70726 Federal Register / Vol. 76, No. 220 / Tuesday, November 15, 2011 / Notices 

EXHIBIT 3—ESTIMATED TOTAL AND ANNUALIZED COST—Continued 

Cost component Total cost Annualized cost 

Overhead ..................................................................................................................................................... 62,500 31,250 

Total ...................................................................................................................................................... 407,063 203,531 

Request for Comments 

In accordance with the Paperwork 

Reduction Act, 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: November 3, 2011. 

Carolyn M. Clancy, 

Director. 

[FR Doc. 2011–29383 Filed 11–14–11; 8:45 am] 

BILLING CODE 4160–90–M 

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: 

‘‘Assessing the Feasibility of 

Disseminating Effective Health Care 

Products through a Shared Electronic 

Medical Record Serving Member 

Organization of a Health Information 

Exchange.’’ In accordance with the 

Paperwork Reduction Act, 44 U.S.C. 

3501–3521, AHRQ invites the public to 

comment on this proposed information 

collection. 

DATES: Comments on this notice must be 

received by January 17, 2012. 

ADDRESSES: Written comments should 

be submitted to: Doris Lefkowitz, 

Reports Clearance Officer, AHRQ, by 

email 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 

email at doris.lefkowitz@AHRQ.hhs.gov. 

SUPPLEMENTARY INFORMATION: 

Proposed Project 

Assessing the Feasibility of 

Disseminating Effective Health Care 

Products through a Shared Electronic 

Medical Record Serving Member 

Organization of a Health Information 

Exchange. 

The Agency for Healthcare Research 

and Quality (AHRQ) requests that the 

Office of Management and Budget 

(OMB) approve under the Paperwork 

Reduction Act of 1995 this collection of 

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. AHRQ’s 

Eisenberg Center’s mission is 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 useful 

formats for customer stakeholders. The 

Eisenberg Center also conducts 

investigations 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 (EHC) Program. The 

collections proposed under this 

clearance include activities to assess the 

feasibility of disseminating materials 

developed by the Eisenberg Center 

through the use of an electronic medical 

record (EMR) shared by a network of 

clinical care providers that are part of a 

Health Information Exchange (HIE) 

operating in multiple sites in several 

states. Our Community Health 

Information Network (OCHIN) members 

include 30 clinical care organizations 

operating more than 230 primary care 

clinics in six states. Data will be 

gathered from three different OCHINmember organizations representing a 

total of 10 primary care clinics. The 

information generated will be provided 

to AHRQ to guide decision making and 

planning for additional efforts to foster 

EHC Program product distribution via 

EMR prompting and product linkages. 

This research has the following goals: 

(1) Identify facilitators and barriers to 

successful efforts to implement 

processes that: (a) Support use of EHC 

Program products by clinicians in 

practice, and (b) place relevant clinical 

information in the hands of patients and 

family members in languages and 

formats that are appropriate to patients’ 

information needs; 

(2) Examine ways in which EHC 

Program products can be used in 

concert with other support programs 

and products (e.g., healthwise®

resources available through the EMR; 

brief patient instructions and letters, 

including those designed for use with 

persons having very low literacy skills); 

(3) Assess the extent to which EHC 

Program products are used (e.g., 

accessed by clinicians, provided to 

patients in relevant formats) in settings 

where use is supported by automated 

EMR features, such as on-screen 

prompts and reminders; and 

(4) Document the perceived value of 

integrating EHC Program products into 

systems of care supported by an EMR 

system as self-reported by clinicians 

involved in direct care of patients and 

clinic support personnel who interact 

with patients. 

This study is being conducted by 

AHRQ through its contractor, the 

Eisenberg Center—Baylor College of 

Medicine, pursuant to AHRQ’s statutory 

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Federal Register / Vol. 76, No. 220 / Tuesday, November 15, 2011 / Notices 70727 

authority to conduct and support 

research, and disseminate information, 

on healthcare and on systems for the 

delivery of such care, including 

activities with respect to the quality, 

effectiveness, efficiency, 

appropriateness and value of healthcare 

services and clinical practice. 42 U.S.C. 

299a(a)(1) and (4). 

Method of Collection 

To achieve the goals of this project the 

following data collections will be 

implemented: 

(1) Automated Data Capture from 

EMR Usage Logs. Electronic usage data 

will be collected to determine the extent 

to which EHC Program guides for 

clinicians and patients were accessed to 

support shared decision making and 

patient education. The data will be 

retrieved from the existing EMR-linked 

database operated by the Kaiser 

Permanente staff in their coordination of 

activities related to the OCHIN HIE. 

