BUDGET OVERVIEW

The Greater Plains Collaborative CDRN will work with [Institution Name]to identify patients and practices across the network to participate in [Project Name].[Briefly describe your project and project aims at your site]. As needed, we can extract and share longitudinal health data for research including clinical data, claims data, patient reported data, genetic/epigenetic and biologic data, and other local and national data. We can also provide a broad array of support related to regulatory issues, governance, data privacy, and stakeholder engagement.

[PI Name] is willing to participate as [“site-PI” and any other titles for project such as “regional recruitment leader,” etc.]. [GPC PI Name] is willing to participate as a co-principal investigator to provide the resources of our CDRN. We understand that our site will be a subcontractor to the [Institution Name] and that [PI Name] and [GPC PI Name] effort will be supported by the [Project Title].

[PI Name] is willing to participate as [“site-PI” and any other titles for project such as “regional recruitment leader,” etc.]. [GPC PI Name] is willing to participate as a co-principal investigator to provide the resources of our CDRN. We understand that our site will be a subcontractor to the [Institution Name] and that [PI Name] and [GPC PI Name] effort will be supported by the [Project Title].

Budget information is provided below.

KEY PERSONNEL

Lemuel Russell Waitman, PhD, [Role for Project]. Support is requested for [list percentages and related project years]. Dr. Waitman is the Director of Medical Informatics, Associate Vice Chancellor of Enterprise Analytics, and Professor of Internal Medicine at KUMC. Dr. Waitman is currently the Principal Investigator for the Greater Plains Collaborative (GPC) Clinical Data Research Network, funded by PCORI. He has extensive experience leading a complex, multi-institutional effort to harmonize data across geographic and infrastructural collaborations. Under Dr. Waitman’s leadership the present functional state of the GPC allows for innovative collaborations. [Briefly describe role in project].

INFORMATICS PERSONNEL

Name, Credentials, Role for Project. Support is requested for [XX% in Year x, y, z. Describe responsibilities for this role].

FRINGE RATE

KUMC Fringe rate is calculated at 35%.

OTHER DIRECT COSTS

Medical Informatics, Fee-for-service. Support is requested for [$X in Years x, y, z.] These funds will be dispersed on a milestone basis, aligned with the deliverable schedule below:

[Please insert a schedule of deliverables for this project].

CONSULTANTS

There are not any consultants or consultant expenses.

INDIRECT COSTS

Indirect costs are calculated at 53% modified total direct costs in accordance with our federally negotiated indirect rate with DHHS dated 7/21/2011.