Where studies actually fail
Rater training, or patient retention?
Signant's irreducible strength is vendor-administered rater training and certification for specific psychometric instruments where regulatory protocols require them. The validated PRO/ClinRO instrument library and Phase III pedigree are real, but Delve also delivers validated instruments under the same regulatory frameworks (FDA DHT, V3, ICH E6 R3) on a modern operating model. And studies rarely fail because raters were undertrained — they fail because patients drift between visits. The May 14, 2026 Ametris (formerly ActiGraph) acquisition signals wearable ambition, but the integrated product is days old — sponsors evaluating Signant should ask for a live, customer-named unified-stack study, not a roadmap pitch.
- Deep validated PRO / ClinRO instrument library
- Rater training and certification services
- CNS and oncology Phase III pharma experience
- Traditional enterprise eCOA workflows
- COA-as-a-Service for sponsors needing supplier outsourcing
Rater training and instrument library. Real heritage.
- A patient who hasn't worn their device for 3 days
- A wearable producing physiologically implausible data
- An eCOA diary missed in a language the patient speaks at home
- A caregiver overwhelmed in a rare-disease trial
- Endpoint integrity when devices have firmware drift
Patient-facing, cross-cultural, real-world. A well-trained rater can't recover a patient who stopped wearing the device.
- 70+ validated wearable algorithms
- 7-dimension real-time compliance scoring
- Concierge-as-a-Service in 120+ languages
- 92–98% per-study eCOA/ePRO completion
- Up to 63% retention uplift in long-duration cohorts
- UI-driven multi-tenant rollout (US/NA, EU, LATAM, APAC, MENA) — no IT tickets, no per-region procurement
- Open endpoint APIs — REST + webhooks + CDISC + Parquet delivery into your EDC and analytics stack, with versioned contracts and provenance
Platform-owned outcomes. Documented per study.
Bottom line: Signant's irreducible strength is vendor-administered rater training and certification for specific psychometric instruments where regulatory protocols mandate it (much of CNS / psychiatry / pain Phase III). If your protocol explicitly requires those services, you'll need Signant or a similar rater-services vendor regardless. For everything else — eCOA, ePRO, wearables, compliance recovery, retention — Delve offers proven, integrated, multilingual capabilities operating today, while Signant's May 2026 Ametris/ActiGraph acquisition is a 12–18 month integration roadmap, not yet a shipping product.
How Delve actually delivers 92–98% completion
Three engagement layers, not one
Other platforms bet on a single approach: configurable software (YPrime), AI agents (Medable), rater services (Signant), or core-lab pedigree (Clario). Delve combines three engagement layers on top of one validated wearable platform — which is why per-study completion lands at 92–98% vs. the published industry baseline of 80–90%.
Fully featured eCOA you can build any study on. Configurable without engineering tickets.
- Branching logic, edit checks, scheduling, scoring, version control
- Validated PRO / ClinRO / ObsRO / PerfO instrument support
- Pre-built diary templates + form builder for custom protocols
- 120+ language delivery, BYOD or provisioned devices
- UI-driven multi-tenant rollout (US/NA, EU, LATAM, APAC, MENA)
Engagement before patients drift. Built into the platform — not a separate product to license.
- Smart push notifications & configurable reminders
- Adaptive UX that responds to completion patterns
- Multimedia guidance (video, audio, visual prompts)
- Patient app with centralized "For You" task view
- Multilingual prompts in the patient's preferred language
When tech engagement isn't enough — humans recover the patient before data goes missing.
- 120+ languages of trained human concierge
- Documented <24h response windows
- Watch-level alerts triaged before they reach sites
- Caregiver support for rare-disease & pediatric trials
- Device troubleshooting, re-engagement, escalation
Why this combination works: Configurable software alone produces blank forms patients ignore. Engagement alerts alone produce notification fatigue. Human concierge alone is expensive and doesn't scale. The three together, operating on one validated wearable platform, are what produce 92–98% completion in real studies. Every other vendor in this comparison provides one or two of these layers — not three.
Two different bets
Legacy enterprise eCOA with rater services, or modern compliance operating system?
Both platforms can run a regulated trial. The difference is how the platforms were built. Signant assembled its product from Bracket and CRF Health (2018 merger) with deep rater training and instrument library DNA. Delve was built from day one around compliance, retention, and modern wearable engineering.
