[Federal Register: April 24, 2009 (Volume 74, Number 78)]
[Notices]
[Page 18720-18722]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr24ap09-64]
-----------------------------------------------------------------------
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.
-----------------------------------------------------------------------
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
under the project: ``Evaluation of AHRQ's Effective Health Care
Program.'' In accordance with the Paperwork Reduction Act of 1995,
Public Law 104-13 (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 June 23, 2009.
ADDRESSES: Written comments should be submitted to: Doris Lefkowitz,
Reports Clearance Officer, AHRQ, by e-mail at
doris.lefkowitz@ahrg.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@ahrg.hhs.gov.
SUPPLEMENTARY INFORMATION:
Proposed Project
``Evaluation of AHRQ's Effective Health Care Program''
AHRQ proposes to perform an evaluation of the Effective Health Care
(EHC) program's governance structure, methods for engaging stakeholders
and approaches to setting national research priorities. Pursuant to
Section 1013 of the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, Pub. L. 108-173, the EHC program was
established by AHRQ to conduct research, demonstrations, and
evaluations designed to improve the quality, effectiveness, and
efficiency of Medicare, Medicaid, and the State Children's Health
Insurance Program. The EHC program was designed to provide
effectiveness and comparative effectiveness evidence of medical
treatments, therapeutics, devices and drugs to assist policymakers,
health care providers, clinicians, consumers, and other stakeholders in
making informed decisions. The EHC program has offered a platform for
combining explicit reviews of scientific evidence on the clinical
effectiveness of pharmaceuticals and other health care interventions,
as well as the translation and dissemination of scientific findings
into meaningful messages for a wide variety of audiences. It serves as
an interface between the clinical research entities and health policy
making entities. This
[[Page 18721]]
program also provides a critical step in AHRQ's mission to support
informed decision making. In addition to its program staff, the EHC
program relies on four centers to generate and disseminate evidences:
the Evidence-based Practice Centers (EPCs), the Developing Evidence to
Inform Decisions about Effectiveness (DEcIDE) Network Centers, the John
M. Eisenberg Clinical Decisions and Communications Science Center, and
the Centers for Education & Research on Therapeutics (CERTs). Since the
process of developing and disseminating this evidence is a complex
undertaking, AHRQ has contracted with IMPAQ International, LLC and Abt
Associates, Inc. (henceforth referred to as the ``IMPAQ team'') to
perform this evaluation.
Information will be collected to identify strengths and weaknesses
in the current EHC program's governance structure, methods for engaging
stakeholders, and approaches to setting priorities for the research
conducted by the EHC program. The second phase of the evaluation will
be to contrast the EHC program with international programs of similar
purpose. To implement this evaluation, the IMPAQ team will conduct the
following information collections:
(1) Key informant interviews about the governance structure of the
EHC program;
(2) An online survey of EHC center staff and EHC program users and
stakeholders;
(3) An Appreciative Inquiry workshop with EHC program staff and
stakeholders;
(4) A document review (will not impose a burden on research
participants) and
(5) Interviews with staff at international organizations of similar
purpose (will not impose a burden on U.S. citizens).
The latter two activities do not require OMB approval and are not
discussed further in this notice. The information collected will
ultimately be used to develop a roadmap, including at least three
alternative models of governance and operation, to be submitted to AHRQ
that could be used to help guide future programmatic development.
Method of Data Collection
Key Informant Interviews
Semi-structured key informant interviews will be used to understand
the EHC program's governance components and structure, from the vantage
point of individuals governing the program, governed by the program,
contributing to the program in various capacities, or impacted by the
program's activities. Thirteen EHC Research Centers Staff, two EHC
Stakeholder Group Members, and nineteen EHC Program Users and
Stakeholders will be interviewed about the governance structure of the
EHC program.
Additional key informant interviews with twenty five EHC Program
Users and Stakeholders will be used to collect more detailed
information on the success or impact of the EHC program product that
results from its governance element or approach, or about a specific,
important governance element.
All key informant interviews will be tape recorded to improve data
capture, with prior permission from the participants.
Online Survey
A structured, web-based online survey of EHC program Research
Centers Staff and EHC program Users and Stakeholders will be used to
gather information about the EHC program. The survey will provide a
robust view of the EHC governance system by providing feedback from a
broad group of individuals whose work is related to the program.
Specifically, the survey will collect data about these individuals'
engagement and involvement with the EHC program; perceptions of the
program's governance; experiences with the development, production,
dissemination, and use of EHC products; and their beliefs regarding the
quality and nature of the collaborative work, including public-private
partnerships, being done within centers, across centers, and between
centers and stakeholders.
Appreciative Inquiry Workshop
Small- and large-group discussions as part of an Appreciative
Inquiry workshop will be designed to encourage EHC decision-makers
(AHRQ staff, EHC program staff, AHRQ project officers for each of the
Research Center networks, principal investigators or other
representatives from each of the Research Center networks) and key
program stakeholders or users to consider and decide which are the
preferred alternative governance models or elements for which roadmaps
should be developed. Appreciative Inquiry (AI) approach is an
organizational development process that engages individuals within an
organization in renewal, change, and focused performance. The AI
approach focuses on successes and opportunities to improve things by
looking forward, rather than looking back on the problems or issues.
