```

[Federal Register: November 2, 2010 (Volume 75, Number 211)]
[Notices]               
[Page 67370-67372]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr02no10-62]                         

-----------------------------------------------------------------------

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 
project: ``Synthesis Reports for Grants and Cooperative Agreements for 
Transforming Healthcare Quality through Information Technology 
(THQIT).'' In accordance with the Paperwork Reduction Act, 44 U.S.C. 
3501-3520, AHRQ invites the public to comment on this proposed 
information collection.

DATES: Comments on this notice must be received by January 3, 2011.

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

Synthesis Reports for Grants and Cooperative Agreements for 
Transforming Healthcare Quality Through Information Technology (THQIT)

    AHRQ's health information technology initiative is part of the 
Nation's strategy to put information technology to work in health care. 
By developing secure and private electronic health records and making 
health information available electronically when and where it is 
needed, health IT can improve the quality of care, even as it makes 
health care more cost effective. This proposed information collection 
will help AHRQ enhance the evidence base to support effective 
information technology (IT) implementation and add to knowledge about 
health IT by synthesizing and drawing lessons from its Transforming 
Healthcare Quality through Information Technology (THQIT) program.
    From 2004-2010, the THQIT program has supported the adoption of 
health IT through 118 grants and cooperative agreements. These grants 
fall into three main categories: Planning grants, implementation grants 
and value demonstration grants. Planning grants are intended to develop 
health IT infrastructure and data-sharing capacity among clinical 
provider organizations in their communities by (1) creating 
multidisciplinary collaboratives and coalitions of health care 
providers, (2) conducting needs assessments and feasibility studies, 
and (3) developing plans to implement electronic health records. 
Implementation grants support community-wide and regional health IT 
systems by (1) developing shared registries, electronic health record 
systems, and telemedicine networks, (2) integrating clinical data from 
a variety of health IT systems, including pharmacy, laboratory, and 
public health organizations, (3) redesigning clinical workflow to 
improve patient care and provider access to information and (4) 
creating novel methods for delivering information to providers. Value 
demonstration grants evaluate how the adoption of health IT will (1) 
impact quality, safety, and resource use in large, integrated delivery 
systems, (2) advance the effectiveness of Web-based, patient education 
tools and (3) improve patient transitions between health care 
facilities and their homes. The program places an emphasis on grants to 
rural health organizations.
    AHRQ does not currently have a system in place for assessing the 
overall outcomes and lessons learned from these health IT grants. This 
project seeks to create such a system and has the following goals:
    (1) Further the state of knowledge of health IT planning, 
implementation, and effects by synthesizing the experiences of THQIT 
grantees and the reported effects of the grants;
    (2) Translate this knowledge into a practical tool to assist rural 
hospitals with electronic health record implementations; and
    (3) Translate this knowledge into recommendations for AHRQ 
activities.
    This study is being conducted by AHRQ through its contractor, 
Mathematica Policy Research, Inc. (Mathematica), pursuant to AHRQ's 
statutory authority to conduct and support research (1) on healthcare 
and on systems for the delivery of such care, 42 U.S.C. 299a, and (2) 
on information systems for health care improvement. 42 U.S.C. 299b-3.

Method of Collection

    To achieve the goals of this project the following data collections 
will be implemented:
    (1) Planning Grant Survey for all grantees that received a planning 
grant;
    (2) Implementation Grant Survey for all grantees that received an 
implementation grant;
    (3) Value Grant Survey for all grantees that received a value 
grant; and
    (4) In-Depth Interviews will be conducted via telephone with a 
sample of grantees from each of the three types of grants. Given the 
complex nature of many of the projects conducted under these grants, 
from each selected grantee organization 1 to 3 persons with different 
areas of expertise will participate in the interview with the most 
knowledgeable person responding to a given question. Questions vary by 
grant type.
    These proposed data collections will gather information from 
grantee principal investigators on topics including: (1) Partnerships, 
which were required of all the grantees-what types are most effective 
and long-lasting and

[[Page 67371]]

how partnerships can be made more effective; (2) planning for health 
IT-information that can help identify successful pathways; (3) 
implementation of health IT-including common and unique barriers and 
facilitators to implementation across types of health IT and care 
settings; (4) the outcomes, benefits, and drawbacks of the grant 
projects; and (5) the sustainability and expansion of implemented 
health IT.
