# Presentation: 699379

## Health Information Technology (IT) FOAs

- Technical Assistance Conference Call
- January 13, 2009

**Notes:**
January 13, 2009
Health IT TA Call

1:00-3:00 pm, ET
Due to volume, call in at 12:45 pm, ET
Dial-in Number: 1-888-324-0236
Participant Passcode: 2362915

## Conference Call Agenda

- Objective of TA Call (2 minutes)
- Overview of three AHRQ-sponsored Health IT FOAs    (dates, funding levels, page limits) (10 minutes)
- Special Emphasis Notice (SEN) for Health IT Focused K-awards and R36
- Common requirements across three Health IT FOAs         (20 minutes)
- FOA-specific Issues
- R03 (15 minutes)
- R21 (5 minutes)
- R18  (10 minutes)
- Frequently asked questions (10 minutes)
- Open forum (50 minutes)

## Objective of TA Call

- Highlight information in the FOAs and provide clarification, if necessary
- Transcript of TA call will be posted by January 23 at http://www.ahrq.gov/fund/grantix.htm

## AHRQ Health IT FOAs

**Small Research Grant to Improve Healthcare Quality through Health IT (R03) FOA (**_**[http://grants.nih.gov/grants/guide/pa-files/PAR-08-268.html](http://grants.nih.gov/grants/guide/pa-files/PAR-08-268.html)**__ )_
**Exploratory and Developmental Grant to Improve Health Care Quality through Health IT (R21) FOA (**_**[http://grants.nih.gov/grants/guide/pa-files/PAR-08-269.html](http://grants.nih.gov/grants/guide/pa-files/PAR-08-269.html)**_**)**
**Utilizing Health IT to Improve Health Care Quality Grant (R18) FOA (**_**[http://grants.nih.gov/grants/guide/pa-files/PAR-08-270.html](http://grants.nih.gov/grants/guide/pa-files/PAR-08-270.html)**_**)**

**Notes:**
AND:   The Health IT Funding Opportunity Announcements (FOAs) and a Special Emphasis Notice to build upon a large body of grants and cooperative agreements that were awarded in 2004-2008 in response to a series of one-time Request for Funding Announcements. 

FOAs are authorized for 3 years. AHRQ will consider the appropriateness of these FOAs before they expire and determine whether or not to reissue them in a current or revised format.

Offers applicants opportunities to received incremental support for the conduct of progressively more complex health IT research projects
Resubmission

## Overview of AHRQ-Sponsored Health IT FOAshttp://healthit.ahrq.gov/healthitfoas 

|  | Small Research Grant to Improve Health Care Quality through Health IT (R03) PAR-08-268
  | Exploratory and Developmental Grant to Improve Health Care Quality through Health IT (R21) PAR-08-269 | Utilizing Health IT to Improve Health Care Quality (R18) PAR-08-270
 |
| --- | --- | --- | --- |
| Authorized Duration | 9/25/2008 – 11/17/2011 | 9/25/2008 – 11/17/2011 | 9/25/2008 – 11/17/2011 |
| Earliest submission date to Grants.gov * | Jan 16, 2009   | Jan 16, 2009   | Dec 26, 2008  |
| Recurring Due Dates (new applications) | Feb 16, June 16, Oct 16 | Feb 16, June 16, Oct 16 | Jan 25, May 25, Sept 25 |
| Maximum Project Period | 2 years | 2 years | 3 years |
| Total Costs (TC) over grant lifetime | $100,000 | $300,000 | $1.2 million |
| Max TC in a given year | $100,000/yr |  $200,000/yr | $500,000/yr |
| Part D. Research Plan  | 15-page limitation | 20-page limitation | 25-page limitation |
| No. of Resubmissions | 1 | 2 | 2 |
| Page limit for Intro in resubmission | 1 | 2 | 3 |
| Recurring Due Dates for resubmissions | March 16, July 16, Nov 16 | March 16, July 16, Nov 16
 | Jan 25, May 25, Sept 25 |

**Electronic** submission of Adobe application package is required;  FOAs revised December 2008 to include new form links see FOAs and  _[NOT-OD-08-117](http://grants.nih.gov/grants/guide/notice-files/NOT-OD-08-117.html)_.
**	****	**

**Notes:**
For each of the recurring due dates there is a one-month window between the earliest date to submit and the due date.    