Data will include: (a) Number and 

frequency of retrieval of EHC resource 

materials; (b) specific types of materials 

retrieved; and (c) health topic or 

condition targeted in the EHC materials. 

These data will inform the development 

of follow-up questions to be 

administered to clinicians and patients 

in the interviews and surveys described 

below. Because the data will be 

obtained using automated systems 

already in place, no special effort will 

be needed to generate these data, and 

thus this task is not included in the 

burden estimates in Exhibits 1 and 2. 

(2) Interviews with Clinicians. 

Interviews will be held with clinical 

service providers for the following 

purposes: (a) Obtain perceptions of the 

overall value, relevancy, currency and 

appropriateness of EHC Program 

products in addressing the health 

service needs of patients treated in 

clinical settings; (b) assess ease of use of 

the materials in terms of access via the 

EMR; (c) determine perceived success of 

efforts to employ EHC Program products 

and related materials in addressing the 

needs of patients with limited language 

skills and/or low literacy levels; and (d) 

describe the relative success of efforts to 

use the EHC Program products in 

concert with other tools (e.g., 

healthwise® resources) in promoting 

patient engagement in their own health 

care or in the care of family members. 

(3) Interviews with Support Staff. 

Interviews will be held with nonclinical support staff to characterize 

perceptions of how the introduction of 

EHC Program products: (a) Affected 

clinic workflows and influenced the 

work that staff was required to do in 

supporting clinician-patient 

interactions; and (b) facilitated or 

impeded efforts to inform patients about 

actions they could take in being more 

fully involved in their own health care. 

(4) Interviews with Patients. 

Interviews will be held with recruited 

patients to determine if they: (a) Viewed 

the EHC Program products that they 

were provided as useful to them in 

understanding their health issues; (b) 

were able to understand the EHC 

Program-related information that was 

provided to them sufficiently to take 

actions in their own health care; and (c) 

have suggestions about how the EHC 

Program materials could be changed or 

the delivery of them done in a different 

way to make the materials more useful 

and/or accessible to patients. 

(5) Survey of Clinicians. A 

questionnaire will be administered to 

clinical care providers near the end of 

the study to gather quantitative data 

around their assessments of: (a) The 

relevancy of the EHC Program materials 

to the patients they serve; (b) the 

appropriateness of the products in 

addressing specific clinical issues; (c) 

the ease of use of the system created to 

provide access to EHC Program products 

through the EMR; and (d) overall ratings 

of the approach in addressing patient 

needs with regard to specific conditions 

addressed by the products available. 

The interviews with clinicians, 

clinical staff, and patients will be 

conducted throughout the project 

period, approximately every three 

months with different sets of 

participants, to inform and refine 

delivery mechanisms and monitor 

progress. 

This information will be used to 

determine the feasibility of: (a) 

Mounting broader efforts to distribute 

clinician and consumer guides, as well 

as other EHC products using EMRs as 

the primary vehicle for providing 

product access at the point of care; and 

(b) initiating additional studies to 

identify factors that encourage or deter 

effective integration of EHC products 

into care processes using electronic 

tools and care delivery support systems, 

like the EMR, that are increasingly 

common in clinical work settings. 

Estimated Annual Respondent Burden 

Exhibit 1 shows the estimated 

annualized burden for the respondents’ 

time to participate in this research. 

Three rounds of interviews will be 

conducted during the project period 

(each round of interviews to be held 

approximately every three months with 

separate sets of participants) to assess 

progress and adjust methods or refine 

materials as needed. Interviews will be 

conducted with 100 patients, 50 

clinicians and 50 clinical support staff. 

Each interview is estimated to last no 

more than 30 minutes. All clinicians in 

each participating clinic will have 

access to the EMR and will be invited 

to participate in an online 

questionnaire. Approximately 200 

clinicians will complete the 10-minute 

questionnaire. 

Exhibit 2 shows the estimated 

annualized cost burden associated with 

the respondents’ time to participate in 

this research. The total annual cost 

burden is estimated to be $6,274. 

