Expression of Interest (EOI) Form

ADVANCINGHEALTH Program: SECOND CALL FOR APPLICATIONS –

Focus on Virtual Care and Patient Engagement

The AdvancingHealth Program is designed to bolster innovation in Ontario’s public healthcare sector by matching
healthcare needs with innovative products and services through partnerships between public healthcare organizations,
companies, and academic institutions.
Applicant projects should have:
 a focus on product or service demonstration
 clear objectives and defined milestones
 defined roles and responsibilities for each project partner
 clearly described benefits of the project for each partner

Upon completion of the EOI template please submit directly via the OCE on-line application system by
June 3, 2015 at 2 p.m. Note – you will receive an auto-confirmation of receipt by the system within 24
hours of submission. If you do not receive confirmation of receipt within this time, please contact
Jennifer Moles, Program Manager at Jennifer.moles@oce-ontario.org

PART A: APPLICANT INFORMATION

The program requires a joint application from an Ontario-based public healthcare organization and an Ontario-
based company with an innovative product or service. The public healthcare organization will provide a
demonstration site or platform for the product or service. The application may also include an academic partner
or partners that will support the demonstration project through the available Academic Vouchers.
Applications must be led by an Ontario-based publicly funded healthcare organization. Companies and
publicly funded postsecondary research institutions may be co-applicants or partners to the project.
(NOTE: Two applicant sections have been provided below. If there are more than two applicants to the
proposal, please add additional sections as required).

PROJECT TITLE:

LEAD APPLICANT (MUST BE A PUBLIC HEATHCARE ORGANIZATION)

Organization Name: Applicant Name (Dr., Mr., Ms.): Position:

Mailing Address: Telephone: E-Mail:

Applicant Role: Explain the role of the Applicant in the Project and the rationale for the relationship with the
other applicants

Applicant Commitment: Describe the Applicant’s financial commitment (cash and/or in-kind) to the Project

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Expression of Interest (EOI) Form

CO-APPLICANT 1

Organization Name: Applicant Name (Dr., Mr., Ms.): Position:

Mailing Address: Telephone: E-Mail:

Applicant Role: Explain the role of the Applicant in the Project and the rationale for the relationship with the
other applicants

Applicant Commitment: Describe the Applicant’s financial commitment (cash and/or in-kind) to the Project

PART B: PROJECT FINANCE SUMMARY

OCE Contribution: Total Applicant(s) Cash: Total Applicant(s) In-kind:

Total Other (cash and in- Total Academic Vouchers: Total Project Value:
kind):

B1: ADDITONAL PROJECT PARTNERS (IF APPLICABLE)

(NOTE: ONE PARTNER SECTION HAS BEEN PROVIDED BELOW. IF THERE ARE MORE THAN
ONE PARTNER TO THE PROPOSAL, PLEASE ADD ADDITIONAL SECTIONS AS REQUIRED).

Partner (Organization’s Name): Mailing Address:

Partner Representative (Dr., Mr., Ms.): Position:

Telephone: E-mail:

Partner Role: Explain the role of the Partner in the Project and the rationale for the partnership

Partner Commitment: Describe the Partner’s financial commitment (cash and/or in-kind) to the Project

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Expression of Interest (EOI) Form

PART C: PROPOSAL
Refer to the bulleted questions in each section to guide the content of your proposal.
C1: PROBLEM AND PROPOSED SOLUTION

 What is the specific healthcare challenge to be addressed in this project? How does this challenge currently
affect patient health outcomes, user (patient and/or care provider) experience, and/or efficient use of
healthcare resources?
 What is the innovative technology to be demonstrated and how will it quantitatively and qualitatively address
the problem and/or challenge identified by the healthcare organization?
 What are the comparative advantages of the proposed solution relative to existing practices, and what
manner of validation (including regulatory approvals) and adoption has been accomplished to date?
 What are the potential barriers and risks to implementing the proposed solution in this project? What are the
mitigation strategies? What is the Change Management Plan?

C2: PROJECT OBJECTIVE AND COLLABORATION

 What is the overall objective of the demonstration project? Provide a summary of the key milestones,
deliverables and timeline (including required resources: HR, IT, equipment, etc.)
 Describe the collaboration that will take place between the partners to implement the demonstration project
including the roles and responsibilities of the team members (include name, title, and project responsibilities).
 For key team members, describe their track record of engagement with other knowledge users, including
government (i.e. policy makers, health-care leaders, patients, and providers.

