[Federal Register Volume 75, Number 97 (Thursday, May 20, 2010)]
[Notices]
[Pages 28255-28257]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-11993]



[[Page 28255]]

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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 
project: ``Eisenberg Center Voluntary Customer Survey Generic Clearance 
for the Agency for Healthcare Research and Quality.'' 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 July 19, 2010.

ADDRESSES: Written comments should be submitted to: Doris Lefkowitz, 
Reports Clearance Officer, AHRQ, by e-mail at 
<a href="/cdn-cgi/l/email-protection#7b1f1409120855171e1d10140c120f013b3a33292a55131308551c140d"><span class="__cf_email__" data-cfemail="62060d100b114c0e0704090d150b161822232a30334c0a0a114c050d14">[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#96f2f9e4ffe5b8faf3f0fdf9e1ffe2ecd6d7dec4c7b8fefee5b8f1f9e0"><span class="__cf_email__" data-cfemail="3c58534e554f1250595a57534b5548467c7d746e6d1254544f125b534a">[email protected]</span></a>.

SUPPLEMENTARY INFORMATION:

Proposed Project

Eisenberg Center Voluntary Customer Survey Generic Clearance for the 
Agency for Healthcare Research and Quality

    The Agency for Healthcare Research and Quality (AHRQ) requests that 
the Office of Management and Budget (OMB) renew, under the Paperwork 
Reduction Act of 1995, AHRQ's Generic Clearance to collect 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. See 42 U.S.C. 299. AHRQ's Eisenberg Center is an innovative 
effort aimed at 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 
a variety of useful formats for customer stakeholders. The Eisenberg 
Center also conducts its own program of research 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 Program, see 42 U.S.C. 299b-7. For the period 2005 until September 
2008, the Eisenberg Center was operated through a contractual 
arrangement with the Oregon Health and Science University (OHSU), 
Department of Medicine, located in Portland, Oregon. In September 2008, 
the contract for operation of the Eisenberg Center was awarded to 
Baylor College of Medicine (BCM), located in Houston Texas.
    The collections proposed under this clearance include activities to 
assist in the development of materials to be disseminated through the 
Eisenberg Center and to provide feedback to AHRQ on the extent to which 
these products meet customer needs. These materials include Summary 
Guides that summarize and translate the findings of comparative 
effectiveness reviews (CER) and research reports for purposes of 
summarizing research findings for various decision-making audiences, 
such as consumers, clinicians, or policymakers. The guides are designed 
to help these decision makers use research evidence to maximize the 
benefits of health care, minimize harm, and optimize the use of health 
care resources. In addition, each year of the project the Eisenberg 
Center will develop one computerized, interactive decision aid for 
those clinical problems identified from selected CERs. The intent is 
for the decision aid to increase the patient/consumer's knowledge of 
the health condition, options, and risk/benefits, lead to greater 
assurance in making a decision, increase the congruence between values 
and choices, and ethance involvement in the decision making process. 
Information collections conducted under this generic clearance are not 
required by regulation and will not be used to regulate or sanction 
customers. Surveys will be entirely voluntary, and information provided 
by respondents will be combined and summarized so that no individually 
identifiable information will be released. The Eisenberg Center will 
produce from 17 to a maximum of 33 Summary Guides per audience (i.e., 
clinician, policymaker, consumer) per year, depending on the 
information needed for each product with each audience.
    In accordance with OMB guidelines for generic clearances for 
voluntary customer surveys and Executive Order 12862, AHRQ has 
established an independent review process to assure the development, 
implementation, and analysis of high quality customer surveys within 
AHRQ. Specifically, AHRQ understands that each activity conducted must 
be submitted to OMB with a supporting statement and accompanying 
instruments. Information collection may not proceed until approved by 
OMB.

