National Health Data Stewardship, 30803-30805 [07-2733]

Download as PDF rwilkins on PROD1PC63 with NOTICES Federal Register / Vol. 72, No. 106 / Monday, June 4, 2007 / Notices • Night Supervision • Non-Legend/Non-Formulary Drugs • Non-Medical Transportation • Nursing Home Diversion Program • Nutrition Therapy • Nutritional Counseling/Assistance • Nutritional Risk • Nutritional Supplements • Occupational Therapy • Optometry Services • Over-the-Counter Drugs • Pediatric Community Transitional Home Services • Periodic Nursing Evaluations • Person Centered Planning • Personal Adjustment Counseling • Personal Agent • Personal Care • Personal Care Assistance • Personal Care Coordination • Personal Care—Rent/Food for Unrelated Live-In Caretaker • Personalized Emergency Response Systems • Phone Reassurance Monitoring • Physical Risk Reduction • Physical Therapy • Physical Therapy—Extended State Plan Services • Physician Services • Podiatry Services • Prescribed Drugs • Prescription Drug Co-Pay • Preventative/Consultative • Prevocational Services Habilitation • Private Duty Nursing • Professional Care Assistant • Professional Services • Protective Services • Psychiatrist Services • Psychologist Services • Psychosocial Counseling • Psychosocial Nutrition • Psychosocial Rehabilitation • Rehabilitation Engineering • Renal Dialysis • Residential Care • Residential Habilitation • Respiratory Therapy • Respite Care • Restorative Assistance • Retainer Payment for Personal Caregivers • Shared Nursing • Skill Building • Skilled Nursing • Socialization/Recreation • Social Reassurance Therapeutic Counseling • Social Work Services • Special Therapeutic Services • Specialized Child Care • Specialized Consultation Services • Specialized Medical Equipment and Supplies • Specialized Psychiatric Services • Specialized Therapies • Speech, Hearing, and Language • Staff/Family Consultation Training VerDate Aug<31>2005 20:34 Jun 01, 2007 Jkt 211001 • Subsidized Housing • Substance Abuse Treatment/ Counseling • Support Brokerage • Support Coordination • Support Services • Supported Employment Habilitation • Supported Living • Therapeutic Counseling • Therapeutic Living • Therapeutic Management • Therapeutic Massage • Therapeutic Resources • Therapeutic Social and Recreational Program • Therapeutic Supplies • Training and Counseling Services for Unpaid Caregivers • Transitional Case Management • Transitional Living • Transportation • Vehicle Modifications • Visual/Mobility Therapy • Wandering Alarm System • Wellness Monitoring • Wrap-Around Services • Extended State Plan Services: Æ Home health care services Æ Physical therapy Æ Occupational therapy Æ Speech, hearing and language services Æ Prescribed drugs, except drugs furnished to participants who are eligible for Medicare Part D benefits Æ Dental services For additional information on HCBS service, please refer to Appendix C: Participant Services (pages 99 to 162) of the Application for a section 1915(c) Home and Community-Based Waiver [Version 3.4] Instructions, Technical Guide and Review Criteria Release Date: November 2006, Disabled and Elderly Health Programs Group, Center for Medicaid and State Operations, Centers for Medicare & Medicaid Services, Department of Health and Human Services, available at: http:// www.cms.hhs.gov/HCBS/ 02_QualityToolkit.asp#TopOfPage. Dated: May 27, 2007. Carolyn M. Clancy, Director. [FR Doc. 07–2732 Filed 6–1–07; 8:45 am] BILLING CODE 4160–90–M DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality National Health Data Stewardship Agency for Healthcare Research and Quality (AHRQ), HHS. AGENCY: PO 00000 Frm 00061 Fmt 4703 Sfmt 4703 ACTION: 30803 Request for information. SUMMARY: There is a growing demand for healthcare data from many sectors. Key drivers for this demand have been surging interest in healthcare performance measurement and the information systems needed to aggregate, process and transmit healthcare data from which measures of health care quality may be derived and to which the measures could be applied. This need has raised the question of responsibility for safeguarding the data beyond the original care setting. This issue has led various stakeholders to propose the formation of a publicprivate national health care data stewardship organization with oversight of the various uses of healthcare data, as described below. For the purpose of achieving a broader understanding of the issues that establishment of such an entity may present, input is requested from the public and private sectors on the concept of a national health data stewardship entity (NHDSE). The primary purpose of this RFI is to gather information to foster broad stakeholder discussion; there are no current plans to issue a related request for proposals (RFP). Responses to this RFI are