Federal Register / Vol. 74, No. 121 / Thursday, June 25, 2009 / Notices 30299 

Form Number of 

respondents 

Responses 

per 

respondent 

Total 

responses 

Hours per 

response 

Total burden 

hours 

EHR Readiness Checklist .................................................... 568 1 568 .25 142 

Total .............................................................................. 568 ........................ 568 ........................ 142 

E-mail comments to 

paperwork@hrsa.gov or mail the HRSA 

Reports Clearance Officer, Room 10–33, 

Parklawn Building, 5600 Fishers Lane, 

Rockville, MD 20857. Written comments 

should be received within 60 days of 

this notice. 

Dated: June 19, 2009. 

Alexandra Huttinger, 

Director, Division of Policy Review and 

Coordination. 

[FR Doc. E9–14978 Filed 6–24–09; 8:45 am] 

BILLING CODE 4165–15–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Health Resources and Services 

Administration 

Health Center Program 

AGENCY: Health Resources and Services 

Administration, HHS. 

ACTION: Notice of Noncompetitive 

Replacement Award to Community 

Health Center of Richmond. 

SUMMARY: The Health Resources and 

Services Administration (HRSA) will be 

transferring Health Center Program 

(section 330 of the Public Health Service 

Act) New Access Point funds originally 

awarded to William F. Ryan Community 

Health Center, Inc., to the Community 

Health Center of Richmond to ensure 

the provision of critical primary health 

care services to underserved 

populations in Staten Island, Richmond 

County, New York. 

SUPPLEMENTARY INFORMATION: 

Former Grantee of Record: William F. 

Ryan Community Health Center, Inc. 

Original Period of Grant Support: 

March 1, 2009, to February 28, 2011. 

Replacement Awardee: Community 

Health Center of Richmond. 

Amount of Replacement Award: 

$1,300,000. 

Period of Replacement Award: The 

period of support for the replacement 

award is March 1, 2009 to February 28, 

2011. 

Authority: Section 330 of the Public 

Health Service Act, 42 U.S.C. 245b. 

CFDA Number: 93.703. 

Justification for the Exception to 

Competition: The former grantee, 

William F. Ryan Community Health 

Center, Inc., notified HRSA that its 

original subrecipient, Community 

Health Center of Richmond, will 

directly initiate primary health care 

services in Staten Island to the more 

than 5,250 low income, underserved 

and uninsured individuals in the 

original service area, Staten Island, 

Richmond County, New York, as had 

been proposed in a funded New Access 

Point grant application. 

Community Health Center of 

Richmond was identified as the 

provider of services on behalf of the 

William F. Ryan Community Health 

Center under the original application. 

Community Health Center of 

Richmond is an experienced provider of 

care to the original target population, 

has a demonstrated record of 

compliance with the Health Center 

Program statutory and regulatory 

requirements, can provide primary 

health care services immediately, and is 

located in the same geographical area 

where the William F. Ryan Community 

Health Center, Inc.’s services were to 

have been provided. 

Community Health Center of 

Richmond is a subrecipient of the 

former grantee and will be able to 

provide continuity of care to patients of 

the former grantee. This underserved 

target population has an immediate 

need for vital primary health care 

services and would be negatively 

impacted by any delay caused by a 

competition. As a result, in order to 

ensure that critical primary health care 

services are available to the original 

target population in a timely manner, 

this replacement award will not be 

competed. 

FOR FURTHER INFORMATION CONTACT: 

Marquita Cullom-Stott via e-mail at 

MCullom-Stott@hrsa.gov or 301–594– 

4300. 

Dated: June 18, 2009. 

Mary K. Wakefield, 

Administrator. 

[FR Doc. E9–14980 Filed 6–24–09; 8:45 am] 

BILLING CODE 4165–15–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Request for Tools and Methods Used 

by Small- and Medium-Sized Practices 

for Analyzing and Redesigning 

Workflows Either Before or After 

Health Information Technology 

Implementation 

AGENCY: Agency for Healthcare Research 

and Quality (AHRQ), HHS. 

ACTION: Notice of request for 

information. 

