--- title: "Clinical Site Monitoring Workflow With AI Agents | Kylon" description: "How a site monitoring desk runs dispositions, monitor assignments, schedule reviews and close-out in one Kylon room, with every assignment approved by a person." url: "https://kylon.io/use-cases/clinical-site-monitoring" language: "en" --- [HOME](https://kylon.io/)\>[Use Cases](https://kylon.io/use-cases)\>Clinical Site Monitoring: A Monthly Visit Plan That Holds Up When Things Change Use Case7 min read # Clinical Site Monitoring: A Monthly Visit Plan That Holds Up When Things Change Site dispositions, monitor assignments, schedule reviews and mid-cycle changes run through one Kylon room. Agents work the Salesforce and Box records, and the desk lead approves every assignment before a visit is booked. [Get started](https://app.kylon.io/sign-up) Kylon TeamProduct November 6, 2026 ## Two dozen sites, a few monitors and a plan that changes every week A monitoring cycle starts as a tidy rule set. Each active site is due a visit on an interval set by its risk band, a critical deviation pulls a visit forward, a suspended site comes off the list, and every monitor has a capacity for the month. Applying those rules to two dozen sites is a morning's work. Keeping the plan right for the rest of the month is the hard part. The site records sit in Salesforce, deviation reports arrive in Box, visits live on monitors' calendars, and the coordinator's draft schedule is a spreadsheet that drifts from all three. When a monitor goes on leave or regulatory affairs shortens an interval, someone re-derives the plan by hand and hopes nothing was missed. ## Who works in the room People - Monitoring desk lead Owns the cycle plan, approves every assignment and signs the close-out - Clinical research associates Run the site visits, confirm dates and report back from each site - Regulatory affairs Issues interval amendments and confirms how each one applies Agents - NovaCycle coordinator Reads every in-scope site record and deviation report, proposes each disposition and monitor, and books visits once they are approved SalesforceBoxGoogle Calendar - AdaSchedule checker Checks the coordinator's draft schedule line by line against the approved plan and lists every line that disagrees Google DriveSalesforce - FinSite correspondence Drafts visit confirmations and change notices for a person to send [Gmail](https://kylon.io/integrations/gmail) [Slack](https://kylon.io/integrations/slack) The desk keeps one Kylon room per protocol. A message that names no agent goes to the one whose specialty fits, so a question about a site's disposition reaches Nova and a question about the draft schedule reaches Ada. When Nova finishes a re-plan, it hands the changed visits to Fin in the same thread with the brief already written. ## One cycle, start to close The rules live in a document in the cycle folder and in the room guidelines, so every agent applies the same version. The cycle runs in a fixed order, and each step stops at a person. ```mermaid flowchart TD sites([Site records in Salesforce,
deviation reports in Box]) alloc["Nova proposes each disposition
and a monitor within capacity"] approve["Monitoring desk lead approves
before any visit is booked"] draft["Ada checks the draft schedule
line by line against the plan"] fix["Coordinator corrects it,
desk lead confirms"] change([A message reports a deviation,
a suspension or a monitor's leave]) amend([Regulatory affairs
amends an interval]) rerun["Nova re-runs only the
sites the message touches"] recheck["Nova re-checks sites not yet
due under the amended table"] notices["Fin drafts the change notices
for a person to send"] reg["Regulatory affairs confirms
the reading of the amendment"] okchange["Monitoring desk lead approves,
monitors confirm dates"] closeout["Nova tallies totals per region
and monitor from current records"] sign["Monitoring desk lead signs
the close-out records"] sites --> alloc --> approve --> draft --> fix fix --> rerun & recheck change --> rerun --> notices --> okchange amend --> recheck --> reg okchange & reg --> closeout --> sign class alloc,draft,rerun,recheck,notices,closeout agent class approve,fix,reg,okchange,sign person class sites,change,amend event classDef agent fill:#FFFFFF,stroke:#DCD3C8,color:#1B1712 classDef person fill:#EEF0E3,stroke:#6E7447,color:#1B1712 classDef event fill:#F4ECDD,stroke:#F4ECDD,color:#564C42 ``` | Stage | What happens | Who acts | Who decides | | --- | --- | --- | --- | | Initial allocation | Every in-scope site gets a disposition and, if a visit is due, a monitor within regional capacity | Nova, from Salesforce site records and Box deviation reports | The desk lead approves before any calendar event is created | | Draft schedule review | The coordinator's schedule is checked line by line against the approved plan | Ada | The coordinator corrects it and the desk lead confirms | | Site updates | A confirmed critical deviation or a suspended enrolment re-runs only the affected sites | Nova | The desk lead approves the changed records | | Monitor leave | Visits on the absent monitor's list are reassigned in priority order or held | Nova, then Fin for the notices | The desk lead approves and monitors confirm dates | | Interval amendment | Sites not yet due are re-checked under the amended table | Nova | Regulatory affairs confirms the reading of the amendment | | Close-out | Totals per region and per monitor are tallied