[Federal Register Volume 74, Number 78 (Friday, April 24, 2009)]
[Notices]
[Pages 18720-18722]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-9245]


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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 
under the project: ``Evaluation of AHRQ's Effective Health Care 
Program.'' 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.

DATES: Comments on this notice must be received by June 23, 2009.

ADDRESSES: Written comments should be submitted to: Doris Lefkowitz, 
Reports Clearance Officer, AHRQ, by e-mail at 
<a href="/cdn-cgi/l/email-protection#63070c110a104d0f0605080c140a171923020b11044d0b0b104d040c15"><span class="__cf_email__" data-cfemail="aecac1dcc7dd80c2cbc8c5c1d9c7dad4eecfc6dcc980c6c6dd80c9c1d8">[email protected]</span></a>.
    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#6e0a011c071d40020b08050119071a142e0f061c094006061d40090118"><span class="__cf_email__" data-cfemail="066269746f75286a63606d69716f727c46676e7461286e6e7528616970">[email protected]</span></a>.

SUPPLEMENTARY INFORMATION: 

Proposed Project

``Evaluation of AHRQ's Effective Health Care Program''

    AHRQ proposes to perform an evaluation of the Effective Health Care 
(EHC) program's governance structure, methods for engaging stakeholders 
and approaches to setting national research priorities. Pursuant to 
Section 1013 of the Medicare Prescription Drug, Improvement, and 
Modernization Act of 2003, Pub. L. 108-173, the EHC program was 
established by AHRQ to conduct research, demonstrations, and 
evaluations designed to improve the quality, effectiveness, and 
efficiency of Medicare, Medicaid, and the State Children's Health 
Insurance Program. The EHC program was designed to provide 
effectiveness and comparative effectiveness evidence of medical 
treatments, therapeutics, devices and drugs to assist policymakers, 
health care providers, clinicians, consumers, and other stakeholders in 
making informed decisions. The EHC program has offered a platform for 
combining explicit reviews of scientific evidence on the clinical 
effectiveness of pharmaceuticals and other health care interventions, 
as well as the translation and dissemination of scientific findings 
into meaningful messages for a wide variety of audiences. It serves as 
an interface between the clinical research entities and health policy 
making entities. This

[[Page 18721]]

program also provides a critical step in AHRQ's mission to support 
informed decision making. In addition to its program staff, the EHC 
program relies on four centers to generate and disseminate evidences: 
the Evidence-based Practice Centers (EPCs), the Developing Evidence to 
Inform Decisions about Effectiveness (DEcIDE) Network Centers, the John 
M. Eisenberg Clinical Decisions and Communications Science Center, and 
the Centers for Education & Research on Therapeutics (CERTs). Since the 
process of developing and disseminating this evidence is a complex 
undertaking, AHRQ has contracted with IMPAQ International, LLC and Abt 
Associates, Inc. (henceforth referred to as the ``IMPAQ team'') to 
perform this evaluation.
    Information will be collected to identify strengths and weaknesses 
in the current EHC program's governance structure, methods for engaging 
stakeholders, and approaches to setting priorities for the research 
conducted by the EHC program. The second phase of the evaluation will 
be to contrast the EHC program with international programs of similar 
purpose. To implement this evaluation, the IMPAQ team will conduct the 
following information collections:
    (1) Key informant interviews about the governance structure of the 
EHC program;
    (2) An online survey of EHC center staff and EHC program users and 
stakeholders;
    (3) An Appreciative Inquiry workshop with EHC program staff and 
stakeholders;
    (4) A document review (will not impose a burden on research 
participants) and
    (5) Interviews with staff at international organizations of similar 
purpose (will not impose a burden on U.S. citizens).
    The latter two activities do not require OMB approval and are not 
discussed further in this notice. The information collected will 
ultimately be used to develop a roadmap, including at least three 
alternative models of governance and operation, to be submitted to AHRQ 
that could be used to help guide future programmatic development.

Method of Data Collection

Key Informant Interviews

    Semi-structured key informant interviews will be used to understand 
the EHC program's governance components and structure, from the vantage 
point of individuals governing the program, governed by the program, 
contributing to the program in various capacities, or impacted by the 
program's activities. Thirteen EHC Research Centers Staff, two EHC 
Stakeholder Group Members, and nineteen EHC Program Users and 
Stakeholders will be interviewed about the governance structure of the 
EHC program.
    Additional key informant interviews with twenty five EHC Program 
Users and Stakeholders will be used to collect more detailed 
information on the success or impact of the EHC program product that 
results from its governance element or approach, or about a specific, 
important governance element.
    All key informant interviews will be tape recorded to improve data 
capture, with prior permission from the participants.

Online Survey

    A structured, web-based online survey of EHC program Research 
Centers Staff and EHC program Users and Stakeholders will be used to 
gather information about the EHC program. The survey will provide a 
robust view of the EHC governance system by providing feedback from a 
broad group of individuals whose work is related to the program. 
Specifically, the survey will collect data about these individuals' 
engagement and involvement with the EHC program; perceptions of the 
program's governance; experiences with the development, production, 
dissemination, and use of EHC products; and their beliefs regarding the 
quality and nature of the collaborative work, including public-private 
partnerships, being done within centers, across centers, and between 
centers and stakeholders.

