Jeff Elton: The pipeline of biomedical innovations has been exceptionally strong across many diseases. However, lower clinical trial access to patients, the pandemic further diminishing patient participation and new study starts, limited research infrastructure and budgets at healthcare providers, and rather burdensome legacy trial technologies have reduced the throughput potential for these innovations. These inefficiencies are, in part, increasing the cost of new medicines and lowering the pace of patient access to the latest innovations. Looking ahead, we have the tools for a better way of operating. Providers at the community and regional health levels are eager for new ways of working and supporting efficient research operations. While some of the new AI digital solutions for patient matching to trials, decentralized solutions, and digital integrated solutions lack certain functionalities of legacy systems, they offer performance, acceleration, and cost advantages unachievable by these older technologies. As the pipeline accelerates, evidence is generated more rapidly, value will improve, and outcomes benefits will accelerate. So, to the spirit of the question, this presents the biggest challenge and the highest promise.