Health Systems Implementation Initiative

HSII Implementation Projects


Key Dates

When can I apply for HSII Implementation Project funding?

PCORI will release the next opportunity for HSII Participants to apply for implementation project funding on May 7, 2024. This upcoming opportunity is the second Call for Proposals (CFP) for HSII Implementation Projects. HSII Participants can find more information about the second CFP – including key dates and maximum budget levels – on this webpage.

The first opportunity to apply for Implementation Project funding was the CFP released in October 2023. HSII Participants can find more information – including links to the CFP and application templates – on this webpage

Evidence Topics in the 2nd Call for Proposals 

What topics will PCORI include in the second Call for Proposals (CFP) for HSII Implementation Projects?

PCORI intends to include the following evidence topics in the second CFP to be released May 7, 2024:

  1. Intensive Lifestyle Treatment for Weight Loss in Primary Care Settings
  2. Appropriate Antibiotic Prescribing for Children with Acute Respiratory Tract Infections (ARTIs)
  3. Addressing Hypertension in Adults (new!)
  4. Monitoring Electronic Patient-Reported Outcomes During Cancer Treatment (new!)

Until the release of the second CFP, HSII Participants may continue to refer to the first CFP for guidance about the first two topics, including the intervention/program description, allowable adaptations, and evaluation outcomes.

Please see below for brief overviews of new evidence topics to be included in the second CFP. Full details will be provided in the CFP. 

Topic 3: Addressing Hypertension in Adults. This topic is expected to include two sub-topics: Addressing Uncontrolled Hypertension (Option A) and Addressing Undiagnosed Hypertension (Option B).

  • Option A: Addressing Uncontrolled Hypertension (HTN). PCORI-funded research compared two team-based care interventions for managing uncontrolled HTN: (a) telehealth-based Medication Therapy Management (MTM) with home blood pressure (BP) telemonitoring coordinated by a clinical pharmacist or nurse practitioner; and (b) optimal clinic-based care coordinated by primary care practitioners and medical assistants. Both interventions lowered BP for adult patients with uncontrolled HTN. For this sub-topic, health systems would address uncontrolled HTN using team-based HTN care interventions that incorporate the core components of rapid follow-up, assessing and addressing treatment non-adherence, and considering medication intensification.
    • Option A will be eligible for an HSII Implementation Project or HSII Pilot Project. 
  • Option B: Addressing Undiagnosed Hypertension. The US Preventive Services Taskforce recommends screening adults for HTN using office BP measurement and obtaining BP measurements outside the clinical setting for diagnostic confirmation before starting treatment. In PCORI-funded research, monitoring BP at home performed better than clinic-based monitoring for confirming HTN. For this sub-topic, health systems would propose to establish or expand programs and protocols to identify patients with undiagnosed hypertension, using an approach that includes out-of-office BP readings where indicated.
    • Option B will be eligible for an HSII Pilot Project alone or for a supplemental pilot project added to an HSII Implementation Project on Option A. (Note that Option B will not be eligible for a full HSII Implementation Project. See additional clarification in the second CFP.)

Topic 4: Monitoring Electronic Patient-Reported Outcomes During Cancer Treatment. PCORI-funded research showed that monitoring patients’ symptoms weekly during cancer treatment using online surveys of patient-reported outcomes (ePROs) and initiating timely follow up improved clinically meaningful outcomes including health-related quality of life, symptom burden and physical function; reduced emergency department visits and hospitalizations; and was highly valued by patients, nurses and doctors. Health systems would propose an approach for remote symptom monitoring for adult patients (ages 21+) with cancer undergoing treatment. Implementation would include putting in place an electronic system for patients to complete ePROs surveys, as well as adoption of protocols and processes for monitoring ePROs (i.e., sending real-time alerts to the care team regarding patients’ urgent needs and worsening symptoms and initiating timely follow-up).

Budgets and Use of PCORI Funds

What will the maximum project budgets be in the second CFP?

Information about project budget levels is available on the webpage about the second CFP. 

It looks like several of the evidence topics might require the use of technology (e.g., acquiring devices and equipment, EHR or IT changes). What will PCORI funds pay for?

PCORI anticipates that software, IT, and equipment costs may be significant considerations for implementation. The CFP will provide further guidance on how PCORI funds may be used. In brief, PCORI anticipates that funds will be available to support health system-based costs and activities associated setting up new IT system components, including integrating software and/or building new components. PCORI funds cannot be used to purchase devices for patient or routine clinical use (e.g., scales for weight monitoring, BP monitoring devices, smartphones or tablets for patients to complete the ePRO surveys). See the upcoming CFP for further details. 

Evidence Topics in Future Calls for Proposals

My health system is interested in more and different options for topics. Why do we have only four options so far, and when will more topics become available?

A central goal of HSII is to support broad scale and wide reach of evidence that can improve patient outcomes. In support of this goal, PCORI is opting to support more awards on fewer topics, rather than fewer awards for each of many topics. This approach will allow documentation of impact across multiple health systems, as well as demonstrating implementation approaches in diverse systems.