due no later than July 27, 2007. ADDRESSES: Electronic responses are preferred and may be addressed to: steward@ahrq.hhs.gov. Written responses should be addressed to: P. Jon White, MD, 540 Gaither Road, Rockville, MD 20850. A copy of this RFI is also available on the AHRQ and AQA Web sites. Please follow the instructions for submitting responses. If a response to this RFI is planned, notification is requested in advance by a simple response to one of the above addresses. Such notification is nonbinding and will not be made public. The submission of written materials in response to the RFI should not exceed 50 pages, including appendices and supplemental documents. Responders may submit other forms of electronic materials to demonstrate or exhibit key concepts of their written responses. If the response is over 20 pages, an executive summary is requested of the comments, no longer than 5 pages. Public access: Responses to this RFI will be available to the public at AHRQ. Please call 301–427–1505 between 9 a.m. and 5 p.m. to arrange access. The RFI and all responses will also be made available on the AHRQ Web site at DATES: E:\FR\FM\04JNN1.SGM 04JNN1 30804 Federal Register / Vol. 72, No. 106 / Monday, June 4, 2007 / Notices http://healthit.ahrq.gov. Any information submitted will be made public. Do not send proprietary, commercial, financial, business confidential, trade secret, or personal information that should not be made public. P. Jon White, MD, Health IT Director, Agency for Healthcare Research and Quality, jonathan.white@ahrq.hhs.gov. FOR FURTHER INFORMATION CONTACT: A primary purpose of this RFI is to gather information that AHRQ can bring to the AQA (http://www.aqaalliance.org), a multistakeholder health care improvement organization formed to advance and implement clinician-level performance measurement. To carry out its statutory mandates to improve health care quality and specifically through quality measurement, AHRQ was a primary convener and has been a participant in AQA alliance from its inception. A full list of AQA participants is available at its Web site, referenced above. The AAQ (http:// www.aqaalliance.org) has extensively discussed, in relation to its activities and objectives, the utility of having a NHDSE. The AQA has outlined and recommended processes for performance of quality measure selection, as well as for the underlying data sharing and data aggregation activities necessary to develop and apply performance measures, and public reporting of performance data. The following framed text contains excerpts from AQA proposal documents. SUPPLEMENTARY INFORMATION: National Health Data Stewardship Entity Proposed Mission The public/private entity will set uniform operating rules and standards for sharing and aggregating public and private sector data on quality and efficiency; offer guidance on implementation of such national operating rules and standards; and provide a framework for collecting, aggregating and analyzing data, to afford means of more effective oversight of health care data analyses and reporting in the United States. rwilkins on PROD1PC63 with NOTICES Proposed Precepts In performing activities, the entity shall follow certain precepts: • To be objective in its decision making. • To weigh carefully the views of its constituents in developing concepts and operating rules and standards. VerDate Aug<31>2005 20:34 Jun 01, 2007 Jkt 211001 • To bring about needed changes in ways that minimizes disruption to current aggregation efforts. • To review the effects of past decisions and interpret, amend or replace operating rules, standards and processes in a timely fashion when such action is indicated. • To follow an open, orderly process for setting policies, operating rules and standards that precludes placing any particular interest above the interests of the many stakeholders who rely on health care information. Proposed Scope of Work As previously noted, a wide range of activities need to be undertaken to advance health data exchange and use, including the development of measures and setting data transmission/lT technical standards. While all of these activities are important, the entity’s responsibilities would primarily focus on specific issues relating to data collection, aggregation, analysis, and sharing. The scope of work shall include setting policies, rules and standards for: • Data aggregation—Should address various data aggregation issues including required characteristics of aggregators (e.g., they should be trusted and respected entities), transparency of aggregation processes, control and ownership rights of the data, potential liability within data aggregation processes, and issues that arise when competing aggregation efforts are in a single market area; should ensure that