Findings
The DTRA Best Practice Evaluation Rubric uses five dimensions to determine if a DCT practice should be considered a “best practice”:
Evidence of Success: Requires measurable and demonstrable success using KPIs and tangible outcomes.
Improving Patient Experience: Must address the needs of patients, caregivers, and therapeutic experts, demonstrating improved experience and engagement.
Site Impact: Must consider the implications of adoption and the practical impact on site burden and working practices.
Operational and Technical Feasibility: Ensures operational and technical aspects (including ongoing support, security, integrity, scaling, and reuse) have been fully considered when deploying new technologies.
Regulatory & Ethical Compliance: Requires appropriate consideration of global and local regulations and guidance (e.g., ICH E6/E8, GDPR, HIPAA), including adherence to privacy, consent, and ethical safeguards.

Recommendations
A practice should demonstrate several key factors across the dimensions:
Patient-Centricity: Reduce patient burden by offering the option to reduce physical visits and enable greater patient empowerment and access to information. It should strive to increase the diversity of recruited patients while mitigating bias toward technologically literate patients.
Site Support: Achieve a net reduction in burden for sites, utilizing simple, intuitive technology with minimal, on-demand training. It must provide clarity of fiduciary responsibility and use technology to increase risk-based monitoring without sacrificing data integrity.
Technical Rigor: Have a clear problem statement and a thoroughly defined strategy to mitigate operational and technical risks. It should take a holistic approach and ensure the solution is fit for use for the specific patient population, aligning with data privacy and security standards.

Regulatory Considerations
Practices must ensure compliance with both global and local regulations and Health Authority guidance. Explicit attention must be given to aligning with ICH E6 (Good Clinical Practice) and privacy laws like GDPR and HIPAA. The design must protect stakeholders providing sensitive or personal data with safeguards to ensure ethical safety.