Transcript
This document summarizes the
technical assistance call for AHRQ-sponsored Health IT funding opportunity
announcements (FOAs). Select to access the FOAs.
The technical assistance
teleconference was held at the Agency for Healthcare Research and Quality
(AHRQ) conference center in Rockville, MD, on January 13, 2009. If after
reading this document you have any questions or comments, contact healthITgrants@ahrq.hhs.gov.
Introductions | Questions and Answers | Open
Forum Questions | General Questions
Submitted after the Technical Assistance Call
Introductions
Rebecca
Roper: Good afternoon. As
identified, I am Rebecca Roper and I'm one of the members of the Health IT (Information
Technology) Team at the Agency for Healthcare Research Quality (AHRQ). We are very pleased with the number of participants this afternoon, both around the table
with me at AHRQ and across the Nation.
There
are many people who are excited about these Health IT Funding Opportunity
Announcements (FOAs), and we hope that translates into many very competitive
and meritorious applications coming in to AHRQ. So before I get started, we'll
take an opportunity to let you know who the people are at AHRQ who are here to
support you through this process and who are here in person. Starting
with Boris Aponte, introduce yourself and maybe tell us where you work in AHRQ.
Boris
Aponte: Good afternoon,
everyone. My name is Boris Aponte, and I'm a Scientific Review Officer (SRO) in
charge of the study section for health care information technology.
Ali
Azadegan: This is Ali
Azadegan, another member of the Division of Scientific Review (DSR). I am a Scientific
Review Officer, who from time to time, [conducts extramural peer review] of the
training applications that come through, some of those [applications] have to
do with health IT.
Jon
White: Hi, my name is Jon White
and I direct the Health IT portfolio at AHRQ.
Ileana
Ponce-González: Hi, my name is Ileana
Ponce-González, and I am a Scientific Review Officer.
Erin
Grace: Hi, my name is Erin Grace.
I'm a member of the Health IT team.
Teresa
Zayas Cabán: My name is Teresa Zayas Cabán;
I'm also a member of the Health IT team.
Matthew Quinn: This is Matthew Quinn; I'm also a member of
the Health IT team.
Debbie Rothstein: I'm Debbie Rothstein, Advisor for the Office of
Extramural Research, Education and Priority Populations (OEREP) at AHRQ.
Michael Hagan: [I am] Michael Hagan, Economist and Program
Officer and contact on research priorities around value.
Rebecca Trocki: [I am] Rebecca Trocki, Program Analyst, Division
of Scientific Review (DSR). I work with Ali Azadegan and Boris Ponte.
Steve Bernstein: [I am] Steve Bernstein, member of the Health IT
team.
Michelle
Burr: [I am] Michelle Burr
with Grants Management.
Kay
Anderson: [I am] Kay
Anderson, the program officer for career awards grants a.k.a., K-awards) grant.
Bob
Mayes: [I am] Bob Mayes, Health IT.
Rebecca
Roper: Thank you. Collectively,
we will be providing an overview of the three Health Information Technology (IT)
Funding Opportunity Announcements (FOAs) that were published last fall
(September 2008). I just need to clarify that the information provided in the
actual funding opportunity announcements is the information that should be used
in the sense of direction of how applicants respond to these FOAs. We
hope to rearticulate or restate in a different way the expectations articulated
in those FOAs. Should I trip myself up and make a misstatement in this oral
presentation [that contradicts guidance in the health IT FOAs], disregard [the
oral statement], and use narrative of the Health IT FOAs as your guidance.
Does
anyone care to add to that?
Jon
White: Mention the transcript;
that there'll be a transcript.
Rebecca
Roper: Oh yes, indeed. We will
have a transcript that will be created based on our presentation and your
thoughtful questions and answers, both those that have been posed previously
and we'll respond to at the end of the call, and any new questions that you will
articulate and we'll respond to today. We're hoping that that transcript will
be posted on our Web site [http://www.ahrq.gov/fund/tacall.htm] by a week from
Friday, by January the 23.
As
I stated, our intent is to highlight the Health IT FOAs and maybe provide some
clarification on issues. Historically, AHRQ Health IT grants initiatives have
really focused on one-time Request for Applications (RFAs) and some of you may
be familiar with the Ambulatory Safety and Quality (ASQ) Program and the RFAs that
were published as part of that Program back in 2007 and 2008 [HS-07-007; HS-07-006;
HS-07-002; HS-08-002] and hopefully several of those folks who were applicants to
those RFAs are interested applicants who are joining us today.