SUMMARY: This notice announces the 

intention of the Agency for Healthcare 

Research and Quality (AHRQ) to request 

information from (1) small- and 

medium-sized practices about how they 

study or redesign their workflow, 

including information on the use of 

tools and methods for studying 

workflow, and (2) others (e.g., experts, 

vendors, professional associations) that 

have developed, implemented and used 

tools and methods for studying 

workflow in the context of health IT 

implementation and use. Workflow is 

defined as the way work is performed 

and patient-related information is 

communicated within small- and 

medium-sized practices and between 

those practices and external 

organizations such as community 

pharmacies and local hospitals. It is our 

understanding that there is currently no 

standard description of workflows for 

care processes that can be used to guide 

decisions of where and how to 

incorporate health information 

technology. This Request for 

Information is part of a three-pronged 

effort to scan the environment, the 

literature and knowledgeable and 

interested parties to produce a useful 

list of resources that may assist smalland medium-sized medical practices 

and clinics to consider the utility and 

potential effectiveness of incorporating 

health IT into the way they practice and 

communicate patient information. The 

responses to this request for information 

will be considered for reference and 

possible incorporation into an electronic 

toolkit to be made available on the 

Internet to assist small- and mediumsized practices in analyzing or 


sroberts on PROD1PC70 with NOTICES
30300 Federal Register / Vol. 74, No. 121 / Thursday, June 25, 2009 / Notices 

redesigning workflow either before or 

after implementation of one or more 

health IT applications. All responses to 

this request for information are 

voluntary. 

DATES: Submit comments on or before 

August 24, 2009. 

ADDRESSES: Electronic responses are 

preferred and should be addressed to: 

WorkflowRFI@ahrq.hhs.gov. Nonelectronic responses will also be 

accepted. Please send to: Teresa ZayasCaba ́n, Senior Manager, Health IT, 

Agency for Healthcare Research and 

Quality, Attention: Workflow RFI 

Responses, 540 Gaither Road, Room 

6115, Rockville, MD 20850, Phone: 301– 

427–1586. 

FOR FURTHER INFORMATION CONTACT: 

Teresa Zayas-Caba ́n, e-mail: 

Teresa.ZayasCaban@AHRQ.hhs.gov, 

Web site of the project on 

‘‘Incorporating Health Information 

Technology Into Workflow Redesign’’: 

http://cqpi.engr.wisc.edu/withit_home. 

SUPPLEMENTARY INFORMATION: 

Submission Criteria 

To assist small- and medium-sized 

medical practices or clinics considering 

implementation of any health IT, AHRQ 

is requesting information about tools, 

methods, technologies, and data 

reporting procedures that may be used 

to analyze and possibly improve the 

delivery of health care in such settings. 

From our perspective, these settings 

would include practices for which 

investment in health IT is financially 

burdensome and therefore regarded as 

high risk. While AHRQ welcomes all 

comments on the above described 

subject, the agency is particularly 

interested in obtaining information and 

opinions from small- and medium-sized 

healthcare practices that have 

implemented or are considering 

implementing health information 

technology as well as information and 

opinions from workflow or health IT 

experts, vendors, professional 

associations, and others that have 

developed and/or used workflow 

analysis or redesign tools. In 

descriptions of workflow analytic tools 

or approaches and health IT that have 

been deployed successfully or 

unsuccessfully, it would be helpful to 

receive basic information about the 

characteristics of the practice(s) or 

clinic(s) where particular tools, 

approaches, or health IT have been used 

including: 

• The number of physicians and 

providers (physician assistants or nurse 

practitioners) in the practice or clinic. 

• The total number of staff (e.g., 

nurses, medical assistants, receptionists, 

educators) in the practice or clinic. 

• The number of patient visits the 

practice or clinic had in 2008. 

• The medical or surgical specialties 

within the practice or clinic. Specialties 

can include: family medicine, internal 

medicine, pediatrics, geriatrics, 

hematolology, oncology, cardiology, 

pulmonology, endocrinology, 

gastroenterology, rheumatology, 

ophthalmology, obstetrics and 

gynecology, nephrology, infectious 

diseases, physical medicine and 

rehabilitation, dermatology, 

neurosurgery, general surgery, pediatric 

surgery, cardiovascular surgery, thoracic 

surgery, vascular surgery, transplant 

surgery, urology, plastic surgery, 

orthopedic surgery, otolaryngology, and 

anesthesiology. 

• Any ancillary services located onsite at the practice or clinic. Examples 

include: laboratory, radiology, physical 

therapy, occupational therapy, speech 

therapy, pharmacy. 

With regard to health IT, please indicate 

what specific health IT applications and 

software have been used in particular 

settings; e.g.: electronic medical records 

(EMRs) (i.e., electronic records of 

health-related information on individual 

patients that may be created, gathered, 

managed, and consulted by authorized 

clinicians and staff within a single 

health care organization), electronic 

health records (EHRs) (i.e., electronic 

records of health-related information on 

individual patients that conform to 

nationally recognized interoperability 

standards and that may be created, 

managed, and consulted by authorized 

clinicians and staff across more than 

one health care organization), 

computerized provider order entry (or 

CPOE), e-prescribing, digital imaging, 

telemedicine, and others. Please include 

information regarding: 

• Functionality of each health IT 

application (i.e., what you use them for). 