The number of topics will grow over time as we add to the topics available for Implementation Projects in upcoming CFPs. PCORI is also cognizant of considerable HSII Participant interest in having more topic options and will take this input into consideration going forward.

My health system is interested in multiple topics. Can we apply for funding for more than one topic?

Each HSII Participant may submit one Letter of Intent (LOI) and proposal per CFP. Therefore, each organization may select and apply for one topic under each CFP.

After the second CFP (May 2024 release), when is the next opportunity to apply for HSII Implementation Project funding?

PCORI plans to release CFPs with new evidence topics approximately once per year. The next opportunity to apply for implementation project funding after the second CFP – i.e., the third CFP – is anticipated to be Spring/Summer 2025.

Will the topics from the first and second CFPs continue to be offered in future CFPs?

PCORI anticipates offering each evidence topic at least twice. For future CFPs, PCORI may assess whether or not to “retire” a topic; for that reason, it is important for HSII Participants to communicate to PCORI when they have interest in a future proposal for a topic for which they have not yet applied.

My health system is interested in a particular topic for implementation that has not yet been offered in a CFP. How should we communicate our interest in this topic to PCORI?

PCORI appreciates learning about your health system’s interest in potential topics for implementation! As a first step, we encourage HSII Project Leads to send PCORI your ideas using the Topic Suggestion Form that can be found on the HSII Learning Network SharePoint webpage. Note that implementation topics must be grounded in evidence generated from PCORI-funded research.

Participating Care Delivery Sites

The CFP indicates that allowable budgets are based upon the number of participating care delivery sites. What counts as an individual care delivery site? 

“Care delivery site” refers to an organizational unit that has the main role in managing the patient’s care with respect to the condition the intervention/program is addressing. Recognizing there is complexity and variation across health systems, in general, individual care delivery sites will be characterized by an organizational structure that includes clinicians, support staff and an administrative leader/manager whose work is co-located and organized as a team. Site clinicians and staff may be physically or virtually co-located. A single practicing clinician (e.g., doctor, advanced practice provider) does not constitute a site. For additional information, see the upcoming CFP.

Evaluation 

These projects aren’t research studies, but I see that PCORI is asking for a rigorous evaluation design. Please clarify – what is PCORI looking for with evaluation of HSII Implementation Projects? 

Evaluation as part of HSII Implementation Projects is designed to document: (1) the roll-out and execution of health system-led implementation efforts, and (2) the impact of the intervention/program, once in place, on patient outcomes, including measures of health and healthcare utilization. 

  1. The documentation of activities included in the roll-out of implementation efforts is part of PCORI’s required monitoring of funded awards. PCORI Contracts contain milestones that are mutually agreed upon by PCORI and each awardee, to describe the progress of implementation efforts.
  2. The documentation of impact on measures of health and healthcare utilization in HSII Implementation Project program evaluation is for the purpose of confirming that impacts shown in the research setting are maintained in real-world delivery settings, as well as to capture the overall impacts of PCORI-funded implementation efforts. With this evaluation, awardees are verifying that the interventions and/or implementation strategies – which usually require adaptation to local settings – are successful outside the research context. In other words, these measures are important to assure that significant “voltage drop” does not occur in this transition between research and real-world uptake. HSII Participants should propose an evaluation design that will support the project’s documentation that the expected change in health and healthcare outcomes did, in fact, occur. 

HSII Program Evaluation is designed to align with the main goal of HSII, which is for health systems to develop and lead their own implementation efforts to successfully put evidence-based interventions or programs into place, leading to impacts on health decisions, healthcare, and health outcomes. In other words, the goal of HSII is practical adoption and use of evidence-based practice by health systems in their care delivery settings. The goal is not to test implementation approaches or compare the effectiveness of implementation strategies. 

What level of data will PCORI expect to see for program evaluation as part of HSII Implementation Projects? 

Health systems should not provide any detailed individual patient-level data sets, including any data sets that contain protected health information (PHI). All evaluation results for project outcomes reported to PCORI should be based on aggregate data (e.g., at the site [clinic] level, system level and/or organized by patient subgroups). Note that health systems should be prepared to report certain aggregate outcome measures — such as patients reached by site at the system-level — on a regular basis to PCORI throughout the project (e.g., every six months).

Patient Engagement

What are PCORI’s expectations for patient engagement as part of HSII Implementation Projects? 

As part of HSII Implementation Projects, health systems are strongly encouraged to work with patient, caregiver, and community-based advisors to ensure that the intervention/program is implemented in such a way that it is feasible, acceptable, and tailored for patients and their families.

To note, PCORI offers this related resource: Engagement in Research: PCORI's Foundational Expectations for Partnerships. The expectations described in this resource are applicable to PCORI-funded research studies. However, HSII Participants might refer to this resource as they consider questions such as the definition of meaningful engagement.  

Collaboration Among HSII Participants

My health system is interested in collaborating with one or more other HSII Participant health systems in an implementation project – is this allowed?