EXHIBIT 1—ESTIMATED ANNUALIZED TOTAL BURDEN HOURS

Type of data collection Number of 

respondents 

Number of 

responses per 

respondent 

Hours per 

response 

Total burden 

hours 

Interviews with Clinicians ................................................................................. 50 1 30/60 25 

Interviews with Support Staff ........................................................................... 50 1 30/60 25 

Interviews with Patients ................................................................................... 100 1 30/60 50 

Survey of Clinicians ......................................................................................... 200 1 30/60 33 

Total .......................................................................................................... 400 na na 133 

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70728 Federal Register / Vol. 76, No. 220 / Tuesday, November 15, 2011 / Notices 

EXHIBIT 2—ESTIMATED ANNUALIZED TOTAL COST BURDEN

Type of Data Collection Number of 

respondents 

Total burden 

hours Average hourly wage rate Total cost burden 

Interviews with Clinicians .......................... 50 25 $83.59 ....................................................... $2,090 

Interviews with Support Staff .................... 50 25 14.31 ......................................................... 358 

Interviews with Patients ............................ 100 50 21.35 ......................................................... 1,068 

Survey of Clinicians .................................. 200 ¥33 83.59 ......................................................... 2,758 

Total ................................................... 400 133 na .............................................................. 6,274 

Based upon the mean wages for clinicians (29–1062 family and general practitioners), clinical team members (31–9092 medical assistants) 

and patients/consumers (00–0000 all occupations), National Compensation Survey: Occupational wages in the United States May 2010, ‘‘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 $217,451 

annually for two years. Exhibit 3 shows 

the total and annualized cost by the 

major cost components. 

EXHIBIT 3—ESTIMATED TOTAL AND ANNUALIZED COST

Cost component Total cost Annualized cost 

Project Development ....................................................................................................................................... $153,750 $76,875 

Data Collection Activities ................................................................................................................................. 162,465 81,233 

Data Processing and Analysis ......................................................................................................................... 33,563 16,781 

Project Management ........................................................................................................................................ 22,625 11,313 

Overhead ......................................................................................................................................................... 62,500 31,250 

Total .......................................................................................................................................................... 434,903 217,451 

Request for Comments 

In accordance with the Paperwork 

Reduction Act, 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: November 3, 2011. 

Carolyn M. Clancy, 

Director. 

[FR Doc. 2011–29382 Filed 11–14–11; 8:45 am] 

BILLING CODE 4160–90–M 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

[30-Day–12–09BY] 

Agency Forms Undergoing Paperwork 

Reduction Act Review 

The Centers for Disease Control and 

Prevention (CDC) publishes a list of 

information collection requests under 

review by the Office of Management and 

Budget (OMB) in compliance with the 

Paperwork Reduction Act (44 U.S.C. 

Chapter 35). To request a copy of these 

requests, call the CDC Reports Clearance 

Officer at (404) 639–5960 or send an 

email to omb@cdc.gov. Send written 

comments to CDC Desk Officer, Office of 

Management and Budget, Washington, 

DC 20503 or by fax to (202) 395–5806. 

Written comments should be received 

within 30 days of this notice. 

Proposed Project 

Healthy Homes and Lead Poisoning 

Surveillance System (HHLPSS)—New— 

National Center for Environmental 

Health (NCEH) and Agency for Toxic 

Substances and Disease Registry 

(ATSDR)/Centers for Disease Control 

and Prevention (CDC). 

Background and Brief Description 

The overarching goal of the Healthy 

Homes and Lead Poisoning Surveillance 

System (HHLPSS) is to establish 

Healthy Homes Surveillance Systems at 

the state and national levels. Currently, 

40 state and local Childhood Lead 

Poisoning Prevention Programs (CLPPP) 

report information (e.g., presence of lead 

paint, age of housing, and type of 

housing) to CDC via the National Blood 

Lead Surveillance System (NBLSS) 

(OMB No. 0920–0337, exp. 1/31/2012). 

The addition of a new panel of housing 

questions would help to provide a more 

comprehensive picture of housing stock 

in the United States and potentially 

modifiable risk factors. 

The objectives for developing this 

new surveillance system are two-fold. 

First, the HHLPSS will allow the CDC 

to systematically track how the state and 

local programs conduct case 

management and follow-up of residents 

with housing-related health outcomes. 

The next objective for the 

development of this system is to 

examine potential housing-related risk 

factors. Childhood lead poisoning is just 

one of many adverse health conditions 

that are related to common housing 

deficiencies. Multiple hazards in 

housing, e.g., mold, vermin, radon and 

the lack of safety devices, continue to 

adversely affect the health of residents. 

It is in the interest of public health to 

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