New FDA Guidance Opens the Door for Electronic Consent Forms That Come with Significant Advantages and Raise Privacy and Secure Data Storage Regulatory Compliance Concerns

On March 9, 2015, the U.S. Food and Drug Administration (FDA) published a draft guidance1 that allows for the use of electronic informed consent (eIC) in human clinical trials. eICs have the potential to:

  • better and more fully educate subjects on whether to voluntarily participate in a clinical trial;
  • gauge a clinical trial subject's understanding of what they are consenting to;
  • more easily allow for the use of an electronic signature (e.g., an encrypted digital signature, an electronic signature pad, a voiceprint, or a digital fingerprint);
  • allow for the possibility of remote consent (e.g., where the consent form is not signed at the same location as the clinical investigator);
  • facilitate rapid patient notification of clinical trial protocol changes;
  • promote timely entry of eIC data into a clinical study database; and
  • allow for the timely collection of remote location informed consent data.

On the other hand, eICs also raise privacy and secure data storage regulation compliance concerns.

The eIC, if properly implemented, will be of significant benefit to institutional review boards (IRBs), clinical investigators, sponsors, patients, parents, and subjects' legally authorized representatives (LARs).

Background

Studies subject to the requirements of FDA regulations (e.g., human clinical studies on drugs, biologics, medical devices, or combinations of these) require the informed consent of participants. The clinical studies' IRB must review and approve the informed consent form, and the IRB is the final authority on the consent form content. In addition, informed consent forms are required to contain the basic elements found in 21 CFR § 50.25(a), and any element(s) of 21 CFR § 50.25 (b) that are appropriate to the specific clinical study.

In the past, consent forms were typically paper forms signed and dated by the subject, or the subject's parent or LAR.2 The FDA notes that the "clinical research community is showing greater interest in using electronic media to provide information usually contained within the written consent document, evaluate the subject's comprehension of the information presented, and document the consent of the subject or the subject's LAR."3 The FDA, recognizing that eICs covey multiple advantages, issued the eIC Guidance.

eIC Guidance Specifics

Section III of the eIC Guidance, entitled "Instituting an Electronic Informed Consent," presents 14 relevant questions and answers related to instituting an eIC. This alert highlights key information taken from these.

The eIC Guidance discusses how the eIC should be presented to the subject. The eIC Guidance notes that the eIC must contain all of the 21 C.F.R. § 50.25 elements, and must be in a language understandable to the subject or the subject's LAR.4

Also addressed is where the eIC process may be conducted. The "consent process my take place at the study site where both the investigator and subject are at the same location, or it may take place remotely (e.g., at the subject's home or another convenient venue) where the subject reviews the consent document in the absence of the investigator."5 For remote location processes, "if the consent process is not personally witnessed by study personnel, the computerized system should include a method to ensure that the person signing the informed consent is the subject who will be participating in the research study (or the subject's LAR)."6

The eIC Guidance maintains that subjects should be allowed to ask questions about the study, and that this "may be accomplished by in-person discussions with study personnel or by using a combination of electronic messaging, telephone calls, videoconferencing, or a live chat with a remotely located clinical investigator or appropriately delegated study personnel."7

To facilitate the subject's understanding, and the investigator's ability to gauge that understanding, "the eIC may use interactive computer-based technology, which may include diagrams, images, graphics, video technology, and narration, as appropriate."8

Regarding electronic signatures, the FDA notes that use of electronic signatures is permitted, provided that these are in compliance with applicable FDA regulations.9,10 The eIC procedure "may include an electronic method to capture the signature of the subject or the subject's LAR (e.g., an encrypted digital signature, electronic signature pad, voice print, digital fingerprint)."11 Notably, the FDA does not mandate a specific method of electronic signature.12

Pediatric subject assent also falls under the eIC process umbrella, but the IRB "must determine that there are adequate provisions for soliciting the assent of children when, in the IRB's judgment, the children are capable of providing assent."13 In addition, the IRB must determine whether and how assent must be documented.14

FDA regulations require that a person signing the informed consent be provided with a copy of the written consent form.15 The eIC Guidance expands the options for fulfilling this requirement, stating that "the copy of the informed consent document could be in the form of printed paper or an e-copy that can be transmitted by email or other form of electronic media."16

The eIC guidance also touches heavily on privacy and data security regulation compliance concerns. For example, if an e-copy of the consent form is offered, "subjects should be informed of the risks of storing or viewing the consent document on a personal electronic device (PED), especially if that PED is shared with other users or is lost, hacked, or subject to a search warrant or subpoena. Unlike paper copies which the subject may refuse to retain or destroy, e-copies delivered directly to the subject's PED may not be able to be permanently removed."17

