Project Summary The Upper Midwest Regional Coordinating Center (RCC), previously the University of Minnesota (UMN) RCC, is an established, high-performance RCC within Stroke Net. The pillars of the Upper Midwest Stroke Net RCC are: 1) unparalleled expertise in clinical trial conduct with a track record of high enrollment, most notably in complex time-sensitive acute stroke trials, 2) close collaboration with robust stroke care systems in the upper Midwest led by our colleagues and former trainees, and 3) direct integration with physician-scientist training programs. The Upper Midwest RCC comprises 12 sites with large urban and rural catchment areas throughout Minnesota and neighboring states. Our leadership is uniquely qualified, complementary, and aligned with Stroke Net aims. Dr. Streib (PI), the Cerebrovascular Director at M Health-Fairview (MHFV), developed a centralized internal stroke research network across MHFV hospitals. Within this network we are driving clinical research innovation: ~50% of our acute stroke trial participants are enrolled utilizing “remote research” in which the subject is not physically in the same location as the clinical and research teams. Remote research expands access to clinical trials more equitably thereby reaching diverse, underrepresented populations in clinical trials. Dr. Lakshminarayan (PI, Career Enhancement Director) directs the Clinical Research Training Program in the nationally-ranked UMN School of Public Health. She is an NIH-funded investigator whose research deliberately involves low-resource health systems, including federally qualified health centers, in order to ensure recruitment of under-represented minorities. Ms. Staugaitis' accumulated experience as project manager for Stroke Net, Strategies to Innovate Emergency Care Clinical Trials Network (SIREN), and essential multicenter COVID trials has been critical to operationalizing practical, efficient, and effective clinical research workflows. M-Health Fairview sites are top enrollers in multiple StrokeNet (MOST, ARCADIA, and CAPTIVA), NIH (PRECISE), and industry stroke trials (TIMELESS). Study aims are: 1) Continue as a leading RCC within StrokeNet through sustained high-volume recruitment and support and mentorship of our satellite sites. 2) Further study, develop, and implement standardized remote research capability throughout MHFV and StrokeNet in order to increase equitable access to clinical trials, promote diversity, and improve the generalizability of StrokeNet clinical trial results. 3) Leverage the resources of the UMN CTSI and School of Public Health and the StrokeNet to mentor exceptional physician scientists who will develop and conduct future stroke trials. In the next grant cycle, our RCC will remain a vital contributor to StrokeNet through continued high-volume recruitment, the further development, modernization and dissemination of best-practice clinical trial workflows, and strong commitment to educating the next generation ...