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[Federal Register: August 25, 2010 (Volume 75, Number 164)]
[Notices]               
[Page 52347-52349]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr25au10-75]                         

[[Page 52347]]

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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: ``Eisenberg Center Voluntary Customer Survey Generic Clearance 
for the Agency for Healthcare Research and Quality.'' In accordance 
with the Paperwork Reduction Act, 44 U.S.C. 3501-3520, AHRQ invites the 
public to comment on this proposed information collection.
    This proposed information collection was previously published in 
the Federal Register on May 20th 2010 and allowed 60 days for public 
comment. One comment was 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 September 24, 2010.

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

Eisenberg Center Voluntary Customer Survey Generic Clearance for the 
Agency for Healthcare Research and Quality

    The Agency for Healthcare Research and Quality (AHRQ) requests that 
the Office of Management and Budget (OMB) renew, under the Paperwork 
Reduction Act of 1995, AHRQ's Generic Clearance to collect information 
from users of work products and services initiated by the John M. 
Eisenberg Clinical Decisions and Communications Science Center 
(Eisenberg Center).
    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. See 42 U.S.C. 299. AHRQ's Eisenberg Center is an innovative 
effort aimed at improving communication of findings to a variety of 
audiences (``customers''), including consumers, clinicians, and health 
care policy makers. The Eisenberg Center compiles research results into 
a variety of useful formats for customer stakeholders. The Eisenberg 
Center also conducts its own program of research 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 Program, see 42 U.S.C. 299b-7. For the period 2005 until September 
2008, the Eisenberg Center was operated through a contractual 
arrangement with the Oregon Health and Science University (OHSU), 
Department of Medicine, located in Portland, Oregon. In September 2008, 
the contract for operation of the Eisenberg Center was awarded to 
Baylor College of Medicine (BCM), located in Houston Texas.
    The collections proposed under this clearance include activities to 
assist in the development of materials to be disseminated through the 
Eisenberg Center and to provide feedback to AHRQ on the extent to which 
these products meet customer needs. These materials include Summary 
Guides that summarize and translate the findings of comparative 
effectiveness reviews (CER) and research reports for purposes of 
summarizing research findings for various decision-making audiences, 
such as consumers, clinicians, or policymakers. The guides are designed 
to help these decision makers use research evidence to maximize the 
benefits of health care, minimize harm, and optimize the use of health 
care resources. In addition, each year of the project the Eisenberg 
Center will develop one computerized, interactive decision aid for 
those clinical problems identified from selected CERs. The intent is 
for the decision aid to increase the patient/consumer's knowledge of 
the health condition, options, and risk/benefits, lead to greater 
assurance in making a decision, increase the congruence between values 
and choices, and enhance involvement in the decision making process. 
Information collections conducted under this generic clearance are not 
required by regulation and will not be used to regulate or sanction 
customers. Surveys will be entirely voluntary, and information provided 
by respondents will be combined and summarized so that no individually 
identifiable information will be released. The Eisenberg Center will 
produce from 17 to a maximum of 33 Summary Guides per audience (i.e., 
clinician, policymaker, consumer) per year, depending on the 
information needed for each product with each audience.
    In accordance with OMB guidelines for generic clearances for 
voluntary customer surveys and Executive Order 12862, AHRQ has 
established an independent review process to assure the development, 
implementation, and analysis of high quality customer surveys within 
AHRQ. Specifically, AHRQ understands that each activity conducted must 
be submitted to OMB with a supporting statement and accompanying 
instruments. Information collection may not proceed until approved by 
OMB.

Method of Collection

    Information collections conducted under this clearance will be 
collected via the following methods:
     Focus Groups. Focus groups may include clinical 
professionals, patients or other health care consumers, or health 
policy makers. They will be used to provide input regarding the needs 
for products and for the development of Decision Aids and Summary 
Guides. Focus groups may also be used to test draft products to 
determine if intended information and messages are being delivered 
through products that are produced and disseminated through the 
Eisenberg Center.
     In-person or Telephone Interviews. Interviews will be 
conducted with individuals from one or more of the three groups 
identified above. The purpose of these interviews is to (1) To provide 
input regarding the development of Decision Aids and Summary Guides, 
(2) to determine if intended information and messages are being 
delivered effectively through products that are produced and 
disseminated through the Eisenberg Center, and (3) to engage the 
subject in cognitive testing to (a) determine if changes in topical 
knowledge levels can be identified following exposure to Eisenberg 
Center informational or instructional products, and (b) identify 
strengths and weaknesses in products and services for purposes of 
making improvements that are practical and feasible.
     Customer Satisfaction Survey for the Decision Aids. 
Baseline survey data will be collected on both clinician and