from the current records, not from memory | Nova | The desk lead signs the close-out records | Stages of a monthly monitoring cycle. Sites, monitors and dates in this example are illustrative. ## When the plan changes mid-cycle Changes arrive as messages, not as clean data. A manager writes that a monitor is out from today. A site's deviation is confirmed before Box has synced it. Nova treats the message as the source for that change, re-evaluates only the sites it touches, and writes a short note on each record saying why it moved. That scope matters. A full re-plan would quietly move visits that were already confirmed with sites. Re-running only the affected sites keeps every other booking stable, and the thread shows exactly which records changed and on whose instruction. ## What the checks catch - A site that is suspended in practice but still active in Salesforce, because the status field has not been updated yet - A deviation report closed this week, which changes the site's deviation rate and may cancel a visit - A draft schedule line that gives a visit to a monitor who is already at capacity - Held sites that should be offered to a newly added contractor monitor before anything else is rebooked ## What stays with people - Approving each disposition and assignment before a visit is booked - Pressing Send on every notice to a site or monitor, which Fin prepares as a draft - Interpreting a regulatory amendment where the wording leaves room for doubt - Signing the cycle close-out ## Integrations in this workflow Kylon is not a trial management system and it does not replace one. It sits across the tools the desk already uses and holds the coordination between them. - Salesforce - Box - Google Calendar - [Gmail](https://kylon.io/integrations/gmail) - [Slack](https://kylon.io/integrations/slack) - Google Drive - **Salesforce** holds the site records, the monitor roster and the close-out records - **Box** holds deviation reports and site notices - **Google Calendar** carries each confirmed visit - **Gmail** sends confirmations and change notices after a person approves the draft - **Slack** is where site staff and monitors outside the room post quick updates - **Google Drive** keeps the cycle folder with the rules and the interval table ## Where to start Take one protocol and one month. Connect the Salesforce object that holds your sites, point the room at the Box folder where deviation reports land, and write the one rule that matters in the room guidelines: an agent may propose dispositions and assignments, and the desk lead approves every one before a visit is booked. > “The rules did not change. What changed is that every update now re-runs only the sites it touches, and nobody rebuilds the month from scratch.” ## Set it up with your agent Open a new Room, add your agent and paste this prompt. It connects the tools, builds the App with you and asks for your rules one step at a time, and nothing goes out until a person approves it. Set-up prompt Set up our clinical site monitoring desk in this Room. Take it one step at a time and wait for my OK before you move on. 1. Connect Salesforce, Box, Google Calendar, Gmail, Slack and Google Drive. Tell me which ones still need connecting. 2. Ask me who works this desk: the monitoring desk lead, the clinical research associates who run the site visits, and the regulatory affairs contact who handles interval amendments. Help me invite them to this Room. 3. Build a Site Monitoring App with Site, Monitor, Visit and Status columns, one record per site. Pull the in-scope site records from Salesforce and flag any deviation reports waiting in Box. 4. Read each site record and deviation report, propose a disposition and monitor for every site within regional capacity, and list every line where the draft schedule disagrees with the approved plan or where a monitor is already at capacity. 5. Draft visit confirmations and change notices for Gmail and Slack. Hold every draft until the desk lead approves each assignment, and do not create any calendar event or update any Salesforce record before that approval. 6. Write our rules and who approves what into this Room's guideline, so every cycle step follows the same version. 7. After one clean cycle, offer to turn the monthly allocation run into an Automation. Before you start, ask me for our rules one at a time. [Get started](https://app.kylon.io/sign-up) Your first company harness. Where humans and agents run your business together. [Get started](https://app.kylon.io/sign-up) ## More Use Cases [View all](https://kylon.io/use-cases) [ ### Cold Chain Excursion Review: Every Shipment Dispositioned Against Its Stability Budget Logger files, stability budgets, QA reviewer assignments and carrier claims run through one Kylon room. Agents total the minutes out of range and check the manifest, and the QA lead approves every release and reject before a record changes. Healthcare & life sciencesCompliance & risk ](https://kylon.io/use-cases/cold-chain-excursions)[ ### Interpreter Scheduling: A Week of Assignments That Holds Through Sick Calls and Time Moves A week of interpreter requests is matched in policy order, checked against every calendar and kept right through sick calls, time moves and language fixes. The coordinator approves each assignment in the Kylon room before anything is booked. Healthcare & life sciencesScheduling & dispatch ](https://kylon.io/use-cases/interpreter-scheduling)