Federal Register: February 10, 2009 (Volume 74, Number 26)

DOCID: fr10fe09-73 FR Doc E9-2679

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Agency for Healthcare Research and Quality

NOTICE: NOTICES

DOCID: fr10fe09-73

DOCUMENT ACTION: Notice.

SUBJECT CATEGORY:

Agency Information Collection Activities: Proposed Collection; Comment Request

DATES: Comments on this notice must be received by April 13, 2009.

DOCUMENT 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 Phase I Demonstrations of the Pharmacy Quality Alliance.'' In accordance with the Paperwork Reduction Act of 1995, Public Law 10413 (44 U.S.C. 3506(c)(2)(A)), AHRQ invites the public to comment on this proposed information collection.

SUMMARY:

Agency Information Collection Activities; Proposals, Submissions, and Approvals

SUPPLEMENTAL INFORMATION

Evaluation of Phase I Demonstrations of the Pharmacy Quality Alliance

AHRQ proposes to conduct an independent evaluation of five Phase I demonstrations undertaken by the Pharmacy Quality Alliance (PQA). The PQA launched the five demonstration projects to test the feasibility of implementing a pharmacy provider report card system, which will be used to provide feedback to pharmacies on their performance. The goals of the demonstrations are to obtain feedback from pharmacists on the credibility of the performance reports and their utility in performance improvement, and to identify the most efficient and useful ways to implement a performancebased quality reporting system. The evaluation will be conducted for AHRQ by its contractor, the CNA Corporation and Thomas Jefferson Medical College.

The purpose of this evaluation is to identify problems associated with the implementation of a performancebased quality reporting system. The evaluation of the Phase I demonstrations will:

  • Test the feasibility and utility of (1) using 15 PQA claimsbased measures on pharmacy performance and (2) a survey of consumers about their experience with pharmacy services, which was developed by the PQA;
  • Determine the resource (time and cost) requirements for collecting the data and generating the pharmacy performance reports; and
  • Provide a base of knowledge that enables the PQA to improve the implementation process, increase operational efficiency, reduce operational costs, and enhance the utility and validity of the performance measures.

    This project is being conducted pursuant to AHRQ's statutory authority to conduct and support research and evaluations on health care and on systems for the delivery of such care, including activities with respect to (1) the quality, effectiveness, efficiency, appropriateness and value of health care services and (2) quality measurement and improvement. 42 U.S.C. 299a(a)(1) and (2).

    Method of Collection

    The project will include the following three data collections: (1) Onsite interviews with key personnel involved in the demonstration; (2) a preinterview questionnaire for the on site interview
    participants; and (3) a survey of pharmacy staff. The data will be collected to obtain the following types of information necessary for the evaluation:

  • Organizational background related to quality measurement, organizational resources for quality measurement;
  • Measurement methodology;
  • Opinions on the performance measures;
  • The process for disseminating the performance measures;
  • Incentives and penalties for participation in pharmacy quality improvement;
  • Usability of the performance reports;
  • Future directions for quality measurement in the organization; and
  • Respondent characteristics.

    Onsite Interviews With Key Demonstration Participants

    Onsite interviews will be conducted with up to six persons at each of the five demonstration sites. The study will try to interview representatives from the following job functions: (1) Pharmacy operations management; (2) clinical pharmacy staff; (3) quality improvement; (4) utilization management; (5) analytics management responsible for oversight of performance report analyses; (6) analytics staff assigned to complete the performance reports; (7) information technology (IT) staff responsible for developing and/or coordinating Internet components of the project; and (8) senior management (executive leadership, i.e., Vice President level and above). PreInterview Questionnaire

    In addition to the onsite interview, a brief written questionnaire will be used to collect information from interview participants prior to the interview. There will be two different versions of this questionnaire, one for the demonstration project leaders and one for all onsite interview participants.

    Survey of Pharmacy Staff

    A pharmacy staff survey will be developed to yield additional quantitative data about the demonstration projects. The sample will consist of practicing pharmacists who are participating in the demonstration sites and who received one or more of the performance reports. It will also include field managers and supervisors. [[Page 6631]]
    At each of the five sites, up to 100 pharmacy staff members will be sampled, with an expected response rate of 75 percent, yielding 75 respondents per site.

    Estimated Annual Respondent Burden

    Exhibit 1 show the estimated annualized burden hours for the respondents' time to participate in this evaluation. The onsite interviews will require about 1 hour to complete for a total of 30 burden hours. The preinterview questionnaire is expected to take 15 minutes to complete for a total of 9 burden hours. The phannacy staff survey will take about 30 minutes to complete for a total of 188 burden hours. The total burden hours for all data collections is estimated to be 227 hours.

    Exhibit 2 shows the estimated annualized cost burden associated with the respondents' time to participate in this project. The cost burden is estimated to be $10,800.
    Exhibit 1Estimated Annualized Burden Hours Number of Form name Number of responses per Hours per Total burden sites site response hours OnSite Interviews.............................. 5 6 1.00 30

    PreInterview Questionnaire for 5 1 15/60 1 Demonstration Project Leaders..............

    PreInterview Questionnaire for All 5 6 15/60 8 Interview Participants.....................
    Survey of Pharmacy Staff........................ 5 75 30/60 188
    Total................................... 20 .............. .............. 227 Exhibit 2Estimated Annualized Cost Burden Number of Total burden Average hourly Total cost Form name sites hours wage rate* burden OnSite Interviews.............................. 5 30 $47.58 $1,427

    PreInterview Questionnaire for 5 1 47.58 48 Demonstration Project Leaders..............

    PreInterview Questionnaire for All 5 8 47.58 380 Interview Participants.....................
    Survey of Pharmacy Staff........................ 5 188 47.58 8,945
    Total................................... 20 227 .............. $10,800 *Based on the national average wage for pharmacists (291051), National Compensation Survey: Occupational wages in the United States May 2007, U.S. Department of Labor, Bureau of Labor Statistics. Estimated Annual Costs to the Federal Government

    The estimated total cost to the Federal government for this one year evaluation is $208,874. Exhibit 3 shows a breakdown of the costs. Exhibit 3Estimated Annual Costs to the Federal Government Component Total Developing the interview guide and survey instrument......... $33,905 Preparing OMB clearance submission........................... 6,704 Site visits to each demonstration............................ 73,368 Analyzing the data from each demonstration site.............. 54,835 Preparing a final report..................................... 40,062

    Total.................................................... 208,874 Request for Comments

    In accordance with the abovecited 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: February 2, 2009.
    Carolyn M. Clancy,
    Director.
    [FR Doc. E92679 Filed 2909; 8:45 am]
    BILLING CODE 416090M

    FOR FURTHER INFORMATION CONTACT

    Doris Lefkowitz, AHRQ Reports Clearance Officer, (301) 4271477, or by email at
    doris.lefkowitz@ahrq.hhs.gov.