Additionally, the FDA states that the "computerized system that supports the eIC must be secure with restricted access, and should include methods to ensure confidentiality regarding the subject's identity, study participation and personal information after informed consent has been obtained."18 For entities holding the subject's personal information and covered under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), or a business associate of a HIPAA covered entity, "the requirements of the HIPAA Privacy, Security, and Breach Notification Rules apply."19

Finally, the FDA requires that the "eIC process should incorporate procedures to ensure that electronic documents can be archived appropriately and all versions of the eIC can be retrieved easily."20 The system should have audit trail capability, and must be in compliance with applicable FDA regulations for electronic records. Notably, if "eIC data are stored on a remote computer, in a data storage center, or in 'the cloud' . . ., data privacy laws and regulations that apply to the remote storage site(s), in addition to those that apply to the research site, may apply and should be considered."21

Conclusion

eICs present significant opportunities to enhance the informed consent process, including the ability to better inform subjects, and to verify that subjects have been informed, of clinical study risks and advantages, and subject rights. In an increasingly multi-lingual society, eICs make it easier (with appropriate pre-planning) to enroll non-English speaking subjects, to capture consent (for example, with a voiceprint or fingerprint), and to populate databases with eIC data. eICs will be more easily understood and adopted by the millennial generation. However, eICs, like other forms of electronic records, raise privacy and data security regulatory compliance concerns.

Companies contemplating clinical trials may wish to employ eICs to gain their many advantages while taking the appropriate steps to comply with privacy and data security regulations. Vendors may wish to create and market eICs to these companies, raising potential issues of software patents, trademarks, copyrights, licensing, and privacy regulation compliance.

 

1 "Use of Electronic Informed Consent in Clinical Investigations–Questions and Answers," Guidance for Industry, FDA, March 9, 2015, (eIC Guidance) available electronically at: http://www.fda.gov/ucm/groups/fdagov-public/@fdagov-drugs-gen/documents/document/ucm436811.pdf, last accessed February 13, 2015.

2 21 C.F.R. § 50 (e.g., the Human Protection Regulation) requires that clinical trial participants sign and date the informed consent form. A somewhat common mistake is for the principal investigator or clinical research investigator, not the patient, to date the consent form (typically by date stamping). This mistake, when uncovered during an FDA on-site inspection, inevitably leads to a Form 483 report.

3 eIC Guidance at page 3.

4 "Understandable means that the information presented to the subjects is in a language and at a reading level the subject can comprehend (including the explanation of scientific and medical terms). All abbreviations should be spelled out at the time of first use. If the eIC programs are interactive, they should be easy to navigate, allowing the user to proceed forward or backward within the system or stop and continue at a later time. Hyperlinks may be provided where helpful." Id. at pages 3-4.

5 Id. at page 4.

6 Id.

7 Id.

8 Id. at page 5.

9 Id.

10 See also 21 C.F.R. part 11, subpart A (11.1)(a).

11 eIC Guidance at page 5.

12 Id.

13 Id.

14 Id.

15 See, e.g., 21 C.F.R. § 50.27(a).

16 eIC Guidance at page 6.

17 Id. at page 6.

18 Id. at page 7.

19 Id.

20 Id. at page 8.

21 Id. at page 9.

Written by:

Wilson Sonsini Goodrich & Rosati
Contact
more
less

Wilson Sonsini Goodrich & Rosati on:

Readers' Choice 2017
Reporters on Deadline

Related Case Law

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
Custom Email Digest
- hide

JD Supra Privacy Policy

Updated: May 25, 2018:

JD Supra is a legal publishing service that connects experts and their content with broader audiences of professionals, journalists and associations.

This Privacy Policy describes how JD Supra, LLC ("JD Supra" or "we," "us," or "our") collects, uses and shares personal data collected from visitors to our website (located at www.jdsupra.com) (our "Website") who view only publicly-available content as well as subscribers to our services (such as our email digests or author tools)(our "Services"). By using our Website and registering for one of our Services, you are agreeing to the terms of this Privacy Policy.

Please note that if you subscribe to one of our Services, you can make choices about how we collect, use and share your information through our Privacy Center under the "My Account" dashboard (available if you are logged into your JD Supra account).