In
the fall [2008], AHRQ chose to publish three FOAs using different types of funding
mechanisms:
- The small research grant to
improve healthcare quality through health IT, that's an R03 [PAR-08-268].
- An exploratory and developmental
grant to improve healthcare quality through health IT, an R21 [PAR-08-269],
which is a little bigger grant as far as total cost and a little more robust
research project is expected.
- The R18 [PAR-08-270], utilizing
health IT to improve healthcare quality, which may be a more familiar mechanism
based on your experience at AHRQ with respect to applying to R18 grant
initiatives.
So we're now on the Slide Number 5 if you're looking
at your PowerPoint® presentation [http://www.ahrq.gov/fund/tacall.htm].
Slide 5 provides a tabular—a table presentation—of the overview of the AHRQ-sponsored health IT FOAs.
For
the purposes of this call, those are the three funding opportunity
announcements we are going to focus on. As you are aware, AHRQ has recently published two new versions of its program announcements for the R01 [PAR-09-070]
and the R18 [PAR-09-069], and a little later we will address how those are
different [from the three health IT-oriented FOAs that we will be discussing]
today with respect to health IT.
You
also are aware that in the fall [2008] we published a Special Emphasis Notice [NOT-HS-08-014]
to encourage applicants who have a health IT focus for either career
development or research dissertation grants to submit those applications to AHRQ and we'll talk about them just briefly. We have Dr. Kay Anderson from that group who will
be able to provide responses to any questions that you pose in the open forum. But
for today, let's take about 5 minutes or so and look at Slide Number 5 [found
at http://www.ahrq.gov/fund/tacall.htm]. It synopsizes some of the milestones related to
the three funding opportunity announcements. To put the FOAs in context, we can
highlight their scopes. So for the R03, three different types of research
grants can be supported through our R03:
- Small pilot and feasibility or
self-contained health IT research projects.
- Secondary data analysis of health
IT research.
- Economic prospective or retrospective
analysis.
The
R21 supports conduct of short-term preparatory pilot or feasibility studies
that are neededto inform future health IT implementation, which may include,
but is not limited to, the conduct of a health IT research grant. And what I'm
reading comes right from the FOAs but our presentation gives you a little
context.
The
R18 supports demonstration research grants that rigorously study health IT
implementation and use to improve the quality, safety, effectiveness, and
efficiency of health care in these settings. So if you look at the authorized
duration, all three mechanisms are currently authorized for 3 years.
The
earliest submission date for the R03 and R21 is coming up; it's February 16,
in about a month. The recurring due dates are also specified. But notice for
the R18, that first due date is right around the corner; it is on Sunday,
January 25.
Whenever
a recurring due date [for submission of an eGOV application] falls on either a
weekend or a Federal holiday, as stated on the FOAs, you have until the next
business day at 5 p.m., local time for the applying institution, to submit your
application. Due to challenges in e-GOV [process] and given that any type of
hiccup can occur, we strongly encourage you to submit your applications before
the recurring due dates as posted.
With
respect to the differences across the different health IT FOAs, you'll notice
for both the R03 and the R21 that one may request a maximum project period of 2
years. If your project design is such that you can accomplish what you need to
in under 2 years, you are welcome to specify a shorter duration. Similarly for
the R18—it's a 3-year maximum project period [although a shorter duration may
be requested].
For
those of you who are familiar with grants, there are no-cost extensions that
may be requested [toward the end of the authorized grant period] but that's a
different issue [known as a] no-cost extension, it would be in addition to the
maximum project period for which you would be articulating a research plan and
a timeline in an application process.
If
you look at the total cost over the grant lifetime—total cost is comprised of
both direct and indirect costs; for the R03 the total cost is $100,000, for the
R21 it's $300,000, and for the R18 it's $1.2 million. Within a given year, the
total cost does have a maximum value for each funding opportunity announcement.
You'll
also notice a progression with respect to Part D, the research plan. For the R03,
we allow a 15-page limitation; for the R21 it's a 20-page limitation; and for R18
it's a 25-page limitation. The number of pages allotted really reflects the
anticipated complexity of the research projects and respective analytical plans
that would be posed. So we try to give you ample room to articulate well your
research plan.
