Clinical Monitoring Oversight & AI Operations

Bots flag the risk.
Humans own the decision.

A sponsor-owned governance model that turns an existing bot ecosystem into controlled, human-reviewed clinical monitoring oversight — and a working product that proves the model runs.

60+Risk indicators
5-partOperating model
90-dayBuild plan
The Pitch · 90 Seconds

The whole idea, in ninety seconds.

VigilNova is risk-based monitoring made continuous: every site watched in real time, risks surfaced before they turn critical, and a clean trail of who reviewed what.

VigilNova pitch ▶ Pitch · 1:18
The Model

Sponsor-owned governance for an existing bot ecosystem.

The goal isn't to replace monitors or clinical judgment. It's to govern, calibrate, and scale bots so they surface the right risks, route the right issues, and leave inspection-ready evidence of sponsor oversight — across FSPs, sites, studies, and implementation teams.

Existing bots need controls

Bots accelerate signal detection, but outputs need intended use, QC, change control, and human review.

FSP scale needs visibility

Outsourced monitoring works best when the sponsor can see quality, risk, and escalation status in near real time.

FDEs need clinical guardrails

Engineers can build fast, but risk logic, evidence standards, and escalation criteria must be clinically led.

01

FSP monitoring delivery

  • Visit execution, MVRs, follow-up letters, site actions.
  • Inputs from CTMS, EDC, eTMF, and RBQM tools.
  • Quality defined in the monitoring & oversight plans.
02

Existing bots & agents

  • Detect gaps, trends, outliers, and aging items.
  • Summarize risks and draft oversight notes.
  • Route signals to humans with evidence and source links.
03

FDE implementation layer

  • Integrate data sources and configure workflows.
  • Translate clinical rules into dashboards and bot logic.
  • Iterate with user feedback and performance metrics.
04 · the role

Monitoring Oversight & AI Operations Lead

  • Owns clinical risk logic, human-in-the-loop criteria, QC sampling, and escalation thresholds.
  • Reviews FSP and bot performance, resolves ambiguity, and prepares leadership recommendations.
05

QA & leadership governance

  • Monthly scorecards, issue aging, and CAPA pathways.
  • Bot change history and inspection-ready evidence.
  • Clear accountability: what was detected and by whom.
  • What action was taken, who reviewed it, and when.
Control principle
Bots flag, summarize, route, and draft. Humans own significance, final decisions, escalation, and accountable documentation.

This keeps automation fast while preserving sponsor oversight, clinical judgment, auditability, and compliance defensibility.

0 – 30

Assess & design

  • Map existing bots, workflows, systems, and FSP handoffs.
  • Define RACI, signal library, QC sampling, and escalation matrix.
  • Select 2–3 pilot workflows with clear value, low ambiguity.
31 – 60

Pilot & calibrate

  • Run pilots for MVR QC, action aging, and trend detection.
  • Track acceptance, overrides, false positives, missed signals.
  • Build the dashboard, review cadence, and doc standards.
61 – 90

Scale & govern

  • Expand successful workflows across studies, sites, FSPs.
  • Formalize bot change control, scorecards, and evidence logs.
  • Publish the FDE playbook and oversight operating model.
The Brief

The two-page proposal.

Monitoring Oversight for FSPs + Existing Bots

The full operating model, 90-day build plan, priority workflows, and the metrics leadership should see — with clear lines of accountability for what was detected, reviewed, decided, and closed.

Regulatory footing — FDA risk-based monitoring guidance · ICH E6(R3) GCP · 21 CFR 312.52 sponsor/CRO transfer of obligations.

Download the PDF
The Product · Proof

From operating model to working software.

VigilNova is a risk-based monitoring platform I designed and built — the model above, running. This is the full guided walkthrough, screen by screen.

60+ KRIs Real-time risk signals 0–100 site health score Portfolio oversight + AI insights 21 CFR Part 11 audit trail
VigilNova full walkthrough ▶ Full walkthrough · 8:22