The code block below illustrates how one might use # and // as comments in your logic and calculations.

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

KneKLeojDtW7qnNc7fACC64Cfy6SpkNsaz8Y8cxCBrzgEc7CU8ZCfRUJnceKdILv5X9BsbZIxwZzNWYENgLCKr

CIDH Innovator Intake Form

Hello,

By completing this form, you are requesting a consultation meeting with the Research and Innovation Acceleration Team (RIAT) at the Center for Innovation in Digital HealthCare (CIDH).

The form contains a few questions and should take approximately 5 minutes to complete.

We will review the information you submit and reach out to you to schedule a meeting time.

Are you a Mass General, Mass General Brigham or affiliated hospital employee?

* must provide value

Yes

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Unfortunately, the Innovator Intake form is for MGH/MGB Employees.

If you are an external vendor/company looking to engage with the Center for Innovation in Digital Healthcare (CIDH), please submit the following Evaluation Form

First Name

* must provide value

Last Name

* must provide value

Division (Department)

* must provide value

How can we help you?

* must provide value

Tell me more about the digital health research process at Mass General and Mass General Brigham

I do not have a developed product/solution, but would like to explore a digital health idea

I developed a digital health product/solution and want to implement or scale it

Other

If other, please specify

* must provide value

What are your area(s) of need? (Please select all that apply)

* must provide value

External vendor or partner identification

Funding identification

Internal Networking or identifying internal resources

Information, helpful feedback, or problem-solving

Process, regulatory guidance, IRB, etc.

EPIC build and integration

EHR data solution

Other:

If other, please specify

* must provide value

In less than 500 words, please provide a summary of your digital health product/solution/idea and include the following information:

1. A description of the problem
2. An outline of the product/solution/idea
3. Information regarding funding
4. Is this a research project

* must provide value

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Please specify the help needed for your project

* must provide value

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Please provide a few options (days and times) to schedule a 30-minute intake meeting to discuss your solution/idea/questions over the next two weeks

* must provide value

Is there anything else you want to tell us?

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You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.