42738 Federal Register / Vol. 77, No. 140 / Friday, July 20, 2012 / Notices 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Patient Safety Organizations: 

Voluntary Relinquishment From the 

Coalition for Quality and Patient Safety 

of Chicagoland (CQPS PSO) 

AGENCY: Agency for Healthcare Research 

and Quality (AHRQ), HHS. 

ACTION: Notice of Delisting. 

SUMMARY: The Patient Safety and 

Quality Improvement Act of 2005 

(Patient Safety Act), Public Law 109– 

41,42 U.S.C. 299b–21–b–26, provides 

for the formation of Patient Safety 

Organizations (PSOs), which collect, 

aggregate, and analyze confidential 

information regarding the quality and 

safety of health care delivery. The 

Patient Safety and Quality Improvement 

Final Rule (Patient Safety Rule), 42 CFR 

Part 3, authorizes AHRQ, on behalf of 

the Secretary of HHS, to list as a PSO 

an entity that attests that it meets the 

statutory and regulatory requirements 

for listing. A PSO can be ‘‘delisted’’ by 

the Secretary if it is found no longer to 

meet the requirements of the Patient 

Safety Act and Patient Safety Rule, or 

when a PSO chooses to voluntarily 

relinquish its status as a PSO for any 

reason. AHRQ has accepted a 

notification of voluntary relinquishment 

from the Coalition for Quality and 

Patient Safety of Chicagoland (CQPS 

PSO) of its status as a PSO, and has 

delisted the PSO accordingly. 

DATES: The directories for both listed 

and delisted PSOs are ongoing and, 

reviewed weekly by AHRQ. The 

delisting was effective at 12:00 Midnight 

ET (2400) on May 24, 2012. 

ADDRESSES: Both directories can be 

accessed electronically at the following 

HHS Web site: http:// 

www.pso.AHRQ.gov/index.html. 

FOR FURTHER INFORMATION CONTACT: 

Eileen Hogan, Center for Quality 

Improvement and Patient Safety, AHRQ, 

540 Gaither Road, Rockville, MD 20850; 

Telephone (toll free): (866) 403–3697; 

Telephone (local): (301) 427–1111; TTY 

(toll free): (866) 438–7231; TTY (local): 

(301) 427–1130; Email: 

pso@AHRQ.hhs.gov. 

SUPPLEMENTARY INFORMATION: 

Background 

The Patient Safety Act authorizes the 

listing of PSOs, which are entities or 

component organizations whose 

mission and primary activity is to 

conduct activities to improve patient 

safety and the quality of health care 

delivery. HHS issued the Patient Safety 

Rule to implement the Patient Safety 

Act. AHRQ administers the provisions 

of the Patient Safety Act and Patient 

Safety Rule (PDF file, 450 KB. PDF 

Help) relating to the listing and 

operation of PSOs. The Patient Safety 

Rule authorizes AHRQ to list as a PSO 

an entity that attests that it meets the 

statutory and regulatory requirements 

for listing. A PSO can be ‘‘delisted’’ if 

it is found no longer to meet the 

requirements of the Patient Safety Act 

and Patient Safety Rule, or when a PSO 

chooses to voluntarily relinquish its 

status as a PSO for any reason. Section 

3.108(d) of the Patient Safety Rule 

requires AHRQ to provide public notice 

when it removes an organization from 

the list of federally approved PSOs. 

AHRQ has accepted a notification from 

Coalition for Quality and Patient Safety 

of Chicagoland (CQPS PSO), PSO 

number P0090, which is a component 

entity of Project Patient Care, Inc., to 

voluntarily relinquish its status as a 

PSO. Accordingly, the Coalition for 

Quality and Patient Safety of 

Chicagoland (CQPS PSO) was delisted 

effective at 12:00 Midnight ET (2400) on 

May 24, 2012. 

More information on PSOs can be 

obtained through AHRQ’s PSO Web site 

at http://www.pso.AHRQ.gov/ 

index.html. 

Dated: July 13, 2012. 

Carolyn M. Clancy, 

Director. 

[FR Doc. 2012–17531 Filed 7–19–12; 8:45 am] 

BILLING CODE 4160–90–M 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Request for Information on Quality 

Measurement Enabled by Health IT 

AGENCY: Agency for Healthcare Research 

and Quality (AHRQ), Health and Human 

Services (HHS). 

ACTION: Notice of Request for 

Information (RFI). 

SUMMARY: The Agency for Healthcare 

Research and Quality (AHRQ) requests 

information from the Public, including 

diversified stakeholders (health 

information technology (IT) system 

developers, including vendors; payers, 

quality measure developers, end-users, 

clinicians, health care consumers) 

regarding current successful strategies 

and challenges regarding quality 

measurement enabled by health IT. 