• How long each health IT 

application has been in use. 

With regard to workflow analysis and 

redesign tools, please tell us about any 

tools, methods, technologies, or data 

reports to analyze or redesign the way 

work is done and information flows in 

your practice or clinic before or after 

health IT implementation. Examples of 

tools include process analysis, 

flowcharting, task analysis and lean 

management. Other examples include 

using data reports from a health IT 

application to analyze or understand 

processes and workflow. 

For each tool, method, technology or 

data report we would appreciate the 

following information: 

• Name and acronym of the tool, 

method, technology, or data report. 

• Authors, sources and/or references. 

• Background about the tool, method, 

technology, or data report; i.e., how did 

you learn about it. 

• Intended purpose; i.e., what it was 

used for and at what point it was used 

during the redesign and/or 

implementation process. 

• How the tool, method, technology, 

or data report was used. Please describe 

the procedure or steps for using it as 

well as who participated in its use. 

• Resources needed to use the tool, 

method, technology, or data report (e.g., 

expertise, time, software). 

• Information about reliability and 

validity of the tool, method, technology, 

or data report, if applicable. 

• Advantages and disadvantages of 

the tool, method, technology, or data 

report. 

• How useful, overall, the tool, 

method, technology, or data report is. 

• How easy or difficult is it to use the 

tool, method, technology, or data report. 

Additionally, please provide 

information that you think will assist 

our target audience to avoid pitfalls of 

complicated or inappropriate tools and 

software. If you are willing and 

authorized to share any referenced tools, 

please submit them with your response 

along with instructional documents 

related to the tool and its use, including 

any restrictions or prerequisite 

permissions necessary for use by others. 

In describing the impact of health IT 

on organization of work and workflow, 

a discussion of the following topics 

would provide valuable information for 

small- and medium-sized practices or 

clinics: 

• Support that was available during 

the health IT implementation (e.g., 

additional staff, overtime, additional 

time to complete tasks, technical 

support, internal versus external 

support). 

• Training provided to the users 

including the duration of the training 

(e.g., number of days of training per end 

user), and the methods used to train 

users (e.g., ‘train-the-trainer,’ super 

users, lecture, hands-on training). 

• Discussion of successful or 

unsuccessful interfacing of the health IT 

application(s) is/are interfaced with 

each other and/or other IT, such as IT 

applications of ancillary services (e.g., 

lab system). 

• Discussion of any formal evaluation 

of the health IT implementation was 

conducted and any measures used for 

the evaluation (e.g., impact on job 

satisfaction, efficiency, workload, 

decisionmaking accuracy, quality of 

care, cost). 


sroberts on PROD1PC70 with NOTICES
Federal Register / Vol. 74, No. 121 / Thursday, June 25, 2009 / Notices 30301 

In assessing the implementation of 

health IT, comments about the impact of 

particular health IT applications on 

different domains of a practice or clinic 

are requested. Thus, we would 

appreciate comments on how health IT 

has impacted or supports: 

• Communication among practice or 

clinic staff (e.g., physician, nurse, 

medical assistant, physician assistant, 

receptionist, technician). 

• Coordination of care among practice 

or clinic staff (e.g., physician, nurse, 

medical assistant, physician assistant, 

receptionist, technician). 

• Information flow between the 

practice or clinic and external 

healthcare organizations (e.g., 

community pharmacies, imaging 

centers, local hospitals). 

• Clinicians’ work during patient 

visit. 

• Clinicians’ thought processes as 

they care for patients. 

• Access to patient-related 

information. 

Additional Submission Instructions 

Responders should identify any 

information that they believe is 

confidential commercial information. 

Information reasonably so labeled will 

be protected in accordance with the 

FOIA, 5 U.S.C. 552(b)(4), and will not be 

released by the agency in response to 

any FOI requests. It will not be 

incorporated directly into any 

requirements or standards that the 

agency may develop as a result of this 

inquiry regarding useful tools or 

information for small- and mediumsized medical practices regarding 

implementation of health information 

technology in such practices. 

Dated: June 17, 2009. 

Carolyn M. Clancy, 

AHRQ, Director. 

[FR Doc. E9–14947 Filed 6–24–09; 8:45 am] 

BILLING CODE 4160–90–P 

DEPARTMENT OF HOMELAND 

SECURITY 

[Docket No. DHS–2009–0082] 

Homeland Security Science and 

Technology Advisory Committee 

AGENCY: Science and Technology 

Directorate, DHS. 

ACTION: Committee Management; Notice 

of Closed Federal Advisory Committee 

Meeting. 

