Federal Register: July 14, 2009 (Volume 74, Number 133)
DOCID: fr14jy09-65 FR Doc E9-16568
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality
NOTICE: NOTICES
DOCID: fr14jy09-65
DOCUMENT ACTION: Notice.
SUBJECT CATEGORY:
Agency Information Collection Activities: Proposed Collection; Comment Request
DATES: Comments on this notice must be received by August 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 under the project: ``Evaluation of AHRQ's Effective Health Care Program.'' 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.
This proposed information collection was previously published in the Federal Register on April 24th, 2009 and allowed 60 days for public comment. No comments were received. The purpose of this notice is to allow an additional 30 days for public comment.
SUMMARY:
Agency Information Collection Activities; Proposals, Submissions, and Approvals
SUPPLEMENTAL INFORMATION
Proposed Project
''Evaluation of AHRQ's Effective Health Care Program''
AHRQ proposes to perform an evaluation of the Effective Health Care (EHC) programs' governance structure, methods for engaging stakeholders and approaches to setting national research priorities. Pursuant to Section 1013 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Public Law 108173, the EHC program was established by AHRQ to conduct research, demonstrations, and evaluations designed to improve the quality, effectiveness, and efficiency of Medicare, Medicaid, and the State Children's Health Insurance Program. The EHC program was designed to provide effectiveness and comparative effectiveness evidence of medical treatments, therapeutics, devices and drugs to assist policymakers, health care providers, clinicians, consumers, and other stakeholders in making informed decisions. The EHC program has offered a platform for combining explicit reviews of scientific evidence on the clinical effectiveness of pharmaceuticals and other health care interventions, as well as the translation and dissemination of scientific findings into meaningfui messages for a wide variety of audiences. It serves as an interface between the clinical research entities and health policy making entities. This program also provides a critical step in AHRQ's mission to support informed decision making. In addition to its program staff, the EHC program relies on four centers to generate and disseminate evidence: The Evidencebased Practice Centers (EPCs), the Developing Evidence to Inform Decisions about Effectiveness (DEcIDE) Network Centers, the John M. Eisenberg Clinical Decisions and Communications Science Center, and the Centers for Education & Research on Therapeutics (CERTs). Since the process of developing and disseminating this evidence is a complex undertaking, AHRQ has contracted with IMPAQ International, LLC and Abt Associates, Inc. (henceforth referred to as the ``IMPAQ team'') to perform this evaluation.
Information will be collected to identify strengths and weaknesses
in the current EHC program's governance structure, methods for engaging
stakeholders, and approaches to setting priorities for the research
conducted by the EHC program. The second phase of the evaluation will
be to contrast the EHC program with international programs of similar
purpose. To implement this evaluation, the IMPAQ team will conduct the following information collections:
(1) Key informant interviews about the governance structure of the EHC program;
(2) An online survey of EHC center staff and EHC program users and stakeholders;
[[Page 34020]]
(3) An Appreciative Inquiry workshop with EHC program staff and stakeholders;
(4) A document review (will not impose a burden on research participants) and
(5) Interviews with staff at international organizations of similar purpose (will not impose a burden on U.S. citizens).
The latter two activities do not require OMB approval and are not discussed further in this notice. The information collected will ultimately be used to develop a roadmap, including at least three alternative models of governance and operation, to be submitted to AHRQ that could be used to help guide future programmatic development. Method of Data Collection
Key Informant Interviews
Semistructured key informant interviews will be used to understand the EHC program's governance components and structure, from the vantage point of individuals governing the program, governed by the program, contributing to the program in various capacities, or impacted by the program's activities. Thirteen EHC Research Centers Staff, two EHC Stakeholder Group Members, and nineteen EHC Program Users and Stakeholders will be interviewed about the governance structure of the EHC program.
Additional key informant interviews with twenty five EHC Program Users and Stakeholders will be used to collect more detailed information on the success or impact of the EHC program product that results from its governance element or approach, or about a specific, important governance element.
All key informant interviews will be tape recorded to improve data capture, with prior permission from the participants.