Quality measurement—the assessment 

of the timeliness, completeness and 

appropriateness of preventive services, 

diagnostic services, and treatment 

provided in health care—has been most 

generally conducted via paper chart 

information capture, manual chart 

abstraction, and the analysis of 

administrative claims data. 

DATES: Submit comments on or before 

August 20, 2012. 

ADDRESSES: Electronic responses are 

preferred and should be addressed to 

HIT-PTQ@AHRQ.hhs.gov. Nonelectronic responses will also be 

accepted. Please send by mail to: 

Rebecca Roper, Agency for Healthcare 

Research and Quality, Attention: HITEnabled QM RFI Responses, 540 Gaither 

Road, Room 6000, Rockville, MD 20850, 

Phone: 301–427–1535. 

FOR FURTHER INFORMATION CONTACT: 

Please identify in the subject line of 

emails that you are inquiring about the 

‘‘Question about HIT-enabled QM RFI’’. 

Contact Angela Nunley, email: 

Armela.Nunley@AHRQ.hhs.gov, Phone: 

301–427–1505, or, Rebecca Roper, 

email: Rebecca.ROPER@AHRQ.hhs.gov, 

Phone: 301–427–1535. 

SUPPLEMENTARY INFORMATION: 

Background 

Health information technology (IT), 

such as, electronic health records (EHR) 

which may include clinical decision 

support and health information 

exchange, has seen a tremendous 

increase in adoption in recent years. 

Some institutions have successfully 

used health IT to generate health ITenabled quality measures which may be 

retooled versions of established paperbased or administrative data-driven 

quality measures or (preferably) they are 

‘‘de novo’’ quality measures that were 

developed with the capabilities of 

health IT in mind. These new health ITenabled quality measures seek to 

leverage the use of electronic clinical 

data capture, analysis and reporting to 

measure and report electronically 

enabled quality measures in order to 

facilitate improvements in the quality of 

care provided. AHRQ supports research 

to improve health care quality through 

enhancements in the safety, efficiency, 

and effectiveness of health care 

available to all Americans. Through this 

RFI, AHRQ is seeking information 

related to successful strategies and/or 

remaining challenges encountered 

regarding the development of health ITenabled quality measure development 

and reporting. 

Health IT has the potential to advance 

quality measurement and reporting 

through the use of efficient automated 

data collection, analysis, processing, 

mstockstill on DSK4VPTVN1PROD with NOTICES

Federal Register / Vol. 77, No. 140 / Friday, July 20, 2012 / Notices 42739 

and its ability to facilitate information 

exchange among and across care 

settings, providers, and patients. Quality 

measurement enabled by health IT, 

referred to as health IT-enabled quality 

measurement, is an emerging field. 

There are numerous perspectives on 

how to achieve the future state of 

quality measurement. These varied 

perspectives sometimes include 

competing choices and challenges: 

(1) Underdeveloped or unavailable 

infrastructure (e.g., whether the measure 

set should be extensive or 

parsimonious); (2) incompleteness of 

the measure set (e.g., developing 

measures that matter to consumers, how 

to measure value); and (3) technology 

challenges (e.g., how might 

unstructured data be captured in the 

EHR to be used for measurement, if and 

how to integrate patient-generated and 

clinician-generated data). 

In preparation for the development of 

this RFI, AHRQ generated a high-level 

overview of the current state of quality 

measurement through health IT, 

challenges facing the advancement of 

quality measurement enabled by health 

IT, a partial catalog of current efforts 

seeking to address those challenges, 

and, possibilities for the next generation 

of health IT-enabled quality 

measurement. This report, ‘‘An 

environmental snapshot—Quality 

Measurement Enabled by Health IT: 

Overview, Possibilities, and Challenges’’ 

can be found at http:// 

healthit.AHRQ.gov/ 

HealthITEnabledQualityMeasurement/ 

Snapshot.pdf. 

AHRQ is committed to garnering 

further insight in order to facilitate 

meaningful advancements in the next 

generation of quality measurement. 

Through this Request for Information 

AHRQ is seeking information on the 

building blocks of health IT-enabled 

quality measurement in terms of 

perspectives, practicalities, and 

priorities. Responses will be used in 

conjunction with deliberative activities 

to inform the development of a 

summary report to be released to the 

public approximately in summer 2013. 

Respondents should note that this 

Request for Information is completely 

voluntary; respondents are welcome to 

address as many of the questions posed 

as they wish. AHRQ would appreciate if 

you clearly indicate the number of the 

question area to which you are 

providing a response. This RFI is for 

planning purposes only. 

Responses to this are not offers, 

cannot be accepted by the Government 

to form a binding contract, and are not 

intended to influence regulation. 