the experience of existing aggregation efforts are leveraged. • Data collection (includes identification of data sources)—Should set policies, rules and standards for collecting public and private sector data from relevant stakeholders, including providers, employers, health insurance plans and others based on an agreedupon measurement set; should assess the pros and cons of using data derived from administrative data (e.g., claims, pharmacy and lab data), medical record review and surveys, and develop policies that prioritize data sources based on various dimensions. • Attribution—Should address at what specific level(s) data should be aggregated (e.g., individual physician level or group practice level). When making this determination, should consider sample size issues and physician/practice identifier issues. • Methodologies—Should set methodological rules and standards for aggregating data, including those addressing risk adjustment, measure weights and sample size. PO 00000 Frm 00062 Fmt 4703 Sfmt 4703 • Data analysis—Should set data analysis rules and standards, including those relating to trending, benchmarking, distribution, outlier analysis, correlation analysis and stratified analysis (variance between regions and states). • Data validation (audits)—Should set policies, rules and standards to ensure that the validity of the data submitted is independently audited. • Uses of data—Based on current law, should recommend allowable and nonallowable uses of data. Allowable data uses may include quality and efficiency improvement, consumer reporting, accountability, and pay for performance programs; also should, address allowable secondary uses of raw/primary data. • Data access—Should specify who should have access to data and applicable limitations, such as confidentiality and privacy rules; should consider policies which allow contributors, including both public and private sector entities, to have access to their own data as well as information which allows them to compare their data against benchmarks. • Data sharing and reporting—Should develop guiding principles for public reporting and reporting back information to clinicians. Screening processes to ensure valid reporting also should be addressed. Proposed Characteristics 1. Objective—Be objective in its decision-making and have the ability to preclude placing any particular interest above the interests of many. 2. Independent—Have a governing structure that is independent of all other business and professional organizations. 3. Knowledgeable—Demonstrates knowledge and expertise in the area of health care delivery, data management, and security or acceptable proxy for this. 4. Responsive—Insure input and use from key experts who possess knowledge of health care quality assessment, health data transmission, IT standards, physician and hospital systems design and a concern for the public interest in matters of health care quality analysis, reporting, and patient privacy. Represent key stakeholder groups that are measured and users of this information. 5. Trustworthy—Is recognized as a trustworthy organization by multi stakeholder groups. 6. Adaptable—Be flexible enough to address issues and key stakeholder needs as the market evolves. 7. Transparent—Have an existing stable infrastructure for consensus E:\FR\FM\04JNN1.SGM 04JNN1 Federal Register / Vol. 72, No. 106 / Monday, June 4, 2007 / Notices decision making that is transparent and involves the broad stakeholder communities. 8. Timely—Have the ability to carry out activities and achieve goals in a timely manner. 9. Collaborative—Have the ability to engage and work with other organizations to ensure effective implementation of rules and standards. 10. Sustainable—Have adequate resources to meet long and short term goals. The concept of a national entity responsible for setting rules and standards for sharing and using healthcare quality measurement data has also been supported by the Institute of Medicine in their 2005 report Performance Measurement. IOM additionally proposed that this entity would be responsible for several other roles in performance measurement, including articulation of national goals, selection of measures, aggregation of data, reporting of results and performance measurement research. It is recognized that the role of a NHDSE might extend to domains beyond health care performance measurement. Respondents are encouraged to describe such domains and provide information relating to NHDSE roles and characteristics, with the understanding that any such information will be considered and will be presented by AHRQ to AQA but may not be acted on in the immediate future. rwilkins on PROD1PC63 with NOTICES Information Requested For the purpose of achieving a broader understanding of the need for a