Agency Information Collection Activities: Proposed Collection; Comment Request, 18722-18724 [E9-9247]
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18722
Federal Register / Vol. 74, No. 78 / Friday, April 24, 2009 / Notices
EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS—Continued
Number of
responses per
respondent
Number of
respondents
Activity name
Hours per
response
Total burden
hours
Key Informant Interviews with EHC Program Users and Stakeholders to Develop Cases ............................................................
Appreciative Inquiry Workshop ........................................................
25
20
1
1
1
6
25
120
Total ..........................................................................................
344
(1)
(1)
246
1 Not
applicable.
EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN
Number of
respondents
Activity name
Total burden
hours
Average hourly
wage rate *
Total cost burden
Key Informant Interviews with EHC Research Centers Staff ..........
Online Survey with EHC Research Centers Staff ...........................
Key Informant Interviews with EHC Stakeholder Group Members
Key Informant Interviews with EHC Program Users and Stakeholders ..........................................................................................
Online Survey with EHC Program Users and Stakeholders ...........
Key Informant Interviews with EHC Program Users and Stakeholders to Develop Cases ............................................................
Appreciative Inquiry Workshop ........................................................
13
95
2
13
24
2
$54.27
54.27
43.52
$706
1,302
87
19
170
19
43
46.73
46.73
888
2009
25
20
25
120
46.73
51.14
1,168
6,137
Total ..........................................................................................
344
246
(1)
12,297
* Wage rates were calculated using the following data: (1) For the Governance Interviews and the Online Survey with EHC Research Centers
Staff the hourly rate is a weighted average for physicians ($58.76 per hour) and medical and health services managers ($37.82); (2) for the Governance Interviews with EHC Stakeholder Group Members the hourly rate is the rate for average for medical and health services managers
($37.82); (3) for the Governance Interviews and the Online Survey with EHC Program Users and Stakeholders the hourly rate is a weighted average for physicians ($58.76 per hour), general and operations managers ($43.52 per hour), medical and health services managers ($37.82 per
hour), and social and community service managers ($24.73 per hour); (4) for the Workshop the hourly rate is a weighted average for physicians
($58.76 per hour) and general and operations managers ($43.52 per hour) from the mean of the average wages, National Compensation Survey:
Occupational Wages in the United States 2006, U.S. Department of Labor, Bureau of Labor Statistics.
1 Not applicable.
Estimated Annual Costs to the Federal
Government
Exhibit 3 shows the estimated cost of
this one year data collection for the
evaluation of the EHC program,
including the cost of developing the
methodology and data collection
instruments, collecting and analyzing
the data, publishing the results, etc. The
work will be carried out by IMPAQ
International and Abt Associates under
contract to the Agency for Healthcare
Research and Quality.
EXHIBIT 3—ESTIMATED ANNUAL
COST * TO THE FEDERAL GOVERNMENT
Total cost
Project Development ....................
Data Collection Activities ..............
Data Processing and Analysis .....
Publication of Results ...................
Project Management ....................
$137,901
179,172
170,577
63,686
97,236
Total .......................................
mstockstill on PROD1PC66 with NOTICES
Cost component
648,572
* Please note the costs include fully loaded
costs (overhead, G&A).
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.
Request for Comments
In accordance with the above-cited
Paperwork Reduction Act legislation,
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Dated: April 15, 2009.
Carolyn M. Clancy,
Director.
[FR Doc. E9–9245 Filed 4–23–09; 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:
‘‘Building an Implementation Toolset
for E-Prescribing.’’ 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
E:\FR\FM\24APN1.SGM
24APN1
18723
Federal Register / Vol. 74, No. 78 / Friday, April 24, 2009 / Notices
to comment on this proposed
information collection.
DATES: Comments on this notice must be
received by June 23, 2009.
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
e-mail at doris.lefkowitz@ahrg.hhs.gov.