## SEN for Health IT Focused K-Awards and R36

- Special Emphasis Notice (SEN) NOT-HS-08-014 (_[http://grants.nih.gov/grants/guide/notice-files/NOT-HS-08-014.html](http://grants.nih.gov/grants/guide/notice-files/NOT-HS-08-014.html)__)_
- Career-Awards (K-awards):
- Mentored Clinical Scientist (K08) _[http://grants.nih.gov/grants/guide/pa-files/PAR-07-443.html](http://grants.nih.gov/grants/guide/pa-files/PAR-07-443.html)_
- Mentored Research Scientist (K01) _[http://grants.nih.gov/grants/guide/pa-files/PAR-08-022.html](http://grants.nih.gov/grants/guide/pa-files/PAR-08-022.html)_
- Independent Scientist (K02) _[http://grants.nih.gov/grants/guide/pa-files/PAR-07-444.html](http://grants.nih.gov/grants/guide/pa-files/PAR-07-444.html)_
-  Grants for HSR Dissertation (R36)   _[http://grants.nih.gov/grants/guide/pa-files/PAR-06-118.html](http://grants.nih.gov/grants/guide/pa-files/PAR-06-118.html)_

**Notes:**
This presentation will focus on the content of the three health IT FOAs. As such, prospective applicants for career awards and dissertation grants will have an enriched concept regarding health IT research projects.  We will not be discussing the career awards and the dissertation grants themselves.   Participants are welcome to send questions.  Dr. Kay Anderson, from OEREP is here to answer your questions during the open forum. 

## Common Requirements Across Health IT FOAs

- Examples of Health IT
- Research Areas
- Research Settings
- Health IT Intervention
- Software, Hardware, and/or Equipment Purchases
- Plan for Privacy and Security
- SF424 (R&R) Electronic Submission
- Eligible Institutions
- Principal Investigator

## Examples of Health IT

- Electronic medical records (EMR)
- Electronic health records (EHR)
- Personal health records (PHR)
- Clinical alerts and reminders
- Computerized provider order entry (CPOE)
- Computerized clinical-decision support (CDS)
- Consumer health informatics (CHI) applications
- Electronic exchange of health information (HIE)

**Notes:**
Note: some R03 proposals, such as cost/benefit analyses and secondary data analyses, will focus on data related to implementation and/ or use of a health IT application or system. For those proposals, the original research area where the health IT was implemented should be identified.

##  Research Areas

- Grant must focus on Health IT’s implementation and use to improve healthcare by addressing at least one of these areas:
- Medication management
- Patient-centered care, including coordination of care and use of electronic exchange of information
- Health care decisionmaking through use of integrated data and knowledge management

**Notes:**

“1) Health IT to improve the quality and safety of medication management; this includes the utilization of medication management systems and technologies; ambulatory health care providers and out-patient pharmacists’ use of electronic prescribing systems and/or medication management technologies; integration of evidence-based decision support for priority conditions within electronic prescribing systems; and, providing patients electronic tools to support medication self-management. 
2) Health IT to support patient-centered care; this includes, but is not limited to, a focus on the coordination of care across transitions in care settings and the use of electronic exchange of health information to improve quality of care. Patient-centered care is responsive to the needs and preferences of individual patients, provides patients and/or their caregivers with access to their medical information, facilitates communication between patients, caregivers and providers, and empowers patients to be active participants in care decisions and in the daily management of their health and illnesses. 
3) Health IT to improve health care decision making; this includes the development, implementation, and integration of health information tools, products or systems through the use of integrated data and knowledge management.  AHRQ encourages research projects that propose use of health IT applications that apply principles of evidence based medicine including the use of the best available evidence, health care providers’ ability to execute their best judgment, and consideration of patients’ expressed treatment preferences.  Ultimately, health IT that supports decision making should possess the capacity for the development and use of aggregate data for ongoing evaluation of quality improvement, organizational improvement, and population management in health care settings.  Highly advanced health IT with this functionality should also identify unwarranted variability in practice, accommodate credible variability in recommendations, and identify gaps in the knowledge base that manifest during implementation for feedback to evidence developers and synthesizers.”

