Dan Leonard with Wells Fargo
Yes. I mean, look, as we mentioned, the decentralized trial opportunity was identified well before COVID. We talked about it before. We used to call it virtual trials, hybrid trials. We talked about it and we felt we were making great progress. And then the pandemic happened, and we saw how critical those capabilities were, and that accelerated the development. Basically, it's a combination of remote technologies and digital -- the part of the clinical trial that can be digitized. So the suite, for us, combined eConsent, which you're familiar with, telemedicine, modules, eCOA, and of course, a lot of digital communication. It basically optimizes and virtualizes the relationships between local labs, health care providers when it's necessary. It sort of establishes a virtual network of investigators and care professionals. And what we do is that we agree on preset terms with the investigators that agreed to participate. We have internally operationalized this business and we have a separate team, a decentralized trial team. For example, we've got decentralized clinical trial, clinical research coordinator that can support the sites in a remote way, help navigate technology. This is new for all of the investigators and certainly for the patients. So we need -- we figured out during the pandemic that we needed a centralized team to assist sort of, kind of a help desk, if you will. There are -- there's also -- so there's kind of a sort of a wide growth service to help patients and sites through the decentralized trial process. We also have research nurses and phlebotomy solutions team that build on our global network to support the decentralized studies. So again, we are moving to -- from -- we moved from the pre-2020 piloting phase where we had, I believe, at the time, sort of 60-or-so small trials that essentially were experimental in nature and people wanted to sort of try it out to a maturing phase. We have added many wins. We've -- so far in 2021, I think we have more than a dozen larger decentralized clinical trials that were won. We added new therapeutic areas. We are working with 5 of the top 10 large pharma clients. And I would note that one of the reasons we were able to win so many, a bigger proportion than anyone else of the COVID work, whether it's therapeutic trials or vaccine trial, was our more advanced decentralized trial capability. And again, we cover probably 10-or-so therapeutic areas, nephrology, oncology, psychiatry, CNS, dermatology, et cetera. And it's moving to a more mature phase, and we will speak more about that in the future. Again, in the context of the very large R&DS business we have, it's still not something that's kind of moving the needle in the numbers. Given the very strong growth that we have, it's not materializing. Ron, do you want to add...