Two operating models
- Signant's strength: SmartSignals Unified Platform (eCOA, EDC/DDC, eConsent, RTSM/IRT, TeleVisits), deep CNS/psychiatry rater training pedigree, 25+ years of Bracket + CRF Health heritage. 600+ sponsors and CROs including all Top 20 pharma. CEO Roger Smith (since 2020, ex-PPD).
- Signant's 2026 move: On May 14, 2026 closed acquisition of Ametris (formerly ActiGraph) to bring validated wearable-derived digital outcome measures in-house. The pitch: “end-to-end eCOA + digital outcomes platform.” The integration is brand new (weeks old) and unproven — treat the unified pitch as a 12–18 month roadmap, not a shipping product.
- Delve's strength: 70+ validated wearable algorithms on a harmonized clinical data layer (operating today, not roadmap), plus Concierge-as-a-Service in 120+ languages — both owned as platform-delivered compliance and retention outcomes.
- Delve's commitment: 92–98% per-study completion ranges and up to 63% retention uplift, documented per study.
- Signant just bought into the wearable space this month; Delve has been operating there for years. For trials that need wearable depth today — not on a future integration roadmap — that maturity matters.
Delve-documented eCOA/ePRO completion range, per study.
Up to 63% retention uplift in long-duration cohorts (Delve).
Validated digital-endpoint algorithms across 25+ wearables.
Languages of human concierge, built into the platform.
Where the two platforms genuinely overlap
At the feature checklist level, Signant Health and Delve Health each support eCOA, ePRO, eConsent, and analytics. Both can run regulated trials with strong CNS/rater context. Both platforms ship:
- Digital informed consent (eConsent) with multimedia and audit trail
- Electronic Clinical Outcome Assessment (eCOA) and patient-reported outcomes (ePRO)
- Wearable and digital health technology integration
- Real-time analytics dashboards for study oversight
- Decentralized and hybrid trial design support
- Full compliance posture: HIPAA, GDPR, 21 CFR Part 11, ICH GCP, ISO 27001
The differences show up only once you ask what happens when compliance starts to drift, when a wearable produces unusable data, or when sites need relief.
Side-by-side comparison
Signant Health vs Delve Health: capability comparison
The table below reflects publicly documented capabilities and standard delivery models for each platform. Specific configurations may vary by contract.
| Capability | Signant Health | Delve Health |
|---|---|---|
| Outcomes — where studies live or die | ||
| Per-study completion rate accountability | Customer-driven | 92–98% documented per study |
| Retention uplift target | Customer-driven | Up to 63% in long-duration cohorts |
| Validated digital-endpoint algorithms | Strong COA library; thin wearable algos | 70+ wearable algorithms across ECG, glucose, activity, sleep, frequency & QC |
| Real-time compliance scoring | Weekly monitoring reports | 7-dimension hourly readiness + closed-loop recovery |
| Human concierge patient support | Professional services arm | Built into platform — 120+ languages, <24h response windows |
| Wearable device support | Partner-driven, limited devices | 25+ devices on harmonized clinical data layer |
| Site burden reduction | Site portal + clinical services | Concierge triages alerts before sites see them |
| Architecture & speed to launch globally | ||
| Multi-region tenant rollout | Enterprise per-region procurement & provisioning | UI-driven multi-tenant — spin up region-aware tenants (US/NA, EU, LATAM, APAC, MENA) without IT tickets or per-region procurement |
| Diary & eCOA template library | Deep PRO/ClinRO instrument library (instruments, not diary templates) | Pre-built diary templates for rapid eCOA build, plus configurable form builder for custom protocols |
| Self-serve admin platform | Vendor-administered, ticket-based for changes | Admin UI for tenant management, user roles, audit log, diary template library |
| API & EDC / analytics integration | SmartSignals platform integrations; API access primarily within Signant stack | Endpoint APIs with lineage — REST pull + webhook push + batch + CDISC packages + Parquet, with versioned contracts, provenance, audit trail and direct EDC delivery |
| Built-in audit log accessible to sponsors | Available on request from vendor | Live admin UI — sponsors and CROs can self-audit |
| Legacy eCOA core — where Signant focuses | ||
| Validated COA library (PRO/ClinRO/ObsRO/PerfO) | Yes — deep instrument library | Yes — validated instrument library |
