Site-level clinical trial execution, run on our own Patient Management System

SiteLink is a Site Management Organization (SMO) in Bulgaria. We deliver investigator-site operations for CROs and sponsors across Phase I to IV. Our proprietary platform brings investigator and coordinator visit planning together, with automated reminders for patients.

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SiteLink Patient Management System

Clinical study and patient visit management, developed internally and deployed at every site we operate. It is the operating system of our sites: the visit schedule, the reminder engine, the audit trail and the role-based views all live in one place.

Principal investigators

A study-wide, real-time view of enrollment and patient progress: every subject, its position in the visit schedule and the next due visit. Read-only and scoped to the investigator's own studies through role-based access control.

Clinical research coordinators

Per-patient visit status from pre-screening to end of study. Visits are anchored on the Day 1 randomisation date with protocol-defined windows, so out-of-window risk is visible before it becomes a deviation.

Patients

Automated SMS or email reminders ahead of scheduled visits, with the confirmed visit date and time. Visit reminders help patients prepare for scheduled appointments and support coordinator follow-up.

  • Role-based access control for investigators, coordinators, finance and administration
  • Field-level audit trail on every patient-affecting action, reviewable as a timeline
  • Confirmed delivery status on SMS reminders; complete communication evidence per patient
  • Visit-based financial tracking per study: billable items, invoices and payments

Example visit workflow

An illustration of the site team's workflow, not a patient record.

  1. Protocol-defined visit window
  2. Coordinator sets the visit date and time
  3. Patient receives an SMS or email reminder
  4. Communication is recorded; patient-affecting actions are audited

Site support across all four clinical development phases

The operational demands differ by phase. The platform, the SOPs and the data-integrity controls do not.

Phase I

First-in-human and clinical pharmacology

Intensive visit schedules, PK/PD sampling windows and dose-escalation cohorts demand precise timing and complete source. Coordinators organise protocol-defined visits and sampling logistics, while the SiteLink Patient Management System tracks visit dates and windows. Investigational product storage is under continuous digital temperature monitoring.

  • Tight-window visit and sampling logistics
  • Cohort-based scheduling and dose-escalation tracking
  • Continuous IP temperature records for the Trial Master File

Phase II

Proof of concept and dose ranging

Recruitment velocity and protocol adherence decide whether a Phase II reads out on time. We pre-screen against inclusion and exclusion criteria, keep enrolled subjects in window and deliver clean EDC data with rapid query turnaround.

  • Targeted pre-screening and enrollment tracking
  • Protocol-window adherence with automated patient reminders
  • Rapid data entry and query resolution against source

Phase III

Pivotal, multi-site registrational studies

At scale, consistency is the deliverable. The same SOPs, the same platform and the same data-integrity controls at every site we manage give the CRO a predictable, monitoring-ready footprint in Bulgaria for long-duration registrational programmes.

  • Standardised operations across multiple sites
  • Retention over multi-year follow-up schedules
  • Inspection-ready source, site files and temperature logs

Phase IV

Post-marketing and real-world evidence

Post-authorisation safety studies and observational programmes need sustained follow-up at low operational overhead. Structured visit scheduling and automated reminders keep large cohorts engaged, while site-level pharmacovigilance support ensures timely event capture and forwarding.

  • Long-term cohort retention and follow-up
  • Site-level safety event collection and forwarding
  • Efficient data capture for observational designs

Site-level services

Each service is defined in a written scope of work and delivered under the investigator's delegation log and the CRO's study-level oversight.

Prepare the site

  • Feasibility and site selection support

    Site-level feasibility responses, patient population estimates and investigator availability, returned in the CRO or sponsor format.

  • Site qualification and startup

    Qualification visit preparation, site file setup and startup tracking until the site is ready to enroll.

  • IRB/EC and regulatory documentation

    Preparation and submission of site-level ethics and regulatory documents, with version control and tracked approvals.

  • Coordinator and site staff provision

    Trained clinical research coordinators (CRCs) working under the investigator and the delegation log.

Run patient visits

  • Recruitment and retention

    Pre-screening, screening logistics and scheduled follow-up so enrolled patients stay in window and on study.

