ARRA - Strategic Health IT Advanced Research Projects (SHARP)

To competitively-awarded cooperative agreements to establish Strategic Health IT Advanced Research Projects (SHARP). The awardees will conduct research focusing on where breakthrough advances are needed to address well-documented problems that have impeded adoption of health IT and to accelerate progress towards achieving nationwide meaningful use of health IT in support of a high-performing, learning health care system.

Any entity submitting an application for this award must be a U.S.-based: • public or private institution of higher education; or • other public or private institution or organization with a research mission.

This Funding Opportunity Announcement (FOA) will result in new competitively-awarded cooperative agreements to establish Strategic Health IT Advanced Research Projects (SHARP). The awardees will conduct research focusing on where breakthrough advances are needed to address well-documented problems that have impeded adoption of health IT and to accelerate progress towards achieving nationwide meaningful use of health IT in support of a high-performing, learning health care system.

ONC expects to award four cooperative agreements to support establishment of Strategic Health IT Advanced Research Projects (SHARP) sites for a project period of four years. Each such research site will have a two-part mission: (1) to implement a collaborative, interdisciplinary program of research addressing a specific focus area from the list provided below, addressing short-term as well as long-term challenges; and (2) to develop and implement a cooperative program between researchers, patient groups, health care providers, and other health IT sector stakeholders to transition the results of research into practice. Each site will focus on areas where breakthrough improvements are needed to address well-documented problems that have impeded adoption of health IT and thereby accelerate progress on the pathway towards achieving the goals outlined in the strategic plan for health IT developed by the National Coordinator pursuant to PHSA Section 3001(c)(3) as added by the Recovery Act, specifically including the nationwide achievement of meaningful use of health IT to achieve transformational improvement of the health care system. Each site will implement a collaborative, inter-disciplinary research program addressing one of the specific focus area(s) listed below. An eligible entity may, apply for funding in separate applications to establish more than one site, and thus it is possible a single eligible entity ("institution") may receive more than one award under this program. Regardless of the total number of institutions funded to establish sites under this program, it is expected that the all of the awardees will collaborate with each other, as there will be numerous points of intersection among the sites' agendas. Within its focus (listed below) area, each site will carry out at least the following set of activities: • Initially define and subsequently update or redefine on a yearly basis, the key issues and research challenges within their respective area(s) of focus. The research areas identified will be those that significantly address barriers and solutions to achieving widespread adoption and meaningful use of health IT. Projects to address the identified issues will be mapped to either a short-term (< 2 years) or long-term (4 years) timeframe. Because this is a cooperative agreement, recipients shall plan and allow for collaboration with ONC and other federal staff with relevant expertise - as identified or approved by ONC - in establishing and updating the definition of key issues and research challenges in the site's focus area; • Conduct ambitious research addressing these key issues and challenges. This work will draw on the scientific methods and expertise of researchers and practitioners in diverse fields; • Collect specific, uniform data about the research activities and track progress toward milestones; • Facilitate practical and efficient processes that enable translation of research into health care and public health innovations, facilitating the transition of multidisciplinary research outcomes into new healthcare products and services both the short- and long-term; • Partner with industry to rapidly transfer short term results of this research into health IT products; • Publish and otherwise disseminate these research findings, preferably in open source journals that maximize the accessibility of this knowledge to the entire health IT community • Participate in an external evaluation; and • Select desired, measurable outcomes specific to the chosen research issue and methods for attaining results. Research focus areas In no particular order, the four foci for research identified below will be addressed by this program. The areas have been assigned numbers for ease of reference. Appendix B provides further detail about each of these areas. 1. Security of Health Information Technology - This research area addresses the challenges of developing security and risk mitigation policies and the technologies necessary to build and preserve the public trust as health IT systems become ubiquitous. This research area is responsive to paragraphs (1), (4), (5), and (6) of the PHSA 3011(a), as added by the Recovery Act, through the following activities: • Promoting the development and implementation of health information technology solutions that will support the electronic exchange and use of health information in a secure, private manner; • Promoting the development and implementation of technologies and best practices that enhance the protection of health information by all holders of individually identifiable health information; • Enhancing the capabilities and functionalities of tools to support privacy and security of individually identifiable health information as it is exchanged and used; and, • Supporting and enhancing the assurance of privacy needed providers' and patients' widespread acceptance of telemedicine and robust participation in clinical data repositories and registries. 