Traditionally, the sponsor has assessed site performance, data quality and addressed risk using on-site monitoring at regular intervals. This activity includes a combination of Source Data Verification (SDV) for accuracy as well as Source Data Review (SDR) for quality. Due to COVID, access to the site is restricted and many sites have started to adopt remote methods for data monitoring. However, many of these strategies were implemented quickly as a stopgap to get research started again. Further, many institutions adopted different strategies, some of which pose challenges for the sponsor depending on relative risk tolerance (e.g., access to EMR that cannot be restricted to specific patients). The ideal solution to remote monitoring is well controlled, direct access to electronic medical records (EMR) by the sponsor that is restricted to only the participants that need to be monitored. Sites may be constrained by the capabilities of their current technology. Ideally, establishing interoperability of EDC systems, EMRs, and digital data collection tools can reduce the amount of SDV required by study monitors. Sustainable solutions may be achieved through technology adoption and a cultural shift toward new processes and procedures.