Questions Regarding Quality 

Measurement Enabled by Health IT 

1. Briefly describe what motivates 

your interest in clinically-informed 

quality measures through health 

information technology. To what extent 

is your interest informed by a particular 

role (e.g., provider, payer, government, 

vendor, quality measure developer, 

quality improvement organization, 

standards organization, consumer 

advocate) in this area? 

2. Whose voices are not being heard 

or effectively engaged at the crucial 

intersection of health IT and quality 

measurement? What non-regulatory 

approaches could facilitate enhanced 

engagement of these parties? 

3. Some quality measures of interest 

have been more difficult to generate, 

such as measures of greater interest to 

consumers, measures to assess value, 

specialty-specific measures, measures 

across care settings (i.e., measures 

enabled by health information 

exchange), and measures that take into 

account variations in risk. Describe the 

infrastructure that would be needed to 

ensure development of such measures. 

4. What health IT-enabled quality 

measures, communication channels, 

and/or technologies are needed to better 

engage consumers either as contributors 

of quality information or as users of 

quality information? 

5. How do we motivate measure 

developers to create new health ITenabled quality measures (which are 

distinct from existing measures which 

were retooled into electronicallyproduced quality measures) that 

leverage the unique data available 

through health IT? Please provide 

examples of where this has been 

successfully. What new measures are in 

the pipeline to leverage data available 

through health IT? 

6. Describe how quality measurement 

and ‘‘real-time’’ reporting could inform 

clinical activity, and the extent to which 

it could be considered synonymous 

with clinical decision support. 

7. Among health IT-enabled quality 

measures you are seeking to generate in 

a reliable fashion, including the 

currently proposed Meaningful Use 

Stage 2 measure set, what types of 

advances and/or strategies for e-measure 

generation if pursued, would support 

more efficient generation of quality 

measures? 

8. Many EHR, HIE, and other health 

IT vendors are developing software code 

to support measures. Tools such as the 

Measure Authoring Tool (MAT) were 

created to improve efficiencies in the 

process of creating and implementing 

eMeasures. What additional approaches 

might be used to enable consistent, 

accurate, and efficient quality 

measurement when using health IT? 

9. How do you see the establishment 

and adoption of data standards 

impacting the future of health ITenabled quality measurement? For what 

types of quality measures should a 

combination of natural language 

processing and structured data be 

considered? 

10. Much support has been voiced for 

the need of longitudinal data in quality 

measurement. What are the strengths 

and weaknesses of different information 

architectures and technologies to 

support health IT-enabled quality 

measurement across time and care 

settings? How can data reuse (capture 

once, use many times) be supported in 

different models? What examples might 

you provide of successful longitudinal 

health IT-enabled quality measurement 

(across time and/or across multiples 

care settings)? 

11. What are the most effective means 

by which to educate providers on the 

importance of health IT-enabled quality 

measurement and how clinical 

information is used to support health 

IT-enabled quality measurement and 

reporting? How can providers be better 

engaged in the health IT-enabled quality 

measurement process? 

12. What is the best way to facilitate 

bi-directional communication between 

vendors and measure developers to 

facilitate collaboration in health ITenabled measure development? 

13. To what extent do you anticipate 

adopting payment models that use 

quality measurement informed by 

electronic clinical records (as opposed 

to exclusively using claims data)? What 

strategies are you pursuing to gain 

access to clinical data and test the 

reliability of health IT-enabled clinical 

outcome measures? How do you 

anticipate sharing quality measure 

results with consumers and other 

stakeholders? 

14. What tools, systems, and/or 

strategies has your organization been 

using to aggregate information from 

various EHRs and other health IT for use 

in quality measurement? What strategies 

is your organization pursuing to move 

toward greater automation in quality 

measurement? 

15. Please describe scalable programs, 

demonstrations, or solutions (domestic 

or internationally) that show material 

progress toward quality measurement 

enabled by health IT. 

Reference Material 

Anderson KM, Marsh CA, Isenstein H, 

Flemming AC, Reynolds J. An 

Environmental Snapshot: Health ITmstockstill on DSK4VPTVN1PROD with NOTICES

42740 Federal Register / Vol. 77, No. 140 / Friday, July 20, 2012 / Notices 

enabled Quality Measurement: Efforts, 

Challenges, and Possibilities (Prepared 

by Booz Allen Hamilton, under Contract 

No. HHSA2902009000241.) AHRQ 

Publication No. 12–0061–EF. Rockville, 

MD: Agency for Healthcare Research 

and Quality. July 2012. See: http:// 

healthit.ahrq.gov/ 

HealthITEnabledQualityMeasurement/ 

Snapshot.pdf 

Dated: July 13, 2012. 

