f

, ,

Centers of Innovation

(COIN)

Sara Knight, PhD

David Atkins, MD, MPH

Seth Eisen, MD, MSc

Health Services Research & Development Se

June 2012
Objectives 

• Review the elements of the COIN application

• Discuss frequently asked questions

• Consider review criteria• Answer questionsVETERANS HEALTH ADMINISTRATION 
COIN Objective 

This initiative seeks to build on the past suc

of HSR&D research research centers centers while providing providing 

effective mechanisms and incentives to re

research and

partnershi

p

s to ensure that re

has the greatest possible impact on VHA po

and health care practices and outcomes 

Veterans.

VETERANS HEALTH ADMINISTRATION 
COIN Timeline 

Eligibility

• Determine eligibility for COIN or Multi

‐Institutiona

• Obtain initial budget information

Review

• Peer review to assess scientific merit

Review

• Investigators/Partners site visit to assess importan

Process

• Investigators/Partners site visit to assess importan

b d i bl (b

d i d l 

Budget

• COIN

b

u

dgets variabl

e (base

d on

size an

d complex

• Fund minimum of 15 COINs

VETERANS HEALTH ADMINISTRATION 
Submission Timeline 

Milestones Deadlines

Intent to Submit Se

ptember

1, 2

First day to submit to

Grants.gov October 8, 20

Down to the Wire Submission November 1, 2

Last Possible Submission Date November 5, 2

VETERANS HEALTH ADMINISTRATION 
VETERANS HEALTH ADMINISTRATION

What counts in the COIN? Eligibility Core Investigator Infrastruct

Approval to Submit Strategic Plan Budget

Minimum of 5

unique HSR&D and

QUERI PIs within

All 5/8ths HSR&D

and QUERI PIs

within a single COIN

Research AEquivalent

Qsingle facility

g

Funded projects, HSR&D and QUERI

f d d d

Dollars sen

i.e., IIR, SDP, SDR, 

NRI, CREATE (one

CDA) active on the

funded PIs, new andestablished PIs (2yrs before or after

to support 

projects; a

) based on a

date of application

submission

yfunding),collaborators

of the prev

years 
Who counts for eligibility? 

• Minimum of 5 unique PIs on HSR&D or QUERI projec

single VA Medical Medical Center

– IIR, SDP, SDR, NRI, CREATE Projects

– One of the qualifying PIs can be a CDA without a 

HSR&D or QUERI project

• Each funded PI is counted once even if that PI as 

VA HSR&D proj t ec s

VETERANS HEALTH ADMINISTRATION 
PI on

ears om

Who Counts as a Core Investig

Employed for <2

years and does

not yet have a

HSR&D funded

PI on HSRD

project that 

closed and is 

HSR&D funded fr

project

years from

project en

5/8th VA

appointment (or

eligibility waiver)

Not PI on HSRD

or QUERI project

but collaborates

eligibility waiver)

but collaborates

as a co‐

investigator on

HSR&D or QUERI

PI on a HSR&D o

QUERI project

VETERANS HEALTH ADMINISTRATION

project

•Non‐Core Investigators have less than 5/8th VA 

are the PI on a peer reviewed research project f

VA entity
Fixed and Variable Infrastruct

• Actual infrastructure infrastructure budgets budgets will depend on 2013/14 2013/14 budgets budgets, 

and their size

• Target Budgets were provided to all REAPs and CoEs, calculated 

1. Estimate Estimate Total Center Research Research Activity Activity Equivalents Equivalents (RAEs) for Each Cent

a. [3 year average total HSR&D project funding

/ $186,000 (all HSR&D pro

funding/total number of projects)]

+

b. [3 year average

# of CDA’s (one CDA=one RAE)]

+

c.

# of Research Career Scientists

2. Target Budget Calculation

a. Variable component (proportional to total RAE)

+

b. Fixed infrastructure infrastructure component component (approx (approx $385,000)

Single Center COIN ‐ all receive the same infrastructure component

Multicenter COIN – all receive 1.3

x single center amount

Centers were then ranked based on RAEs and each center was assign

VETERANS HEALTH ADMINISTRATION

Centers were then ranked based on RAEs and each center was assign

three budget categories: $600k, $800k, $1.0m.
Infrastructure for CREATEs 

• Will there be additional money for administering the CREATE

– There will not be additional support to cover the costs of coordin

between CREATE projects, ensuring communication

between PIs 

researchers and partners, and convening regular (annual) meetin

investigators and partners. Only those CREATEs NOT located at

a c

Center (or future COIN) g are eli

gible to receive

a supplement of $ 

5

year for the administration of the COIN.

• Supplemental Travel funds for all CREATES

– Travel of up to $10,000 per year will be available to your CREATE f

support the overall CREATE goals and allow collaboration betweepartners/PIs.

VETERANS HEALTH ADMINISTRATION 
COIN Application Elements 

• Strategic Plan covering:

• Focused areas of research• Research outside the focused areas• M t en

toring an

d career

developmen

t

• Cross

‐center collaboration

• Engagement Eng emen ag t with Partners Partners in at least one

focused 

• Partnered research component with at least one o

projects providing Veteran or system impact early 

two years of COIN funding funding (similar (similar to CREATE) CREATE)

• Specific goals and objectives tied to current and p

activities

VETERANS HEALTH ADMINISTRATION

• Service to partners
Strategic Plan: Forward Lookin

It will be important important to show how the Cent

plans to develop new collaborations acro

medical medical centers centers and how the Center plan

sustain existing and new collaborations

extending extending into the future.VETERANS HEALTH ADMINISTRATION 
Focused Area of Research 

• At least one, but no more than three, focused areas of researc• Presents

a

framewor

k

for systematicall

y

developing eac

h area

– Identifying critical gaps in the science

– Anticipating future research priorities

– Engaging partners if appropriate

• Specific goals and objectives tied to current and future activitie

• Plans for coordinating relevant expertise across medical center

• At least one focused area describes relevant health systems pa

that have been integrated into the strategic plan.

