Release Date: August 21, 2013
Agency for Healthcare Research and Quality (AHRQ)
This Special Emphasis Notice (SEN) informs the research community that the Health IT Portfolio at the Agency for Healthcare Research and Quality (AHRQ) intends to support research career development grants (K08) and dissertation grants (R36) focusing on health information technology (health IT). This Notice supersedes previous Health IT Portfolio SENs on health IT-focused career development and dissertation grants (NOT-HS-11-016 and NOT-HS-08-014).
AHRQ’s Health IT Portfolio
AHRQ’s Health IT Portfolio develops and disseminates evidence about the effectiveness of health IT on health care quality and evidence-based tools on how to use health IT to improve health care quality. To accomplish this, the Portfolio:
What is Health IT?
Health information technology (IT) is broadly defined as the use of information and communication technology in health care to support the delivery of patient or population care or to support patient self-management. Health IT can support patient care related activities such as order communications, results reporting, care planning, and clinical or health documentation. Health IT applications or systems can use a variety of platforms, such as desktop computer applications, tablet computer applications, cellular phones, smart phones, touch screen kiosks, and others. Examples of health IT applications or systems include electronic health records (EHRs), electronic medical records (EMRs), telemedicine, computerized provider order entry (CPOE), computerized clinical decision support (CDS) systems, consumer health informatics applications (including personal health records [PHRs]), and electronic exchange of health information. Health IT applications or systems of interest to AHRQ under this SEN must support patient care related activities as described.
Research Areas of Interest
Effective health IT applications or systems should support delivery of high quality care and their design and implementation should be part of quality improvement processes. Ideally, health IT applications or systems should be implemented as part of a planned quality improvement effort in which careful consideration has been given to the goals of the quality improvement effort and how health IT will help support it.
Accordingly, this SEN is focused on five research areas of interest that are needed to support health care quality and are considered part of a continuous quality improvement process. Grant applications submitted in response to this SEN must clearly specify at least one primary research area to be addressed. The five research areas of interest for this SEN are:
1. Design: System design includes understanding current information needs and related processes; user needs, goals, and motivations; and the environments and context in which the health IT application or system will be used. Understanding of these issues can then be used to establish functional requirements, as well as develop and test system specifications and designs. AHRQ is interested in research projects that address issues with the design of health IT identified in the literature. This may include incorporating innovative or successful approaches from other fields to the design of health IT. In addition, there is a need to identify health IT design factors that may lead to less than optimal use and which may limit the effectiveness of health IT and impact on outcomes.
2. Implementation: Implementation includes the steps needed to make the health IT application or system operational, including conducting training and testing before go-live. Research is needed regarding best practices in health IT implementation and their relationship to health IT adoption and use, and outcomes, including barriers and facilitators to implementation. It is also important to identify how implementation processes may need to vary based on the care process, care setting, end users, and/or type of health IT application or system being implemented.
3. Use: This area includes factors that lead to increased adoption and use and how those may vary by care process, care setting, end users, and/or type of health IT application or system being implemented. There is a need to characterize drivers and barriers to use of health IT as well as understanding how health IT is used once implemented and the implications for design and quality improvement. Additional research is also needed regarding optimal levels of use of health IT systems, particularly for consumer health IT applications, and impact on other aspects of care due to use of a health IT application or system.
4. Impact on outcomes: This includes understanding whether the health IT implementation goals were achieved and the impact of the implementation on different types of outcomes. There is a need to also understand what moderates that impact and which outcomes can actually be impacted by the system based on its functionality and design. AHRQ is particularly interested in understanding the impact of health IT on the priorities listed below as well as addressing gaps regarding the impact on workflow and workload, efficiency, economic, and health or clinical outcomes:
a. Making care safer by reducing harm caused in the delivery of care;
b. Ensuring that each person and his/her family and caregivers are engaged as partners in their care;
c. Promoting effective communication and coordination of care;
d. Promoting the most effective prevention and treatment practices for the leading causes of mortality;
e. Working with communities to promote wide use of the best practices to enable healthy living; and/or
f. Making quality care more affordable for individuals, families, employers, and governments by developing and spreading new health care delivery models.
5. Measurement: Central to the use of health IT to support quality improvement is the ability to enable quality measurement using health IT. Quality measurement can both support health care providers and other members of their care team in providing effective and efficient care, as well as health care organizations to understand overall performance. Further research is needed regarding how to best leverage health IT to support quality measurement activities.
AHRQ is interested in funding projects that will fill known gaps in the field. To review known gaps applicants are encouraged to view health IT evidence reports available at: http://www.ahrq.gov/research/findings/evidence-based-reports/services/health-it/index.html. In addition, applicants should review specific AHRQ’s Health IT Portfolio program announcements, available at http://healthit.ahrq.gov/healthitfoas, which solicit grant applications that address the Portfolio’s most pressing priorities.
Applicants must clearly state in the Project Summary (abstract) and in the Specific Aims sections of the grant application that they are responding to this particular SEN (NOT-HS-13-011) and which research area of interest the proposed research will address.
Use of Funding Mechanisms. AHRQ will use its current career development mechanism – the K08 and its current dissertation grant mechanism –the R36. To learn more about AHRQ’s research training funding announcements, go to http://www.ahrq.gov/funding/fund-opps/index.html.
Timeline Limitations. Career development grant applications will be funded for 3-5 years. Dissertation grant applications will be funded for 9 to 17 months.
Grant Application Submission. With this notice, AHRQ is providing information about one of the highest research priorities for grant applications. AHRQ will continue to provide regular updates of research priorities as research budget information becomes available. Grant applications focused on areas identified in this SEN should be submitted on regular research career development or dissertation grant receipt dates and will be reviewed by AHRQ’s standing study sections. Information about the grant application process, including e-grant applications and the funding mechanisms noted above, can be found at http://www.ahrq.gov/funding/fund-opps/index.html.
The AHRQ designated contacts for this SEN are:
AHRQ Health IT Program inquiries:
Health IT Program
Tamara D. Willis, Ph.D., M.P.H.
Office of Extramural Research, Education, and Priority Populations
Gregory Stuppard, M.S.
Office of Extramural Research, Education, and Priority Populations
Applicants are encouraged to contact the designated AHRQ staff early in the process of preparing grant applications in order to clarify questions and discuss potential research projects.