# A global open trials operating system any hospital can plug into

Source: https://onco.cc/ideas/idea-moon-global-open-trials-os/  
OnCo record `idea-moon-global-open-trials-os` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Build the shared software, legal templates and data standards that let any hospital in the world join a cancer trial in weeks instead of years, the way the internet let any computer join the network.

## Summary

Trial start-up takes many months per site because every sponsor, country and hospital reinvents contracts, ethics submissions, data capture and monitoring. The proposal is an open-source, openly governed trials operating system: standard master agreements, a single global ethics dossier format accepted by participating regulators, e-consent and eligibility modules, mCODE-based data capture from electronic records, risk-based remote monitoring and open protocol templates, with certification of sites and a fund to connect hospitals in low- and middle-income countries.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Sites on the operating system open trials in under 60 days at a fifth of current start-up cost, and the share of global trial enrolment from middle-income countries doubles within five years.
- Rationale: Open standards and shared infrastructure transformed payments, logistics and the web; trials remain artisanal. Regulatory convergence (ICH, reliance pathways) makes a shared dossier plausible now.
- Proposed test: Deploy across 100 hospitals in ten countries with five sponsors; compare start-up time, cost per patient and enrolment diversity against matched conventional sites.
- Maturity: speculative
- Actor: engineering

## Sources

- Clinical Trials Transformation Initiative: https://ctti-clinicaltrials.org/

## Connected records

- technologies: [AI trial matching & clinical decision support](https://onco.cc/technologies/ai-trial-matching/)
- bottlenecks: [Regulatory divergence between regions](https://onco.cc/bottlenecks/b-regulatory-fragmentation/), [Trials do not represent the people who get cancer](https://onco.cc/bottlenecks/b-trial-diversity/), [Trials enrol too few, too slowly](https://onco.cc/bottlenecks/b-trial-enrolment/)

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