## Appropriate Research Settings:

- For purposes of the new FOAs, ambulatory care
- settings include:
- Health care clinician offices
- Outpatient clinics and outpatient mental health centers
- Outpatient substance abuse centers
- Urgent care centers
- Ambulatory surgery centers
- Community-based school or occupational health centers
- Safety-net clinics, pharmacies, or homes
- Independent living centers and long-term residential care facilities

**Notes:**
These settings are somewhat different than those allowed previously in the Ambulatory Safety and Quality RFAs (HS-07-002;  HS-07-006; Hs-07-003; Hs-08-002).  The characterization of ambulatory settings has been broadened in the three new FOAS (HS-08-268 (R03); HS-08-269 (R21); HS-08-270 (R18)).  However, the transition from ED to inpatient setting is not permissible in the new health IT FOAS.

## Nonresponsive Research Settings

- Applications that feature health IT implementation in a nonambulatory setting, such as:
- A hospital [Emergency Department],
- Skilled nursing facility, or
- Inpatient mental health facility
- 	for purposes other than facilitating transitions in care to and from an ambulatory setting will be considered nonresponsive to these FOAs and will not be reviewed.

**Notes:**

Clarification examples:
1. A study which starts with a patient being treated in an Emergency Room and then being admitted to the hospital, would not be responsive to these FOAs.

2. A study which features a patient being transported/treated in an ambulance and/or being admitted to a hospital without a focus on transport/treatment to an ambulatory setting, such as a home, would not be considered responsive. In a study featuring an ambulance to ED transport only, the ambulance would be considered an extension of the Emergency Department.   However, if a study focuses on the use of an ambulance in the care transport/treatment of a patient to an ambulatory setting, it would be allowable.  

## Health IT Intervention

- Detailed description
- Describe interface with preexisting health IT, if any
- If possible, health IT intervention should conform to Federal and other interoperability standards and use certified products (see http://www.cchit.org). If not feasible, provide an explanation. This is not reflected in priority score.

**Notes:**

Health IT Intervention: 
The application must include detailed descriptions of the specific health IT application(s) being implemented and support services for each. The description of the health IT application to be implemented should also identify if it is open source or proprietary and the extent to which available functions of the newly implemented health IT application are/would be used.  To the extent there is a pre-existing health IT application in the care setting of interest, such as an electronic health record, applicants should describe this, and specify whether or not the new health IT application would be interfaced with it during the course of the research period or subsequently. 

Applicant’s status for conforming to those standards will not impact peer reviewers’ priority scores. 

## Software, Hardware, and/or Equipment Purchases

- In combination, such purchases are expected to be less than 20% of total costs of project over its duration.
- May include modest incremental software development for new settings or improved functionality.
- If such funds are in excess of 20%, explicit justification is required.

## At End of Section D. Research Methods: Identify if  Privacy & Security (P & S) Plan is Necessary

**Yes:**
- Public or nonprofit private institution
- Provide a concise summary of the planned resources and processes to be used to address P and S issues in the development and implementation, and/or use of the health IT intervention
- Provide full description of P & S Plan in Appendix A.
**No:**
- Provide justification.
- P & S Plans are anticipated for all Health IT R18 proposals and most Health IT R21 proposals.
- P & S Plans may not be necessary for some Health IT R03 proposals, e.g., secondary data analyses and retrospective economic analyses.
- P & S Plan would not be expected in Appendix A.

**Notes:**
If applicant chooses to provide all information in Section D. that fact and the page number on which it is located should be so noted in Appendix A.  

## SF424(R&R): Electronic Submission

- All applications must be submitted electronically.
- Please see FOA for instructions on how to obtain electronic forms and register your institution and PI.
- December 8, 2008, SF424 Guide updated:
- http://grants.nih.gov/grants/funding/424/SF424_RR_Guide_General_Adobe_VerA.pdf
- New Form Requirements: Adobe Reader 8.1.3, or 9.0 required to open forms (See eGOV slides in Reference section)

## AHRQ Does Not Accept Modular Budgets

- AHRQ accepts only the detailed Research & Related Budget.
- Do not use the PHS 398 Modular Budget.
- Applications submitted in modular budget format will *not* be reviewed.

## Eligible Institutions

- You may submit an application if your organization is a:
- Public or nonprofit private institution
- including nonprofit health care organizations, universities, colleges, and faith-based or community-based organizations
- Unit of local or State government or eligible Agency of the Federal Government
- Indian/Native American Tribal Government or Tribally Designated Organization
- For-profit organizations are not eligible to lead applications
- Foreign institutions are not eligible to apply

**Notes:**
For-profit organizations may participate in projects as members of consortia or as subcontractors
For-profit organizations that produce health IT systems are encouraged to apply in partnership with a non-profit organization

Foreign institutions may participate in projects as members of consortia or as subcontractors

## Principal Investigator (PI)

- PI may come from a variety of background areas.
- PI should devote a considerable portion of time to the project.
- If less than 20% time will be devoted, the application must include an explicit justification.
- Applications should describe PI responsibilities and background.