nationwide health data stewardship entity, and what form it might take, input is requested from interested parties. It is not necessary to answer all questions. In your response, please indicate which question you are addressing in your comments. Specific areas for comment include: 1. Whether or not there is a need for a national health data stewardship entity with reasons, including value such an entity might bring and issues it might solve 2. Desirable governmental and private sector roles in such an organization or in health data stewardship more generally 3. The roles and responsibilities currently assumed by other existing entities that might be addressed by a NHDSE, as well as roles that should not be fulfilled by a NHDSE 4. The relationship of a NHDSE and its work to other quality improvement organizations and activities VerDate Aug<31>2005 20:34 Jun 01, 2007 Jkt 211001 5. The relationship of a NHDSE and its work to other initiatives which set national standards for health information, such as the ANSI Health IT Standards Panel (HITSP) 6. Key challenges to creation and maintenance of a NHDSE 7. The risks of creating a NHDSE 8. The appropriate role(s) of a NHDSE in advancing quality measurement 9. The appropriate role(s) of a NHDSE in characterization and evaluation of the comprehensiveness, accuracy and reliability of shared and aggregated health care quality measurement data 10. The appropriate role(s) of a NHDSE regarding the transmission of shared and aggregated data 11. The appropriate scope of activities for a NHDSE beyond quality measurement (in such domains as research and population health) 12. The key stakeholders that would be impacted by a NHDSE and how to structure interactions with a NHDSE 13. Appropriate governance model(s) for a NHDSE 14. Means to assure NHDSE objectivity and independence 15. Means to achieve trustworthiness or trust in a NHDSE, and how that would best be achieved 16. Recommendations for achieving timeliness in NHDSE decision making 17. Recommendations for achieving compliance with NHDSE recommendations, rules or standards 18. The essential external inputs to a NHDSE 19. Recommendations for achieving organizational flexibility for a NHDSE 20. The potential organizational infrastructure needs of a NHDSE 21. Potential funding requirements and sources of funding for a NHDSE 22. The organizational skill set required of a NDHSE 23. Priority activities for NHDSE to support data sharing and aggregation 24. Issues concerning the aboveexcerpted AQA characterizations of a NHDSE 25. The suitability of one or more existing organizations to fulfill the role of a NHDSE Potential Responders Responses are both requested and anticipated from a broad range of individual organizations that have interests in healthcare data. Examples of commenters from whom we would hope to hear include, but are not limited to: Health care professional societies Payers, including public and private insurers Health maintenance organizations PO 00000 Frm 00063 Fmt 4703 Sfmt 4703 30805 Purchasers, including employers and healthcare consumers Consumer and patient interest groups Community health delivery systems State and local health agencies Interested Federal agencies University-based health systems Advocacy groups and public interest organizations Trade industry organizations Health information technology industry vendors Regional health information organizations Interested individuals We look forward to receiving constructive comments representing diverse perspectives. Dated: May 25, 2007. Carolyn M. Clancy, AHRQ, Director. [FR Doc. 07–2733 Filed 6–1–07; 8:45 am] BILLING CODE 4160–90–M DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Proposed Information Collection Activity; Comment Request Proposed Projects: Title: Communities Empowering Youth (CEY) Program Evaluation. OMB No.: New collection. Description: This proposed information collection activity is to obtain information from Communities Empowering Youth (CEY) grantee agencies and the faith-based and community organizations working in partnership with them. The CEY evaluation is an important opportunity to examine the outcomes achieved through this component of the Compassion Capital Fund in meeting its objective of improving the capacity of faith-based and community organizations and the partnerships they form to increase positive youth development and address youth violence, gang involvement, and child abuse/neglect. The evaluation will be designed to assess changes and improvements in the structure and functioning of the partnership and the organizational capacity of each participating organization. Respondents: CEY grantees and the faith-based and community organizations that are a part of the partnership approved under the CEY grant. E:\FR\FM\04JNN1.SGM 04JNN1

