Clinical trial recruitment fails 80-85% of the time, with 30% of sites enrolling zero patients

80-85% of clinical trials fail to meet their initial enrollment projections, and nearly 30% of trial sites enroll zero patients, meaning the physical locations set up to conduct the trial — with staff, equipment, and regulatory approvals — produce no usable data. So what? Patient recruitment accounts for 37% of all trial postponements, adding months or years to the drug development timeline for treatments that patients with terminal or debilitating conditions desperately need. So what? 30% of enrolled patients who do join subsequently drop out, further compounding the recruitment failure and invalidating statistical power. So what? Each day a clinical trial is delayed costs the pharmaceutical sponsor $600,000-$8,000,000 in lost revenue opportunity, costs that are passed through to drug prices that patients and insurers ultimately pay. So what? Rare disease patients — who stand to benefit the most from novel therapies — are the hardest to match to trials because their conditions are spread across thousands of sites and EHR systems with no unified patient registry. So what? The entire pipeline of potentially life-saving therapies moves slower than it should, and many promising treatments never reach market because the trial economics collapse. This persists structurally because patient medical records are siloed across incompatible EHR systems, trial eligibility criteria are written in complex medical jargon that doesn't map cleanly to structured data, and physicians at community practices (where most patients are) have no time or incentive to screen patients for trials.