[Federal Register: December 9, 2008 (Volume 73, Number 237)]
[Notices]
[Page 74721-74723]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr09de08-56]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Health Care Research and Quality
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Agency for Health Care 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 the Office of
Management and Budget (OMB) to allow the proposed information
collection project: ``Overcoming Barriers to Expanded Health
Information Exchange (HIE) Participation in Indiana.'' 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.
This proposed information collection was previously published in
the Federal Register on June 10th, 2008 and allowed 60 days for public
comment. No comments were received. The purpose of this notice is to
allow an additional 30 days for public comment.
DATES: Comments on this notice must be received by January 8, 2009.
ADDRESSES: Written comments should be submitted to: AHRQ's OMB Desk
Officer by fax at (202) 395-6974 (Attention: AHRQ's desk officer) or by
e-mail at OIRA_submission@omb.eop.gov (attention: AHRQ's desk
officer).
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
``Overcoming Barriers to Expanded Health Information Exchange (HIE)
Participation in Indiana.''
AHRQ, through its contractor, the Regenstrief Institute at Indiana
University, proposes to assess the barriers to participation in health
information exchange (HIE) in Indiana. The Regenstrief Institute will
use its experience to date working with a variety of organizations to
establish specific barriers to engagement in HIE cited by stakeholders,
define the barriers and evaluate them.
The Regenstrief Institute will develop and implement a
questionnaire and survey process to identify barriers that may exist
throughout the State of Indiana to participation in the Indiana Network
of Patient Care (INPC). The INPC is a local health information
infrastructure that includes information from five major hospital
systems (fifteen separate hospitals), the county and State public
health departments, and Indiana Medicaid and RxHub. The INPC began
operation seven years ago and is one of the first examples of a local
health information infrastructure.
This research will elicit and aggregate feedback from large and
small physician groups, as well as hospitals, throughout the State of
Indiana. The goal is to identify the gaps in understanding, barriers
and disconnects that may exist with providers' adoption of, and
membership in, the INPC. The relationship between the stakeholders
involved in the Indiana HIE is governed by a contract between the
participants. The Regenstrief Institute, acting on behalf of the
participants, created and operates the exchange, including serving as
the custodian of the data.
The Regenstrief Institute will survey three key stakeholder groups
in the State of Indiana: Small hospitals, small physician practices
(less than 5 providers) and large physician practices (greater than 20
providers) to identify barriers for each of these groups to participate
in a HIE in general, and specifically the INPC. It is difficult to
predict the barriers that will be identified, but based on their
experience to date, anecdotal evidence suggests that
[[Page 74722]]
the cost of interfaces and the management attention needed to
participate will be the two major barriers. The findings will be used
to create approaches to engage specific entities to participate in
their statewide HIE.
This project is being conducted pursuant to AHRQ's statutory
mandates to conduct and support research, evaluations and initiatives
to advance information systems for health care improvement (42 U.S.C.
299b-3) and to promote innovations in evidence-based health care
practices and technologies by conducting and supporting research on the
development, diffusion, and use of health care technology (42 U.S.C.
299b-5(a)(1)). This project is also being conducted pursuant to a
modification to an earlier AHRQ request for proposals entitled ``State
and Regional Demonstrations in Health Information Technology'' (issued
under contract 290-04-0015).
Method of Collection
To ease the burden on the participating health care providers a
Web-based questionnaire will be used. An initial screener interview
will be conducted by telephone to describe the purpose of the survey
and the survey process and to request the hospital's or physician
practice's participation in the survey. After a hospital or practice
agrees to participate, a communication packet will be sent by e-mail to
the contact person identified during the telephone screening. The
communication packet includes: (a) An HIE description and definition;
(b) description of the INPC, its mission, overall direction, and other
relevant background information; and (c) purpose for the contact,
estimated time required to complete the Web-based questionnaire and a
link to the questionnaire.
Responses to the survey are expected from about 20 hospitals and 40
physician practices of each size. Two to three individuals from each
hospital will be asked to respond to the questionnaire. For physician
practices, one person from each practice will be asked to respond: A
practice manager, director of technology, or person occupying a similar
role.
Following the completion of the Web-based questionnaire,
respondents will be re-contacted by telephone for a follow-up
interview. The purpose of the follow-up interview is to determine the
steps necessary to overcome the barriers to HIE identified in the Web-
based questionnaire. A structured interview guide has been developed
with standard questions for the telephone follow-up.
The data will be aggregated, analyzed and a final report will be
prepared that focuses on the following major topic areas:
a. General perceptions on electronic sharing of health information;
b. The extent to which electronic health information sharing exists
in the contact's current environment;
c. Barriers to the adoption and implementation of electronic health
information sharing and, specifically, INPC; and
d. Recommendations for addressing and resolving issues preventing
the adoption of HIE (general as well as entity-specific
recommendations).
This information will assist AHRQ's mission to advance ``the
creation of effective linkages between various sources of health
information, including the development of information networks.'' 42
U.S.C. 299b-3(a)(3). A seventy-five percent (75%) response rate is
anticipated.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated annualized burden hours for the
respondents' time to participate in this research. A screener interview
will be completed once by each of the 20 hospitals and 80 physician
practices and is expected to require about 5 minutes to complete. The
Web-based questionnaire will be completed by an average of 3 persons
from each of the 20 hospitals and by one person from each of the 80
physician practices and will take about 10 minutes to complete. The
telephone follow-up interview will be conducted with each person that
completed the Web-based questionnaire and is expected to last about 15
minutes. The total burden hours for the participating health care
providers is estimated to be 66 hours.
Exhibit 2 shows the estimated annualized cost burden to the
responding health care providers based on their time to participate in
this research. The total cost burden is estimated to be $3,074.
Exhibit 1--Estimated Annualized Burden Hours
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Number of
Form name Number of responses per Hours per Total burden
respondents respondent response hours
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Screener........................................ 100 1 5/60 8
Web-based Questionnaire......................... 100 1.4 10/60 23
Telephone Follow-up Interview................... 100 1.4 15/60 35
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Total....................................... 300 na na 66
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Exhibit 2--Estimated Annualized Cost Burden
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Average
Form name Number of Total burden hourly wage Total cost
respondents hours rate * burden
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Screener........................................ 100 8 $46.58 $373
Web-based Questionnaire......................... 100 23 46.58 1,071
Telephone Follow-up Interview................... 100 35 46.58 1,630
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Total....................................... 300 66 na 3,074
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* Based upon the average of the ``Wage estimates, mean hourly'' for the following occupation codes and titles:
11-101/Chief executives; 13-0000/Business and financial operations occupations; 15-1071/Network and computer
systems administrators; 29-1062/Family and general practitioners; 11-9111/Medical and health services
managers, from the ``May 2007 State Occupational Employment and Wage Estimates, Indiana; Occupational
Employment Statistics, U.S. Department of Labor, Bureau of Labor Statistics, http://www.bls.gov/oes/current/
oes_in.htm.''
[[Page 74723]]
Estimated Annual Costs to the Federal Government
This project will last for one year and is estimated to cost the
government $120,000. The scope of work includes the development of the
survey instruments and data collection ($90,000), and data analysis
($10,000) to establish specific barriers to HIE participation cited by
stakeholders and to define and evaluate them ($20,000).
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
functions 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 on
the information to be collected; and (d) ways to minimize the burden of
the collection of information on 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: December 1, 2008.
Carolyn M. Clancy,
Director.
[FR Doc. E8-28901 Filed 12-8-08; 8:45 am]
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