It seems that in many cases, IRB offices are struggling with processing and turnaround time of new and revised protocols. This can lead to overloaded agendas, which may not allow all IRB members enough time to review every item on the agenda prior to the IRB meetings. Jon Newlin, assistant director in the Office of the HRPP at North Shore-LIJ, explained during his presentation at the 2015 Advancing Ethical Research Conference (AER15), "Transformation to an All-Videoconference Flexible IRB Model: One Institution’s Experience," that to rectify this problem his institution consolidated their IRBs into one roster. In this process, they reduced their IRB from more than 20 voting members to nine with 60 alternates. They also eliminated their in-person meetings in favor of video conferencing. This process allowed for shorter agendas, eliminated the need for commuting to a meeting, and helped lessen the load of items to review. This restructuring also allowed the IRB to meet more often, which cuts the turnaround time in half.
I think that there is a tendency to not want to change the structure of something that has become ingrained in us. We should be looking towards new technology, like video conferencing, to help with the processing and reviewing protocols in a timely and efficient manner. The most advantageous aspect to video-conferencing for IRB meetings is, simply put, the ease of access. Members can integrate the IRB meeting into their daily work schedule without having to consider commute time and traffic reports. People who travel for their professions have an opportunity to participate remotely. Another possible advantage is having access to a larger pool of potential IRB consultants. The technology that North Shore-LIJ uses is relatively simple to operate, with 95% of their IRB members saying that it is easy to use. This technology also allows all of the members to be on one screen together, which helps maintain the feel of a meeting. Many of the problems that you might anticipate did not seem to trouble North Shore-LIJ in their transition to IRB meetings conducted via video conferencing. One might expect transitioning from many IRBs into one to present issues for current members used to the old system. The usability of the medium chosen for video conferencing can also play a role in whether or not an institution runs into transition related problems. North Shore-LIJ was able to transition to the new system relatively smoothly. After transitioning, the majority of the IRB members felt that the new system did not affect their opportunity to discuss protocols, the protection that they offer for human subjects, and overall actually preferred the new system.
While change can be trying, and navigating the unknown, especially when it comes to new technology can be a bit unnerving, maintaining an open mind towards new technology actually offers better opportunities for human subjects in research. Something like a video conference that can decrease the turnaround time on protocol review, which in turn can allow research to begin earlier and potentially begin to help subjects faster. This particular presentation was very eye-opening to many of the attendees at AER15, including myself, and gave many of us a different way of approaching IRB meetings, while maintaining the structure and process that an IRB meeting must retain.
Courtney Zwieg, regulatory coordinator at NorthShore University HealthSystem, is a member of the PRIM&R Blog Squad for the 2015 AER Conference. The PRIM&R Blog Squad is composed of PRIM&R members who blogged here, on Ampersand, to give our readers an inside peek of what happened at the conference in Boston, MA.