| Rater training and certification services | Yes — established services line | Available via partner |
| CNS / oncology specialty depth | Yes — pharma trust | Yes — modern CNS / oncology operating model |
| Shared baseline | ||
| eCOA / ePRO platform | Yes | Fully configurable eCOA — adaptive UX, branching logic, multimedia, 120+ languages, validated PRO/ClinRO/ObsRO/PerfO instruments, version control without engineering tickets |
| Patient engagement model | Reminders + rater-mediated workflows; concierge via professional services | Multi-layered — smart reminders + adaptive UX + multimedia guidance + multilingual prompts + human concierge in 120+ languages when tech isn't enough |
| eConsent | Yes | Yes — multimedia with audit trail |
| Telehealth & video visits | Partner integration | Yes — built into platform |
| Compliance posture (HIPAA, GDPR, 21 CFR Part 11, ICH GCP, ISO 27001) | Yes | Yes |
| Engagement model | ||
| Pricing model | Enterprise license + rater services + professional services | Outcomes-scoped integrated engagement |
| Accountability for outcomes | Customer's clin ops team + Signant services | Delve owns drift recovery between visits |
| Strongest fit | Traditional CNS/oncology Phase III with rater-training requirements | Wearable-heavy, long-duration, hybrid-trial, or compliance-critical studies |
Why outcomes-grade studies pick Delve over Signant
Four reasons sponsors pick Delve when their trial is wearable-heavy, multilingual, or compliance-fragile — where rater training and legacy COA library aren't the binding constraint.
Completion guaranteed, not hoped for
Delve publishes documented 92–98% per-study eCOA/ePRO completion ranges as a platform deliverable. Signant Health provides tools; the customer's clinical operations team owns the completion number. Different accountability models.
Your algorithm, not the device's
70+ validated digital-endpoint algorithms across ECG, glucose, activity, sleep, frequency, and QC — running on Delve's harmonized data layer, not consumer-grade vendor SDKs. Endpoint integrity is engineered, not assumed.
Humans recover patients. Period.
Patient drift gets recovered by trained humans in 120+ languages, not chatbots. AI agents handle internal paperwork well; they don't solve a caregiver in a rare-disease trial who's burned out, or a non-native speaker confused by an ePRO prompt.
Hourly readiness, not weekly reports
7-dimension compliance scoring updated every hour. Signant's monitoring reports surface after the fact; Delve's readiness scoring is designed to recover drifting patients before data goes missing.
1. Human concierge vs. customer-driven recovery
Signant Health delivers patient-facing support through its software platform plus (where needed) professional services or partners. Multilingual outreach, proactive compliance follow-up, and real-time recovery operations are typically handled by the sponsor's clinical operations team or contracted vendors.
Delve includes Concierge-as-a-Service as a built-in platform layer, with humans operating in 120+ languages, with documented response windows and escalation rules. The model targets the compliance loss that happens between visits — missed diaries, device confusion, wear-time decay — through trained humans, not chatbots.
Why it matters: in real-world studies, the majority of compliance loss does not show up in monitoring reports — it shows up in patient confusion, missed reminders, and device issues that need human follow-through. Whoever owns that follow-through determines completion rates.
2. Wearable platform depth
Signant Health integrates with selected wearables and relies more heavily on vendor-supplied metrics. Delve runs 70+ validated digital-endpoint algorithms across 25+ supported devices on a harmonized clinical data layer that normalizes units, sampling rates, time bases, QC flags, and algorithm versions.
The data-layer engineering is the part most evaluators miss. Two vendors can both “support wearables” and have very different validation evidence behind the data each platform produces.
Why it matters: for wearable-heavy studies, endpoint integrity depends on more than just data ingestion. Validation evidence is part of the submission package.
Which platform fits your study
Choose the platform that fits your operating model
Both platforms run modern clinical trials successfully. The right answer depends on your study profile and your internal operating model.