SUPPLEMENTARY INFORMATION:
Proposed Project
‘‘Building an Implementation Toolset
for E-Prescribing’’
AHRQ proposes to develop and test
an electronic prescribing (e-prescribing)
toolset to provide information and tools
of sufficient detail to act as a ‘‘how-to
guide’’ for implementing e-prescribing
across various organizational settings.
The current system of prescribing and
dispensing medications in the United
States poses widespread safety and
efficiency problems. E-prescribing
systems have the potential to avert some
of the more than 2 million adverse drug
events (ADEs) annually, of which
130,000 are life threatening. Eprescribing also has enormous potential
to create savings in health care costs,
both through reducing ADEs and
through more efficient work processes
of prescribers and pharmacists. One
recent study estimated the potential
savings at $27 billion per year in the
United States. [Johnston D, Pan E,
Middleton B, Walker J, Bates DW. The
value of computerized provider order
entry in ambulatory settings. 2003 [cited
2003/12/10]. Available from: https://
www.citl.org/research/
ACPOE_Executive_Preview.pdf.]
The Medicare Prescription Drug
Improvement and Modernization Act
(MMA) of 2003, Public Law 108–173,
provided that Medicare Part D sponsors
are required to establish electronic
prescription drug programs to provide
for electronic transmittal of certain
information to the prescribing provider
and dispensing pharmacy and the
dispenser. There is no requirement that
prescribers or dispensers implement eprescribing, but those who do
electronically transmit prescription and
certain other prescription-related
information for Medicare Part D covered
drugs prescribed for Medicare Part D
eligible individuals, either directly or
through an intermediary, are required to
comply with any applicable final
standards that are in effect.
However, adoption of e-prescribing
technology remains limited. On the
surface, e-prescribing involves getting a
prescription from point A to point B. In
reality, the complexity of e-prescribing
reflects all aspects of the process from
appropriate prescribing, through
dispensing, to correct patient use.
Much current work has been on the
adoption of technical standards that
establish a common language, contain
technical specifications, and provide
other specific criteria designed to be
used consistently as rules or definitions.
While standards are a necessary
foundation for e-prescribing systems,
they are insufficient in themselves to
insure a successful implementation. Of
equal importance to successful eprescribing implementations are
appropriate workflows and sustainable
commitment from the various
organizations that must participate in
such a system.
This Accelerating Change and
Transformation in Organizations and
Networks (ACTION) project will
produce a toolset to help a diverse range
of provider organizations, from small
independent offices to large medical
groups to ‘‘safety net’’ clinics, to adopt
e-prescribing systems and use them
effectively in ways that advance the
organization’s goals. By enabling the
greater adoption of e-prescribing
systems that are effective in improving
safety, quality and reducing prescription
drug costs, the project will advance each
of the priorities embodied in AHRQ’s
mission, which is to improve the
quality, safety, efficiency, and
effectiveness of health care for all
Americans.
This work is being conducted by the
RAND Corporation under AHRQ
ACTION contract HHSA290200600017,
Task Order #4, period of performance—
8/1/08–1/31/10. It is being conducted
pursuant to AHRQ’s statutory authority
to conduct research and evaluations (1)
on health care and systems for the
delivery of such care, including
activities with respect to health care
technologies, facilities and equipment,
42 U.S.C. 299a(a)(5), and (2) to advance
training for health care practitioners and
researchers in the use of information
systems. 42 U.S.C. 299b–3(a)(2).
Method of Collection
In order to evaluate the draft toolset’s
usability and usefulness, we will pilot
test the toolset by studying its effects
among 6 practices that are attempting to
implement e-prescribing for the first
time. Field researchers will visit each
practice before and after the eprescribing implementation effort to
conduct semi-structured interviews and
observations of work processes. Finally,
selected members of the practices will
be surveyed via a web-based instrument
regarding the effort’s success and the
degree to which elements of the toolset
were helpful.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated
annualized burden hours for the
respondents’ time to participate in this
project. Pre-test and post-test interviews
will be conducted with 3 physicians, 3
nurses or clinical support staff and 3
other staff from each of the 6 test sites.