[[Page 52348]]

patient characteristics, characteristics of the health care condition, 
and selected outcome measures such as knowledge and decisional self-
efficacy. Following delivery of the decision aid, a user survey will be 
completed to explore subjects' impressions of the tool, including ease 
of use, clarity of presentation, length, balance of information, rating 
of interactive features, and overall satisfaction. Both clinicians and 
patients/consumers will be surveyed. For patients, the customer 
satisfaction survey will include decisional outcome measures (e.g., 
decisional conflict, desire for involvement in decision making), 
measures of attitudes and self-efficacy, and indicators of choice 
intention or actual choice made. If the aid is evaluated within a 
clinical context, measures of physician-patient interaction will also 
be considered. Additionally, clinicians may be interviewed about the 
impact of the aid on clinical flow.
     Customer Satisfaction Surveys for the Summary Guides. 
These surveys will be offered to health care professionals, consumers, 
and policy makers that use the online Summary Guides. Respondents will 
report via Likert-type or numerical response scales how specific 
informational or educational products or materials influenced health 
care or clinical practice behaviors.
     Follow-up CME Surveys. Continuing Medical Education (CME) 
credit will be offered to physicians who wish to participate in online 
activities developed around the Summary Guides for clinicians. Three 
months after completing the educational activity, physicians will be 
asked to complete a follow-up survey to assess realized changes in 
clinical practice, barriers to making change, and self-assessed impacts 
on patient care.
     Solicited Topic Nominations. Visitors to the Web site will 
have the opportunity to provide information about suggested topics that 
might be addressed through the research and dissemination efforts of 
the EHC program.
     Web site Registration. Visitors to the Web site will be 
able to register personal contact information (e.g., name, email 
address) if wishing to receive updated information and materials as 
they become available.
     Glossary Feedback Survey. Visitors to the Web site who 
access the health care glossary will be asked to suggest missing terms 
and provide additional comments on definitions or usage sentences, if 
desired.
    This information will be used to develop, improve and/or maintain 
high quality products and services to lay and health professional 
publics.

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated total burden for the respondents' 
time to participate in this research. These estimates assume a maximum 
of 99 Summary Guides over 3 years and separate Guides for clinicians, 
policy makers and consumers and are thus slight overestimates.
    Focus groups will be used for needs assessment and will be 
conducted with clinicians and consumers for development of the Summary 
Guides, and additionally with policymakers for those Guides in which 
policy recommendations are applicable. Focus groups will be conducted 
with no more than 3,168 persons over 3 years and will last about 1\1/2\ 
hours.
    Once the Summary Guides are developed they will be subjected to in-
person or telephone interviews for purposes of usability and product 
testing with clinicians, policy makers and consumers. In-
personltelephone interviews will be conducted twice with about 4,158 
persons over 3 years and will take about 66 minutes on average. As 
depicted in Attachment B, two rounds of interviews will be conducted 
with all consumer representatives during product development, with a 
second round of interviews conducted occasionally with clinicians and 
policy makers, as needed.
    Customer satisfaction surveys for the Summary Guides will be 
conducted with approximately 19,800 representatives from the audience 
to be targeted by the Summary Guides over 3 years (i.e., clinician, 
policymaker or consumer) and will take 5 minutes to complete.
    Customer satisfaction surveys will also be administered to 
approximately 150 clinicians and 1,500 patients in evaluating the 
Decision Aid. These surveys will take about 10 minutes to complete, and 
will be administered before and after implementation of the Decision 
Aid in the study populations.
    Clinicians that have completed CME accrediting requirements and are 
requesting CME credit will be asked to complete the follow-up CME 
Survey three months following completion of the online activity. This 
data collection will be completed with about 3,960 clinicians over 3 
years and will require 5 minutes to complete.
    Approximately 7,500 solicited topic nomination forms will be 
completed over 3 years by healthcare professional and consumer visitors 
to the Web site and will require about 5 minutes to complete. Web site 
Registration will be completed by all persons wanting to stay up-to-
date with the latest information from the Eisenberg Center, about 
18,000 over 3 years, and requires about 5 minutes to complete. The 
Glossary Feedback Survey will be completed by about 600 persons that 
access the glossary over a 3-year period and takes 5 minutes to 
complete. The total burden hours are estimated to be 18,605 over 3-
years.
    Exhibit 2 shows the estimated total cost burden associated with the 
respondents' time to participate in this research. The cost burden is 
estimated to be $865,829 annually.

