The concept of the internet of Healthcare things (IoHT) is gaining momentum among patients and healthcare organizations. mHealth technologies can measure a multitude of physiological signals, facilitating the capture of data from patients as they go about their daily lives and currently used to monitor patients outside of traditional hospital settings. The impact of the data captured in real life scenarios also has significant value in clinical trials with the potential to transform the current trial design. The digital approach has a number of potential benefits including a more patient focused trial design with a positive impact on recruitment and retention. However the real value of this approach is in the granularity of the signal which could be used to generate new composite endpoints from multiple sensors and could evolve to become disease and population specific digital biomarkers with the potential to map specific populations and responses to drugs. Transforming how we conduct trials in the future.