The Advanced Research Projects Agency for Health (ARPA-H) is pursuing an ambitious infrastructure goal for U.S. clinical research: that 90% of eligible Americans should be able to reach a clinical trial site within 30 minutes of their home. The effort, called Advancing Clinical Trial Readiness (ACTR), is the first initiative launched under ARPANET-H, ARPA-H’s nationwide health innovation engagement network, and it is one of the more concrete access-and-equity benchmarks any U.S. federal health research agency has set for trial infrastructure.
What ACTR is
ARPA-H introduced ACTR in October 2023 as a call for input on how to build a decentralized, nationwide clinical trial infrastructure. Rather than funding a single trial or disease area, ACTR is infrastructure-first: it aims to change where and how trials can physically and operationally reach participants, addressing long-standing problems in U.S. trial conduct that ARPA-H’s own materials describe as electronic health record (EHR) interoperability gaps, non-representative enrollment, overly complex protocols, uneven geographic access, and inconsistent real-world trial variables.
Following a public feedback period (with a stated deadline of December 1, 2023), ARPA-H moved ACTR from a request-for-input to an active funding opportunity. A December 2024 program announcement formalized ACTR’s funding solicitation around three technical areas:
- Automated data collection and standardization — reducing the manual burden of capturing and normalizing trial data from clinical and real-world sources.
- Trial participant identification and engagement — tools to identify and reach eligible participants who are not currently served by trial sites concentrated at large academic medical centers.
- Decentralized data curation and auditing — infrastructure to curate and audit data generated outside traditional, centralized trial-site settings.
ARPA-H has named Etta Pisano as ACTR’s Portfolio Lead; the agency’s ARPANET-H network is organized around a Customer Experience Hub model intended to connect patients, health systems, community health centers, retail pharmacies, home health providers, and industry and academic partners into the same trial-access infrastructure.
Why the 90%/30-minute figure matters
The 90%-within-30-minutes target is a proximity metric, not a participation or enrollment quota — it describes how close an eligible person should be to a site capable of running a trial, not a guarantee that they will enroll in one. Framed this way, it functions less like a single research program and more like a national access-infrastructure target for the clinical trials enterprise, comparable in spirit to how DOE’s ARPA-E or DARPA set infrastructure-level goals rather than single-study endpoints. For research-administration audiences, the practical implication is that ACTR sits upstream of any individual protocol: it is meant to expand the physical and technical footprint of feasible trial sites — including community, primary-care, pharmacy, and home-health settings — rather than to fund a specific disease-area trial.
This ties directly into the broader shift toward decentralized clinical trials (DCTs) and decentralized clinical trial platforms that sponsors and CROs have been building out over the past several years. Where DCT platforms address how remote or hybrid visits, e-consent, and direct-to-participant logistics work within a single trial, ACTR is aimed at the underlying national capacity question: whether a viable site or access point exists near enough to a given person in the first place. Site networks organized on a hub-and-spoke model are one existing structural approach to extending site reach into community settings that ACTR-funded infrastructure could plug into or accelerate.
What research administrators and site operations teams should track
- Solicitation status. ACTR’s funding opportunity, announced in its current form in December 2024, is still working through proposal review and award stages; as with other ARPA-H programs, the agency states that award numbers and amounts depend on proposal quality and available funding rather than a fixed schedule.
- EHR interoperability requirements. Because automated data collection and standardization is one of ACTR’s three technical areas, any resulting tools are likely to intersect with existing EHR interoperability and real-world-data standards work that research institutions already have to navigate.
- Non-traditional site partners. ARPA-H’s stated intent to bring in retail pharmacies, home health providers, and community health centers as trial-capable sites is a meaningful departure from a model centered on academic medical centers, with direct implications for site qualification, monitoring, and IRB oversight practices if and when ACTR-funded tools reach deployment.
- Regulatory alignment. ACTR is a funding and infrastructure program, not a regulatory change — it does not itself alter FDA trial-conduct requirements. Institutions should watch for how ACTR-funded tools interact with parallel FDA modernization efforts, such as the agency’s real-time and decentralized trial initiatives.
Where this stands as of publication
ACTR is still in its early, program-building phase relative to the scale of its stated goal. ARPA-H has published the initiative’s aims, its three technical focus areas, and named portfolio leadership, but as of this writing the agency has not published site-level or population-level progress data toward the 90%/30-minute target itself. Readers should treat the target as ARPA-H’s current, publicly stated design goal for the program rather than a reported outcome, and should check ARPA-H’s own ACTR and ARPANET-H pages directly for the latest solicitation and award status, since program details on federal funding-opportunity pages change as solicitations progress.
Frequently asked questions
Is ACTR a clinical trial itself?
No. ACTR is an infrastructure and funding initiative — it funds tools and capabilities intended to make trial sites more reachable and trial data easier to collect and standardize, rather than sponsoring a specific interventional trial.
How does ACTR relate to ARPANET-H?
ACTR was launched as the first initiative under ARPANET-H, ARPA-H’s broader nationwide network for engaging patients, health systems, community organizations, and industry partners in the agency’s work.
Does the 90%/30-minute goal mean 90% of Americans will be enrolled in a trial?
No. It is a proximity/access target — that a trial site or access point should be reachable within 30 minutes for 90% of eligible people — not an enrollment or participation target.
Who leads ACTR at ARPA-H?
ARPA-H has named Etta Pisano as ACTR’s Portfolio Lead, within the agency’s broader program structure.
