The speed and precision of medical product research have increased remarkably over time. Genome-informed target identification and automated candidate molecule screening have made the discovery process much more efficient. The use of model-informed drug development and innovative trial designs is ushering in a wave of advanced modalities such as precision medicine. Yet, unlike technological advances in other areas, the cost and length of clinical trials have remained relatively unchanged, as the evaluation process has not kept pace with medical innovation. To facilitate development of better, more precise, easier-to-use treatments that work for all patients, we need to expand innovative approaches to trial design, regulation, and conduct. Many exciting pilots are being developed now that are pressure testing these new approaches. Panelists will discuss what these pilots look like, how well they are working so far, and how they can be scaled and expanded.