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Expression of Interest (EOI) Form

C3: ADOPTION AND SCALABILITY

 Beyond the scope of the proposed demonstration project, what plans are in place to scale adoption of the
solution to the system level (provincially and/or nationally)?
 Please describe plans to roll out the solution to address priorities in different healthcare settings, if applicable
(e.g., home care, mental health, paediatric, acute care, ambulatory care, complex continuing care, etc.).
 How will the proposed solution be used across the Ontario healthcare system to achieve greater:
 Sustainability (e.g., reduced cost and increased value for patients and providers);
 Productivity (e.g., increased capacity of service delivery model); and
 Efficiency (e.g., reduced wait times)?
 What are the potential barriers to adoption on a system-wide scale, and how will you mitigate these barriers?

C4: IMPACT

 Using quantitative and qualitative metrics, describe the potential impact of the proposed solution on:
 Healthcare system performance (i.e. redesigning of the healthcare system, health outcomes, patient
experience, and/or costs of care suppliers);
 Existing and future infrastructure (e.g., supply chain, IT support);
 Policy (i.e. reimbursement models, scope of practice constraints/opportunities and regulatory/legislative
policy);
 Economic development within Ontario (i.e. globally competitive business and market opportunity);
 Industry;
 Practitioners; and,
 Patients.

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PART D: PROJECT ACTIVITIES, PLAN AND ESTIMATED BUDGET

Each project may request up to $250,000 to support project activities, with a minimum matching cash contribution
from the project partners of 25% with in-kind contributions bringing the total partner match to 100%.

D1: IN THE ACTIVITY TABLE BELOW PROVIDE A LIST OF KEY ACTIVITIES PROPOSED TO DEMONSTRATE
YOUR PRODUCT OR SERVICE AND A HIGH LEVEL BUDGET THAT SUMMARIZES EXPENDITURES RELATED TO
THE KEY MILESTONES, DELIVERABLES AND TIMEFRAME OF THE PROJECT. (INSERT ADDITIONAL LINES AS
REQUIRED)

Team Member Expected Estimated

Activity Duration
Name, Affiliation Outcome Budget

D2: ACADEMIC VOUCHERS (OPTIONAL)

Applicants have the option to access up to two academic vouchers per demonstration project to support academic
researchers and students to work on the demonstration project and/or to assist with adoption. Each academic voucher
is valued at up to $50,000 (no match required).

In the table below identify the Academic Voucher institutions (up to 2), briefly describe the proposed project and
identified the Lead Supervisor that may be responsible for this project

Academic Voucher Proposed Project Lead Supervisor

Institution

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Expression of Interest (EOI) Form

PROJECT REVIEW & TIMELINE

Please complete all the information in the EOI template ensuring:
 The proposal’s font and format are maintained
 The proposal is submitted via the OCE on-line application system and uploaded as an attachment (Word
or PDF format accepted). To set up an account for the OCE on-line application system contact
Application-Support@oce-ontario.org. If you have an account use your existing username and password
to access the application module.

APPLICATION SUBMISSION CHECKLIST

Use the following list to ensure the necessary documentation is provided to OCE for a complete submission
 Expression of Interest stage
 EOI document uploaded as an attachment in this profile
EOI DEADLINE: by June 3, 2015 at 2 p.m.

Upon review of your EOI, OCE may request additional information or clarification to determine project eligibility.
You will be notified via e-mail and asked to follow up accordingly. This documentation will be appended to the
submission.
Upon EOI approval, Applicants will be invited to submit a Full Proposal within 60 days of submission.

For more project-related inquiries, including assistance with application development and partnerships, please
contact:
Matthew Johnson, Senior Business Development Manager, matthew.johnson@oce-ontario.org

For inquiries specifically related to eligibility, contracting and funding disbursements, please contact
Jennifer Moles, Program Manager, jennifer.moles@oce-ontario.org

For general inquiries about the online application system and application form, please contact Application
Support, 416-861-1092 ext. 2400 or application-support@oce-ontario.org

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