Speeding the Way to an NIH Grant

By Maya Hadar and John McGowan
February 8, 1999

For decades, scientists accepted the yearlong wait to get a grant from the National Institutes of Health (NIH). They figured it was the price to pay for being sure their application got a thorough peer review, the basis for determining who gets funded.

But at the close of the 20th century, waiting a year to get a government grant seems as dated as car fins.

So, when Vice President Al Gore made NIH a reinvention lab, NIH began thinking about renovating its business practices, especially harnessing the power of electronic data transfer. Building an electronic grants application system is part of the Vice President's vision of electronic government in his report, Access America: Reengineering Through Information Technology.

"We are charting new waters for expediting the award process, while giving scientists better ways to respond quickly to new research opportunities to cure and prevent disease," says Dr. John J. McGowan, director of the Division of Extramural Activities of the National Institute of Allergy and Infectious Diseases (NIAID, one of 18 NIH institutes).

During the past three years, Dr. McGowan led the development of groundbreaking electronic systems that are revamping NIH operations. These systems tie into NIH's goal to fully automate grants administration. Ultimately, all functions involved -- from a scientist's sending NIH a grant or contract application to peer review to the issuance of an award and then post-award activities -- will be performed electronically.

Though this enormous undertaking will take several years to fully implement, glimmers of progress are coming to light. NIAID built three unique systems using Internet-based technology that will merge with NIH efforts to create fully electronic commerce. These systems have slashed the grant application process to four to five months for the highest quality grants. Further innovations promise a three-month cycle, a 75 percent reduction from the old ways of doing business.

Due to NIAID's innovations, a totally paperless acquisition system has completely revamped contracting processes. The Web-based Contract Review Online (CRON) houses the full spectrum of contracting activities -- publishing requests for proposals (RFP), proposal submission by offerors, and peer review and award, all done over the Internet. CRON saves NIAID tens of thousands of dollars for each RFP and eliminates the cost of mailing in proposals for offerors.

Nonetheless, with grants representing the vast majority of NIH awards, hastening grant application presents a much a bigger and more significant challenge. For example, the agency's central receipt office labors under the weight of 30,000 applications a year, scanning each one for scientific area before forwarding it to the appropriate Institute and review group. Automating such functions is no small feat.

Still, the push to go online is moving forward because the benefits are sparkling clear. NIAID's systems have proven that doing business online only saves time but actually enhances the peer review function. In fact, everyone involved in review -- applicants, reviewers, and NIH staff -- seems to like the approach. Staff efficiency goes up, and, even more important, NIH better serves its extramural research community, the scientists in research institutions around the country funded by NIH.

"The flexibility of the Web-based systems lets us bring people into peer review we would otherwise miss. Because travel is often eliminated, busy clinicians can now participate on review committees, whereas before they simply couldn't afford the time," notes Dr. McGowan.

Beginning with Peer Review

Though ripe for streamlining, peer review is, in NIH culture, nothing less than a sacred cow. Its outcome makes or breaks careers, potentially affecting scientific progress. So it's understandable that the agency goes the extra mile to ensure that applications get a truly high-quality and fair review.

NIH's two-tiered peer review process begins with an assessment by an applicant's scientific peers. For grants, this is generally done by standing committees of experts in various scientific disciplines. They meet three times a year in the Bethesda, Maryland, area to judge an application's scientific merit and assign it a numerical score.

For the second level review, applications are approved (or not approved) for funding by an institute's advisory Council, as is mandated by law. Councils also meet in Bethesda, usually three times a year but not necessarily in sync with review meetings. Contracts follow a similar, two-step approach (with some procedural differences).

While the much acclaimed system is thorough and effective, it is also replete with inefficiencies: a central receipt point in NIH processes all incoming applications, makes paper copies, and sends them to Institutes and reviewers; applicants wait for a review meeting to occur and then paper notification of its outcome; Institutes mail applications and review outcomes to Council members; and applicants who made it through the first level peer review must then wait for a Council meeting before they can be awarded their grant or contract.

Altogether, these delays drag out the time to award to a full year.

NIAID's Web-based systems streamline this process by automating three broad functions: initial peer review of grants, the entire contract application process, and Council approval. Over the Internet, reviewers and Council members complete all tasks needed to move applications to the next stage, resulting in earlier awards.

Information Sharing, Secure Systems

"Internet-based systems can house and transmit all information necessary for application review and approval while providing the security that is absolutely essential for this type of operation," says Mr. Alexander I. Rosenthal, who is in charge of the Management Information Systems Branch of NIAID.