  • Visit scheduling and reminders

    Every study visit planned from the Day 1 anchor, with SMS and email reminders sent to patients before each visit.

  • Site-level safety reporting support

    Collection and timely forwarding of adverse event information to the investigator and the sponsor or CRO, per protocol.

Maintain data and readiness

  • EDC data entry and query resolution

    Timely entry into the sponsor EDC and closure of queries against source.

  • Environmental and temperature monitoring

    Calibrated digital sensors on every refrigerator, freezer and visit room, reporting continuously to a locally hosted platform with threshold alerts and 24 h / 7 d / 30 d trends.

  • Source documentation

    Complete, attributable, contemporaneous source records maintained for every visit.

  • Site budget, contract and invoice administration

    Visit-based tracking of billable items, invoices and payments per study.

  • Monitoring, audit and inspection readiness

    Site files, source and logs kept ready for monitoring visits, sponsor audits and regulatory inspections.

Continuous digital temperature monitoring: storage and visit rooms

Every refrigerator, freezer and patient visit room at the sites we operate is monitored by calibrated digital sensors, around the clock. Time-stamped readings and threshold alerts.

Readings are collected on a local-first, event-driven automation platform (Home Assistant) that we run on site and operate ourselves. Each sensor reports continuously; the platform stores every time-stamped value, plots minimum, mean and maximum over 24 hours, 7 days and 30 days, and raises an alert the moment a threshold is crossed. Because the platform is open source and runs locally, the record stays under our control and remains available for the life of the study.

We standardise on established, commercially available hardware such as Sonoff-class sensors, calibrated against reference devices, so every site reports in the same format and a replacement sensor is never a procurement project.

The resulting time-stamped temperature history covers investigational product storage, biological sample storage and patient visit rooms, and is available for review by the monitor, auditor or inspector.

What the CRO receives

  • Continuous, time-stamped record for every fridge, freezer and visit room
  • Minimum / mean / maximum trends at 24 h, 7 d and 30 d per location
  • Threshold alerts on the day, with excursion evidence for IP accountability
  • Automated readings over weekends and holidays
  • Locally hosted, open-source platform: data retained for the life of the study
  • One standard across every site we manage
SiteLink temperature monitoring dashboard: refrigerator temperature trends for four locations, each with minimum, mean and maximum over the last 24 hours, 7 days and 30 days
Live refrigerator monitoring at a SiteLink-operated site: four storage locations, each plotted over 24 hours, 7 days and 30 days.

CROs we have worked with

SiteLink has provided site-level operational support on studies run by or with the following organisations.

  • IQVIA
  • ICON plc
  • PPD (Thermo Fisher Scientific)
  • Medpace
  • Fortrea (formerly Labcorp)

Names are trademarks of their respective owners. Reference indicates site-level operational experience and does not imply endorsement, partnership or certification.

Our role: the SMO scope

SiteLink manages sites. The sponsor and its CRO manage the study. That boundary is written into every scope of work we sign and is consistent with ICH E6 responsibilities. Our coordinators are recruited for their medical background — a deliberate lever on trial quality, from source documentation to query resolution and patient follow-up.

SiteLink does

  • Provide and train coordinators with a medical background, working under the investigator
  • Run a working-student programme in partnership with medical universities
  • Prepare site-level ethics and regulatory documentation
  • Recruit, pre-screen and schedule patients
  • Enter EDC data and resolve queries against source
  • Maintain source documentation and the investigator site file
  • Keep the site ready for monitoring, audit and inspection

SiteLink does not

  • Design, sponsor or oversee the study
  • Make protocol, medical or safety decisions
  • Hold study-level regulatory or CRO responsibility
  • Replace the principal investigator

Frequently asked questions

Study fit and start-up

Can SiteLink support our study regardless of phase or design?

Yes. SiteLink provides site-level execution for Phase I through Phase IV, interventional and observational, including post-authorisation safety studies. The operational model, the SOPs and the SiteLink Patient Management System are the same across phases; only the visit density, sampling logistics and follow-up horizon change. Send the synopsis and we will confirm feasibility for the specific design.