Eight physicians from each of the 6 test
sites will complete the physician survey
and 12 other staff from each site will
complete the other staff survey. The
total burden hours are estimated to be
168 hours.
Exhibit 2 shows the estimated
annualized cost burden associated with
the respondent’s time to participate in
this project. The total cost burden is
estimated to be $7,423.
EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS
mstockstill on PROD1PC66 with NOTICES
Pre-test Interviews:
Physician interviews .................................................................................
Nurse or clinical support interviews ..........................................................
Other staff interviews ................................................................................
Post-test interviews:
Physician interviews .................................................................................
Nurse or clinical support interviews ..........................................................
VerDate Nov<24>2008
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Jkt 217001
PO 00000
Number of
responses per
site
Number of
sites
Form name
Frm 00041
Fmt 4703
Sfmt 4703
Hours per
response
Total burden
hours
6
6
6
3
3
3
1
1
1
18
18
18
6
6
3
3
1
1
18
18
E:\FR\FM\24APN1.SGM
24APN1
18724
Federal Register / Vol. 74, No. 78 / Friday, April 24, 2009 / Notices
EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS—Continued
Number of
responses per
site
Number of
sites
Form name
Hours per
response
Total burden
hours
Other staff interviews ................................................................................
Web-based survey:
Physician survey .......................................................................................
Other staff survey .....................................................................................
6
3
1
18
6
6
8
12
30/60
30/60
24
36
Total ...................................................................................................
48
(1)
(1)
168
1 Not
applicable.
EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN
Number of
sites
Form name
Pre-test Interviews:
Physician interviews .................................................................................
Nurse or clinical support interviews ..........................................................
Other staff interviews ................................................................................
Post-test interviews:
Physician interviews .................................................................................
Nurse or clinical support interviews ..........................................................
Other staff interviews ................................................................................
Web-based survey:
Physician survey .......................................................................................
Other staff survey .....................................................................................
Total ...................................................................................................
Total burden
hours
Average
hourly wage
rate *
Total cost
burden
6
6
6
18
18
18
$78.24
30.42
14.97
$1,408
548
269
6
6
6
18
18
18
78.24
30.42
14.97
1,408
548
269
6
6
24
36
78.24
30.42
1,878
1,095
48
168
(1)
7,423
* Based upon the mean of the national average hourly wages for physicians and surgeons, registered nurses, and medical secretaries, National Compensation Survey: Occupational wages in the United States July 2007, U.S. Department of Labor, Bureau of Labor Statistics.
1 Not applicable.
Estimated Annual Costs to the Federal
Government
Exhibit 3 shows the estimated total
and annual costs of this project. Since
data collection will not exceed one year,
the total and annual costs are the same.
The total cost is estimated to be
$119,976.
EXHIBIT 3—ESTIMATED TOTAL AND ANNUAL COST
Cost component
Total cost
Annualized
cost
Instrument Development ..................................................................................................................................................
Data Collection Activities .................................................................................................................................................
Data Processing and Analysis .........................................................................................................................................
Report Preparation/Publication ........................................................................................................................................
Project Management ........................................................................................................................................................
Overhead .........................................................................................................................................................................
$12,533
33,422
16,711
16,711
4,178
36,421
$12,533
33,422
16,711
16,711
4,178
36,421
Total ..........................................................................................................................................................................
119,976
119,976
mstockstill on PROD1PC66 with NOTICES
Request for Comments
In accordance with the above-cited
Paperwork Reduction Act legislation,
comments on AHRQs 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
VerDate Nov<24>2008
16:20 Apr 23, 2009
Jkt 217001
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
PO 00000
Frm 00042
Fmt 4703
Sfmt 4703
proposed information collection. All
comments will become a matter of
public record.
Dated: April 15, 2009.
Carolyn M. Clancy,
Director.