If
you don't get funded the first time around, I encourage you to consider coming
back [with a resubmission] based on your areas of interest for research and the
nature of the comments that you receive; you may submit one resubmission. [For
the R03, you have one resubmission opportunity.] You have two more bites of
the apple, so to speak, for the R21 and the R18; and whether or not you proceed
with the resubmission, that's completely up to you.
Also,
for each funding opportunity announcement you have a requirement to have an
introduction to describe your resubmission: [the length of that introduction]
is one [R03], two [R21] and three [R18] pages for the progressively more
complex health IT funding opportunity announcements.
With
that, I'll see if anybody around the table seeks to provide clarification.
I
want to emphasize to you that unlike the one-time RFAs, you have an opportunity
for resubmission [with these health IT FOAs]. So if you don't succeed [get
funded] the first time and you think you have a good idea, come back to us
[Resubmit]. Really, this is what we're hoping will happen; we'll learn by your
application process and you'll learn by our response and the input of the
extramural peer reviewers as well.
Debbie Rothstein: One comment I would make is if anyone is thinking
about trying to get funding in Fiscal Year (FY) 2009 for AHRQ, this upcoming
grant cycle [due dates in January, February, and March], this is the only cycle
that will be considered for FY 09 funding; all future cycles based on how long
it takes to receive, review, and make funding decisions, they'll all be bumped
into 2010 and beyond.
Rebecca
Roper: Moving on to our special
emphasis notice (SEN) for health IT focus on career awards. There are three
different career awards that were featured in the health IT focus. And just so
you know, the (K) awards, the first for this cycle, are due February 12.
The
grants for the Health Services Research (HSR) dissertation R36 for the first
cycle, they're due February 16. In the body of the PowerPoint®
presentation, you have the contact information for (Kay Anderson) who is in
charge of the (K) awards and (Brenda Harding) who is in charge of the
dissertation research grants.
Any
additional input here? Okay.
Now,
we're going to take a few minutes to talk about those issues that are common
across all three health IT funding opportunity announcements. And after we give
those presentations, we'll begin to talk about what differentiates each funding
opportunity announcement.
Examples
of health IT were articulated in each of the FOAs. But, they are examples;
there are other types of health IT that can be quite applicable to the FOAs;
for example, bar coded medication administration (BCMA) is another type of health
IT that can be appropriately applied in this particular series of health IT FOAs.
There are telemedicine applications that can be quite appropriate. To the
extent that you can demonstrate the appropriateness of your health IT, you're
encouraged to submit an application.
We
have three research areas with respect to health IT. You'll notice these
research areas are consistent across the health IT-oriented FOAs that we're
talking about today. These three research areas are also echoed in what I will
call the AHRQ-wide FOAs–the R01 [PA-09-070] and R18 [PAR-0-071] that were just
issued.
So
applications [to AHRQ] that involve health IT must identify themselves as
addressing at least one of the three research areas:
- Medication management (described in
the synoptic fashion).
- Patient-centered care including
coordination of care and use of electronic exchange of information.
- Health care decisionmaking
through the use of integrated data and knowledge management.
Now
the breadth of how these particular concepts [research areas] is quite large
and the examples given are quite varied. We do not expect a given application
to address all the different forms, for example, of healthcare decisionmaking
in a given application. Also, we recognize that some applications may address
one or more of the research areas and that's fine to articulate. But [you
should] also articulate to us which particular one [research area] is your
primary area of focus.
An
important area for reinforcement in these health IT FOAs is the appropriateness
of the research settings that you've identified. For the purposes of these
health IT funding opportunity announcements, we require that the health IT being
implemented or the health IT evaluation that's going to be conducted [be related
to health IT implementation that] has occurred in ambulatory care settings [or
in transitions in care settings], and we have listed several example ambulatory
care settings.
You
may have other ambulatory care settings that are quite applicable. You need to
just demonstrate the appropriateness of them in your application. One thing to
point out for these health IT FOA applications is that those [proposals which
would] focus on health IT implementation in emergency departments or the
transition from emergency departments to an inpatient hospital setting would
not be permissible and would not be reviewed.
So
again to reemphasize that, within each of the health IT FOAs, we specify some nonresponsive
research settings where an application that features health IT implementation
in non-ambulatory settings such as a hospital, an emergency department, a
skilled nursing facility, or an inpatient mental health facility for purposes
other than facilitating transitions in care to and from an ambulatory setting would
be considered nonresponsive to these FOAs and will not be reviewed.