Collection of Information

Registration Information. When you register with JD Supra for our Website and Services, either as an author or as a subscriber, you will be asked to provide identifying information to create your JD Supra account ("Registration Data"), such as your:

  • Email
  • First Name
  • Last Name
  • Company Name
  • Company Industry
  • Title
  • Country

Other Information: We also collect other information you may voluntarily provide. This may include content you provide for publication. We may also receive your communications with others through our Website and Services (such as contacting an author through our Website) or communications directly with us (such as through email, feedback or other forms or social media). If you are a subscribed user, we will also collect your user preferences, such as the types of articles you would like to read.

Information from third parties (such as, from your employer or LinkedIn): We may also receive information about you from third party sources. For example, your employer may provide your information to us, such as in connection with an article submitted by your employer for publication. If you choose to use LinkedIn to subscribe to our Website and Services, we also collect information related to your LinkedIn account and profile.

Your interactions with our Website and Services: As is true of most websites, we gather certain information automatically. This information includes IP addresses, browser type, Internet service provider (ISP), referring/exit pages, operating system, date/time stamp and clickstream data. We use this information to analyze trends, to administer the Website and our Services, to improve the content and performance of our Website and Services, and to track users' movements around the site. We may also link this automatically-collected data to personal information, for example, to inform authors about who has read their articles. Some of this data is collected through information sent by your web browser. We also use cookies and other tracking technologies to collect this information. To learn more about cookies and other tracking technologies that JD Supra may use on our Website and Services please see our "Cookies Guide" page.

How do we use this information?

We use the information and data we collect principally in order to provide our Website and Services. More specifically, we may use your personal information to:

  • Operate our Website and Services and publish content;
  • Distribute content to you in accordance with your preferences as well as to provide other notifications to you (for example, updates about our policies and terms);
  • Measure readership and usage of the Website and Services;
  • Communicate with you regarding your questions and requests;
  • Authenticate users and to provide for the safety and security of our Website and Services;
  • Conduct research and similar activities to improve our Website and Services; and
  • Comply with our legal and regulatory responsibilities and to enforce our rights.

How is your information shared?

  • Content and other public information (such as an author profile) is shared on our Website and Services, including via email digests and social media feeds, and is accessible to the general public.
  • If you choose to use our Website and Services to communicate directly with a company or individual, such communication may be shared accordingly.
  • Readership information is provided to publishing law firms and authors of content to give them insight into their readership and to help them to improve their content.
  • Our Website may offer you the opportunity to share information through our Website, such as through Facebook's "Like" or Twitter's "Tweet" button. We offer this functionality to help generate interest in our Website and content and to permit you to recommend content to your contacts. You should be aware that sharing through such functionality may result in information being collected by the applicable social media network and possibly being made publicly available (for example, through a search engine). Any such information collection would be subject to such third party social media network's privacy policy.
  • Your information may also be shared to parties who support our business, such as professional advisors as well as web-hosting providers, analytics providers and other information technology providers.
  • Any court, governmental authority, law enforcement agency or other third party where we believe disclosure is necessary to comply with a legal or regulatory obligation, or otherwise to protect our rights, the rights of any third party or individuals' personal safety, or to detect, prevent, or otherwise address fraud, security or safety issues.
  • To our affiliated entities and in connection with the sale, assignment or other transfer of our company or our business.

How We Protect Your Information

JD Supra takes reasonable and appropriate precautions to insure that user information is protected from loss, misuse and unauthorized access, disclosure, alteration and destruction. We restrict access to user information to those individuals who reasonably need access to perform their job functions, such as our third party email service, customer service personnel and technical staff. You should keep in mind that no Internet transmission is ever 100% secure or error-free. Where you use log-in credentials (usernames, passwords) on our Website, please remember that it is your responsibility to safeguard them. If you believe that your log-in credentials have been compromised, please contact us at privacy@jdsupra.com.

Children's Information

Our Website and Services are not directed at children under the age of 16 and we do not knowingly collect personal information from children under the age of 16 through our Website and/or Services. If you have reason to believe that a child under the age of 16 has provided personal information to us, please contact us, and we will endeavor to delete that information from our databases.

Links to Other Websites

Our Website and Services may contain links to other websites. The operators of such other websites may collect information about you, including through cookies or other technologies. If you are using our Website or Services and click a link to another site, you will leave our Website and this Policy will not apply to your use of and activity on those other sites. We encourage you to read the legal notices posted on those sites, including their privacy policies. We are not responsible for the data collection and use practices of such other sites. This Policy applies solely to the information collected in connection with your use of our Website and Services and does not apply to any practices conducted offline or in connection with any other websites.

Information for EU and Swiss Residents

JD Supra's principal place of business is in the United States. By subscribing to our website, you expressly consent to your information being processed in the United States.