**Notes:**
Level of experience for expected for PI varies across type of health IT research project

## FOA-Specific Issues

- Small Research Grant to Improve Healthcare Quality through Health IT (R03) FOA
- Exploratory and Developmental Grant to Improve Health Care Quality through Health IT (R21) FOA
- Utilizing Health IT to Improve Health Care Quality Grant (R18) FOA

## Health IT R03 FOA

- Wide variety of research designs in order to improve the quality, safety, effectiveness, and efficiency of health care through implementation and use:
- Small pilot and feasibility or self-contained health IT research projects
- Secondary data analysis of health IT research
- Economic (prospective or retrospective) analyses of health IT implementation.

**Notes:**
Privacy and Security Protection in the Development and Implementation of Health IT System.

The Principal Investigator (PI) is expected to contribute a minimum of 20-percent effort throughout the course of the grant.  If less time is allocated an explicit justification of the lower level of effort must be included. 

The PI for a small pilot and feasibility or self-contained research project, one of the three types of R03 projects,  is not expected or required to be extensively published or have prior experience in a leadership capacity in the conduct of a research project. 

Software, Hardware, and/or Equipment Purchases: Combined purchases for software, hardware or any other equipment needed to conduct the project are expected to be less than 20% of the total costs of the project over the duration of the project.  These purchases may include modest incremental software development to enable implementation of existing health IT in a new setting or to improve health IT functionality.  If funds for such purchases are in excess of 20% of overall total costs budgeted for the duration of the project an explicit justification must be included.     

## 1. Small pilot and feasibility or self-contained health IT project

- Inform future development of health IT, strategies for health IT research, or implementation activities
- Preparatory work
- Proof of concept studies
- Needs assessments
- Development of new health IT applications
- Development or validation of research methodology
- PI not expected to be extensively published or have prior leadership in research project

**Notes:**
The Principal Investigator (PI) is expected to contribute a minimum of 20-percent effort throughout the course of the grant.  If less time is allocated an explicit justification of the lower level of effort must be included. 

The PI for a small pilot and feasibility or self-contained research project, one of the three types of R03 projects,  is not expected or required to be extensively published or have prior experience in a leadership capacity in the conduct of a research project. 

## 2. Secondary data analysis of health IT research

- Designed to generate insight regarding facilitators and barriers to health IT implementation through evaluation of factors impacting utilization and implementation
- (e.g., setting characteristics, workflow, and integration with preexisting health IT).
- May test new hypotheses or synthesize existing data derived elsewhere

## 2. Secondary data analysis of health IT Research (continued)

- Additional Requirements:
- Identify source of data and discuss completeness, reliability, and accuracy of the data
- Analyses may be related to but must be distinct from the specific aims of the original data collection and analytical plan
- Describe the data and conditions (e.g., availability, costs) for data use
- Additional information may be collected to supplement data set; data collection must be well described and justified

## 3. Economic analyses of health IT implementation

- Must focus on specific health IT implementation project
- Sponsored by AHRQ or others
- Concurrent (prospective) economic analysis: identify concurrent health IT R18 implementation project
- Retrospective economic analysis: identify predecessor health IT implementation project
- Describe data and conditions for use
- Designed to conduct sound economic evaluations of health IT implementation and use
- Consider to whom benefits accrue
- Include evaluation of financial and nonfinancial costs and benefits of a companion health IT implementation project

## R03 Submission Requirements 

- Submission requirements (Section IV.6) and review criteria (Section V) vary depending on the type of small research being proposed.

## R03 Submission Requirements 

***Specific Aims***
***Background and Significance***
***Theoretical Framework***
***Research Design and Methods***** **
**Health IT Intervention**
**Software, Hardware, and/or Equipment Purchases**
***Personnel ***
***Project Administration***
***Dissemination***

***Additional requirements for secondary data analysis of health IT research ***
***Additional requirements for economic analysis of health IT implementation***** **
**Budget**
**Privacy and Security Protections**
**Plan for Protection of Human Subjects**
**Priority Populations**
***Resubmission ***
***Once***
***One-page Introduction***

- Note: Italicized text indicates FOA-specific requirements

**Notes:**
Yellow, italicized test indicates requirements are specific to this health IT FOA.

White, non-italicized text indicates submission requirements are the same across health IT FOAs (r03, R21, R18).