    Collecting this information will assist AHRQ in its mission of 
supporting the synthesis and dissemination of available evidence for 
the planning, implementation, and use of health IT by patients, 
practitioners, providers, purchasers, policymakers, and educators.
    The proposed data collection is also designed to assist AHRQ in 
improving the effectiveness with which it supports future research, 
synthesis, and initiatives on health IT topics. The grantees' 
experiences with the THQIT grant process and features is an important 
topic covered including feedback on whether the funding and time period 
were sufficient, how effective the grant was in furthering health IT in 
grantee organizations, and whether planning grants are a useful 
mechanism to prepare health care organizations and researchers to 
participate in future large-scale research.
    This research also supports AHRQ's mission, 42 U.S.C. 299(c), to 
specifically focus on rural populations and priority populations by 
collecting information on special factors affecting rural health care 
grantees, and the outcomes of the grant projects for AHRQ priority 
populations.

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated annualized burden hours associated 
with the respondents' time to participate in this research. The Value 
Grant Survey will be completed by the 24 grantees that received a value 
grant and takes 30 minutes to complete. The Planning Grant Survey will 
be completed by all 38 recipients of a planning grant and requires 30 
minutes to complete. The Implementation Grant Survey will be completed 
by the 56 grantees that received an implementation grant and takes 45 
minutes to complete. In-depth interviews will be conducted with 1 to 3 
persons (2 on average) from each of 30 different grantee organizations 
and is estimated to average 1.8 hours; actual burden will vary since 
some sections apply to specific grant types. The total annualized 
burden is estimated to be 181 hours.
    Exhibit 2 shows the estimated annualized cost burden associated 
with the respondents' time to participate in this research. The total 
annualized cost burden is estimated to be $7,917.

                                  Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                     Number of
                    Form name                        Number of     responses per     Hours per     Total burden
                                                    respondents     respondent       response          hours
----------------------------------------------------------------------------------------------------------------
Value Grant Survey..............................              24               1           30/60              12
Planning Grant Survey...........................              38               1           30/60              19
Implementation Grant Survey.....................              56               1           45/60              42
In-Depth Interviews.............................              30               2             1.8             108
                                                 ---------------------------------------------------------------
    Total.......................................             148             n/a             n/a             181
----------------------------------------------------------------------------------------------------------------

                                   Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
                                                     Number of     Total burden   Average hourly    Total cost
                    Form name                       respondents        hours        wage rate*        burden
----------------------------------------------------------------------------------------------------------------
Value Grant Survey..............................              24              12           43.74            $525
Planning Grant Survey...........................              38              19           43.74             831
Implementation Grant Survey.....................              56              42           43.74           1,837
In-Depth Interviews.............................              30             108           43.74           4,724
                                                 ---------------------------------------------------------------
    Total.......................................             148             181              na           7,917
----------------------------------------------------------------------------------------------------------------
* Based upon the mean of the average wages for medical and health services managers, Department of Labor, Bureau
  of Labor Statistics, Occupational and Employment Wages. May 2009. Accessed at: http://www.bls.gov/news.release/  pdf/ocwage.pdf.

Estimated Annual Costs to the Federal Government

    Exhibit 3 shows the estimated total and annualized cost for this 
project. Although data collection activities will last for one year, 
the entire project will span 2.25 years; therefore, the annualized 
costs cover two and a quarter years. The total project cost is 
estimated to be $600,055.

             Exhibit 3--Estimated Total and Annualized Cost
------------------------------------------------------------------------
                                                            Annualized
             Cost component                 Total cost         cost
------------------------------------------------------------------------
Project Development.....................         $80,584         $35.815
Data Collection Activities..............          72,198          32,088
Data Processing and Analysis............          52,389          23,284
Publication of Results..................         149,476          66,434
Project Management......................          70,313          31,250
Overhead................................         175,095          77,820
                                         -------------------------------

[[Page 67372]]

    Total...............................         600,055         266,691
------------------------------------------------------------------------

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: October 21, 2010.
Carolyn M. Clancy,
Director.
[FR Doc. 2010-27568 Filed 11-1-10; 8:45 am]
BILLING CODE 4160-90-M
```