[FR Doc. E9–9247 Filed 4–23–09; 8:45 am]
BILLING CODE 4160–90–M
E:\FR\FM\24APN1.SGM
24APN1
]]>Agencies
[Federal Register Volume 74, Number 78 (Friday, April 24, 2009)]
[Notices]
[Pages 18722-18724]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-9247]
-----------------------------------------------------------------------
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: ``Building an Implementation Toolset for E-Prescribing.'' 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
[[Page 18723]]
to comment on this proposed information collection.
DATES: Comments on this notice must be received by June 23, 2009.
ADDRESSES: Written comments should be submitted to: Doris Lefkowitz,
Reports Clearance Officer, AHRQ, by e-mail 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 e-mail at
doris.lefkowitz@ahrg.hhs.gov.
SUPPLEMENTARY INFORMATION:
Proposed Project
``Building an Implementation Toolset for E-Prescribing''
AHRQ proposes to develop and test an electronic prescribing (e-
prescribing) toolset to provide information and tools of sufficient
detail to act as a ``how-to guide'' for implementing e-prescribing
across various organizational settings.
The current system of prescribing and dispensing medications in the
United States poses widespread safety and efficiency problems. E-
prescribing systems have the potential to avert some of the more than 2
million adverse drug events (ADEs) annually, of which 130,000 are life
threatening. E-prescribing also has enormous potential to create
savings in health care costs, both through reducing ADEs and through
more efficient work processes of prescribers and pharmacists. One
recent study estimated the potential savings at $27 billion per year in
the United States. [Johnston D, Pan E, Middleton B, Walker J, Bates DW.
The value of computerized provider order entry in ambulatory settings.
2003 [cited 2003/12/10]. Available from: https://www.citl.org/research/ACPOE_Executive_Preview.pdf.]
The Medicare Prescription Drug Improvement and Modernization Act
(MMA) of 2003, Public Law 108-173, provided that Medicare Part D
sponsors are required to establish electronic prescription drug
programs to provide for electronic transmittal of certain information
to the prescribing provider and dispensing pharmacy and the dispenser.
There is no requirement that prescribers or dispensers implement e-
prescribing, but those who do electronically transmit prescription and
certain other prescription-related information for Medicare Part D
covered drugs prescribed for Medicare Part D eligible individuals,
either directly or through an intermediary, are required to comply with
any applicable final standards that are in effect.
However, adoption of e-prescribing technology remains limited. On
the surface, e-prescribing involves getting a prescription from point A
to point B. In reality, the complexity of e-prescribing reflects all
aspects of the process from appropriate prescribing, through
dispensing, to correct patient use.
Much current work has been on the adoption of technical standards
that establish a common language, contain technical specifications, and
provide other specific criteria designed to be used consistently as
rules or definitions. While standards are a necessary foundation for e-
prescribing systems, they are insufficient in themselves to insure a
successful implementation. Of equal importance to successful e-
prescribing implementations are appropriate workflows and sustainable
commitment from the various organizations that must participate in such
a system.
This Accelerating Change and Transformation in Organizations and
Networks (ACTION) project will produce a toolset to help a diverse
range of provider organizations, from small independent offices to
large medical groups to ``safety net'' clinics, to adopt e-prescribing
systems and use them effectively in ways that advance the
organization's goals. By enabling the greater adoption of e-prescribing
systems that are effective in improving safety, quality and reducing
prescription drug costs, the project will advance each of the
priorities embodied in AHRQ's mission, which is to improve the quality,
safety, efficiency, and effectiveness of health care for all Americans.
This work is being conducted by the RAND Corporation under AHRQ
ACTION contract HHSA290200600017, Task Order 4, period of
performance--8/1/08-1/31/10. It is being conducted pursuant to AHRQ's
statutory authority to conduct research and evaluations (1) on health
care and systems for the delivery of such care, including activities
with respect to health care technologies, facilities and equipment, 42
U.S.C. 299a(a)(5), and (2) to advance training for health care
practitioners and researchers in the use of information systems. 42
U.S.C. 299b-3(a)(2).
