DCTs have picked up significantly in previous years, catalyzed by the pandemic and a move to remote research. With this move comes a host of new challenges, including those surrounding technical interoperability, resistance to adopting new technologies, and the need for flexibility in technology uptake at research sites. With additional considerations to be made, such as ensuring regulatory compliance, and enforcing standardized metrics in assessing DCT performance, this episode provides valuable insight into the dynamic and relatively novel landscape of decentralization in clinical trials.