How does SiteLink contract with a CRO or sponsor?

Through a single scope of work per study, with SiteLink as the counterparty for the site-level services and the principal investigator retaining the investigator agreement. One point of contact, one invoice stream and one set of KPIs for every site we operate on the study. Where the sponsor prefers a tripartite clinical trial agreement, we work within that structure.

What should a feasibility request include, and what information do you return?

Send the protocol synopsis, inclusion and exclusion criteria, target enrollment and timelines to info@sitelinkeu.com. We return the completed feasibility questionnaire in the CRO or sponsor template, with investigator availability, a realistic patient-population estimate from the sites we operate and any protocol-specific constraints flagged up front rather than at site initiation.

How do you protect start-up timelines in Bulgaria?

Site-level documents for the EU Clinical Trials Regulation Part II package, ethics committee submissions and the investigator site file are prepared in parallel with contract and budget negotiation, not after it. Start-up tasks are tracked per site with named owners, and the CRO receives a status view rather than a status meeting. The study-level CTIS submission remains with the sponsor or CRO.

Visit delivery and oversight

How does SiteLink keep enrolled patients on schedule and in window?

Every visit is planned in the SiteLink Patient Management System from the Day 1 anchor with its protocol window. Coordinators see upcoming and at-risk visits per patient, and each patient receives an automated SMS or email reminder before the visit with the confirmed date and time. Reminder delivery is recorded per patient, so retention effort is evidenced, not asserted.

What visibility does the CRO or monitor get into site performance?

Enrollment and visit status are available on request in the format the CRO uses for its own tracking, and the principal investigator has a real-time study-wide view in the platform. Monitors are supported with organised source, a current investigator site file and continuous temperature records, so monitoring visits and remote source data verification proceed without reconstruction.

How do you ensure data quality and query turnaround?

Source is completed at the visit, entered into the sponsor EDC within the agreed window and reconciled against source before queries arrive. Queries are answered against source, not memory. A field-level audit trail in the platform records who changed what and when for every patient record, which supports both internal QC and ALCOA+ expectations during inspection.

How are investigational product storage and visit rooms temperature-monitored?

Every refrigerator, freezer and patient visit room at the sites we operate carries a calibrated digital sensor reporting continuously to a locally hosted, open-source automation platform (Home Assistant) that SiteLink runs itself. Each time-stamped reading is stored; minimum, mean and maximum are plotted over 24 hours, 7 days and 30 days; threshold alerts fire the moment a limit is crossed. There are no paper logs and no transcription, and the record is available to the monitor or inspector for the life of the study in one format across every site.

People, data and collaboration

Are your staff GCP-trained and how is delegation handled?

Coordinators hold current ICH E6 (R3) GCP training and are added to the delegation log by the principal investigator before performing any study task. Training records and CVs are maintained in the site file. Role-based access in the platform mirrors the delegation log, so a coordinator sees only the studies and functions delegated to them.

How do you handle personal data and GDPR?

Bulgaria is an EU member state and SiteLink operates under the GDPR. Patient data is held on infrastructure controlled by SiteLink, access is role based and logged, and reminder messages carry only what the patient needs to attend. Sponsor and CRO data-processing terms are incorporated into the scope of work.

Can SiteLink operate more than one site for the same study?

Yes. Each site keeps its own investigator, delegation log and site file, while SiteLink applies one set of SOPs, one platform and one reporting format across all of them. For the CRO that means a single operational counterpart in Bulgaria and consistent quality between sites.

What is the fastest way to start a conversation?

Email info@sitelinkeu.com with the therapeutic area, phase, expected timelines and the sites or regions under consideration. That address is monitored by the people who run the sites, and it is the only contact channel we use.

Planning a study in Bulgaria?

One channel, answered by the people who run the sites. Share the therapeutic area, phase, expected timelines and the sites or regions under consideration, and we will return the information you need for feasibility.

Email

info@sitelinkeu.com

Opens your email app with the study-enquiry subject filled in. Send your message there.

SITELINK LTD, Varna, Bulgaria