                              Exhibit 1--Estimated Total Burden Hours Over 3 Years
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                                                                     Number of
             Type of data collection                 Number of     responses per     Hours per     Total burden
                                                    respondents     respondent       response          hours
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Focus Groups....................................           3,168               1             1.5           4,752
In-person/Telephone Interviews..................           4,158               2             1.1           9,148
Customer Satisfaction Surveys for the Decision             1,650               2           10/60             550
 Aid............................................
Customer Satisfaction Surveys for the Summary             19,800               1            5/60           1,650
 Guides.........................................
Follow-up CME Surveys...........................           3,960               1            5/60             330
Solicited Topic Nominations.....................           7,500               1            5/60             625
Web site Registration...........................          18,000               1            5/60           1,500
Glossary Feedback Survey........................             600               1            5/60              50
                                                 ---------------------------------------------------------------
    Total.......................................          58,836              na              na          18,605
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[[Page 52349]]

                               Exhibit 2--Estimated Total Cost Burden Over 3 Years
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                                                     Number of     Total burden   Average hourly    Total cost
             Type of data collection                respondents        hours        wage rate*        burden
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Focus Groups....................................           3,168           4,752          $46.71        $221,966
In-person/Telephone Interviews..................           4,158           9,148           53.17         486,399
Customer Satisfaction Surveys for the Decision             1,650             550           24.50          13,475
 Aid............................................
Customer Satisfaction Surveys for the Summary             19,800           1,650           46.71          77,072
 Guides.........................................
Follow-up CME Surveys...........................           3,960             330           73.86          24,374
Solicited Topic Nominations.....................           7,500             625           19.56          12,225
Web site Registration...........................          18,000           1,500           19.56          29,340
Glossary Feedback Survey........................             600              50           19.56             978
                                                 ---------------------------------------------------------------
    Total.......................................          58,836          18,605              na         865,829
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* Based upon the mean and weighted mean wages for clinicians (29-1062 family and general practitioners), policy
  makers (11-0000 management occupations, 11-3041 compensation & benefits managers, 13-1072 compensation,
  benefits & job analysis specialists, 11-9111 medical and health service managers, 13-2053 insurance
  underwriters and 15-2011 actuaries) and consumers (00-0000 all occupations). Focus groups include 528
  clinicians ($77.64/hr) and 528 consumers ($20.32/hr); in-person/telephone interviews include 528 clinicians,
  330 policy makers ($39.91/hr) and 528 consumers; customer satisfaction surveys for the decision aid include 50
  clinicians and 500 consumers; customer satisfaction surveys for the summary guides include 1,650 clinicians,
  1,650 policy makers and 3,300 consumers; follow-up CME surveys include 1,320 clinicians; solicited topic
  nominations include 1,125 clinicians, 250 policy makers and 1,125 consumers; Web site registration includes
  2,700 clinicians, 600 policy makers and 2,700 consumers; glossary feedback survey includes 90 clinicians, 20
  policy makers and 90 consumers, National Compensation Survey: Occupational wages in the United States May
  2008, ``U.S. Department of Labor, Bureau of Labor Statistics.''

Estimated Annual Costs to the Federal Government

    The maximum cost to the Federal Government is estimated to be 
$1,439,003 annually. Exhibit 3 shows the total and annualized cost by 
the major cost components.

             Exhibit 3--Estimated Total and Annualized Cost
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                                                            Annualized
             Cost component                 Total cost         cost
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Project Development.....................      $1,019,970        $339,990
Data Collection Activities..............         735,405         245,135
Data Processing and Analysis............       1,889,505         629,835
Project Management......................         557,380         185,793
Overhead................................         114,750          38,250
                                         -------------------------------
    ~~Total.............................       4,317,010       1,439,003
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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 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: August 9, 2010.
Carolyn M. Clancy,
Director.
[FR Doc. 2010-20913 Filed 8-24-10; 8:45 am]
BILLING CODE 4160-90-M
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