Agencies

[Federal Register Volume 72, Number 106 (Monday, June 4, 2007)]
[Notices]
[Pages 30803-30805]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 07-2733]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Agency for Healthcare Research and Quality


National Health Data Stewardship

AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS.

ACTION: Request for information.

-----------------------------------------------------------------------

SUMMARY: There is a growing demand for healthcare data from many 
sectors. Key drivers for this demand have been surging interest in 
healthcare performance measurement and the information systems needed 
to aggregate, process and transmit healthcare data from which measures 
of health care quality may be derived and to which the measures could 
be applied. This need has raised the question of responsibility for 
safeguarding the data beyond the original care setting. This issue has 
led various stakeholders to propose the formation of a public-private 
national health care data stewardship organization with oversight of 
the various uses of healthcare data, as described below.
    For the purpose of achieving a broader understanding of the issues 
that establishment of such an entity may present, input is requested 
from the public and private sectors on the concept of a national health 
data stewardship entity (NHDSE). The primary purpose of this RFI is to 
gather information to foster broad stakeholder discussion; there are no 
current plans to issue a related request for proposals (RFP).

DATES: Responses to this RFI are due no later than July 27, 2007.

ADDRESSES: Electronic responses are preferred and may be addressed to: 
steward@ahrq.hhs.gov. Written responses should be addressed to: P. Jon 
White, MD, 540 Gaither Road, Rockville, MD 20850.
    A copy of this RFI is also available on the AHRQ and AQA Web sites. 
Please follow the instructions for submitting responses.
    If a response to this RFI is planned, notification is requested in 
advance by a simple response to one of the above addresses. Such 
notification is nonbinding and will not be made public.
    The submission of written materials in response to the RFI should 
not exceed 50 pages, including appendices and supplemental documents. 
Responders may submit other forms of electronic materials to 
demonstrate or exhibit key concepts of their written responses. If the 
response is over 20 pages, an executive summary is requested of the 
comments, no longer than 5 pages.
    Public access: Responses to this RFI will be available to the 
public at AHRQ. Please call 301-427-1505 between 9 a.m. and 5 p.m. to 
arrange access. The RFI and all responses will also be made available 
on the AHRQ Web site at

[[Page 30804]]

http://healthit.ahrq.gov. Any information submitted will be made 
public.
    Do not send proprietary, commercial, financial, business 
confidential, trade secret, or personal information that should not be 
made public.

FOR FURTHER INFORMATION CONTACT: P. Jon White, MD, Health IT Director, 
Agency for Healthcare Research and Quality, 
jonathan.white@ahrq.hhs.gov.

SUPPLEMENTARY INFORMATION: A primary purpose of this RFI is to gather 
information that AHRQ can bring to the AQA (http://
www.aqaalliance.org), a multistakeholder health care improvement 
organization formed to advance and implement clinician-level 
performance measurement. To carry out its statutory mandates to improve 
health care quality and specifically through quality measurement, AHRQ 
was a primary convener and has been a participant in AQA alliance from 
its inception. A full list of AQA participants is available at its Web 
site, referenced above. The AAQ (http://www.aqaalliance.org) has 
extensively discussed, in relation to its activities and objectives, 
the utility of having a NHDSE. The AQA has outlined and recommended 
processes for performance of quality measure selection, as well as for 
the underlying data sharing and data aggregation activities necessary 
to develop and apply performance measures, and public reporting of 
performance data. The following framed text contains excerpts from AQA 
proposal documents.

National Health Data Stewardship Entity

Proposed Mission

    The public/private entity will set uniform operating rules and 
standards for sharing and aggregating public and private sector data on 
quality and efficiency; offer guidance on implementation of such 
national operating rules and standards; and provide a framework for 
collecting, aggregating and analyzing data, to afford means of more 
effective oversight of health care data analyses and reporting in the 
United States.