Method of Collection

    Information collections conducted under this clearance will be 
collected via the following methods:
    <bullet> Focus Groups. Focus groups may include clinical 
professionals, patients or other health care consumers, or health 
policy makers. They will be used to provide input regarding the needs 
for products and for the development of Decision Aids and Summary 
Guides. Focus groups may also be used to test draft products to 
determine if intended information and messages are being delivered 
through products that are produced and disseminated through the 
Eisenberg Center.
    <bullet> In-person or Telephone Interviews. Interviews will be 
conducted with individuals from one or more of the three groups 
identified above. The purpose of these interviews is to (1) to provide 
input regarding the development of Decision Aids and Summary Guides, 
(2) to determine if intended information and messages are being 
delivered effectively through products that are produced and 
disseminated through the Eisenberg Center, and (3) to engage the 
subject in cognitive testing to (a) determine if changes in topical 
knowledge levels can be identified following exposure to Eisenberg 
Center informational or instructional products, and (b) identify 
strengths and weaknesses in products and services for purposes of 
making improvements that are practical and feasible.
    <bullet> Customer Satisfaction Survey for the Decision Aids. 
Baseline survey data will be collected on both clinician and patient 
characteristics, characteristics of the health care condition, and 
selected outcome measures such as knowledge and decisional self-
efficacy. Following delivery of the decision aid, a user survey will be 
completed to explore subjects' impressions of the tool,

[[Page 28256]]

including ease of use, clarity of presentation, length, balance of 
information, rating of interactive features, and overall satisfaction. 
Both clinicians and patients/consumers will be surveyed. For patients, 
the customer satisfaction survey will include decisional outcome 
measures (e.g., decisional conflict, desire for involvement in 
decision-making), measures of attitudes and self-efficacy, and 
indicators of choice intention or actual choice made. If the aid is 
evaluated within a clinical context, measures of physician-patient 
interaction will also be considered. Additionally, clinicians may be 
interviewed about the impact of the aid on clinical flow.
    <bullet> Customer Satisfaction Surveys for the Summary Guides. 
These surveys will be offered to health care professionals, consumers, 
and policy makers that use the online Summary Guides. Respondents will 
report via Likert-type or numerical response scales how specific 
informational or educational products or materials influenced health 
care or clinical practice behaviors.
    <bullet> Follow-up CME Surveys. Continuing Medical Education (CME) 
credit will be offered to physicians who wish to participate in online 
activities developed around the Summary Guides for clinicians. Three 
months after completing the educational activity, physicians will be 
asked to complete a follow-up survey to assess realized changes in 
clinical practice, barriers to making change, and self-assessed impacts 
on patient care.
    <bullet> Solicited Topic Nominations. Visitors to the Web site will 
have the opportunity to provide information about suggested topics that 
might be addressed through the research and dissemination efforts of 
the EHC program.
    <bullet> Web site Registration. Visitors to the Web site will be 
able to register personal contact information (e.g., name, e-mail 
address) if wishing to receive updated information and materials as 
they become available.
    <bullet> Glossary Feedback Survey. Visitors to the Web site who 
access the health care glossary will be asked to suggest missing terms 
and provide additional comments on definitions or usage sentences, if 
desired.
    This information will be used to develop, improve and/or maintain 
high quality products and services to lay and health professional 
publics.

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated annualized burden for the respondents 
time to participate in this research. These estimates assume a maximum 
of 33 Summary Guides per year and separate Guides for clinicians, 
policy makers and consumers and are thus slight overestimates.
    Focus groups will be used for needs assessment and will be 
conducted with clinicians and consumers for development of the Summary 
Guides, and additionally with policymakers for those Guides in which 
policy recommendations are applicable. Focus groups will be conducted 
with no more than 1,056 persons per year and will last about 1\1/2\ 
hours.
    Once the Summary Guides are developed they will be subjected to in-
person or telephone interviews for purposes of usability and product 
testing with clinicians, policy makers and consumers. In-person 
telephone interviews will be conducted twice with about 1,386 persons 
annually and will take about 66 minutes on average. Two rounds of 
interviews will be conducted with all consumer representatives during 
product development, with a second round of interviews conducted 
occasionally with clinicians and policy makers, as needed.
    Customer satisfaction surveys for the Summary Guides will be 
conducted with approximately 6,600 representatives from the audience to 
be targeted by the Summary Guides annually (i.e., clinician, 
policymaker or consumer) and will take 5 minutes to complete.
    Customer satisfaction surveys will also be administered to 
approximately 50 clinicians and 500 patients in evaluating the Decision 
Aid. These surveys will take about 10 minutes to complete, and will be 
administered before and after implementation of the Decision Aid in the 
study populations.
    Clinicians that have completed CME accrediting requirements and are 
requesting CME credit will be asked to complete the follow-up CME 
Survey three months following completion of the online activity. This 
data collection will be completed with about 1,320 clinicians annually 
and will require 5 minutes to complete.
    Approximately 2,500 solicited topic nomination forms will be 
completed annually by healthcare professional and consumer visitors to 
the Web site and will require about 5 minutes to complete. Web site 
Registration will be completed by all persons wanting to stay up-to-
date with the latest information from the Eisenberg Center, about 6,000 
annually, and requires about 5 minutes to complete. The Glossary 
Feedback Survey will be completed by about 200 persons annually that 
access the glossary and takes 5 minutes to complete. The total burden 
hours are estimated to be 6,203.
    Exhibit 2 shows the estimated annualized cost burden associated 
with the respondents time to participate in this research. The cost 
burden is estimated to be $290,227 annually.

Exhibit 1. Estimated Annualized Burden Hours

----------------------------------------------------------------------------------------------------------------
                                                                  Number of
           Type of data collection               Number of      responses per      Hours per       Total burden
                                                respondents       respondent        response          hours
----------------------------------------------------------------------------------------------------------------
Focus Groups................................            1,056                1              1.5            1,584
In-person/Telephone Interviews..............            1,386                2              1.1            3,050
Customer Satisfaction Surveys for the                     550                2            10/60              184
 Decision Aid...............................
Customer Satisfaction Surveys for the                   6,600                1             5/60              550
 Summary Guides.............................
Follow-up CME Surveys.......................            1,320                1             5/60              110
Solicited Topic Nominations.................            2,500                1             5/60              208
Web site Registration.......................            6,000                1             5/60              500
Glossary Feedback Survey....................              200                1             5/60               17
                                             -------------------------------------------------------------------
    Total...................................           19,612            (\1\)            (\1\)           6,203
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\1\ Not applicable.


[[Page 28257]]

Exhibit 2. Estimated Annualized Cost Burden

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                                                 Number of       Total burden    Average hourly     Total cost
           Type of data collection              respondents         hours         wage rate *         burden
----------------------------------------------------------------------------------------------------------------
Focus Groups................................            1,056            1,584           $48.98          $77,584
In-person/Telephone Interviews..............            1,386            3,050            46.82          142,801
Customer Satisfaction Surveys for the                     550              184            25.53            4,698
 Decision Aid...............................
Customer Satisfaction Surveys for the                   6,600              550            39.55           21,753
 Summary Guides.............................
Follow-up CME Surveys.......................            1,320              110            77.64            8,540
Solicited Topic Nominations.................            2,500              208            48.07            9,999
Web site Registration.......................            6,000              500            48.07           24,035
Glossary Feedback Survey....................              200               17            48.07              817
                                             -------------------------------------------------------------------
    Total...................................           19,612            6,203            (\1\)          290,227
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\1\ Not applicable.
* Based upon the mean and weighted mean wages for clinicians (29-1062 family and general practitioners), policy
  makers (11-0000 management occupations, 11-3041 compensation & benefits managers, 13-1072 compensation,
  benefits & job analysis specialists, 11-9111 medical and health service managers, 13-2053 insurance
  underwriters and 15-2011 actuaries) and consumers (00-0000 all occupations). Focus groups include 528
  clinicians ($77.64/hr) and 528 consumers ($20.32/hr); in-person/telephone interviews includes 528 clinicians,
  330 policy makers ($39.91/hr) and 528 consumers; customer satisfaction surveys for the decision aid includes
  50 clinicians and 500 consumers; customer satisfaction surveys for the summary guides includes 1,650
  clinicians, 1,650 policy makers and 3,300 consumers; follow-up CME surveys includes 1,320 clinicians;
  solicited topic nominations include 1,125 clinicians, 250 policy makers and 1,125 consumers; Web site
  registration includes 2,700 clinicians, 600 policy makers and 2,700 consumers; glossary feedback survey
  includes 90 clinicians, 20 policy makers and 90 consumers, National Compensation Survey: Occupational wages in
  the United States May 2008, ``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 
$1,439,003 annually. Exhibit 3 shows the total and annualized cost by 
the major cost components.

Exhibit 3. Estimated Total and Annualized Cost

------------------------------------------------------------------------
                                                              Annualized
                Cost component                  Total  cost      cost
------------------------------------------------------------------------
Project Development...........................   $1,019,970     $339,990
Data Collection Activities....................      735,405      245,135
Data Processing and Analysis..................    1,889,505      629,835
Project Management............................      557,380      185,793
Overhead......................................      114,750       38,250
                                               -------------------------
    Total.....................................    4,317,010    1,439,003
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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 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: May 10, 2010.
Carolyn M. Clancy,
Director.
[FR Doc. 2010-11993 Filed 5-19-10; 8:45 am]
BILLING CODE 4160-90-M


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