All three systems share key features: user access to NIAID's secure servers, enhanced information exchange by enabling users to view each others' actions, and online discussion.

They are designed with a premium on user friendliness: reviewers and Council members access NIAID's resources through their own computers, at their own convenience, and at little or no cost to them. To make the systems virtually painless, NIAID trained staff, made help available to users at all times, and modified the programs based on user feedback.

Mr. Rosenthal and his staff designed the electronic systems in-house using the latest, most advanced commercial technologies available for the World Wide Web. Though it took several years and major releases to get to the present stage, ultimately, they created a system that is complex but easy to maintain, very secure but convenient to use, and flexible enough to produce a wide range of required reports.

They began with the Council Action system for Council grant approval. Like the other systems, it was designed for maximal sharing of information, but, as with the other systems, data can be accessed only when appropriate. Thus, logged-in Council members scan review scores, see whether there are any administrative problems, read each other's recommendations, and resolve issues. However, until the week before the meeting, each member can only access applications assigned to him or her, thus keeping the spirit of an initial individual assessment characteristic of traditional NIH peer review.

With Council Action, the NIH community quickly saw the benefits of conducting business electronically.

"Council members used to wait as long as three months for a Council meeting to get their grants," noted Dr. McGowan. "Now, they get immediate access to information from initial review. Our high-quality applications are processed for funding in weeks or even months faster."

Electronic methods cut workloads and costs for the government. Gone are the days when, before each Council meeting, NIAID mailed mounds of review information to Council members. The new system not only saves paper but also spreads the issuing of grant awards throughout the year, as opposed to having hundreds of grants needing to be processed immediately after each Council meeting.

Streamlined Review: Pleasing Reviewers and Grantees

Following the success of Council Action, NIAID's electronic initial peer review system emerged as an NIH-wide success. Tested at seven NIH institutes and centers during the past two years, the system is moving many review activities online. Though live review meetings may still take place, review committees are communicating a lot of information beforehand. Reviewers are pleased: more than 80 percent of those questioned told us that exchanging ideas before a meeting helps them sort out difficult points and focuses face-to-face discussions.

Dr. Judith Appleton, member of the NIH Tropical Medicine and Parasitology review committee, summed it up by saying, "I can't see going back to doing the reviews the old way."

To date, more than 2,000 grant applications have been reviewed using the electronic review system, involving 110 phone reviews or meetings and 800 reviewers, and almost 500 NIAID grantees have received their awards earlier as a result of Council Action.

Further boosting flexibility, NIAID is spearheading an NIH-wide initiative to speed up receipt to award times even further. "Hyperaccelerated" review and award trims the grant award process to just three months.

The first trial begins with a request for applications, Hyperaccelerated Award/Mechanisms in Immune Disease Trials. Begun in fall 1998, the effort is coordinated by Dr. Howard Dickler, chief of the Clinical Immunology Branch in NIAID's Division of Allergy, Immunology, and Transplantation.

The pilot inaugurates dramatic changes for NIH. Hinging on flawless coordination between reviewers and NIH staff, seamless electronic systems relay information from one organization to the next in a virtual domino effect.

Reviewers enter reviews and scores into the browser, share comments through an electronic chat room, and then discuss and vote for a score at a monthly conference call. Within the next two weeks, review results are ready, and all other administrative requirements wrapped up. Using Council Action, expedited Council review then lets NIAID send awards out just three months from the start. The first awards are being made in January following receipt of applications in October.

Moving Beyond NIH

Through collaborations with the private sector, NIAID's systems are reaching to other agencies and nongovernmental organizations. CRON is not only being tested by other Institutes but also by the Department of Health and Human Services, which is piloting it in several agencies to explore the potential of using NIAID as a service center for the Department.

NIAID is also seeking to make the technology available to any interested parties for internal use or to improve their interface with NIH.

Dr. McGowan is exploring relationships with several vendors to ensure that all parties that interact with NIH, such as universities and societies, are using the same computer systems. Toward those ends, the Institute recently has signed a letter of intent with the electronic administration and resources company RAMS-FIE for a cooperative research and development agreement. Through the CRADA, NIAID and RAMS-FIE will jointly develop software to create compatible, integrated systems for funding and executive management of grants and contracts for the government and the NIH research community.

About the Authors

Maya Hadar and John McGowan are at the National Institute of Allergy and Infectious Diseases in Bethesda, MD. Maya is Special Assistant to the Director, Division of Extramural Activities. You may reach her at 301-496-3773 or MHADAR@mercury.niaid.nih.gov. John is Director, Division of Extramural Activities. You may reach him at 301-496-7291 or JMCGOWAN@mercury.niaid.nih.gov.