February 12, 1975

Robert Greenes

Joshua Lederberg

Dear Bob,

I have your note of February l@th on the Health Services Research
Proposal Committee. The article by Wysong was particularly illuminating
about the background of the solicitation.

I have trouble seeing just how we are going to put a credible
proposal together; on the other hand, we can hardly afford not to!

Since the solicitation places a lot of emphasis on the roster of
ongoing research projects, I wonder if you have yet accumulated and
summarized information on that score that would be helpful to us. I would
guess that the Sponsored Projects Office directory of research and
scholarship, of which a new edition should be available shortly,and which
is also accessible on line, might be particularly helpful in assessing
the present range of research activities at Stanford. I am sure Bill Massy
would want to be helpful in every way possible to make such information
readily available to us.

One point that occurred to me was whether it woubddmake sense to
come in with an explicit joint Proposal with the NBER. I just have a hunch
that we can do a lot more together than eithen of us would be able to do
separately. But I have not yet measured the byproduct’ problems that mhght
might generate.

Also, I wondered whether we would be able to recruit Bob Haggerty
as a possible consultant to us in the development of the proposal.

I was particularly interested in the attribution of clinical research
centers as models for what would be funded here. That is an area where one
would have expected Stanford to be a paragon and I guess I ama little puzzled
just what the evaluation of that program has ended up to be in fact.

Besides the kinds of things that Enthoven was talking about, I would
ha@pe that we might find a way to get a further handle not only on cost
reduction but on health outcome,

For the core activity some of the most important things that one could
justify funding as a support base for a variety of research projects would
be faculty slots in epidemiology and in biohetry. We have not been too
spectacular in that general area, especially epidemiology! As for biometry,
I wonder if Bill Brown might not be able to give you a handle on the range
of existing research projects that he and his colleagues have collaborated on
that would be pertinent to the theme of the solicitation.

anwar
Robert Greenes -2- 2/12/75

The way the solicitation is now worded, I find it rather difficult
to see how we are going to be able to bring in EE for the particular
kinds of things that are now asked for. Evaluationsof existing and
prospective health technology rather than the design and building of
devices would seem to be the most that could be regarded as relevant
to the charge.

My remarks are probably unnecessarily gloomy and I will be looking
forward to seeing some of the more positive proposals that will be brought
together at our planning meeting.

Sincerely yours,

JL/rr