NOTE: Some research projects, such as an economic analysis, will not actively engage in an health IT intervention.  However, the type of health IT intervention that is related to the current research study being proposed should be described.

## RO3 Review Criteria

***Significance***
***Approach (special requirements by type of R03 study)***
***Innovation***
***Investigators***
***Environment***

- Privacy and Security Protections
- Inclusion
- Protection of Human Subjects
- Budget
- Resubmission

- Note: Italicized text indicates FOA-specific review criteria

**Notes:**
Yellow, italicized text indicates  review criteria are unique to this FOA.
White, non-italicized text indicates review requirements are the same across Health IT FOAs (R03, R21, R18).
Approach:  Are the conceptual framework, research design, methods, and analyses adequately developed, well-integrated, well-reasoned, and appropriate to the aims of the project? Does the application reflect an adequate understanding of the workflow and consideration of barriers and facilitators of real world implementation of the health IT intervention?
For applications featuring secondary data or economic analyses, are the reliability, validity, completeness, and availability of the data adequately discussed?
For applications featuring economic analyses, does the application adequately consider appropriate financial and non-financial costs and benefits?
For applications featuring small pilot and feasibility or self-contained health IT research projects that focus on the development or testing of new health IT applications, to what extent are end users (e.g. patients, patients’ families, staff or health care providers) directly involved in the design, development and/or selection of the health IT application or is adequate justification of why their involvement is not feasible or appropriate provided?

## FOA-specific Issues

**Exploratory and Developmental Grant to Improve Health Care Quality through Health IT (R21) FOA**

## Exploratory and Developmental Grant to Improve Health Care Quality through Health IT (R21) 

- This R21 mechanism (PAR-08-269) supports the conduct of short-term preparatory, pilot, or feasibility studies that are needed to inform future health IT implementation which may include but is not limited to the conduct of a health IT research demonstration grant.
- The R21 grants are more comprehensive and broader in scope than the small, self-contained health IT research projects supported by the health IT R03 FOA.

## Health IT R21 Requirements 

***Specific Aims***
***Background and Significance***
***Theoretical Framework***
***Research Design and Methods ***
- Health IT Intervention
- Software, Hardware, and/or Equipment Purchases
***Personnel***
***PI is not expected or required to be extensively published or have extensive experience in leadership capacity as expected for R18 or R01***

***Project Administration***
***Dissemination***
- Budget
- Privacy and Security Protections
- Plan for Protection of Human Subjects
- Priority Populations
*Resubmission *
*Twice*
*Two-page Introduction*

- Note: Italicized text indicates FOA-specific requirements

**Notes:**
Yellow, italicized text indicates  requirements are unique to this FOA.
White, non-italicized text indicates submission requirements are the same across Health IT FOAs (R03, R21, R18).

Research Design and Methods
Wide range of methods
Describe components of health IT implementation and use plan
Address unintended consequences
To extent process/outcome measures proposed, describe in detail. Encouraged use of nationally recognized measures.
Evaluation using clinical outcome measures should be well-matched to [limited] scope of R21 mechanism
Clinician/staff perspectives on use/utility of health IT should be evaluated or justification provided
Privacy and Security Plan

## Health IT R21 Review Criteria

***Significance***
***Approach ***
***Innovation***
***Investigators***
***Environment***

- Privacy & Security Protections
- Inclusion
- Protection of Human Subjects
- Budget
- Resubmission

- Note: Italicized text indicates FOA-specific review criteria

**Notes:**
Yellow, italicized text indicates  review criteria are unique to this FOA.
White, non-italicized text indicates review criteria are the same across Health IT FOAs (R03, R21, R18).

## FOA-specific Issues

**Utilizing Health IT to Improve Health Care Quality Grant (R18) FOA**

## Utilizing Health IT to Improve Health Care Quality Grant (R18)

- This R18 mechanism (PAR-08-270) supports demonstration research grants that rigorously study health IT implementation and use to improve the quality, safety, effectiveness, and efficiency of health care in ambulatory settings and in the transitions between care settings.