VETERANS HEALTH ADMINISTRATION 
– Independent investigators at other COINs and non‐affiliate

• Emphasis on research thatResearch Outside Focused Are• Emerging Emerging research research areas within a COIN

– Investigators working in VA‐relevant areas that are innovat

– May not fit in one of COIN’s focused areas of research

• Critical to describe how the COIN will support the

collaborations of these investigators with

– Other COIN and CREATE groups– Is innovative– Advances science and improves health care for Veterans– Influences policy and practice in VA and beyond

VETERANS HEALTH ADMINISTRATION

p y p y

– Involves active partnerships
Mentoring/Career Developme

• Integrated in the strategic plan, even if no CDA•

Plan should include include

a goal relevant relevant to career develop

develop

– Individual objectives related to specific activities to pr

effective mentoring and professional development of 

investigators

– Demonstrate how knowledge, skills, and techniques w

disseminated

• New incorporation of distance mentoring, off

‐site ac

cross

‐disciplinary interactions, engaging partners

VETERANS HEALTH ADMINISTRATION 
– ‐

Cross-Medical Center Collabor• Commitment to collaborative work across institution

– Goes beyond the collaboration collaboration of a Multi‐Institutiona

Institutiona

• Evidence of or plans for collaboration may include:

– Involvement of another investigator in the developme

COIN strategic plan

– Investment of COIN investigators in focused areas of r

conducted conducted at other facilities facilities

– Joint sponsorship of HSR&D initiatives including confe

agenda setting meetings, and publication efforts

VETERANS HEALTH ADMINISTRATION 
Other Elements of COIN 

Application • Service activities• Implementation capacity

• Prior productivity and impact (FY09

– Summer 2012 revie

• Center leadership including Steering Committee

• Center organization and management plan

• Investigators Investigators and staff• Available infrastructure and institutional supportVETERANS HEALTH ADMINISTRATION 
–

Implementation Capacity • A goal of the COIN program is to build capacity for

implementation and implementation research beyon

• Attention Attention to implementation implementation should occur early in re

re

– Increases likelihood of knowledge translation into pol

practice

• Current and planned implementation activities shou

described in application

– Collaborations Collaborations with QUERIs, VERCs, implementation implementation a

improvement initiatives

– Activities with other non‐ORD research centers, e.g., G

MIREC

VETERANS HEALTH ADMINISTRATION

MIREC
,

Prior Productivity and Impact • This section can be used to highlight additional evide

productivity and impact on HSR&D and VA. Appropr

measures include :

– Total number of funded investigators

– Levels of funding over the past three years from VA an

sources

– Publications, especially high‐impact publications (high

circulation journals, widely‐cited and influential p pa er

• This section should cover only the preceding three y

should not repeat specific examples covered in othe

th t t i l

VETERANS HEALTH ADMINISTRATION

the strategic plan.
Multi-Institutional COIN 

• Multi

‐Institutional Institutional COINs should include: include:

– Demonstration of

a specific value to collaborating between multi

investigators at the two medical centers;

– Evidence Evidence of either: either: (a) unique expertise expertise and responsibilities responsibilities at eac

center that are required for the success of the COIN, or (b) fully in

responsibilities that depend on investigators at both medical cent

– An organizational plan that identifies

a single COIN Director and C

and clearly describes intra‐ and inter‐institutional lines of authori

– Specific plans to address anticipated budgetary challenges associa

sharing COIN resources at two medical centers;

–

A minimum of

5 unique, HSRD

/QUERI‐funded investigators at eac

• Multi

‐institutional COINs will get slightly more (but less than 2

component of infrastructure support than

a single institution C

VETERANS HEALTH ADMINISTRATION• Infrastructure will be revised should one institution fall below m
COINs with an Affiliated Site 

•

A COIN may affiliate with an institution that does nominimum minimum eligibility eligibility but which has investigators investigators that integral to its strategic plan.

• Only the institution that meets eligibility will be guar

core and variable COIN funding.

• Infrastructure support for COINs will be revisited ann

based on available available budget and needs; an affiliated affiliated si

able to grow to meet COIN eligibility may be eligible 

additional funds.

VETERANS HEALTH ADMINISTRATION 
relative weighting of the other 4 characteristics will vary by COIN depe

size and composition

• Reviewers will evaluate both the unique strengths of each COIN and th

Review Criteria • Reviewers will judge likely contribution of the proposed COIN based o

characteristics:

– Strategic plan for focused areas of research (including CREATE element)– Research contributions outside of focused areas

– Mentoring and career development– Cross‐center collaborations and capacity for service to partners

– Research Research capacity capacity, implementation implementation capacity capacity, infrastructure infrastructure and leadership leadership

• The strategic plan for focused areas of research will be most importan

no explicit weighting system for the 5 elements

• Although Although the last element element (capacity (capacity, infrastructure infrastructure and leadership) leadership) is 

VETERANS HEALTH ADMINISTRATION 

strength of each COIN compared to the others
Questions and Discussion 

VETERANS HEALTH ADMINISTRATION