[Federal Register: February 15, 2008 (Volume 73, Number 32)]
[Notices]
[Page 8872-8874]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr15fe08-56]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Agency for Healthcare Research and Quality, HHS.
ACTION: Notice.
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SUMMARY: This notice announces the intention of the Agency for
Healthcare Research and Quality (AHRQ) to request that the Office of
Management and Budget (OMB) approve the proposed information collection
project: ``Feasibility of secure messaging for pediatric patients with
chronic disease: Pilot implementation in pediatric respiratory
medicine.'' In accordance with the Paperwork Reduction Act of 1995, 44
U.S.C. 3506(c)(2)(A), AHRQ invites the public to comment on this
proposed information collection.
DATES: Comments on this notice must be received by April 15, 2008.
ADDRESSES: Written comments should be submitted to: Doris Lefkowitz,
Reports Clearance Officer, AHRQ, by e-mail at
doris.lefkowitz@ahrq.hhs.gov.
Copies of the proposed collection plans, data collection
instruments, and specific details on the estimated burden can be
obtained from the AHRQ Reports Clearance Officer.
FOR FURTHER INFORMATION CONTACT: Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427-1477, or by e-mail at
doris.lefkowitz@ahrq.hhs.gov.
SUPPLEMENTARY INFORMATION:
Proposed Project
Feasibility of Secure Messaging for Pediatric Patients With Chronic
Disease: Pilot Implementation in Pediatric Respiratory Medicine
AHRQ proposes to evaluate how the implementation of a secure email
messaging (e-messaging) system between clinicians and adolescent
patients affects: (1) Time spent by providers communicating with
patients, (2) Emergency Department utilization for medication refills,
and (3) qualitative satisfaction with care of the patients. The study
will be conducted in the Yale University School of Medicine Pediatric
Respiratory Medicine Clinic.
Several studies have evaluated the use of e-mail between providers
and patients and found that it is typically satisfactory to both, has
not been abused by patients, and has not been used inappropriately for
urgent items. Studies have not evaluated the use of e-mailing or secure
messaging by children or adolescents with chronic diseases as well as
their families. The setting of chronic disease provides a natural forum
for discussion about the use of such technologies since these families
may need more frequent contact with their care-providers, need more
frequent medication refills, and may have close relationships with
their providers that encourage a communication genre such as secure
messaging.
In particular, because many adolescents are comfortable with text
messaging and email, the investigators hypothesize that adolescent
patients themselves may feel empowered to contact their providers using
this medium. This potential shift to having adolescents communicate
with the providers presents two main hypotheses of interest. (1)
Adolescents may be more prone to send a message that may be of an
urgent nature because of the sense that messaging is``instant'' as well
as a possible feeling of more privacy. This issue presents the concern
that adolescents in particular could send a secure message about
information that is potentially urgent in nature such as a severe
asthma exacerbation or suicidal ideation. Such messages will need
immediate attention. (2) Adolescents may be more apt to disclose
questions about their care that they would not have otherwise brought
up with the provider. By giving adolescents a medium where they feel
comfortable communicating, clinicians may be able to better meet the
medical and psychosocial needs of adolescents and their families.
[[Page 8873]]
Method of Collection
The project will include 300 patient/family participants and 138
provider participants. Data will be collected from (1) e-messaging
content, to understand what children, adolescents and their parents
will send in secure messages to their provider; (2) a survey, to
determine the demographic characteristics of the patients and their
family; and (3) qualitative interviews with patients and their families
and clinic staff, to assess their attitudes and satisfaction with e-
messaging.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated annualized burden hours. Each of the
300 patient/family participants will complete a demographic survey and
use the e-messaging system, sending an average of one e-message per
month. Thirty of the patient/family participants will be randomly
selected to participate in a qualitative interview. Each of the 138
provider participants will use the e-messaging system, responding to
about twenty-six e-messages per year, and keep a pre- and post-
intervention log of patient/provider communications. Ten provider
participants will be randomly selected to participate in a qualitative
interview. The total burden for all participants is estimated to be
2,148 hours.
Exhibit 2 shows the estimated annualized cost burden for the
participants' time to participate in this study. The total cost burden
for all participants is estimated to be $72,664.
Exhibit 1.--Estimated Annualized Burden Hours
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Number of
Interview participants Number of responses per Hours per Total burden
respondents respondent response hours
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Patient/Family Participants:
Demographic Survey.......................... 300 1 1 300
E-messaging................................. 300 12 15/60 900
Qualitative Interview....................... 30 1 30/60 15
Provider Participants:
E-messaging................................. 138 26 15/60 900
Qualitative Interviews...................... 10 1 30/60 5
Pre-intervention Provider Log............... 138 1 6/60 14
Post-intervention Provider Log.............. 138 1 6/60 14
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Total................................... 438 na na 2,148
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Exhibit 2.--Estimated Annualized Cost Burden
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Number of Total burden Average hourly Total cost
Interview participants respondents hours wage rate* burden
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Patient/Family Participants:
Demographic Survey.......................... 300 300 $26.20 $7,860
E-messaging................................. 300 900 26.20 23,580
Qualitative Survey.......................... 30 15 26.20 393
Provider Participants:
E-messaging................................. 138 900 43.78 39,402
Qualitative Interviews...................... 10 5 43.78 219
Pre-intervention Provider Log............... 138 13.8 43.78 605
Post-intervention Provider Log.............. 138 13.8 43.78 605
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Total................................... 438 na na 72,664
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* For Patient/Family Participants: Based upon the mean of the average wages for all occupations, National
Compensation Survey, ``U.S. Department of Labor, Bureau of Labor Statistics.''
* For Provider Participants: Based upon the mean of the average wages for physicians ($65.54/hr) and nurses
($43.85/hr) in the New York, New Jersey, Connecticut and Pennsylvania region, National Compensation Survey,
``U.S. Department of Labor, Bureau of Labor Statistics.'' For Pulmonary Fellows: Based upon internal Yale
University School of Medicine data.
[[Page 8874]]
Estimated Annual Costs to the Federal Government
The total cost to the Federal Government for this project is
$399,970 over a two year period. The average annual cost is $199,985.
The following is a breakdown of the average annual costs:
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Direct Costs:
Personnel.......................................... $159,488.5
Consultancies...................................... 5,475
Data support....................................... 5,336.5
Indirect Costs:
Indirect costs..................................... 29,685
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Total.......................................... 199,985
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Request for Comments
In accordance with the above-cited Paperwork Reduction Act
legislation, comments on AHRQ's information collection are requested
with regard to any of the following: (a) Whether the proposed
collection of information is necessary for the proper performance of
AHRQ health care research and health care information dissemination
functions, including whether the information will have practical
utility; (b) the accuracy of AHRQ's estimate of burden (including hours
and costs) of the proposed collection(s) of information; (c) ways to
enhance the quality, utility, and clarity of the information to be
collected; and (d) ways to minimize the burden of the collection of
information upon the respondents, including the use of automated
collection techniques or other forms of information technology.
Comments submitted in response to this notice will be summarized
and included in the Agency's subsequent request for OMB approval of the
proposed information collection.
All comments will become a matter of public record.
Dated: February 6, 2008.
Carolyn M. Clancy,
Director.
[FR Doc.08-659 Filed 2-14-08; 8:45 am]
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