The U.S. Department of Health and Human Services launched SURPASS, a simulation-augmented, real-time platform for adapted seamless trials, aimed at transforming how clinical studies are designed and run. Backed by ARPA-H, the program combines predictive computational models, shared infrastructure, common control groups, and real-time analysis. HHS described SURPASS as reducing time lost to duplicated operational infrastructure and allowing teams to learn in real time and adapt when needed. The program manager said the existing trial ecosystem often forces too many stops before teams can determine whether a study is on track. Digital twins are expected to be used to test trial designs before launch, while an “inference engine” is planned to enable on-demand analysis that can reduce dependence on large conventional control groups while maintaining rigorous evidence generation.