Appreciative Inquiry Workshop

    Small- and large-group discussions as part of an Appreciative 
Inquiry workshop will be designed to encourage EHC decision-makers 
(AHRQ staff, EHC program staff, AHRQ project officers for each of the 
Research Center networks, principal investigators or other 
representatives from each of the Research Center networks) and key 
program stakeholders or users to consider and decide which are the 
preferred alternative governance models or elements for which roadmaps 
should be developed. Appreciative Inquiry (AI) approach is an 
organizational development process that engages individuals within an 
organization in renewal, change, and focused performance. The AI 
approach focuses on successes and opportunities to improve things by 
looking forward, rather than looking back on the problems or issues. 
The AI workshop is expected to facilitate consensus among decision-
makers to contribute to the endorsement of the roadmap(s), and to 
encourage utilization of the evaluation findings. The workshop will 
involve a creative thinking process that will build on existing 
successes, identify and rank preferred alternatives, and ultimately 
develop a plan to strengthen the EHC program's governance system.

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated annualized burden hours for the 
respondents to participate in this evaluation. Key informant interviews 
will be conducted about the governance structure of the EHC program and 
will last about one hour. The on-line survey will be completed by 95 
EHC program Research Centers Staff and 170 EHC Program Users and 
Stakeholders and will require about 15 minutes to complete. The 
Appreciative Inquiry workshop will be conducted with 20 participants 
and will last about 6 hours. The total burden hours are estimated to be 
246 hours. Exhibit 2 shows the estimated annualized cost burden based 
on the respondents' time to participate in the evaluation. The total 
cost burden is estimated to be $6,137.

                                  Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                Number of
              Activity name                   Number of       responses per       Hours per       Total burden
                                             respondents       respondent         response            hours
----------------------------------------------------------------------------------------------------------------
Key Informant Interviews with EHC                       13                 1                 1                13
 Research Centers Staff.................
Online Survey with EHC Research Centers                 95                 1             15/60                24
 Staff..................................
Key Informant Interviews with EHC                        2                 1                 1                 2
 Stakeholder Group Members..............
Key Informant Interviews with EHC                       19                 1                 1                19
 Program Users and Stakeholders.........
Online Survey with EHC Program Users and               170                 1             15/60                43
 Stakeholders...........................

[[Page 18722]]

 
Key Informant Interviews with EHC                       25                 1                 1                25
 Program Users and Stakeholders to
 Develop Cases..........................
Appreciative Inquiry Workshop...........                20                 1                 6               120
                                         -----------------------------------------------------------------------
    Total...............................               344             (\1\)             (\1\)               246
----------------------------------------------------------------------------------------------------------------
\1\ Not applicable.


                                   Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
                                              Number of       Total burden     Average hourly      Total cost
              Activity name                  respondents          hours          wage rate *         burden
----------------------------------------------------------------------------------------------------------------
Key Informant Interviews with EHC                       13                13            $54.27              $706
 Research Centers Staff.................
Online Survey with EHC Research Centers                 95                24             54.27             1,302
 Staff..................................
Key Informant Interviews with EHC                        2                 2             43.52                87
 Stakeholder Group Members..............
Key Informant Interviews with EHC                       19                19             46.73               888
 Program Users and Stakeholders.........
Online Survey with EHC Program Users and               170                43             46.73              2009
 Stakeholders...........................
Key Informant Interviews with EHC                       25                25             46.73             1,168
 Program Users and Stakeholders to
 Develop Cases..........................
Appreciative Inquiry Workshop...........                20               120             51.14             6,137
                                         -----------------------------------------------------------------------
    Total...............................               344               246             (\1\)            12,297
----------------------------------------------------------------------------------------------------------------
* Wage rates were calculated using the following data: (1) For the Governance Interviews and the Online Survey
  with EHC Research Centers Staff the hourly rate is a weighted average for physicians ($58.76 per hour) and
  medical and health services managers ($37.82); (2) for the Governance Interviews with EHC Stakeholder Group
  Members the hourly rate is the rate for average for medical and health services managers ($37.82); (3) for the
  Governance Interviews and the Online Survey with EHC Program Users and Stakeholders the hourly rate is a
  weighted average for physicians ($58.76 per hour), general and operations managers ($43.52 per hour), medical
  and health services managers ($37.82 per hour), and social and community service managers ($24.73 per hour);
  (4) for the Workshop the hourly rate is a weighted average for physicians ($58.76 per hour) and general and
  operations managers ($43.52 per hour) from the mean of the average wages, National Compensation Survey:
  Occupational Wages in the United States 2006, U.S. Department of Labor, Bureau of Labor Statistics.
\1\ Not applicable.

Estimated Annual Costs to the Federal Government

    Exhibit 3 shows the estimated cost of this one year data collection 
for the evaluation of the EHC program, including the cost of developing 
the methodology and data collection instruments, collecting and 
analyzing the data, publishing the results, etc. The work will be 
carried out by IMPAQ International and Abt Associates under contract to 
the Agency for Healthcare Research and Quality.

      Exhibit 3--Estimated Annual Cost * to the Federal Government
------------------------------------------------------------------------
                                                                 Total
                        Cost component                            cost
------------------------------------------------------------------------
Project Development..........................................   $137,901
Data Collection Activities...................................    179,172
Data Processing and Analysis.................................    170,577
Publication of Results.......................................     63,686
Project Management...........................................     97,236
                                                              ----------
    Total....................................................    648,572
------------------------------------------------------------------------
* Please note the costs include fully loaded costs (overhead, G&A).

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.
Carolyn M. Clancy,
Director.
[FR Doc. E9-9245 Filed 4-23-09; 8:45 am]
BILLING CODE 4160-90-M


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