  • Our Legal Basis for Processing: Generally, we rely on our legitimate interests in order to process your personal information. For example, we rely on this legal ground if we use your personal information to manage your Registration Data and administer our relationship with you; to deliver our Website and Services; understand and improve our Website and Services; report reader analytics to our authors; to personalize your experience on our Website and Services; and where necessary to protect or defend our or another's rights or property, or to detect, prevent, or otherwise address fraud, security, safety or privacy issues. Please see Article 6(1)(f) of the E.U. General Data Protection Regulation ("GDPR") In addition, there may be other situations where other grounds for processing may exist, such as where processing is a result of legal requirements (GDPR Article 6(1)(c)) or for reasons of public interest (GDPR Article 6(1)(e)). Please see the "Your Rights" section of this Privacy Policy immediately below for more information about how you may request that we limit or refrain from processing your personal information.
  • Your Rights
    • Right of Access/Portability: You can ask to review details about the information we hold about you and how that information has been used and disclosed. Note that we may request to verify your identification before fulfilling your request. You can also request that your personal information is provided to you in a commonly used electronic format so that you can share it with other organizations.
    • Right to Correct Information: You may ask that we make corrections to any information we hold, if you believe such correction to be necessary.
    • Right to Restrict Our Processing or Erasure of Information: You also have the right in certain circumstances to ask us to restrict processing of your personal information or to erase your personal information. Where you have consented to our use of your personal information, you can withdraw your consent at any time.

You can make a request to exercise any of these rights by emailing us at privacy@jdsupra.com or by writing to us at:

Privacy Officer
JD Supra, LLC
10 Liberty Ship Way, Suite 300
Sausalito, California 94965

You can also manage your profile and subscriptions through our Privacy Center under the "My Account" dashboard.

We will make all practical efforts to respect your wishes. There may be times, however, where we are not able to fulfill your request, for example, if applicable law prohibits our compliance. Please note that JD Supra does not use "automatic decision making" or "profiling" as those terms are defined in the GDPR.

  • Timeframe for retaining your personal information: We will retain your personal information in a form that identifies you only for as long as it serves the purpose(s) for which it was initially collected as stated in this Privacy Policy, or subsequently authorized. We may continue processing your personal information for longer periods, but only for the time and to the extent such processing reasonably serves the purposes of archiving in the public interest, journalism, literature and art, scientific or historical research and statistical analysis, and subject to the protection of this Privacy Policy. For example, if you are an author, your personal information may continue to be published in connection with your article indefinitely. When we have no ongoing legitimate business need to process your personal information, we will either delete or anonymize it, or, if this is not possible (for example, because your personal information has been stored in backup archives), then we will securely store your personal information and isolate it from any further processing until deletion is possible.
  • Onward Transfer to Third Parties: As noted in the "How We Share Your Data" Section above, JD Supra may share your information with third parties. When JD Supra discloses your personal information to third parties, we have ensured that such third parties have either certified under the EU-U.S. or Swiss Privacy Shield Framework and will process all personal data received from EU member states/Switzerland in reliance on the applicable Privacy Shield Framework or that they have been subjected to strict contractual provisions in their contract with us to guarantee an adequate level of data protection for your data.

California Privacy Rights

Pursuant to Section 1798.83 of the California Civil Code, our customers who are California residents have the right to request certain information regarding our disclosure of personal information to third parties for their direct marketing purposes.

You can make a request for this information by emailing us at privacy@jdsupra.com or by writing to us at:

Privacy Officer
JD Supra, LLC
10 Liberty Ship Way, Suite 300
Sausalito, California 94965

Some browsers have incorporated a Do Not Track (DNT) feature. These features, when turned on, send a signal that you prefer that the website you are visiting not collect and use data regarding your online searching and browsing activities. As there is not yet a common understanding on how to interpret the DNT signal, we currently do not respond to DNT signals on our site.

Access/Correct/Update/Delete Personal Information

For non-EU/Swiss residents, if you would like to know what personal information we have about you, you can send an e-mail to privacy@jdsupra.com. We will be in contact with you (by mail or otherwise) to verify your identity and provide you the information you request. We will respond within 30 days to your request for access to your personal information. In some cases, we may not be able to remove your personal information, in which case we will let you know if we are unable to do so and why. If you would like to correct or update your personal information, you can manage your profile and subscriptions through our Privacy Center under the "My Account" dashboard. If you would like to delete your account or remove your information from our Website and Services, send an e-mail to privacy@jdsupra.com.

Changes in Our Privacy Policy

We reserve the right to change this Privacy Policy at any time. Please refer to the date at the top of this page to determine when this Policy was last revised. Any changes to our Privacy Policy will become effective upon posting of the revised policy on the Website. By continuing to use our Website and Services following such changes, you will be deemed to have agreed to such changes.