Proposed Precepts

    In performing activities, the entity shall follow certain precepts:
     To be objective in its decision making.
     To weigh carefully the views of its constituents in 
developing concepts and operating rules and standards.
     To bring about needed changes in ways that minimizes 
disruption to current aggregation efforts.
     To review the effects of past decisions and interpret, 
amend or replace operating rules, standards and processes in a timely 
fashion when such action is indicated.
     To follow an open, orderly process for setting policies, 
operating rules and standards that precludes placing any particular 
interest above the interests of the many stakeholders who rely on 
health care information.

Proposed Scope of Work

    As previously noted, a wide range of activities need to be 
undertaken to advance health data exchange and use, including the 
development of measures and setting data transmission/lT technical 
standards. While all of these activities are important, the entity's 
responsibilities would primarily focus on specific issues relating to 
data collection, aggregation, analysis, and sharing.
    The scope of work shall include setting policies, rules and 
standards for:
     Data aggregation--Should address various data aggregation 
issues including required characteristics of aggregators (e.g., they 
should be trusted and respected entities), transparency of aggregation 
processes, control and ownership rights of the data, potential 
liability within data aggregation processes, and issues that arise when 
competing aggregation efforts are in a single market area; should 
ensure that the experience of existing aggregation efforts are 
leveraged.
     Data collection (includes identification of data 
sources)--Should set policies, rules and standards for collecting 
public and private sector data from relevant stakeholders, including 
providers, employers, health insurance plans and others based on an 
agreed-upon measurement set; should assess the pros and cons of using 
data derived from administrative data (e.g., claims, pharmacy and lab 
data), medical record review and surveys, and develop policies that 
prioritize data sources based on various dimensions.
     Attribution--Should address at what specific level(s) data 
should be aggregated (e.g., individual physician level or group 
practice level). When making this determination, should consider sample 
size issues and physician/practice identifier issues.
     Methodologies--Should set methodological rules and 
standards for aggregating data, including those addressing risk 
adjustment, measure weights and sample size.
     Data analysis--Should set data analysis rules and 
standards, including those relating to trending, benchmarking, 
distribution, outlier analysis, correlation analysis and stratified 
analysis (variance between regions and states).
     Data validation (audits)--Should set policies, rules and 
standards to ensure that the validity of the data submitted is 
independently audited.
     Uses of data--Based on current law, should recommend 
allowable and nonallowable uses of data. Allowable data uses may 
include quality and efficiency improvement, consumer reporting, 
accountability, and pay for performance programs; also should, address 
allowable secondary uses of raw/primary data.
     Data access--Should specify who should have access to data 
and applicable limitations, such as confidentiality and privacy rules; 
should consider policies which allow contributors, including both 
public and private sector entities, to have access to their own data as 
well as information which allows them to compare their data against 
benchmarks.
     Data sharing and reporting--Should develop guiding 
principles for public reporting and reporting back information to 
clinicians. Screening processes to ensure valid reporting also should 
be addressed.

Proposed Characteristics

    1. Objective--Be objective in its decision-making and have the 
ability to preclude placing any particular interest above the interests 
of many.
    2. Independent--Have a governing structure that is independent of 
all other business and professional organizations.
    3. Knowledgeable--Demonstrates knowledge and expertise in the area 
of health care delivery, data management, and security or acceptable 
proxy for this.
    4. Responsive--Insure input and use from key experts who possess 
knowledge of health care quality assessment, health data transmission, 
IT standards, physician and hospital systems design and a concern for 
the public interest in matters of health care quality analysis, 
reporting, and patient privacy. Represent key stakeholder groups that 
are measured and users of this information.
    5. Trustworthy--Is recognized as a trustworthy organization by 
multi stakeholder groups.
    6. Adaptable--Be flexible enough to address issues and key 
stakeholder needs as the market evolves.
    7. Transparent--Have an existing stable infrastructure for 
consensus