Choose Signant Health if…
- Your protocol explicitly requires vendor-administered rater training and certification for psychometric instruments (typical for many CNS / psychiatry / pain Phase III)
- You need Signant's Bracket / CRF Health legacy pedigree as a vendor-selection requirement
- You can wait 12–18 months for Signant's Ametris/ActiGraph wearable integration to ship and mature
- You can absorb the operational risk of betting on a brand-new wearable acquisition for a regulated study
Choose Delve Health if…
- You're launching a multi-region study and need self-serve UI-driven tenant rollout (US/NA, EU, LATAM, APAC, MENA) without per-region procurement, IT tickets, or pre-built validated diary templates available on day one
- Your protocol doesn't mandate vendor-administered rater services — eCOA, ePRO, wearables, and analytics are the deliverable
- You want the same configurable eCOA Signant offers, plus 70+ validated wearable algorithms operating today, not on a roadmap
- You need multilingual human concierge in 120+ languages built into the platform
- You want documented per-study completion (92–98%) and retention uplift (up to 63%) in your scope
- Your study needs proven wearable depth today — not a 12–18 month integration of a 2-week-old acquisition
- Your compliance loss happens through patient drift between visits
Frequently asked questions
Questions sponsors ask when comparing Signant Health and Delve Health
These answers clarify the operational differences and how to evaluate them for your protocol.
How is Delve Health different from Signant Health?
Signant Health was formed from the 2018 Bracket + CRF Health merger, assembling legacy enterprise eCOA / ePRO with a deep PRO instrument library and rater training services — particularly trusted in CNS and oncology Phase III. Delve Health is a modern operating system built around compliance and retention: 70+ validated wearable endpoint algorithms, 7-dimension real-time compliance scoring, and Concierge-as-a-Service in 120+ languages. The decision usually comes down to: traditional eCOA pedigree with rater services, or modern wearable + compliance operating model with documented outcomes.
Is Signant better for CNS or oncology trials?
Signant has well-respected CNS and oncology Phase III experience through its Bracket heritage, with strong rater training services. Delve also has deep CNS and oncology expertise (see our cardiology digital endpoints, CNS digital endpoints, oncology eCOA articles) — built around modern operating realities: wearable endpoints, multilingual concierge, and documented per-study completion outcomes. The question is whether your bottleneck is rater quality or patient retention.
Does Signant have wearable platform depth?
Until the May 14, 2026 Ametris (formerly ActiGraph) acquisition closed, Signant did not own a validated wearable stack — wearable integration was via partners. The combined product is brand new and unproven; sponsors should treat the "integrated" pitch as a 12–18 month roadmap. Delve runs 70+ validated digital-endpoint algorithms across 25+ wearable devices on a harmonized clinical data layer, operating today.
Does Signant include human concierge like Delve?
Signant delivers patient support through its professional services arm, typically billed separately. Delve includes Concierge-as-a-Service in 120+ languages as a built-in platform layer with documented response windows and escalation rules, and is responsible for compliance recovery as a platform outcome.
How do pricing models compare?
Signant typically prices as enterprise license + rater services + professional services billing common to legacy eCOA vendors. Delve prices as an integrated outcomes-scoped engagement where eCOA, wearables, analytics, and concierge support are scoped against the trial's compliance and retention outcomes.
When should I choose Signant over Delve Health?
Choose Signant when the priority is a traditional CNS or oncology Phase III with deep PRO instrument library, rater training services, and you have internal clinical operations capacity to drive compliance recovery. Choose Delve when the priority is wearable endpoint integrity, multilingual concierge, real-time compliance scoring, and documented platform-owned completion and retention outcomes.
Related learning
Build a complete picture before you commit
Knowledge pages that help sponsors evaluating eCOA, DCT, and wearable platforms understand what separates execution-grade vendors from platforms that look good in demos.
How to choose an eCOA vendor
Evaluation criteria beyond software — execution, support, compliance, site impact.
Read the guide →eCOA Vendor Comparison framework
Dimensions that predict study performance — used to compare any pair of platforms.
Open the framework →Why eCOA data fails in real-world trials
Missed diaries, patient drift, fragmented systems — hidden failure modes and what fixes them.
Read more →How to measure compliance in clinical trials
A practical, vendor-neutral framework for measuring compliance across modalities.
Read more →Evaluating Delve against your current stack?
If you are comparing Signant Health, Delve, or other DCT/eCOA platforms, ask each vendor one question: what happens when a participant stops responding? The answer tells you more than any demo.
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