## Health IT R18 Requirements 

***Specific Aims***
***Background and Significance***
***Theoretical Framework***
***Research Design and Methods***
- Health IT Intervention
- Software, Hardware, and/or Equipment Purchases

***Personnel***
***Project Administration***
***Dissemination***
- Budget
- Privacy and Security Protections
- Plan for Protection of Human Subjects
- Priority Populations
***Resubmission ***
***Twice***
***Three-page Introduction***

- Note: Italicized text indicates FOA-specific requirements

**Notes:**
Yellow, italicized text indicates indicates requirements are unique to this FOA.
White, non-italicized text indicates submission requirements are the same across Health IT FOAs (R03, R21, R18).
R-18 Research Design and Methods
Wide range of methods
Well justified and consistent with specific aims
Describe components of health IT implementation and use plan
Address unintended consequences
To extent process/outcome measures proposed, describe in detail. Encouraged use of nationally recognized measures.
Clinician/staff perspectives on use/utility of health IT should be evaluated or justification provided
Research that directly engages patients or caregiver’s use of health IT should solicit their perspective during design, development, and/or selection of health IT

## Health IT R18 Review Criteria

***Significance***
***Approach ***
***Innovation***
***Investigators***
***Environment***

- Privacy and Security Protections
- Inclusion
- Protection of Human Subjects
- Budget
- Resubmission

- Note: Italicized text indicates FOA-specific review criteria

## Frequently Asked Questions

## Can there be Co-PIs?

- No.
- AHRQ requires that the lead institution designate one and only one individual as the project’s principal investigator.

## Will AHRQ accept unsolicited additional materials during initial peer review phase?

- AHRQ’s policy is to review applications as received by the application receipt date.
- http://grants.nih.gov/grants/guide/notice-files/NOT-HS-08-012.html

**Notes:**
For applications submitted electronically through Grants.gov, AHRQ continues to provide a two business day ‘application viewing window’ to allow the Program Director/Principal Investigator (PD/PI) and Authorized Organization Representative (AOR)/Signing Official (SO) to check the assembled application image in the eRA Commons.  AHRQ will accept additional materials only when requested by the AHRQ Scientific Review Officer (SRO) or the AHRQ Referral Officer

Additions after the Peer Review MeetingAfter the initial peer review phase is completed, the AHRQ Grants Management Officer is the AHRQ official responsible for accepting additional materials.  Most of the material submitted after peer review can be submitted as part of the Just-in-Time process. 
Inquiries
For general inquiries concerning this policy contact: Gerald E. Calderone, Ph.D. Referral Officer Office of Extramural Research, Education, and Priority PopulationsAgency for Healthcare Research and Quality 540 Gaither Road Rockville, MD 20850 Telephone: (301) 427-1548 E-mail address:  Gerald.Calderone@ahrq.hhs.gov

## Who will review the Health IT  applications?

- The Office of Extramural Research, Education and Priority Populations (OEREP) is in charge of assigning applications to initial peer review groups.
- As appropriate, OEREP will assign an application to an AHRQ Standing Review Group (SRG) or Special Emphasis Panel.
- We anticipate that many of the health IT applications will be reviewed by the Healthcare Technology and Dissemination Sciences (HCTDS) SRG.
- Descriptions of the SRGs’ research foci are available at: http://www.ahrq.gov/fund/peerrev/peerdesc.htm.
- Rosters of the SRGs are available at: http://www.ahrq.gov/fund/peerrev/hctdsrst.htm
- OEREP’s Division of Scientific Review will invite additional experts to serve as ad hoc reviewers, as needed.

## Are nonprofit entities eligible to apply if they do not have a 501(c)3 status?

- Nonprofit organizations are eligible.
- You do not have to be 501(c)3 status, but you cannot be 501(c)4 status.  Organizations described in section 501(c)4 of the Internal Revenue Code that engage in lobbying are not eligible for federal funding.

## Allowable Health Care Settings

*Mobile Van:*
- A health IT study for which ambulatory care is being provided in a mobile van would be considered responsive to these FOAs.
*Ambulance:*
**Yes:** A health IT study for which the patient is being transported between ambulatory settings or from a hospital to an ambulatory setting would be considered responsive to these FOAs, because the level of care provided is commensurate with the level of care provided in ambulatory settings, as specified in these FOAs.
**No:** A health IT study for which the patient is being transported to the Emergency Department to receive acute care would not be considered responsive to these FOAs, because the ambulance is in essence an extension of the acute care provided in the hospital.