2. Patient-Centered Cognitive Support - This research area addresses the challenge of harnessing the power of health IT so that it integrates with, enhances and supports clinicians' reasoning and decision making, rather than forcing them into a mode of thinking that is natural to machines but not to people. PHSA 3011(a), as added by the Recovery Act, directs the support of health IT architecture that will support the use of health information in an accurate manner. Additionally, paragraphs (3) and (5) of the same subsection of the statute authorize use of funding appropriated under PHSA Section 3018, as added by the Recovery Act, to disseminate training and information on best practices to integrate health IT into a provider's delivery of care, and to promote the use of clinical data repositories and registries. All of these paragraphs ((1), (3), and (5) of PHSA 3011(a) as added by the Recovery Act) point to longstanding challenges that require new and creative research related to the accurate and effective use of electronic health information to enhance the safety, quality, efficacy, and thus the overall value of care. 3. Healthcare Application and Network Platform Architectures - This research area focuses on the development of architectures that are necessary to achieve electronic exchange and use of health information in a secure, private and accurate manner. PHSA 3011(a)(1), as added by the Recovery Act, authorizes support of health IT architecture that will support "the nationwide electronic exchange and use of health information in a secure, private, and accurate manner". This research focus specifically supports the development of new and improved architectures and technology infrastructure needed to achieve the goals outlined in the plan for health IT by the National Coordinator in support of PHSA 3001(c)(3), as added by the Recovery Act, and to support measures for determination of meaningful use of health IT by providers over time (required by Social Security Act (SSA) Sections 1848(o) and 1866(n), as added by Title IV in Division B of the Recovery Act). 4. Secondary Use of EHR Data - This research area focuses on strategies to enhance the use of health IT in improving the overall quality of health care. PHSA 3011(a), as added by the Recovery Act, states that the Secretary shall invest in the infrastructure necessary to allow for and promote the electronic exchange and use of health information for each individual in the United States consistent with the goals outlined in the strategic plan developed by the National Coordinator. PHSA 3001(c)(3), as added by the Recovery Act, directs that the National Coordinator shall, "in consultation with other appropriate Federal agencies (including the National Institute of Standards and Technology), update the Federal Health IT Strategic Plan (developed as of June 3, 2008) to include specific objectives, milestones, and metrics with respect to" a specific set of topic areas. The current Federal Health IT Strategic Plan (developed as of June 3, 2008), as referenced in the statute, advances "secondary use" as a key mode of information technology use to transform health care. This is consistent with, and will be updated and expanded upon pursuant to the direction of PHSA 3001(c)(3)(i), (vii) and (vii), as added by the Recovery Act, to add to the updated strategic plan such objectives, milestones, and metrics with respect to: • (Reference: PHSA 3001(c)(3)(i)) - the electronic exchange and use of health information and the enterprise integration of such information. • (Reference: PHSA 3001(c)(3)(vii)) - strategies to enhance the use of health IT in improving the quality of health care, reducing medical errors, reducing health disparities improving public health, increasing prevention and coordination with community resources, and improving the continuity of care among health care settings. • (Reference: PHSA 3001(c)(3)(viii)) - the specific plans for ensuring that populations with unique needs, such as children, are appropriately addressed in the technology design, as appropriate.

ONC expects to award four cooperative agreements to support establishment of Strategic Health IT Advance Research Projects (SHARP) for a project period of four years.

Application procedures will be specified in individual program announcements. Applicants should consult with the office or official designated as the contact for additional information on the application procedures.

Specific, detailed criteria for determining the merit of applications will be made available in the program announcements for this program. In general, all applicants are required to demonstrate capability to achieve the goals, purposes, and objectives of the program consistent with applicable statutory provisions.

Following objective review of applications, those applicants whose applications have been selected by the Secretary of HHS (or designee) for funding will receive a Notice of Award signed by an HHS Grants Management Officer. The Notice of Award, which is sent to the applicant's Authorized Organizational Representative, is the only official notification of award. Unsuccessful applicants will be advised by letter.