Carolyn M. Clancy, 

AHRQ Director. 

[FR Doc. 2012–17530 Filed 7–19–12; 8:45 am] 

BILLING CODE 4160–90–M 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

Statement of Organization, Functions, 

and Delegations of Authority 

Part F of the Statement of 

Organization, Functions, and 

Delegations of Authority for the 

Department of Health and Human 

Services, Centers for Medicare & 

Medicaid Services (CMS), (last amended 

at Federal Register, Vol. 76, No. 203, 

pp. 65197–65199, dated October 20, 

2011) is amended to change the 

organizational title from the Office of 

Clinical Standards and Quality (OCSQ) 

to the Center for Clinical Standards and 

Quality. The organizational title change 

reflects the increasing breadth and 

importance of quality, patient safety, 

evidence-based coverage, and valuebased purchasing programs. The 

administrative code is not changed and 

remains the same. 

Part F., Section FC. 10 (Organization) 

is revised as follows: 

Office of the Administrator (FC) 

Office of Equal Opportunity and Civil 

Rights (FCA) 

Office of Legislation (FCC) 

Office of the Actuary (FCE) 

Office of Strategic Operations and 

Regulatory Affairs (FCF) 

Center for Clinical Standards and 

Quality (FCG) 

Center for Medicare (FCH) 

Center for Medicaid and CHIP Services 

(FCJ) 

Center for Strategic Planning (FCK) 

Center for Program Integrity (FCL) 

Chief Operating Officer (FCM) 

Office of Minority Health (FCN) 

Center for Medicare and Medicaid 

Innovation (FCP) 

Federal Coordinated Health Care Office 

(FCQ) 

Center for Consumer Information and 

Insurance Oversight (FCR) 

Office of Public Engagement (FCS) 

Office of Communications (FCT) 

Authority: 44 U.S.C. 3101) 

Dated: July 11, 2012. 

Marilyn Tavenner, 

Acting Administrator and Chief Operating 

Officer, Centers for Medicare & Medicaid 

Services. 

[FR Doc. 2012–17782 Filed 7–19–12; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Submission for OMB Review; 

Comment Request 

Title: Tribal TANF Data Report, TANF 

Annual Report, and Reasonable Cause/ 

Corrective Action Documentation 

Process-Final. 

OMB No.: 0970–0215. 

Description 

42 U.S.C. 612 (Section 412 of the 

Social Security Act as amended by Pub. 

L. 104–193, the Personal Responsibility 

and Work Opportunity Reconciliation 

Act of 1996 (PRWORA)), mandates that 

federally recognized Indian Tribes with 

an approved Tribal TANF program 

collect and submit to the Secretary of 

the Department of Health and Human 

Services data on the recipients served 

by the Tribes’ programs. This 

information includes both aggregated 

and disaggregated data on case 

characteristics and 

individualcharacteristics. In addition, 

Tribes that are subject to a penalty are 

allowed to provide reasonable cause 

justifications as to why a penalty should 

not be imposed or may develop and 

implement corrective compliance 

procedures to eliminate the source of 

the penalty. Finally, there is an annual 

report, which requires the Tribes to 

describe program characteristics. All of 

the above requirements are currently 

approved by OMB and the 

Administration for Children and 

Families is simply proposing to extend 

them without any changes. 

Respondents 

Indian Tribes 

ANNUAL BURDEN ESTIMATES

Instrument Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden hours 

per response 

Total burden 

hours 

Final Tribal TANF Data Report ........................................................................ 66 4 451 119,064 

Tribal TANF Annual Report ............................................................................. 66 1 40 2,640 

Tribal TANF Reasonable Cause/Corrective .................................................... 66 1 60 3,960 

Estimated Total Annual Burden Hours ..................................................... ........................ ........................ ........................ 125,664. 

Additional Information 

Copies of the proposed collection may 

be obtained by writing to the 

Administration for Children and 

Families, Office of Planning, Research 

and Evaluation, 370 L’Enfant 

Promenade, SW., Washington, DC 

20447, Attn: ACF Reports Clearance 

Officer. All requests should be 

identified by the title of the information 

collection. Email address: 

infocollection@acf.hhs.gov. 

OMB Comment 

OMB is required to make a decision 

concerning the collection of information 

between 30 and 60 days after 

publication of this document in the 

Federal Register. Therefore, a comment 

is best assured of having its full effect 

if OMB receives it within 30 days of 

publication. Written comments and 

recommendations for the proposed 

information collection should be sent 

directly to the following: Office of 

Management and Budget, Paperwork 

Reduction Project, Fax: 202–395–7285, 

Email: 

mstockstill on DSK4VPTVN1PROD with NOTICES