SUMMARY: The Homeland Security 

Science and Technology Advisory 

Committee will meet July 21–23, 2009, 

at Strategic Analysis, Inc. Executive 

Conference Center, 3601 Wilson Blvd., 

Suite 600, Arlington, Virginia. This 

meeting will be closed to the public. 

DATES: The Homeland Security Science 

and Technology Advisory Committee 

will meet July 21, 2009, from 9 a.m. to 

5 p.m., July 22, 2009, from 9 a.m. to 5 

p.m. and on July 23, 2009, from 9 a.m. 

to 3 p.m. 

ADDRESSES: The meeting will be held at 

Strategic Analysis, Inc. Executive 

Conference Center, 3601 Wilson Blvd., 

Suite 600, Arlington, Virginia. Requests 

to have written material distributed to 

each member of the committee prior to 

the meeting should reach the contact 

person at the address below by Friday, 

July 10, 2009. Send written material to 

Ms. Deborah Russell, Science and 

Technology Directorate, Department of 

Homeland Security, 245 Murray Lane, 

Bldg. 410, Washington, DC 20528. 

Comments must be identified by DHS– 

2009–0082 and may be submitted by 

one of the following methods: 

• Federal eRulemaking Portal: http:// 

www.regulations.gov. Follow the 

instructions for submitting comments. 

• E-mail: HSSTAC@dhs.gov. Include 

the docket number in the subject line of 

the message. 

• Fax: 202–254–6173. 

• Mail: Ms. Deborah Russell, Science 

and Technology Directorate, Department 

of Homeland Security, 245 Murray 

Lane, Bldg. 410, Washington, DC 20528. 

Instructions: All submissions received 

must include the words ‘‘Department of 

Homeland Security’’ and the docket 

number for this action. Comments 

received will be posted without 

alteration at http://www.regulations.gov, 

including any personal information 

provided. 

Docket: For access to the docket to 

read background documents or 

comments received by the HSSTAC, go 

to http://www.regulations.gov. 

FOR FURTHER INFORMATION CONTACT: Ms. 

Deborah Russell, Science and 

Technology Directorate, Department of 

Homeland Security, 245 Murray Lane, 

Bldg. 410, Washington, DC 20528 202– 

254–5739. 

SUPPLEMENTARY INFORMATION: Notice of 

this meeting is given under the Federal 

Advisory Committee Act, 5 U.S.C. 

Annotated, Appendix 2 (Pub. L. 92– 

463). 

At this meeting, the Committee will 

receive classified, SECRET-level 

updated threat briefings; conduct 

classified reviews of sensor technologies 

in science and technology; and receive 

classified reports from the Committee 

panels. In addition, intelligence 

agencies, Department of Defense and 

Homeland Security experts will present 

SECRET-level briefings concerning 

these matters sensitive to homeland 

security. 

Basis for Closure: In accordance with 

section 10(d) of the Federal Advisory 

Committee Act, it has been determined 

that the Homeland Security Science and 

Technology Advisory Committee 

meeting concerns sensitive Homeland 

Security information and classified 

matters within the meaning of 5 U.S.C. 

552b(c)(1) and (c)(9)(B) which, if 

prematurely disclosed, would 

significantly jeopardize national 

security and frustrate implementation of 

proposed agency actions and that, 

accordingly, the portion of the meeting 

that concerns these issues will be closed 

to the public. 

Dated: June 17, 2009. 

Bradley I. Buswell, 

Under Secretary for Science and Technology 

(Acting). 

[FR Doc. E9–14903 Filed 6–24–09; 8:45 am] 

BILLING CODE 9110–9F–P 

DEPARTMENT OF HOMELAND 

SECURITY 

Office of the Secretary 

[Docket No. DHS–2008–0167] 

Privacy Act of 1974; DHS/All—026 

Personal Identity Verification 

Management System Systems of 

Records 

AGENCY: Privacy Office; DHS. 

ACTION: Notice of Privacy Act system of 

records. 

SUMMARY: The Department of Homeland 

Security (DHS) is giving notice that it 

proposes to update, rename, and reissue 

the record system DHS/OS–2 Personal 

Identity Verification Management 

System (9/12/2006) to the DHS/All— 

026 Personal Identity Verification 

Management Record System. DHS is 

publishing this updated notice because 

the categories of individuals and 

categories of records have been updated, 

and the routine uses of this system of 

records notice have been updated to 

coincide with updates to DHS’s 

Personal Identity Verification 

Management Record System. The 

system will support the administration 

of the Homeland Security Presidential 

Directive 12 (HSPD–12) program that 

directs the use of a common 

identification credential for both logical 

and physical access to Federally 

controlled facilities and information 

systems. 

DATES: Written comments must be 

submitted on or before July 27, 2009. 


sroberts on PROD1PC70 with NOTICES