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[Federal Register Volume 77, Number 22 (Thursday, February 2, 2012)]
[Notices]
[Pages 5255-5257]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-2130]

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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: ``Assessing the Feasibility of Disseminating EHC Products 
through Educational Activities.'' In accordance with the Paperwork 
Reduction Act, 44 U.S.C. 3501-3521, AHRQ invites the public to comment 
on this proposed information collection.
    This proposed information collection was previously published in 
the Federal Register on November 23rd, 2011 and allowed 60 days for 
public comment. No substantive 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 March 5, 2012.

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 
email 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 email at 
doris.lefkowitz@AHRQ.hhs.gov.

SUPPLEMENTARY INFORMATION: 

Proposed Project

Assessing the Feasibility of Disseminating EHC Products through 
Educational Activities

    The Agency for Healthcare Research and Quality (AHRQ) requests that 
the Office of Management and Budget (OMB) approve under the Paperwork 
Reduction Act of 1995 this collection of information from users of 
products provided by the John M. Eisenberg Clinical Decisions and 
Communications Science Center (Eisenberg Center). Information collected 
consists of feedback from managers, instructors, and learners about 
these health care guides and other products presented as part of 
Continuing Medical Education activities.
    AHRQ is the lead agency charged with supporting research designed 
to improve the quality of healthcare, reduce its cost, improve patient 
safety, decrease medical errors, and broaden access to essential 
services. AHRQ's Eisenberg Center's mission is improving communication 
of research findings to a variety of audiences (``customers''), 
including consumers, clinicians, and health care policy makers. The 
Eisenberg Center compiles research results into useful formats for 
customer stakeholders. The Eisenberg Center also conducts 
investigations into effective communication of research findings in 
order to improve the usability and rapid incorporation of findings into 
medical practice. The Eisenberg Center is one of three components of 
AHRQ's Effective Health Care (EHC) Program.
    A primary goal of the Eisenberg Center is to translate results from 
systematic reviews of evidence comparing the effectiveness of two or 
more clinical care processes into information that can be used to 
support clinical decision-making. The major products of such efforts 
are brief guides designed for clinicians, patients, and policy makers 
that summarize the evidence concerning the effectiveness of various 
diagnostic and treatment processes. All of the guides and other 
products are designed to help decision makers, including clinicians and 
health care consumers, use research evidence to maximize the benefits 
of health care, minimize harm, and optimize the use of health care 
resources.
    The collections proposed under this project include activities to 
assess the feasibility of disseminating EHC products through Continuing 
Medical Education (CME) activities, specifically those planned and 
implemented by member organizations of the Society of Academic 
Continuing Medical Education (SACME). SACME is an organization with 
members in both the U.S. and Canada formed in 1976 to ``promote the 
research, scholarship, evaluation and development of CME and Continuing 
Professional Development (CPD) that helps to enhance the performance of 
physicians and other healthcare professionals practicing in the United 
States, Canada, and elsewhere for purposes of improving individual and 
population health.''
    For this project, the Eisenberg Center will work with six 
organizations selected from applications submitted by SACME members 
that had been invited to compete for funding. The Eisenberg Center 
selected sites based on the size of each organization's CME audience, 
the project's ability to inform the CME community, its degree of 
generalizability and replicability, and overall quality. Organizations 
selected for participation in the feasibility study have committed to 
specific activities designed to disseminate EHC Program summary guides 
to physicians, other clinicians, instructional faculty, and clinical 
researchers who participate in CME activities. Another partner in these 
efforts is the Association of American Medical Colleges (AAMC), which 
is assisting the project through access to MedEdPORTAL and CME4docs, 
two recently launched initiatives that are designed to encourage use of 
high quality CME resources by medical school faculty and others 
involved in development and delivery of CME.
    This research has the following goals:
    (1) Identify critical factors that enhance or impede integration of 
EHC products into CME activities;
    (2) Assess strategies to remove, overcome, or work around barriers 
to

[[Page 5256]]

integration of EHC products into CME programming with selected 
audiences;
    (3) Confirm approaches that can be used in whole or in part to 
create and deliver effective CME instruction about EHC products (e.g., 
clinician guides, consumer guides, faculty slide sets); and,
    (4) Review early educational program outcomes associated with 
integration of EHC products into CME activities.
    This study is being conducted by AHRQ through its contractor, the 
Eisenberg Center--Baylor College of Medicine (EC-BMC), pursuant to 
AHRQ's statutory authority to conduct and support research, and 
disseminate information, on healthcare and on systems for the delivery 
of such care, including activities with respect to both the quality, 
effectiveness, efficiency, appropriateness and value of healthcare 
services and clinical practice. 42 U.S.C. 299a(a)(1) and (4).