We'll
have some examples later on [in the question and answer section of this
presentation] of what we consider to be appropriate and some nonappropriate
health IT care settings for these health IT FOAs.
(The
following statement from later on in the call was repeated for emphasis: We
anticipate that there will be many different variants of allowable ambulatory
settings and/or transitions in care and have not chosen to select an exhaustive
or present an exhaustive list; we just encourage you to articulate and
demonstrate why the care provided [in your proposed health care setting] is
commensurate [with the level of care provided] in an ambulatory setting.)
Several
examples within questions and answers are provided. Go to the
PowerPoint® Presentation that accompanies this Technical Assistance Call,
slides 10, 11, 41 (Mobile Van and Ambulance examples), 42, and 43 (allowable
overnight care settings).
Rebecca
Roper: In each of the funding
opportunity announcements there is a section IV. 6, which identifies specifics [required
for a given] proposal. First, let's talk about the requirements that are consistent
across the health IT FOAs. You need to provide a detailed description of the
health IT intervention.
We
encourage you to describe the interface with preexisting health IT, if any. And,
if possible, the health IT intervention should conform to Federal and other
interoperability standards and use certified products. If this isn't feasible
just give us an explanation.
Also,
depending on the type of research you're proposing, for example, if you're
conducting a secondary data analysis or if you're conducting an economic
analysis you may not actually be implementing a health IT, you [should] discuss
the type of health IT that was implemented about which you're conducting your
analysis.
Here's
another issue that pops up regularly: guidance on software/hardware and/or
equipment purchases. In combination, over the lifetime of the grant we expect
that such purchases will be 20 percent or less of the total cost. But in your
circumstance, you may require more money; if you do, we require that you
provide a justification. You will be evaluated on the appropriateness of these
purchases.
Next
is something that you will see in the health IT FOAs that has a new dimension to
it and it has to do with the research methods section: identify if a privacy
and security plan is necessary. For many of you who participated in the earlier
AHRQ health IT requests for applications for the Ambulatory Safety and Quality
(ASQ) Program [you will note] that a similar requirement was put forth. But we
have tried to provide you more guidance with respect to what we anticipate and
what we need to see.
To
reinforce the importance of the privacy and security plan and not to discourage
you from taking the appropriate amount of time and narrative to address it, we
ask that you provide a concise summary of the plan in your Part D [PHS 398
Research Plan]. In your page limitation for research methods [for each health
IT FOA], you provide a concise presentation of your privacy and security plan.
But
in Appendix A, if you are engaged in health IT implementation, you have an
unlimited opportunity to articulate the privacy and security plan as you've
identified it at the time of preparing your application.
All
[submissions to these FOAs must be made electronically.] As you know in
December 2008, our three health IT FOAs were updated to include the Adobe forms
for the new process. So if you haven't looked at the electronic version of the health
IT FOAs in the last month, you may not have seen that the forms are available.
I strongly encourage you to download either Adobe® Reader® 8.1.3 or 9 (it's available
through the link that you have in the health IT FOAs) and to download the [application]
forms and take a look at them, if you have not engaged in this process before.
I
also want to reemphasize that for AHRQ, we require that you use a Research and Related
budget form [detailed budget]. So if you should accidentally use the (PHS 398)
Modular Budget Forms, your application will not be reviewed. So be very
careful.
Debbie
Rothstein: One other side note to that,
I'm assuming most of you have seen this but if you have not previously done an
electronic submission you will note that the funding announcements indicate
that you and your institution have to actually register in two different places:
eGov: [http://www.grants.gov/applicants/get_registered.jsp]
and eRA Commons [http://era.nih.gov/ElectronicReceipt/preparing.htm].
You should plan that it could take as long as 2 weeks, so that you should also
begin thinking in terms of what you need to do to prepare for electronic
submission almost immediately.
Rebecca
Roper: Thank you. Also identified
within each FOA are eligible institutions. And I suggest you look at the narrative
in detail. But to highlight: For-profit organizations are not eligible to
receive funding as the awardee institution for an application. And foreign
institutions are not eligible to apply as the primary awardee institution
although they can be part of a consortium and we'll get to that in a little
more detail later.
