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Managing conflict of interest

Stanford University's OPACS system to manage conflict of interest in biomedical research

Stanford University must assure objectivity in research to protect its students. But they had a single conflict of interest manager and a lengthy paper form that got sent back and forth by email. If any questions arose, it meant long hours piecing everything back together to prove that any conflicts had been reported and managed. Research administration hired more managers and needed a more scalable way for them to collect, evaluate, share, save, and sign off on each conflict of interest case.

This project dates back to 2009 and the design choices show their age. But the design thinking is still solid here. The work is based in evidence that moved my client from a short-term solution to a better definition of the problem they faced and a more sustainable approach.

As a design strategy consultant, I worked with the Stanford business owner and their developers, who would create the new solution. They expected only to put the form online, somehow. In learning the nature of research at Stanford University and why conflict of interest is expected and must be transparently managed, I discovered a bigger ecosystem of people with a stake in this problem. I began with their main conflict of interest manager, but quickly spread out to many other departments that depend on the information collected and evaluated around conflict of interest.

I interviewed dozens to learn about conflict of interest
Conflict of interest at Stanford University affects multiple stakeholders

I settled on task analysis as the best approach and converted the interviews into an ecosystem of personas, showing how each one interacted with a conflict of interest case, where they had pain points, and what product opportunities that presented.

Conflict of interest is a system of personas
Personas who play a role in the conflict of interest system at Stanford
Task analysis for researchers
A task analysis example. Researchers wanted to do the right thing, but found the process cumbersome.
Task analysis for conflict of interest managers
Another task analysis example. Conflict of interest managers manually filled too many gaps in the process

I presented research findings and product opportunities to the business owner and other key stakeholders in research administration at Stanford. After hearing this, they no longer believed a simple form was the solution. The project moved towards designing a system that allowed various roles to work on conflict of interest cases together.

To help the development teams understand the work fully, I converted the task analyses to logical flows for each role, plus a birds-eye view of how a conflict of interest case moved among roles, so they could see who created, reviewed, or shared information and how.

Logical flow of a conflict of interest case
One logical flow: how a case moved through the conflict of interest system

After this, I created wireframes for the conflict of interest system. Stanford’s team iteratively reviewed designs with me, and we updated them, based on feedback. Their product manager wanted to use these designs not just to build the product, but to screen possible vendors for a content management system that could be customized for this purpose. They included me in vendor reviews, wanting to be sure they chose appropriate technology for their new transactional conflict of interest system, or T-COI.

Researcher's landing page for the conflict of interest system
A researcher’s view of the conflict of interest system. You can see past cases and create new ones.
Researchers wanted a way to file the same details for multiple conflicts
Researchers can attach the same case details to multiple company conflicts and save themselves time and effort.
Researchers review and submit a conflict of interest case.
When all the sections are complete, the research signs and submits their case.
Conflict of interest managers see all system activity.
Conflict of interest managers can manage incoming cases, track existing ones, and see total activity for any researcher or company.
Comments and responses let stakeholders collaborate on a conflict of interest case.
Stakeholders can comment on a conflict of interest case, and others can respond by email. Comments and responses get stored with the case for a full record.

Since this project, T-COI has been folded into a larger effort called OPACS: Outside Professional Activities Certification System. Stanford believes in taking research from “bench to bedside,” so it’s common for conflicts to arise. Now, researchers, conflict of interest managers, reviewers, and research administrators all have a view into conflict of interest cases. They can communicate and track progress, avoid losing information or providing the same details multiple times, and assure academic integrity in research for their students.