[Federal Register Volume 74, Number 78 (Friday, April 24, 2009)]
[Notices]
[Pages 18725-18726]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-9248]



[[Page 18725]]

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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 (0MB) approve the proposed information collection 
project: ``Evaluation of Phase I Demonstrations of the Pharmacy Quality 
Alliance.'' 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.
    This proposed information collection was previously published in 
the Federal Register on February 10th, 2009 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 May 26, 2009.

ADDRESSES: Written comments should be submitted to: AHRQ's 0MB Desk 
Officer by fax at (202) 395-6974 (attention: AHRQ's desk officer) or by 
e-mail at OIRA--submissionomb.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 
<a href="/cdn-cgi/l/email-protection#aacec5d8c3d984c6cfccc1c5ddc3ded0eacbc2d8cd84c2c2d984cdc5dc"><span class="__cf_email__" data-cfemail="cfaba0bda6bce1a3aaa9a4a0b8a6bbb58faea7bda8e1a7a7bce1a8a0b9">[email protected]</span></a>.

SUPPLEMENTARY INFORMATION:

``Evaluation of Phase I Demonstrations of the Pharmacy Quality 
Alliance''

    AHRQ proposes to conduct an independent evaluation of five Phase I 
demonstrations undertaken by the Pharmacy Quality Alliance (PQA). The 
PQA launched the five demonstration projects to test the feasibility of 
implementing a pharmacy provider report card system, which will be used 
to provide feedback to pharmacies on their performance. The goals of 
the demonstrations are to obtain feedback from pharmacists on the 
credibility of the performance reports and their utility in performance 
improvement, and to identify the most efficient and useful ways to 
implement a performance-based quality reporting system. The evaluation 
will be conducted for AHRQ by its contractor, the CNA Corporation and 
Thomas Jefferson Medical College.
    The purpose of this evaluation is to identify problems associated 
with the implementation of a performance-based quality reporting 
system. The evaluation of the Phase I demonstrations will:
    <bullet> Test the feasibility and utility of (1) using 15 PQA 
claims-based measures on pharmacy performance and (2) a survey of 
consumers about their experience with pharmacy services, which was 
developed by the PQA;
    <bullet> Determine the resource (time and cost) requirements for 
collecting the data and generating the pharmacy performance reports; 
and
    <bullet> Provide a base of knowledge that enables the PQA to 
improve the implementation process, increase operational efficiency, 
reduce operational costs, and enhance the utility and validity of the 
performance measures.
    This project is being conducted pursuant to AHRQ's statutory 
authority to conduct and support research and evaluations on health 
care and on systems for the delivery of such care, including activities 
with respect to (1) the quality, effectiveness, efficiency, 
appropriateness and value of health care services and (2) quality 
measurement and improvement. 42 U.S.C. 299a(a)(l) and (2).

Method of Collection

    The evaluation will include the following two data collections: (1) 
On-site interviews with key staff from each demonstration project and 
(2) a survey of pharmacy staff. The data will be collected to obtain 
the following types of information necessary for the evaluation:
    <bullet> Organizational background related to quality measurement, 
organizational resources for quality measurement;
    <bullet> Measurement methodology;
    <bullet> Opinions on the performance measures;
    <bullet> The process for disseminating the performance measures;
    <bullet> Incentives and penalties for participation in pharmacy 
quality improvement;
    <bullet> Usability of the performance reports;
    <bullet> Future directions for quality measurement in the 
organization; and
    <bullet> Respondent characteristics.
    On-site interviews with key demonstration participants.
    On-site interviews will be conducted with up to six persons at each 
of the five demonstration sites. The study will try to interview 
representatives from the following job functions: (1) Pharmacy 
operations management; (2) clinical pharmacy staff; (3) quality 
improvement; (4) utilization management; (5) analytics management 
responsible for oversight of performance report analyses; (6) analytics 
staff assigned to complete the performance reports; (7) information 
technology (IT) staff responsible for developing and/or coordinating 
Internet components of the project; and (8) senior management 
(executive leadership, i.e., Vice President level and above).

Survey of Pharmacy Staff

    A pharmacy staff survey will be developed to yield additional 
quantitative data about the demonstration projects. The sample will 
consist of practicing pharmacists who are participating in the 
demonstration sites and who received one or more of the performance 
reports. It will also include field managers and supervisors. At each 
of the five sites, up to 100 pharmacy staff members will be sampled, 
with an expected response rate of 75 percent, yielding 75 respondents 
per site.

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated annualized burden hours for this one 
year data collection. On-site interviews will be conducted with 6 staff 
members from each of the 5 demonstration projects and will last about 1 
hour and 15 minutes. The survey of pharmacists will be completed by 
about 75 staff members from each demonstration project and is estimated 
to take 30 minutes to complete. The total estimated annualized burden 
is 226 hours.
    Exhibit 2 shows the estimated annualized cost burden associated 
with the respondents' time to participate in this evaluation. The cost 
burden is estimated to be $10,753.

[[Page 18726]]



                                  Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                     Number of
                    Form name                        Number of    responses  per     Hours per     Total burden
                                                     projects         project        response          hours
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Demonstration Staff Interviews..................               5               6            1.25              38
Survey of Pharmacists...........................               5            * 75           30/60             188
                                                 ---------------------------------------------------------------
    Total.......................................              10              na              na             226
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* We expect that some demonstration projects will have fewer than 75 responses, but we are indicating 75
  responses here to avoid underestimating the response burden.


                                   Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
                                                                                      Average
                    Form name                        Number of     Total burden     hourly wage     Total cost
                                                     projects          hours          rate *          burden
----------------------------------------------------------------------------------------------------------------
Demonstration Staff Interviews..................               5              38          $47.58          $1,808
Survey of Pharmacists...........................               5             188           47.58           8,945
                                                 ---------------------------------------------------------------
    Total.......................................              10             226              na          10,753
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* Based on the national average wage for pharmacists (29-1051), National Compensation Survey: Occupational Wages
  in the United States May 2007, U.S. Department of Labor, Bureau of Labor Statistics.

Estimated Annual Costs to the Federal Government

    The estimated total cost to the Federal government for this one 
year evaluation is $208,874. Exhibit 3 shows a breakdown of the costs.

       Exhibit 3--Estimated Annual Costs to the Federal Government
------------------------------------------------------------------------
                          Component                              Total
------------------------------------------------------------------------
Developing the interview guide and survey instrument.........    $33,905
Preparing 0MB clearance submission...........................      6,704
Site visits to each demonstration............................     73,368
Analyzing the data from each demonstration site..............     54,835
Preparing a final report.....................................     40,062
                                                              ----------
    Total....................................................    208,874
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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 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.
Carol M. Clancy,
Director.
[FR Doc. E9-9248 Filed 4-23-09; 8:45 am]
BILLING CODE 4160-90-M


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