Online Survey
A structured, webbased online survey of EHC program Research Centers Staff and EHC program Users and Stakeholders will be used to gather information about the EHC program. The survey will provide a robust view of the EHC governance system by providing feedback from a broad group of individuals whose work is related to the program. Specifically, the survey will collect data about these individuals' engagement and involvement with the EHC program; perceptions of the program's governance; experiences with the development, production, dissemination, and use of EHC products; and their beliefs regarding the quality and nature of the collaborative work, including publicprivate partnerships, being done within centers, across centers, and between centers and stakeholders.
Appreciative Inquiry Workshop
Small and largegroup discussions as part of an Appreciative Inquiry workshop will be designed to encourage EHC decisionmakers (AHRQ staff, EHC program staff, AHRQ project officers for each of the Research Center networks, principal investigators or other representatives from each of the Research Center network) and key program stakeholders or uers to consider anddecide which are the preferred alternative governance models or elements for which roadmaps should be developed. Appreciative Inquiry (AI) approach is an organizational development process that engages individuals within an organization in renewal, change, and focused performance. The AI approach focuses on successes and opportunities to improve things by looking forward, rather than looking back on the problems or issues. The AI workshop is expected to facilitate consensus among decision makers to contribute to the endorsement of the roadmap(s), and to encourage utilization of the evaluation findings. The workshop will involve a creative thinking process that will build on existing successes, identify and rank preferred alternatives, and ultimately develop a plan to strengthen the EHC program's governance system. Estimated Annual Respondent Burden
Exhibit 1 shows the estimated annualized burden hours for the
respondents to participate in this evaluation. Key informant interviews
will be conducted about the governance structure of the EHC program and
will last about one hour. The online survey will be completed by 95 EHC
program Research Centers Staff and 170 EHC Program Users and
Stakeholders and will require about 15 minutes to complete. The
Appreciative Inquiry workshop will be conducted with 20 participants
and will last about 6 hours. The total burden hours are estimated to be
246 hours. Exhibit 2 shows the estimated annualized cost burden based
on the respondents' time to participate in the evaluation. The total cost burden is estimated to be $12,297.
Exhibit 1Estimated Annualized Burden Hours
Number of
Activity name Number of responses per Hours per Total burden
respondents respondent response hours
Key Informant Interviews with EHC Research 13 1 1 13 Centers Staff..................................
Online Survey with EHC Research Centers Staff... 95 1 15/60 24
Key Informant Interviews with EHC Stakeholder 2 1 1 2 Group Members..................................
Key Informant Interviews with EHC Program Users 19 1 1 19 and Stakeholders...............................
Online Survey with EHC Program Users and 170 1 15/60 43 Stakeholders...................................
Key Informant Interviews with EHC Program Users 25 1 1 25 and Stakeholders to Develop Cases..............
Appreciative Inquiry Workshop................... 20 1 6 120
Total....................................... 344 na na 246
Exhibit 2Estimated Annualized Cost Burden
Average
Activity name Number of Total burden hourly wage Total cost
respondents hours rate* burden
Key Informant Interviews with EHC Research 13 13 $54.27 $706 Centers Staff..................................
Online Survey with EHC Research Centers Staff... 95 24 54.27 1,302 [[Page 34021]]
Key Informant Interviews with EHC Stakeholder 2 2 43.52 87 Group Members..................................
Key Informant Interviews with EHC Program Users 19 19 46.73 888 and Stakeholders...............................
Online Survey with EHC Program Users and 170 43 46.73 2,009 Stakeholders...................................
Key Informant Interviews with EHC Program Users 25 25 46.73 1,168 and Stakeholders to Develop Cases..............
Appreciative Inquiry Workshop................... 20 120 51.14 6,137
Total....................................... 344 246 na 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. 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 3Estimated Annual Cost to the Federal Government
Cost component Total cost
Project Development........................................ $137,901
Data Collection Activities................................. 179,172
Data Processing and Analysis............................... 170,577
Publication of Results..................................... 63,686
Project Management......................................... 97,236
Total.................................................. 648,572 * Please note the costs include fully loaded costs (overhead, G&A). 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: July 2, 2009.
Carolyn M. Clancy,
Director.
[FR Doc. E916568 Filed 71309; 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.