Grant Details

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Summary

History of Funding

Projects funded under this program can be seen at https://reporter.nih.gov/search/zaBfaCIN3kiul9A8Tvvwiw/projects

Additional Information

The overarching objective of this FOA is to improve the quality of healthcare services delivery at the point of care. This FOA aims to support phased exploratory and developmental research projects that test promising digital healthcare interventions intended to improve quality at the point of care.

Research should be designed to test promising digital healthcare solutions that enable or facilitate technology-driven, point of care process solutions that use advanced analytics, patient-centered clinician and patient facing digital healthcare technologies, or clinical decision support systems to improve quality and health outcomes at the point of care. A theoretical framework should inform the research study and incorporate the use of care models when appropriate.

Accordingly, this FOA is focused on three research areas of interest. Examples of research projects responsive to this FOA include but are not limited to:

Use advanced analytics to improve quality at the point of care.

• Projects that will test innovative digital healthcare solutions that integrate the use of artificial intelligence (AI) (e.g., Natural Language Processing, Machine Learning) during the provision of healthcare services at the point of care. Such applications should assess and evaluate AI's impact on practice workflow and quality of care
• Projects that apply machine learning against large health data sets to improve care delivery and quality at the point of care.

Use innovative, patient-centered, clinician and patient facing digital healthcare technologies to improve patient experiences and healthcare services delivery at the point of care

• Projects that explore understanding how the use of patient-centered digital healthcare technologies (e.g., wearables, sensors, mhealth solutions) impacts patient outcomes, experiences, and healthcare services delivery at the point of care. Such applications should assess and evaluate the technology implementation's impact on practice workflow and quality of care.

Of particular interest is (1) testing innovative digital healthcare technologies that facilitate information sharing and shared decision-making between patients and providers, and (2) evaluating the use of novel digital solutions for patients with multiple chronic conditions.

Use evidence-based knowledge and patient-data to augment support for clinical decision-making at the point of care.

• Projects that will test innovative digital clinical decision-making tools that incorporate the use of patient-generated data and patient-reported outcomes at the point of care.
• Projects that evaluate a digital point of care solution that combines the use of natural language processing (NLP) with a decision support tool in order to turn unstructured clinical data into knowledge and facilitate the advancement of the knowledge into practice.
• Enabling clinicians and health system decision makers to effectively and efficiently use standardized computable biomedical knowledge to support clinical decision making is also an interest area. Applications that explore digital healthcare innovations in support of this interest area are welcome.

It is acceptable for applicants to propose research that crosses the research categories of interest mentioned above. For example, an applicant may propose to study an innovation that integrates AI with a clinical decision support solution that incorporates patient-reported outcomes at the point of care.

Phased Innovation Award

This FOA will use the Phased Innovation Award Mechanism (R21/R33) to provide up to 2 years of R21 support for initial developmental activities and up to an additional 3 years of R33 support for expanded activities.

Proposed projects must include both an R21 phase, with milestone-driven developmental activities, and an R33 phase with expanded activities that will build on the initial developmental phase to achieve the aims of the entire award.

Applications proposing only R21 or R33 activities alone will not be accepted. 

Preliminary data are not required for this mechanism, but may be included if available.

Prior to funding an application, AHRQ staff will contact the applicant to discuss the proposed milestones. AHRQ staff and the applicant organization will negotiate and agree on a final set of milestones, which will be incorporated into the terms and conditions of the award and will be the basis for judging the success of the R21 work.

Three months prior to the end of the R21 phase, awardees will submit a package, endorsed by an authorized institutional official, that requests transition to the R33 phase. This package will include a progress report that describes progress made toward each of the initial milestones, and a clear description of whether the original R33 proposed aims will remain intact or be modified based on the results of the R21 phase. Materials will be reviewed by AHRQ program staff and then, if selected to continue into the R33 phase, the R21 grant will be transitioned to an R33 award without the need to submit a new grant application.

Decisions on transitioning to the R33 phase will be based on the original R21/R33 peer review recommendations, successful completion of the originally described milestones, program priorities, and availability of funds. Transition to the R33 phase is not guaranteed for all grants awarded under this FOA. If R21 awardees are not ready to submit an R33 transition package prior to the end of the R21 award, a no-cost extension for up to one year may be requested, during which time awardees may submit an R33 transition package. This one-year no cost extension period will not count against the 5-year limit for the entire R21/R33 award, but will count as the one grantee-initiated no-cost extension allowed under expanded authorities. A subsequent no-cost extension of the R33, if awarded, would require AHRQ prior approval.

All projects must:

• Describe the healthcare practice setting(s) for the research;
• Describe the patient population(s) impacted by the research;
• Describe the digital healthcare intervention and the problem indicating its readiness for an exploratory/developmental research project;
• Describe how performance will be measured (expected standards, outcomes, baselines, indicators, etc).
• Describe all users of the digital healthcare solution or system;
• Describe how the solution should be expected to reduce (or at least not exacerbate) disparities;
• Evaluate the reliability, validity, and usability of the digital healthcare solution used at the point of care;
• Describe how the digital healthcare intervention will be incorporated into the clinical workflow;
• Describe how technology modifications, systems, or tools will be designed from the outset to be easily adopted by other providers and teams in the organization and how the project will be designed to scale across the organization and beyond to other, similar organizations;
• Clearly demonstrate how the resulting innovation can be sustained and adopted by other settings;
• Develop an innovative and leading-edge dissemination strategy that will be implemented during the second phase of the grant;
• Evaluate and report (as applicable):
• Improvement in the quality of care and reduction in adverse events;
• Improvement in patient experience;
• Reduction in provider burden; and
• Unintended patient safety events.
• Provide a detailed project timeline that shows major milestones.

Recipients of awards under this FOA must provide annual and final reports of performance in achieving the FOA objective to develop projects that test promising digital healthcare interventions aimed at improving the quality of healthcare services delivery at the point of care. (see section VI.3. Reporting).

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