Providing annual reviews on IDMP progress has proved painful in recent years because momentum has not always been where it should be, due to shifting timescales and fluctuating focus and alignment among the various stakeholders. While 2019 saw a crystallisation of ideas about what needs to happen next, Frits Stulp at Iperion Life Sciences Consultancy calls for focus and mutual support during what will be a critical year for the regulatory network’s improved patient safety initiatives in 2020.