Three different definitions for e-Clinical trials chart the industry's progress with e-Clinical systems in clinical trials; from the first initial stage involving the replacement of standalone paper based technologies, to the simple integration of two or more e-Clinical systems, and finally on to a future vision where an e-Clinical 'SAP for Clinical trials' changes the face of pharmaceutical Research and Development. At each stage the business drivers pushing the industry forwards with e-Clinical trials are discussed along with some typical examples, and the advantages gained by introducing the technology. Finally, current industry trends are examined that indicate movement and support for a fully integrated, paperless e-Clinical 'SAP' environment.: