[Federal Register Volume 79, Number 210 (Thursday, October 30, 2014)]
[Notices]
[Pages 64597-64599]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-25790]


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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: ``Evaluation of the AHRQ Healthcare Horizon Scanning System.'' 
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 August 12th, 2014 and allowed 60 days for 
public comment. AHRQ received no substantive comments. The purpose of 
this notice is to allow an additional 30 days for public comment.

DATES: Comments on this notice must be received by December 1, 2014.

ADDRESSES: Written comments should be submitted to: AHRQ's OMB Desk 
Officer by fax at (202) 395-6974 (attention: AHRQ's desk officer) or by 
email at <a href="/cdn-cgi/l/email-protection#145b5d46554b676176797d67677d7b7a547b79763a717b643a737b62"><span class="__cf_email__" data-cfemail="cd82849f8c92beb8afa0a4bebea4a2a38da2a0afe3a8a2bde3aaa2bb">[email protected]</span></a> (attention: AHRQ's desk officer).

FOR FURTHER INFORMATION CONTACT: Doris Lefkowitz, AHRQ Reports 
Clearance Officer, (301) 427-1477, or by email at 
<a href="/cdn-cgi/l/email-protection#b2d6ddc0dbc19cded7d4d9ddc5dbc6c8f2f3fae0e39cdadac19cd5ddc4"><span class="__cf_email__" data-cfemail="e78388958e94c98b82818c88908e939da7a6afb5b6c98f8f94c9808891">[email protected]</span></a>.

SUPPLEMENTARY INFORMATION:

Proposed Project

``Evaluation of the AHRQ Healthcare Horizon Scanning System''

    The American Recovery and Reinvestment Act (ARRA) appropriated $1.1 
billion for comparative effectiveness research (CER), of which $300 
million was made available to the

[[Page 64598]]

Agency for Healthcare Research and Quality (AHRQ). The goal of CER is 
to improve patient outcomes by providing clinicians and patients the 
information they need to choose between preventive and diagnostic 
treatments, and other health care options to identify the options that 
best fit an individual patient's needs and preferences. The EHC Program 
was created in response to Section 1013 of the Medicare Prescription 
Drug, Improvement, and Modernization Act (MMA) of 2003.
    To better inform comparative effectiveness research investments at 
the EHC Program, AHRQ used some of the ARRA funds to develop a horizon 
scanning system to identify and monitor emerging health care 
technologies and innovations. While horizon scanning systems exist in 
other countries, these systems do not take into account the unique 
political, regulatory, cultural, and economic context of the U.S. 
health care system. To meet this need, the AHRQ Healthcare Horizon 
Scanning System was implemented in November 2010. The AHRQ Healthcare 
Horizon Scanning System provides a systematic process to identify and 
monitor target technologies and innovations in health care and to 
create an inventory of target technologies that have the highest 
potential for impact on clinical care, the health care system, patient 
outcomes, and costs. It is also a tool for the public to identify and 
find information on new health care technologies and interventions.
    Additionally, the AHRQ Healthcare Horizon Scanning System serves as 
a resource for those involved in decision making about adoption, 
implementation, and coverage of new health care interventions.
    To fulfill its purpose, the AHRQ Healthcare Horizon Scanning System 
performs three functions: (1) Identification and prioritization of 
interventions in late phase development for tracking and monitoring; 
(2) monitoring of target interventions through the development of 
detailed information on interventions in late phase development; and 
(3) assessment of potential impact of target interventions through the 
gathering and synthesizing the perspectives of experts from various 
areas of the health care community about the potential impact those 
target interventions may have on the health care system, clinical care, 
patient outcomes, and health care costs.
    As the first and only U.S. horizon scanning system, it is important 
to understand whether the AHRQ Healthcare Horizon Scanning System is 
implementing its functions effectively. This evaluation is also 
essential to determining whether the AHRQ Healthcare Horizon Scanning 
System is meeting the needs of patients, clinicians, private industry, 
and policymakers and how it can be improved to better meet those needs. 
The evaluation will address the following research questions:
    1. How successfully did the AHRQ Healthcare Horizon Scanning System 
identify and prioritize interventions for monitoring?
    2. How successfully did the AHRQ Healthcare Horizon Scanning System 
monitor the selected target interventions?
    3. How accurately did the AHRQ Healthcare Horizon Scanning System 
assess the potential impact of the interventions?
    4. How can the processes for identification, prioritization, 
monitoring, and assessment of potential impact of the interventions be 
improved?
    This research has the following goals:
    1. To assess the performance of the AHRQ Healthcare Horizon 
Scanning System in the identification and prioritization of 
interventions which are important topics for further assessment.
    2. To assess the performance of the AHRQ Healthcare Horizon 
Scanning System in terms of the quality of information provided on the 
topics selected, and the accuracy of the assessment of potential 
impact.
    3. To identify which, if any, of these areas of performance may 
require improvement so as to strengthen the effectiveness of the AHRQ 
Healthcare Horizon Scanning System.
    This evaluation is being conducted by AHRQ through its contractor, 
ECRI Institute, and ECRI's subcontractor, Mathematica Policy Research, 
pursuant to AHRQ's statutory authority to conduct and support research 
on health care and on systems for the delivery of such care, including 
activities with respect to the quality, effectiveness, efficiency, 
appropriateness and value of health care services and with respect to 
quality measurement and improvement. 42 U.S.C. 299a(a)(1) and (2)

Method of Collection

    To achieve the goals of this project the following data collections 
will be implemented:
    1. Expert Survey--The purpose of this survey, completed by domain 
experts, is to measure the accuracy and completeness of the AHRQ 
Healthcare Horizon Scanning System Potential High Impact reports and to 
collect their assessment of the potential for high impact for the 
included Potential High Impact interventions.
    2. Expert Consultation--The purpose of this consultation with 
experts is to confirm the cases of inaccurate or missing information 
identified by a sole expert in the Expert Survey.
    3. Stakeholder Survey--The purpose of this survey, completed by 
stakeholders and likely users of the reports issued by the AHRQ 
Healthcare Horizon Scanning System, is to rate the relevance, clarity, 
and usefulness of the Potential High Impact reports.
    4. Key Informant Interview--The purpose of these interviews of the 
AHRQ Healthcare Horizon Scanning System staff is to learn about areas 
and suggestions for improvement in the identification, monitoring, and 
impact assessment processes.
    The data collected by the Expert Survey will be used to measure the 
accuracy and completeness of the Potential High Impact reports and the 
accuracy of the potential for high impact assessments. If the expert 
survey identifies cases of inaccurate or missing information that are 
not reported by multiple experts, we will conduct an Expert 
Consultation with another expert to confirm these cases. Accuracy of 
the potential for high impact assessments will be measured by the level 
of sensitivity (if experts agree that the Potential High Impact 
interventions identified by the AHRQ Healthcare Horizon Scanning System 
are high impact interventions) and specificity (if experts agree that 
the No Potential High Impact interventions identified by the AHRQ 
Healthcare Horizon Scanning System should be excluded from the group of 
Potential High Impact interventions).
    The Stakeholder Survey will collect data to measure the usability 
of the Potential High Impact reports and the specific report sections 
that include the potential high impact assessment, summary, and 
synthesis of expert comments. These data will be used to inform the 
improvement of the format and content of the report. The survey will 
also collect information on the sources and media these stakeholders 
use to find CER information to help AHRQ better target distribution of 
these reports to stakeholders.
    A series of semi-structured Key Informant Interviews will be 
conducted with staff and domain experts at ECRI Institute and other 
organizations that participate in the AHRQ Healthcare Horizon Scanning 
System in order to identify opportunities for improvements to the AHRQ 
Healthcare Horizon Scanning System process. Qualitative interviews are 
the main vehicle for gathering data to (1) learn which elements of the 
AHRQ Healthcare

[[Page 64599]]

Horizon Scanning System Protocol are working well and the reasons why 
they are working well; and (2) understand which elements of the AHRQ 
Healthcare Horizon Scanning System Protocol can be improved, how they 
might be improved, and the relative importance of suggested 
improvements.
    All of these information collection activities will allow for an 
evaluation of the AHRQ Healthcare Horizon Scanning System, thereby 
creating the opportunity to both maintain and improve this important 
national resource. The findings will be presented in a report to ECRI 
Institute and AHRQ.

Estimated Annual Respondent Burden

    Mathematica expects a response rate of 80 percent from the sample 
of 67 experts for the Expert Survey--54 completed surveys. The Expert 
Survey is expected to require about 20 minutes, on average, to 
complete. Mathematica expects that Expert Consultation with 15 experts 
will be needed to confirm cases of inaccurate or missing information 
identified in the Expert Survey. The follow-ups should be about 10 
minutes.
    For the Stakeholder Survey, Mathematica expects that 30 percent of 
the sample of 700 stakeholders will be ineligible (i.e. will not find 
any of the presented reports relevant and therefore unable to rate a 
report) and that 65 percent of the eligible sample will complete, 
resulting in 319 completes. It should take about 30 minutes to complete 
the Stakeholder Survey. Mathematica will conduct semi-structured Key 
Informant Interviews, on average lasting 50 minutes, with 23 
respondents.

                                  Exhibit 1--Estimated Annualized Burden Hours
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                                                                     Number of
                    Form name                        Number of     responses per     Hours per     Total burden
                                                    respondents     respondent       response          hours
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Expert Survey...................................              54               1             .33              18
Expert Consultation.............................              15               1             .17               3
Stakeholder Survey..............................             319               1             .50             160
Key Informant Interviews........................              23               1             .83              19
                                                 ---------------------------------------------------------------
    Total.......................................             411  ..............  ..............             200
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                                   Exhibit 2--Estimated Annualized Cost Burden
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                                                     Number of     Total burden   Average hourly    Total cost
                    Form name                       respondents        hours        wage rate *       burden
----------------------------------------------------------------------------------------------------------------
Expert Survey...................................              54            17.8       ** $92.25          $1,642
Expert Consultation.............................              15             2.5       ** $92.25             231
Stakeholder Survey..............................             319           159.5      *** $48.72           7,771
Key Informant Interviews........................              23            19.1     **** $38.68             739
                                                 ---------------------------------------------------------------
    Total.......................................             411  ..............  ..............         $10,383
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* May 2013 National Occupational Employment and Wage Estimates, U.S. Department of Labor, Bureau of Labor
  Statistics.
** Based on average wage for physicians and surgeons.
*** Based on average wage for medical and health services managers.
**** Based on average wage for social scientists and related workers.

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: October 22, 2014.
Richard Kronick,
AHRQ Director.
[FR Doc. 2014-25790 Filed 10-29-14; 8:45 am]
BILLING CODE 4160-90-M


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