Transformation to an All-Videoconference Flexible IRB Model: One Institution’s Experience


Abstract Description 
In December 2013, the HRPP at our Health System evaluated its local IRB committee structure. While the structure had worked effectively for decades, an increasing research portfolio was pressing for change. At the time, the structure included: large agendas; multiple IRB committees at different physical locations (some generalist committees, others restricted to reviewing research at their site); and each meeting monthly, in-person, with 20+ members in attendance. This resulted in several disadvantages: long wait times before studies reached an agenda; agendas too long for members to reasonably review each item prior to a meeting; extended meeting length; exclusion of institutions from sending members to the IRB because of commute time; and slow turnaround times. 

The decision was made to restructure the local IRB system, starting July 2014. The new system consists of:  (1) “Flexible” IRB model, with all members listed on one roster with the Office for Human Research Protections; (2) Four small IRB committees, each meeting on a bi-weekly basis; (3) Each committee is a generalist committee, reviewing research from any health system site; (4) All meetings held via videoconference; (5) Committees include persons from any Health System institution (not just those who live close to the IRB office); (6) Each IRB meeting attended by seven to 15 persons; (7) No submission deadlines; submissions go to a meeting within 14 days of receipt; (8) Agendas limited to no more than five items; and (9) IRB meeting limited to 60 minutes.

As a result, full board new study turnaround times have been drastically reduced (halved, from an average of 113.5 calendar days in 2013, to 48.9 days between September 1, 2014 and April 20, 2015), meeting length shortened, and regulatory compliance enhanced, as members can now be familiar with all items on the shorter agendas. The videoconference method is well tolerated, with members able to participate from anywhere. Ad hoc meetings are simple to arrange, providing flexibility to handle urgent issues (i.e., Ebola treatment protocol).

In a survey of IRB members at 90 days post-transformation, 68% of members (n=24) found the new system more efficient than the old, in person meetings. Eighty-four percent of members (n=37) thought the new system offered the same level of protection of human subjects as the old system. Sixty-one percent of members (n=27) thought the system offered better or equivalent opportunity for discussion, compared to in-person meetings. When asked which system the members preferred overall, only 30% (n=14) preferred the old system. In regards to the use of videoconferencing, 95% of members (n=41) found it easy to use, 84% (n=37) found the video quality good, and 80% (n=35) felt the audio (sound) quality was good.

At this point, the restructuring is considered a success, and is expected to be maintained into the foreseeable future. No member has yet asked IRB staff to return to the old, in-person meeting structure. 

As health systems continue to add new institutions through mergers and acquisitions, the flexible videoconference IRB model easily adapts to new members; or even the creation of new committees. It is a strongly viable alternative to physical location-based in-person meetings, and offers an effective solution for organizations with multiple facilities, and IRB members whose schedules cannot allow for long commutes or extended meetings.