Notice Number: NOT-HS-16-015

Key Dates
Release Date: May 18, 2016

PA-14-001
PA-14-290
PA-14-291
PA-15-147

Issued by
Agency for Healthcare Research and Quality (http://www.ahrq.gov/)

Purpose

This Special Emphasis Notice (SEN) informs the research community that AHRQ intends to support research on how health IT can facilitate the collection and use of patient-reported outcomes and patient contextual data to improve the quality and outcomes of care in primary and other ambulatory settings.

The effective use of patient-reported outcomes data is anticipated to play a critical role in improving health care delivery and patient experiences with care. In this effort we define patient-reported outcomes (PROs) as information gathered from patients or their families regarding health and functional status, including quality of life, symptoms, and activities of daily living. PROs may be gathered via specific PRO measures (PROMs). PROs can be analyzed and presented in forms that have clinical applications and can be used with individuals or aggregated to summarize information about groups (PRO population measures) thereby providing important data for clinical decision making, quality measurement, practice improvement, and research. Although collection of PROs is advancing rapidly, and they have been widely used in research and select clinical settings, little is known about how to best use them in primary care and diverse populations served in ambulatory settings. Furthermore, existing electronic health records (EHRs) are frequently unable to import these data and seldom incorporate them in a way that physicians (and patients) can easily use.

Effective care planning also requires information about patients’ values, preferences, circumstances and life contexts. This contextual information could include patient characteristics such as health literacy level and language preferences, access to transportation, amount of practical assistance at home, preference for decision-making authority, as well as community characteristics and resources. As with PROs, opportunities exist to enhance the collection and use of patient contextual data. Moreover, contextual data may be specific to a particular situation and may change over time. The dynamic nature of these data adds to the complexity of appropriate data collection and use.

In general, there is a need to facilitate the collection and use of PROs and patient contextual data in the primary care context in a manner that is efficient, actionable by the physician, supports patients' engagement with their health and care, and improves clinical processes and outcomes. PROs and patient contextual data can potentially inform clinical management of individuals, shared decision making, patient self-management support, care planning, goal setting and goal attainment. Use of these data for guiding and improving care may be especially important for patients with multiple chronic conditions, older adults, and people with functional impairments and disability.

Research Areas of Interest:

AHRQ is interested in understanding how health IT can facilitate the collection and use of patient-reported outcome and patient contextual data to improve clinical management, care planning, patient experiences and health outcomes in ambulatory settings. Examples of potential research include:

• Development, implementation, and evaluation of health IT interventions to collect PROs and/or patient contextual data.
• Development, implementation, and evaluation of health IT interventions to present and utilize PROs and/or patient contextual data during clinical care to achieve improved quality and outcomes of care including risk modification and adherence to interventions, intermediate endpoints such as blood pressure and glucose control, symptom control, quality of life, and avoidable morbidity and mortality.
• Development, implementation, and evaluation of strategies to use health IT as a tool to efficiently integrate PROs and/or patient contextual data in care planning and delivery across multiple providers.

Research with individuals in diverse populations and/or with multiple chronic conditions is encouraged.

Further Guidance

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-16-NNN).

Use of Funding Mechanisms. AHRQ will use a variety of new and existing research mechanisms as well as standing Funding Opportunity Announcements (FOAs) to support applications submitted in response to this notice. Applicants may apply under one of the following FOAs:

PA-14-001:  Exploratory and Developmental Grant to Improve Health Care Quality through Health Information Technology (IT) (R21)
PA-14-290:  AHRQ Health Services Research Demonstration and Dissemination Grants (R18)
PA-14-291:  AHRQ Health Services Research Projects (R01)
PA-15-147:  AHRQ Small Research Grant Program (R03)

Limitations on Timelines and Funds. Project period limitations, application deadlines, and budget limitations are specific to each FOA and are stated in each FOA.

Inquiries

Please direct all inquiries to:

CDR Derrick L. Wyatt
Agency for Healthcare Research and Quality (AHRQ)
Center for Evidence and Practice Improvement
Telephone: 301-427-1505
Email: [email protected]