All
right, principal investigator (PI), you'll notice in the announcements that the
terms principal investigator, PI, and PD, project director, are used
interchangeably. PIs may come from a variety of different background areas. The
extent to which a PI is appropriate is really in terms of the particular
funding announcement to which you are responding and the requirements
identified [within that FOA] and the research scope of the particular
application.
One
thing that's standard across our three health IT FOAs is that a PI should
devote a considerable portion of time to the project proposed. If less than 20
percent time will be devoted, the application must include an explicit
justification. Applications should describe PI responsibilities and
backgrounds. The level of experience expected for our PIs really varies across
the type of health IT research project.
We
are hoping through these announcements not only to generate particular types of
research topics but also to cultivate health IT research capacity among
interested professionals.
I'll
just see if anybody has any general comments. Now we're going to forge on to
the FOA specific issues. We'll start off with a small research grant to improve
health care quality through health IT [R03] and then we'll go up the line to
the R21 and R18.
So
the R03 really supports a wide variety of research designs. It's foreseeable
that you may have unique ideas and you could [submit] different R03 proposals
at the same time. But let's just talk about the three basic types of research
design [for the health IT R03].
There's
the small pilot and feasibility or self-contained health IT research project.
There's the secondary data analysis of health IT research. And there's the
economic analysis of health IT implementation and that might either be
prospective or retrospective. So we hope we've given you lots of choices here.
In
general, for the R03, you need to pay particular attention to the research
criteria given the type of study you propose. So for the small pilot and
feasibility or self-contained health IT project we expect it to inform future
development of health IT strategies for health IT research or implementation
activity. This is preparatory work.
The
PI is not expected to be extensively published or have prior leadership in the
research project. And consistently across all types of research design and the
different mechanisms, applicants are encouraged to consider a wide range of
scientific methods including both quantitative and qualitative methods. The
study design and analytical plan should be well justified and consistent with
specific aims. But we anticipate that they will be quite different in their
approaches.
The
second type of design in R03 is secondary data analysis of health IT research.
And this is intended to generate insight regarding facilitators and barriers to
health IT implementation through evaluation of factors impacting utilization
and implementation.
So
some of the recipients [of the earlier] Ambulatory Safety and Quality (ASQ) RFAs
may be in a good position to put forth new [secondary data] analyses—although
[R03 secondary data analyses] proposals are not limited to those grantees. Secondary
data analysis is not a regurgitation of previously conducted analysis but new
analysis, evaluating various characteristics, workflow, and integration with
pre-existing health IT and to test hypotheses or synthesize data derived
elsewhere.
There
are additional requirements that I encourage you to carefully consider when
you're putting forth your proposal with respect to secondary data analysis.
Again, I want to emphasize that [secondary data] analysis may be related to but
must be distinct from the specific aim for the original data collection and
analytical plan.
Also
keep in mind that the extramural peer reviewers will be assessing the merit of
your application and will be looking at what we have articulated as being
important in the research methods section and that is reflected in the review
criteria, which are unique when it comes to approach for each of the types of R03
study designs that you may pursue.
We've
got something new: the economic analysis of health IT implementation. It is
our third broad category of type of R03 research that can be conducted. It must
focus on a specific health IT implementation project. That project could either
have been sponsored by AHRQ or others. Here you have two options, which may
provide you opportunities that may be a little confusing.
[First]
we have a concurrent prospective economic analysis. So let's say for example
you are putting forth [submitting] a health IT R18 implementation study [PAR-08-270]
and you would also like to prospectively conduct an economic analysis of that
implementation [during the same due date cycle]. You may put forth both the R03
for the economic analysis and the R18 to evaluate the health IT implementation
and use project at the same time.
You'll
see within the R03 and the R18, they identify how you cross reference both of
those studies—so that we can make sure that they're linked up when the
decisions are made with respect to funding.
We
also give the opportunity for retrospective economic analysis. Here it's
important that you identify a predecessor health IT implementation project and
make sure you describe the conditions for use of the data. As with regular
secondary data analysis, the extent to which you articulate clearly how this R03
is distinct from your previous work will be very important.
As
we highlight, in your design to conduct sound economic evaluations of health IT
implementation and use, you should consider to whom the benefits accrue,
include evaluation of financial and nonfinancial costs and benefits of the
companion health IT implementation project.
In
the body of the R03 FOA, we highlight more information with respect to what can
be emphasized in the economic analysis.