[[Page 30805]]

decision making that is transparent and involves the broad stakeholder 
communities.
    8. Timely--Have the ability to carry out activities and achieve 
goals in a timely manner.
    9. Collaborative--Have the ability to engage and work with other 
organizations to ensure effective implementation of rules and 
standards.
    10. Sustainable--Have adequate resources to meet long and short 
term goals.
    The concept of a national entity responsible for setting rules and 
standards for sharing and using healthcare quality measurement data has 
also been supported by the Institute of Medicine in their 2005 report 
Performance Measurement. IOM additionally proposed that this entity 
would be responsible for several other roles in performance 
measurement, including articulation of national goals, selection of 
measures, aggregation of data, reporting of results and performance 
measurement research. It is recognized that the role of a NHDSE might 
extend to domains beyond health care performance measurement. 
Respondents are encouraged to describe such domains and provide 
information relating to NHDSE roles and characteristics, with the 
understanding that any such information will be considered and will be 
presented by AHRQ to AQA but may not be acted on in the immediate 
future.

Information Requested

    For the purpose of achieving a broader understanding of the need 
for a nationwide health data stewardship entity, and what form it might 
take, input is requested from interested parties. It is not necessary 
to answer all questions. In your response, please indicate which 
question you are addressing in your comments. Specific areas for 
comment include:
    1. Whether or not there is a need for a national health data 
stewardship entity with reasons, including value such an entity might 
bring and issues it might solve
    2. Desirable governmental and private sector roles in such an 
organization or in health data stewardship more generally
    3. The roles and responsibilities currently assumed by other 
existing entities that might be addressed by a NHDSE, as well as roles 
that should not be fulfilled by a NHDSE
    4. The relationship of a NHDSE and its work to other quality 
improvement organizations and activities
    5. The relationship of a NHDSE and its work to other initiatives 
which set national standards for health information, such as the ANSI 
Health IT Standards Panel (HITSP)
    6. Key challenges to creation and maintenance of a NHDSE
    7. The risks of creating a NHDSE
    8. The appropriate role(s) of a NHDSE in advancing quality 
measurement
    9. The appropriate role(s) of a NHDSE in characterization and 
evaluation of the comprehensiveness, accuracy and reliability of shared 
and aggregated health care quality measurement data
    10. The appropriate role(s) of a NHDSE regarding the transmission 
of shared and aggregated data
    11. The appropriate scope of activities for a NHDSE beyond quality 
measurement (in such domains as research and population health)
    12. The key stakeholders that would be impacted by a NHDSE and how 
to structure interactions with a NHDSE
    13. Appropriate governance model(s) for a NHDSE
    14. Means to assure NHDSE objectivity and independence
    15. Means to achieve trustworthiness or trust in a NHDSE, and how 
that would best be achieved
     16. Recommendations for achieving timeliness in NHDSE decision 
making
    17. Recommendations for achieving compliance with NHDSE 
recommendations, rules or standards
    18. The essential external inputs to a NHDSE
    19. Recommendations for achieving organizational flexibility for a 
NHDSE
    20. The potential organizational infrastructure needs of a NHDSE
    21. Potential funding requirements and sources of funding for a 
NHDSE
    22. The organizational skill set required of a NDHSE
    23. Priority activities for NHDSE to support data sharing and 
aggregation
    24. Issues concerning the above-excerpted AQA characterizations of 
a NHDSE
     25. The suitability of one or more existing organizations to 
fulfill the role of a NHDSE

Potential Responders

    Responses are both requested and anticipated from a broad range of 
individual organizations that have interests in healthcare data. 
Examples of commenters from whom we would hope to hear include, but are 
not limited to:

Health care professional societies
Payers, including public and private insurers
Health maintenance organizations
Purchasers, including employers and healthcare consumers
Consumer and patient interest groups
Community health delivery systems
State and local health agencies
Interested Federal agencies
University-based health systems
Advocacy groups and public interest organizations
Trade industry organizations
Health information technology industry vendors
Regional health information organizations
Interested individuals

    We look forward to receiving constructive comments representing 
diverse perspectives.

    Dated: May 25, 2007.
Carolyn M. Clancy,
AHRQ, Director.
[FR Doc. 07-2733 Filed 6-1-07; 8:45 am]
BILLING CODE 4160-90-M