## Allowable Overnight Care Settings

- Describe the type of care provided to patients so that it is clear that it is commensurate with the level of care that would be provided in the *ambulatory settings* specified for these FOAs.
*Assisted living settings:* In general, an assisted living setting where there is low level or intermittent care provided COULD be responsive to the FOAs, if the low level of care is clearly demonstrated.
*Nonskilled nursing beds within a skilled nursing home:** *We had not intended for the care setting to be a subsection of nonskilled nursing beds within a skilled nursing facility.  Such a care setting would NOT be considered responsive to these health IT FOAs because it is not seeking to understand health IT implementation and use in an ambulatory setting.

## Allowable Overnight Care Settings 

***Would a study that focuses on health IT implementation in dementia care facilities be allowable?***
- 	Given the continuum of types of care (and facilities) that could be provided for a patient with dementia, it is possible that an overnight facility treating dementia patients might meet the spirit of the “ambulatory setting.”  For example, an assisted living facility providing patients with low level or intermittent care would be considered responsive to the FOAs.  However, an overnight facility providing a high level of care (such as a skilled nursing facility) for the monitoring or treatment of patients with dementia would not be considered responsive.

## AHRQ National Resource Center for Health IT

- http://healthit.ahrq.gov
- Events
- AHRQ-funded Projects
- Health IT Tools
- Knowledge Library
- Funding Opportunities
- Frequently Asked Questions

## Additional Questions and Answers

## Ground Rules for Open Forum

- The conference call operator will put you in a queue based on  call order.
- Please keep your questions brief.
- We will try to keep responses brief.
- Questions that are very specific to a particular institution or situation will not be addressed; these can be discussed individually with a Project Officer from AHRQ at a later time.
- If you do not get an opportunity to ask a question, please e-mail your question to HealthITGrants@ahrq.hhs.gov

## Transcript of TA Call

- A Transcript of the TA call will be posted by January 23 at http://www.ahrq.gov/fund/grantix.htm

## References

## AHRQ contacts

- For additional technical assistance, please contact an AHRQ staff person who will be glad to provide technical assistance:
- Health IT Scientific/Research Issues:
- Angela Lavanderos: HealthITGrants@ahrq.hhs.gov
- Career Awards:
- Kay Anderson: Kay.Anderson@ahrq.hhs.gov
- Dissertation Grants:
- Brenda Harding: Brenda.Harding@ahrq.hhs.gov
- Peer Review Issues:
- Kish Wadhwani:  Kishena.Wadhwani@ahrq.hhs.gov
- Financial/Grant Management Issues:
- Sherry Cochran:  Sherry.Cochran@ahrq.hhs.gov

## AHRQ Web sites

- Grants Process (http://www.ahrq.gov/fund/grconix.htm)
- Peer Review (http://www.ahrq.gov/fund/peerrev/peerproc.htm)
- Grants Management
- See http://info.ahrq.gov/
- The HHS Grants Policy Statement (HHS GPS) (http://www.ahrq.gov/fund/hhspolicy.htm)

**Notes:**
HHS GPS is a prime resource for answering most grant-related questions. Also, please utilize the resources available in your institution's sponsored projects or research administration office for guidance before contacting AHRQ. 

## eGOV Transition Resources

- NIH Electronic Submission of Grant Applications Web site: _[http://](http://era.nih.gov/ElectronicReceipt/)__[era.nih.gov/ElectronicReceipt](http://era.nih.gov/ElectronicReceipt/)__[/](http://era.nih.gov/ElectronicReceipt/)_
- Grants.gov Web site (Applicant Resources): http://grants.gov/applicants/app_help_reso.jsp

## Tips to ensure eGOV submission success

- Check _[www.Grants.gov](http://www.grants.gov/)__ for help on settings to ensure the application reader opens in the correct version of Adobe._
- More information at: http://grants.nih.gov/grants/forms.htm
- 	_[http://era.nih.gov/ElectronicReceipt/avoiding_errors.htm](http://era.nih.gov/ElectronicReceipt/avoiding_errors.htm)_

## Support for e-submission

- Contact Grants.gov Contact Center for questions on form functionality or submission of the forms to Grants.gov
- E-mail: _[support@grants.gov](mailto:support@grants.gov)_
- Phone: 1-800-518-4726
- eRA Help Desk at NIH for post submission questions or technical issues that threaten receipt of your application
- Document technical issues and provide NIH with the contact center tracking number
- Web support: _[http://ithelpdesk.nih.gov/eRA/](http://ithelpdesk.nih.gov/eRA/)_
- Phone: 1-866-504-9552 or 301-402-7469