Over the recent decade, there has been great emphasis on improving quality of care and health outcomes, as well as speeding bench-to-bedside medical product development and translation with knowledge generated from clinical trials.1 However, burgeoning costs, lengthy research timelines, and low and slow uptake of findings have continued to undermine impact and hamper more rapid improvement of US patient health outcomes.2 Thus, the clinical research enterprise, including cardiology leadership, has taken a hard look at its successes, failures, and use of finite resources through numerous public workshops, consortia activities, and portfolio reviews that have identified barriers to research and translation and sought to better understand stakeholder needs and opportunities to maximize their contributions and optimize clinical trials.1-4