Michael
Hagan: I was just going to add that
the interpretation of benefits and costs is broad, that within the organization
one could consider the distribution of costs and not just costs in terms of
what's paid for but the cost of diverting resources to the implementation of IT
or input of information or for maintenance or whatever so that the cost is
considered in a broad way.
Rebecca
Roper: Thank you, Mike.
Michael
Hagan: Okay.
Rebecca
Roper: As we've discussed,
there are specific R03 submission requirements which we've pretty much
highlighted so far. We'll go through the submission requirements. There are
several different categories [of the types of submission requirements]. Again,
I really encourage you to look at the instructions in the health IT FOA and
make sure that you're meeting them and can provide as much information to
demonstrate that you've addressed these different issues.
It
just so happens on Slide 26 of the PowerPoint® presentation, budget was
inadvertently dropped off, but that is one of the other requirements that you
need to address.
As we already articulated, there are specific review
criteria depending on the type of R03 to be evaluated. Now, unless there are anymore
comments about the R03, we'll go on the R21, exploratory and developmental
grant to improve health care quality through health IT.
This
[R21] mechanism offers $300,000 total cost over 2 years. So like the R03, you
can take up to 2 years [to complete], but the R03 has a cap of $100,000 total
cost. The R21 is to conduct a 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 health IT research demonstration
grants.
The
R21 grants are more comprehensive and broader in scope than the small
self-contained health IT research projects. So a question sometimes is raised [by
a would-be applicant], I don't know which is more appropriate, should I come in
under the R03 or the R21? As you look at the specificity of the two FOAs, you
can choose [the one that best meets your research objectives] but sometimes
just keeping in mind the actual total cost limit, may inform your best route to
pursue. So if your small self-contained health IT research project requires
more than $100,000 total cost, the R21 would be the better way to go.
Also,
to emphasize again for the R21 personnel, the PI is not expected or required to
be extensively published or have extensive experience in leadership as is
traditionally expected for R18 and R01. This [information] is within the body
of the health IT FOA document to which you will be applying. This [information]
will also be [considered by] the extramural peer reviewers who use the same
information to evaluate the merit of your application; they will be taking that
into consideration also.
Unlike
the R03, though, you have two bites of the R21 apple. So if it doesn't go well
the first time around and you're interested you can come again; you have two
more times to get funded. You have an additional allotment of two pages to
address how your revised application responded to previous concerns. Again, we
anticipate a wide range of methods, both qualitative and quantitative, to be
appropriate to the analytical analyses that are proposed [in the R21]
applications.
Now
we're in the more familiar territory of the R18, Utilizing Health IT to Improve
Healthcare Quality. This [FOA mechanism] supports demonstration research
grants that rigorously study health IT information and use to improve the
quality, safety, effectiveness, and efficiency of health care and ambulatory
settings and transitions between care settings.
It
offers $1.2 million over a 3-year period. The research design and methods
section has other requirements that provide more specificity compared to the R03
and R21; more rigorous research evaluation is expected. [For example,] you'll see
that we have guidance with respect to clinical and staff perspectives being
solicited on the utility of health IT as it is evaluated or justification for
not including them.
Also,
we expect that patient or caregiver's use of health IT should be considered and
a variety of other issues that we ask you to address, including unintended
consequences. The review criteria are quite specific for this mechanism and
really take the time to look at those as you form your proposal because those
will be the review criteria that the extramural peer reviewers will be using to
assess the merit of your application.
Anything
else from the group? Okay, so we received a series of question and answers from
our interested public, and we'll just take a few moments to go through the
questions posed and our responses. And then we'll take a [short] break and
should there be any outstanding questions we'll work with the operator to
solicit your input and then we will provide feedback as we can.
So
here we are on Slide 37, "Can there be a co-PI?"
No. AHRQ requires that the lead institution designate
one and only one individual as the project's principal investigator (PI). This
does serve as a nice segue. You will notice that NIH [the National Institutes of Health] is considering different
types of review requirements and application requirements that may be
considered by AHRQ. AHRQ will be making decisions whether or not we will
subscribe to those changes or have our own policy. Is there anything else Debbie
Rothstein or the Office of Extramural Research, Education,
and Priority Populations (OEREP) cares to add?
Debbie Rothstein: No. Other than what we'll be doing is everything
that's articulated in these FOAs and should there be any changes, there will be
notices about that. But, no additional information is provided at this time.
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