Protected Time for Research Research Administrative Review Subgroup Ali F. Sonel, MD, FACC, FACP

VA Local Accountability Meeting January 13, 2009 Ali F. Sonel, MD How are VA investigators paid to do research? How can VA clinicians get protected time to do research? How are NIH grant budgets prepared for people who also get a salary from the VA? Managing Time for Research

VA Local Accountability Meeting January 13, 2009 Ali F. Sonel, MD How are VA investigators paid to do research on VA grants? Merit Review Awards MDs No direct salary support Need Medical Center support Non-MDs Direct salary support within grant) Career Development Awards Salary support

VA Local Accountability Meeting January 13, 2009 Ali F. Sonel, MD Managing Time for Research Non-Physicians Physicians (VHA Directive ) –Multiple roles (Direct patient care, education, research, administration) –Direct patient care pressures >>> research performance pressures? –Research is often not priority when time commitments conflict

VA Local Accountability Meeting January 13, 2009 Ali F. Sonel, MD “More than 70 percent of research investigators are also clinicians whose dual roles allow the rapid application of research results to patient care.” Source: ORD Fact Sheet, ORD Web Site

VA Local Accountability Meeting January 13, 2009 Ali F. Sonel, MD How to Fund Protected Time VERA Research Allocation –Support for salary, administrative, and facilities costs –Often the basis for requesting protected time Other MC Resources?

VA Local Accountability Meeting January 13, 2009 Ali F. Sonel, MD No dual compensation : VA and academic affiliate cannot pay for the same time For example, one cannot be the recipient of a K award, which is supposed to pay for 75% protected research time, and be 8/8ths VA. COMBINED NIH AND VA SUPPORT

VA Local Accountability Meeting January 13, 2009 Ali F. Sonel, MD VERA Research dollarsNIH indirect dollars Based on grant expenditures Same using VA as performance site Based on data from 2 yrs agoCurrent year Must cover salaries + F&ACovers F&A only Rate = 43.3%Rate = 50% Based on discounted % Based on full amount of grant expenditures VERA RESEARCH DOLLARS vs. NIH INDIRECT DOLLARS

VA Local Accountability Meeting January 13, 2009 Ali F. Sonel, MD VA grant:$100,000 x 100% x 43.3% = $43,300 NIH grant:$100,000 x 75% x 43.3% = $32,475 Industry:$100,000 x 25% x 43.3% = $10,833 How much salary is covered by VERA $? Maximum Salary Allocation VERA $ rate Discount rate

VA Local Accountability Meeting January 13, 2009 Ali F. Sonel, MD No firm guidance or policy for protected time Allocation by Department/Service Line –ACOS/R&D often not consulted Funding often not transparent VERA dollars may be insufficient to fund adequate time ACOS/R&D, investigators often unaware of the VERA funds generated per investigator Lack of uniform implementation in special circumstances –Junior investigators –Bridging Implementation Challenges

VA Local Accountability Meeting January 13, 2009 Ali F. Sonel, MD RESEARCH ADMINISTRATIVE REVIEW 1.Governance (Randy Petzel) 2.Human Capital (Jack Hetrick, MEd) i.Organization of Research Subgroup  Lead: Peggy Hannon ii.Recruitment and Retention Subgroup  Lead: John Vara, MD iii.Protected Time Subgroup  Lead: Ali Sonel, MD

VA Local Accountability Meeting January 13, 2009 Ali F. Sonel, MD Protected Time Subgroup: Members  Ali Sonel, MD (ACOS/R&D, Pittsburgh)  Ralph Gigliotti, FACHE (MCD, Durham)  Martin Heyworth, MD (COS, Philadelphia)  Laurence Meyer, MD, PhD (ACOS/R&D, Salt Lake City)  Dean Norman, MD (COS, Los Angeles)  Bruce Sangeorzan, MD (Orthopedic Surgeon, Seattle)

VA Local Accountability Meeting January 13, 2009 Ali F. Sonel, MD Managing Time for Research: Needs Identified by RAR Group What practices would be useful in managing time for research efforts? Need concrete formula for linking research time to performance measures and formula for tracking VERA dollars to justify time spent in research Need statement that VERA dollars can be used for research Need guidelines that allow administrators to backfill positions based on number of VERA dollars coming in Need enhanced use of study coordinators and other types of support staff to reduce researcher burden Need examples of good practices for effective time management

VA Local Accountability Meeting January 13, 2009 Ali F. Sonel, MD Performance Measures Initially Proposed by the RAR Group Purpose of any measure is to track and improve research success, including productivity and compliance/integrity Proposed 5 categories of measures: Content of research Alignment with VHA research goals Human capital – Support for ACOSs, investigators, protected time, release time Infrastructure : Adequacy of research infrastructure Resources: Expenditure of VERA dollars and other funds Compliance: Minimum necessary compliance processes and staffing

VA Local Accountability Meeting January 13, 2009 Ali F. Sonel, MD Possible Solutions Transparency of research VERA funds VERA calculations reevaluated –VA vs. NIH expenditures –Monitoring/Auditing of RDIS reports Monitoring of protected time –ACOS/R&D –R&D Committee Protected time as a performance measure Guideline vs. Handbook for protected time for research Explore changes to regulations prohibiting MD salary support for VA research awards

VA Local Accountability Meeting January 13, 2009 Ali F. Sonel, MD Protected Time Allocation: Sample ActivityFTEE PI Merit Review3/8 Chair on VA CSP4/8 Site PI on Merit/VA CSP1/8 PI NIH RO13/8 CDA6/8 Major Foundation Awards1/8-2/8

VA Local Accountability Meeting January 13, 2009 Ali F. Sonel, MD Protected Time Allocation: Sample ActivityFTEE Funded, non-peer reviewed0.5/8 - 1/8 Chair of VA Center4/8 - 6/8 Mentor of VA CDA0.5/8 New investigator (3 years)1/8-2/8 Bridge (2 years)1/8-2/8

VA Local Accountability Meeting January 13, 2009 Ali F. Sonel, MD Protected Time Allocation: Sample ActivityFTEE Chair, IRB/IACUC2/8-4/8 Member IRB/IACUC1/8 Chair, R&DC1/8 Member, R&DC0.5/8 Chair IBC/SRS1/8 Member IBC/SRS0.5/8

VA Local Accountability Meeting January 13, 2009 Ali F. Sonel, MD QUESTIONS?COMMENTS?