Contacting JD Supra

If you have any questions about this Privacy Policy, the practices of this site, your dealings with our Website or Services, or if you would like to change any of the information you have provided to us, please contact us at: privacy@jdsupra.com.

JD Supra Cookie Guide

As with many websites, JD Supra's website (located at www.jdsupra.com) (our "Website") and our services (such as our email article digests)(our "Services") use a standard technology called a "cookie" and other similar technologies (such as, pixels and web beacons), which are small data files that are transferred to your computer when you use our Website and Services. These technologies automatically identify your browser whenever you interact with our Website and Services.

How We Use Cookies and Other Tracking Technologies

We use cookies and other tracking technologies to:

  1. Improve the user experience on our Website and Services;
  2. Store the authorization token that users receive when they login to the private areas of our Website. This token is specific to a user's login session and requires a valid username and password to obtain. It is required to access the user's profile information, subscriptions, and analytics;
  3. Track anonymous site usage; and
  4. Permit connectivity with social media networks to permit content sharing.

There are different types of cookies and other technologies used our Website, notably:

  • "Session cookies" - These cookies only last as long as your online session, and disappear from your computer or device when you close your browser (like Internet Explorer, Google Chrome or Safari).
  • "Persistent cookies" - These cookies stay on your computer or device after your browser has been closed and last for a time specified in the cookie. We use persistent cookies when we need to know who you are for more than one browsing session. For example, we use them to remember your preferences for the next time you visit.
  • "Web Beacons/Pixels" - Some of our web pages and emails may also contain small electronic images known as web beacons, clear GIFs or single-pixel GIFs. These images are placed on a web page or email and typically work in conjunction with cookies to collect data. We use these images to identify our users and user behavior, such as counting the number of users who have visited a web page or acted upon one of our email digests.

JD Supra Cookies. We place our own cookies on your computer to track certain information about you while you are using our Website and Services. For example, we place a session cookie on your computer each time you visit our Website. We use these cookies to allow you to log-in to your subscriber account. In addition, through these cookies we are able to collect information about how you use the Website, including what browser you may be using, your IP address, and the URL address you came from upon visiting our Website and the URL you next visit (even if those URLs are not on our Website). We also utilize email web beacons to monitor whether our emails are being delivered and read. We also use these tools to help deliver reader analytics to our authors to give them insight into their readership and help them to improve their content, so that it is most useful for our users.

Analytics/Performance Cookies. JD Supra also uses the following analytic tools to help us analyze the performance of our Website and Services as well as how visitors use our Website and Services:

  • HubSpot - For more information about HubSpot cookies, please visit legal.hubspot.com/privacy-policy.
  • New Relic - For more information on New Relic cookies, please visit www.newrelic.com/privacy.
  • Google Analytics - For more information on Google Analytics cookies, visit www.google.com/policies. To opt-out of being tracked by Google Analytics across all websites visit http://tools.google.com/dlpage/gaoptout. This will allow you to download and install a Google Analytics cookie-free web browser.

Facebook, Twitter and other Social Network Cookies. Our content pages allow you to share content appearing on our Website and Services to your social media accounts through the "Like," "Tweet," or similar buttons displayed on such pages. To accomplish this Service, we embed code that such third party social networks provide and that we do not control. These buttons know that you are logged in to your social network account and therefore such social networks could also know that you are viewing the JD Supra Website.

Controlling and Deleting Cookies

If you would like to change how a browser uses cookies, including blocking or deleting cookies from the JD Supra Website and Services you can do so by changing the settings in your web browser. To control cookies, most browsers allow you to either accept or reject all cookies, only accept certain types of cookies, or prompt you every time a site wishes to save a cookie. It's also easy to delete cookies that are already saved on your device by a browser.

The processes for controlling and deleting cookies vary depending on which browser you use. To find out how to do so with a particular browser, you can use your browser's "Help" function or alternatively, you can visit http://www.aboutcookies.org which explains, step-by-step, how to control and delete cookies in most browsers.

Updates to This Policy

We may update this cookie policy and our Privacy Policy from time-to-time, particularly as technology changes. You can always check this page for the latest version. We may also notify you of changes to our privacy policy by email.

Contacting JD Supra

If you have any questions about how we use cookies and other tracking technologies, please contact us at: privacy@jdsupra.com.

- hide

This website uses cookies to improve user experience, track anonymous site usage, store authorization tokens and permit sharing on social media networks. By continuing to browse this website you accept the use of cookies. Click here to read more about how we use cookies.