Method of Collection
In order to evaluate the draft toolset's usability and usefulness,
we will pilot test the toolset by studying its effects among 6
practices that are attempting to implement e-prescribing for the first
time. Field researchers will visit each practice before and after the
e-prescribing implementation effort to conduct semi-structured
interviews and observations of work processes. Finally, selected
members of the practices will be surveyed via a web-based instrument
regarding the effort's success and the degree to which elements of the
toolset were helpful.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated annualized burden hours for the
respondents' time to participate in this project. Pre-test and post-
test interviews will be conducted with 3 physicians, 3 nurses or
clinical support staff and 3 other staff from each of the 6 test sites.
Eight physicians from each of the 6 test sites will complete the
physician survey and 12 other staff from each site will complete the
other staff survey. The total burden hours are estimated to be 168
hours.
Exhibit 2 shows the estimated annualized cost burden associated
with the respondent's time to participate in this project. The total
cost burden is estimated to be $7,423.
Exhibit 1--Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
Number of
Form name Number of responses per Hours per Total burden
sites site response hours
----------------------------------------------------------------------------------------------------------------
Pre-test Interviews:
Physician interviews........................ 6 3 1 18
Nurse or clinical support interviews........ 6 3 1 18
Other staff interviews...................... 6 3 1 18
Post-test interviews:
Physician interviews........................ 6 3 1 18
Nurse or clinical support interviews........ 6 3 1 18
[[Page 18724]]
Other staff interviews...................... 6 3 1 18
Web-based survey:
Physician survey............................ 6 8 30/60 24
Other staff survey.......................... 6 12 30/60 36
---------------------------------------------------------------
Total................................... 48 (\1\) (\1\) 168
----------------------------------------------------------------------------------------------------------------
\1\ Not applicable.
Exhibit 2--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
Number of Total burden Average hourly Total cost
Form name sites hours wage rate * burden
----------------------------------------------------------------------------------------------------------------
Pre-test Interviews:
Physician interviews........................ 6 18 $78.24 $1,408
Nurse or clinical support interviews........ 6 18 30.42 548
Other staff interviews...................... 6 18 14.97 269
Post-test interviews:
Physician interviews........................ 6 18 78.24 1,408
Nurse or clinical support interviews........ 6 18 30.42 548
Other staff interviews...................... 6 18 14.97 269
Web-based survey:
Physician survey............................ 6 24 78.24 1,878
Other staff survey.......................... 6 36 30.42 1,095
---------------------------------------------------------------
Total................................... 48 168 (\1\) 7,423
----------------------------------------------------------------------------------------------------------------
* Based upon the mean of the national average hourly wages for physicians and surgeons, registered nurses, and
medical secretaries, National Compensation Survey: Occupational wages in the United States July 2007, U.S.
Department of Labor, Bureau of Labor Statistics.
\1\ Not applicable.
Estimated Annual Costs to the Federal Government
Exhibit 3 shows the estimated total and annual costs of this
project. Since data collection will not exceed one year, the total and
annual costs are the same. The total cost is estimated to be $119,976.
Exhibit 3--Estimated Total and Annual Cost
------------------------------------------------------------------------
Annualized
Cost component Total cost cost
------------------------------------------------------------------------
Instrument Development........................ $12,533 $12,533
Data Collection Activities.................... 33,422 33,422
Data Processing and Analysis.................. 16,711 16,711
Report Preparation/Publication................ 16,711 16,711
Project Management............................ 4,178 4,178
Overhead...................................... 36,421 36,421
-------------------------
Total..................................... 119,976 119,976
------------------------------------------------------------------------
Request for Comments
In accordance with the above-cited Paperwork Reduction Act
legislation, comments on AHRQs 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: April 15, 2009.
Carolyn M. Clancy,
Director.
[FR Doc. E9-9247 Filed 4-23-09; 8:45 am]
BILLING CODE 4160-90-M