The AI workshop is expected to facilitate consensus among decision-
makers to contribute to the endorsement of the roadmap(s), and to
encourage utilization of the evaluation findings. The workshop will
involve a creative thinking process that will build on existing
successes, identify and rank preferred alternatives, and ultimately
develop a plan to strengthen the EHC program's governance system.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated annualized burden hours for the
respondents to participate in this evaluation. Key informant interviews
will be conducted about the governance structure of the EHC program and
will last about one hour. The on-line survey will be completed by 95
EHC program Research Centers Staff and 170 EHC Program Users and
Stakeholders and will require about 15 minutes to complete. The
Appreciative Inquiry workshop will be conducted with 20 participants
and will last about 6 hours. The total burden hours are estimated to be
246 hours. Exhibit 2 shows the estimated annualized cost burden based
on the respondents' time to participate in the evaluation. The total
cost burden is estimated to be $6,137.
Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
Number of
Activity name Number of responses per Hours per Total burden
respondents respondent response hours
----------------------------------------------------------------------------------------------------------------
Key Informant Interviews with EHC 13 1 1 13
Research Centers Staff.................
Online Survey with EHC Research Centers 95 1 15/60 24
Staff..................................
Key Informant Interviews with EHC 2 1 1 2
Stakeholder Group Members..............
Key Informant Interviews with EHC 19 1 1 19
Program Users and Stakeholders.........
Online Survey with EHC Program Users and 170 1 15/60 43
Stakeholders...........................
[[Page 18722]]
Key Informant Interviews with EHC 25 1 1 25
Program Users and Stakeholders to
Develop Cases..........................
Appreciative Inquiry Workshop........... 20 1 6 120
-----------------------------------------------------------------------
Total............................... 344 (\1\) (\1\) 246
----------------------------------------------------------------------------------------------------------------
\1\ Not applicable.
Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
Number of Total burden Average hourly Total cost
Activity name respondents hours wage rate * burden
----------------------------------------------------------------------------------------------------------------
Key Informant Interviews with EHC 13 13 $54.27 $706
Research Centers Staff.................
Online Survey with EHC Research Centers 95 24 54.27 1,302
Staff..................................
Key Informant Interviews with EHC 2 2 43.52 87
Stakeholder Group Members..............
Key Informant Interviews with EHC 19 19 46.73 888
Program Users and Stakeholders.........
Online Survey with EHC Program Users and 170 43 46.73 2009
Stakeholders...........................
Key Informant Interviews with EHC 25 25 46.73 1,168
Program Users and Stakeholders to
Develop Cases..........................
Appreciative Inquiry Workshop........... 20 120 51.14 6,137
-----------------------------------------------------------------------
Total............................... 344 246 (\1\) 12,297
----------------------------------------------------------------------------------------------------------------
* Wage rates were calculated using the following data: (1) For the Governance Interviews and the Online Survey
with EHC Research Centers Staff the hourly rate is a weighted average for physicians ($58.76 per hour) and
medical and health services managers ($37.82); (2) for the Governance Interviews with EHC Stakeholder Group
Members the hourly rate is the rate for average for medical and health services managers ($37.82); (3) for the
Governance Interviews and the Online Survey with EHC Program Users and Stakeholders the hourly rate is a
weighted average for physicians ($58.76 per hour), general and operations managers ($43.52 per hour), medical
and health services managers ($37.82 per hour), and social and community service managers ($24.73 per hour);
(4) for the Workshop the hourly rate is a weighted average for physicians ($58.76 per hour) and general and
operations managers ($43.52 per hour) from the mean of the average wages, National Compensation Survey:
Occupational Wages in the United States 2006, U.S. Department of Labor, Bureau of Labor Statistics.
\1\ Not applicable.
Estimated Annual Costs to the Federal Government
Exhibit 3 shows the estimated cost of this one year data collection
for the evaluation of the EHC program, including the cost of developing
the methodology and data collection instruments, collecting and
analyzing the data, publishing the results, etc. The work will be
carried out by IMPAQ International and Abt Associates under contract to
the Agency for Healthcare Research and Quality.
Exhibit 3--Estimated Annual Cost * to the Federal Government
------------------------------------------------------------------------
Total
Cost component cost
------------------------------------------------------------------------
Project Development.......................................... $137,901
Data Collection Activities................................... 179,172
Data Processing and Analysis................................. 170,577
Publication of Results....................................... 63,686
Project Management........................................... 97,236
----------
Total.................................................... 648,572
------------------------------------------------------------------------
* Please note the costs include fully loaded costs (overhead, G&A).
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: April 15, 2009.
Carolyn M. Clancy,
Director.
[FR Doc. E9-9245 Filed 4-23-09; 8:45 am]
BILLING CODE 4160-90-M