Method of Collection

    To achieve the goals of this project the following activities and 
data collections will be implemented:
    (1) Interviews with CME Project Directors--Semi-structured 
interviews will be conducted with the representative of each 
participating CME institution leading the development and 
implementation of the educational activities associated with the study. 
The director is typically, but not always, an expert physician. The 
interviews will be designed to: (a) Assess perceived feasibility and 
obtain feedback on strategies used to integrate EHC products into their 
planned CME activities involving varied content, instructional methods, 
and delivery formats; and, (b) characterize barriers and facilitators 
to the integration of EHC products into specific CME activities.
    (2) Focus Group with CME Project Directors--A focus group will also 
be convened with the CME Project Directors described above near the 
midpoint of the project to: (a) Obtain feedback on the perceived 
usefulness, currency and quality of the EHC products; and, (b) explore 
the overall implications concerning CME activities as an avenue for 
disseminating EHC products.
    (3) Interviews with Faculty Members--Semi-structured interviews 
will be conducted with clinicians who served as faculty in the CME 
activities associated with this study to: (a) Obtain perspectives on 
the quality, relevance, and utility of the resources that they accessed 
and integrated into their CME activities; (b) identify obstacles to the 
integration of EHC products into specific CME activities and contexts; 
and, (c) identify additional tools or resources that could facilitate 
the integration of EHC content into CME activities.
    (4) Initial Survey Assessments of CME Participants--Learner 
questionnaires will be administered to each clinician participating in 
a CME activity to determine the degree to which the learning activities 
with integrated EHC products affected educational outcomes such as 
levels of knowledge about specific clinical treatment issues and 
incorporation of new knowledge into clinical practice. The initial 
questionnaire will be distributed by paper or electronically at the 
immediate conclusion of participation in the CME activity.
    (5) Follow-up Survey Assessments of CME Participants--A second 
questionnaire will be distributed electronically two months after each 
activity to each clinician learner and will be accessible through the 
Eisenberg Center Web site. An email message will be sent to invite 
participation and will include a link to the questionnaire. Gathering 
such data will provide a view of current awareness of EHC products and 
learners' intentions to use the products in practice as well as 
perceptions of barriers to implementation.
    The collected data will be used to determine the feasibility of: 
(a) Including EHC products (i.e., clinician guides, consumer guides, 
faculty slide sets) in CME activities that employ varied delivery 
modalities; and, (b) initiating additional studies to identify factors 
that promote effective integration of evidence-based content into 
educational activities. The data gathered from physicians and other 
clinical professionals who are participating in CME activities will 
foster understanding of the current state of awareness of and 
willingness to learn about results from comparative effectiveness 
research studies. The planned assessment approaches will promote better 
understanding of strategies that are most appropriate for use in 
incorporating comparativeness effectiveness research findings into CME 
activities, as well as understanding which strategies produce desired 
educational outcomes and are most acceptable to targeted learners in 
this case clinical professionals. The information generated will be 
used in designing learning programs for delivery through the Eisenberg 
Center for Clinical Decisions and Communications Science and will be 
shared with others in the CME community through journal articles, Web-
based publications, and scientific presentations.

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated annualized burden for the 
respondents' time to participate in this research. Interviews will be 
conducted with each CME Project Director and will last about 30 
minutes, while the focus group will last about 90 minutes. A maximum of 
30 interviews will be conducted with CME faculty members. These are 
estimated to take 30 minutes to complete. The initial survey assessment 
of CME participant learners will take about 5 minutes to complete per 
questionnaire, as will the follow-up survey assessment. These 
questionnaires will be administered to the approximately 4,500 
clinicians who will complete one of the study's CME activities. Each 
learner will be asked to complete both the initial and follow-up 
surveys.

                                  Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                     Number of
             Type of data collection                 Number of     responses per     Hours per     Total burden
                                                    respondents     respondent       response          hours
----------------------------------------------------------------------------------------------------------------
Interviews with CME Project Directors...........              10               1           30/60               5
Focus Group with CME Project Directors..........              10               1             1.5              15
Interviews with Faculty Members.................              30               1           30/60              15
Initial Survey Assessment of CME Participants...           4,500               1            5/60             375
Follow up Survey Assessment of CME Participants.           4,500               1            5/60             375
                                                 ---------------------------------------------------------------
    Total.......................................           9,050              na              na             785
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[[Page 5257]]

    Exhibit 2 shows the estimated annualized cost burden associated 
with the respondent's time to participate in this research. The total 
annual cost burden is estimated to be $65,233.

                                   Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
                                                     Number of     Total burden   Average hourly    Total cost
             Type of data collection                respondents        hours         wage rate        burden
----------------------------------------------------------------------------------------------------------------
Interviews with CME Project Directors...........              10               5         $64.31+            $322
Focus Group with CME Project Directors..........              10              15          64.31+             965
Interviews with Faculty Members.................              30              15         83.59++           1,254
Initial Survey Assessment of CME Participants...           4,500             375         83.59++          31,346
Follow up Survey Assessment of CME Participants.           4,500             375         83.59++          31,346
                                                 ---------------------------------------------------------------
    Total.......................................           9,050             785              na          65,233
----------------------------------------------------------------------------------------------------------------
+Based upon the mean wages for clinicians (29-1062 family and general practitioners), National Compensation
  Survey: Occupational wages in the United States May 2010, U.S. Department of Labor, Bureau of Labor
  Statistics. http://www.bls.gov/oes/current/oes_nat.htm.
++Based upon the mean wages for clinicians (29-1062 family and general practitioners) and medical and health
  services managers (11-9111), National Compensation Survey: Occupational wages in the United States May 2010,
  U.S. Department of Labor, Bureau of Labor Statistics. http://www.bls.gov/oes/current/oes_nat.htm.

Estimated Annual Cost to the Government

    Exhibit 3 shows the total and annualized cost by the major cost 
components. The maximum cost to the Federal Government is estimated to 
be $166,417 annually.

             Exhibit 3--Estimated Total and Annualized Cost
------------------------------------------------------------------------
                                                            Annualized
             Cost component                 Total cost         cost
------------------------------------------------------------------------
Project Development.....................        $110,846         $55,423
Data Collection Activities..............          47,563          23,781
Data Processing and Analysis............          38,250          19,125
Project Management......................          73,675          36,838
Overhead................................          62,500          31,250
                                         -------------------------------
    Total...............................         332,834         166,417
------------------------------------------------------------------------

Request for Comments

    In accordance with the Paperwork Reduction Act, 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 healthcare research and 
healthcare 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: January 20, 2012.
Carolyn M. Clancy,
Director.
[FR Doc. 2012-2130 Filed 2-1-12; 8:45 am]
BILLING CODE 4160-90-P
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