PCORI will only accept formal implementation project proposals submitted by single HSII Participant organizations to undertake implementation within their care delivery settings. HSII Participants are welcome to talk about their PCORI-funded Implementation Projects with representatives from other participating health systems informally – for example, holding discussion of implementation plans, sharing training materials or conferring on evaluation metrics with other organizations. These informal collaborations may occur within or outside of the HSII Learning Network. Further, HSII Participants may include formal structures supporting collaboration within an HSII Implementation Project proposal, for example, specifying an external stakeholder advisory committee that includes representatives from other HSII Participant organizations or from other health systems.

PCORI will also consider requests from HSII Participants to allocate PCORI funds in their proposed HSII Implementation Project budgets to support consultation with, or procurement of specific services from, individuals employed at other HSII Participant organizations when specific and critical expertise resides outside of the applying HSII Participant health system. In these cases, the HSII Participant may arrange a direct consulting agreement with specific individuals but not with the HSII Participant organization. Please refer to the CFP for additional guidance. HSII Participants must describe in their LOI proposed plans for engaging individuals at other HSII Participant organizations as consultants in connection with their PCORI-funded HSII Implementation Project.

In the future, PCORI may consider joint proposals from two or more HSII Participants through other contracting and/or funding mechanisms, to support collaborative, multi-health system implementation efforts. These mechanisms are not available at this time.

Contacting PCORI

My health system has specific questions about the CFPs. How can our questions be addressed?

PCORI encourages HSII Participants to closely review CFPs and applicant materials. For any project-specific or clarifying questions, applicants may email PCORI at [email protected]. PCORI will respond by email, and we are also happy to set up calls as needed.

I want to share an idea about HSII with PCORI that isn’t related to the CFP. How do I get in touch?

PCORI welcomes your ideas and suggestions! We are interested in hearing from you about how HSII, including the HSII Learning Network, can support you as you move forward with implementing evidence from PCORI-funded research in your care delivery settings. To send PCORI a comment, suggestion, or idea, please use the Ideas and Suggestions Form that can be found on the HSII Learning Network SharePoint webpage.  

Please note that questions requiring a specific response or assistance should not be submitted using the Ideas and Suggestion Form. Instead, please send specific questions as follows: 

  • Regarding the HSII Learning Network: [email protected]. 

  • Regarding HSII, including funding opportunities: [email protected].  

  • Regarding funded HSII projects (e.g., Capacity Building Projects): Please email your assigned PCORI Program Officer or PCORI Contract Administrator directly.  

HSII Learning Network


Who should attend HSII Learning Network meetings?

The HSII Project Lead should attend HSII Learning Network meetings. In the case of Dual Project Leads, at least one Project Lead should attend. Project Leads may invite members of their organization to attend one or more meetings of the Learning Network in addition to themselves, as relevant to their activities.

Can an HSII Project Lead appoint someone to attend HSII Learning Network meetings in their place?

The HSII Project Lead may request to designate a consistent representative (Learning Network Designee) to attend HSII Learning Network meetings on their behalf. The Designee will also be included on Learning Network communications and in other Learning Network activities as relevant. The representative should be a leader at the HSII Participant organization who is closely tied to health care operations and authorized to speak on behalf of the HSII Project Lead and the HSII Participant. Each HSII Project Lead may designate one representative; therefore, each HSII Participant may have up to two Learning Network designees.

Requests to appoint a designee may be submitted to PCORI at [email protected]. Please email the designee’s:

  • Name.
  • Position title.
  • Contact information.
  • Assistant’s name and contact information.
  • Length of time at the organization.
  • Brief description of their role at the organization, including their connection to the HSII Project Lead and authority to speak on behalf of the Project Lead at meetings.
  • Brief description of the designee’s connection to healthcare operations.
Where do I find documents and resources shared through the HSII Learning Network (e.g., meeting agendas)?

The HSII Learning Network’s SharePoint webpage is here. Please note that access is only available for personnel at HSII Participant health systems. To request access, please ask your HSII Project Lead or Learning Network Designee to send an email to [email protected].

 

HSII Master Funding Agreement


Our organization would like to make changes to the HSII Project Lead(s) named in our HSII MFA. How do I request a change?

Adding or changing an HSII Project Lead will require PCORI review and approval. HSII MFAs may include up to two HSII Project Leads. To submit a change request, your Administrative Official will need to submit the materials below to [email protected]

  1. Administrative Official-signed memo stating your organization’s request to add a Dual HSII Project Lead (or change your HSII Project Lead), including the rationale for the request
  2. Email address for the proposed Project Lead
  3. Letter of Support from the proposed Project Lead’s leader
  4. Leadership Plan template, if adding a Dual Project Lead
  5. Project Lead template with the proposed Project Lead’s information
  6. Section A.4 of the HSII Participation Project Plan template completed with information about the proposed Project Lead

General HSII FAQs


My organization is not an HSII Participant, but we are looking for ways to get involved in HSII. How can we get involved?

At this time, involvement in HSII is limited to HSII Participants. The best way for other organizations to stay informed about HSII is to see updates on PCORI's HSII web page, www.pcori.org/HSII.

Will PCORI open more opportunities to join HSII? If so, when will future opportunities be available?

PCORI may open future opportunities to join HSII. The timing of any future opportunities is not known.


Posted: January 20, 2022; Updated: April 2, 2024

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