[Federal Register Volume 76, Number 11 (Tuesday, January 18, 2011)]
[Notices]
[Pages 2911-2913]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-410]
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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.
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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: ``Barriers to Meaningful Use in Medicaid.'' In accordance with
the Paperwork Reduction Act, 44 U.S.C. 3501-3520, AHRQ invites the
public to comment on this proposed information collection.
DATES: Comments on this notice must be received by March 21, 2011.
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@AHRQ.hhs.gov.
SUPPLEMENTARY INFORMATION:
Proposed Project
Barriers to Meaningful Use in Medicaid
The Health Information Technology for Economic and Clinical Health
(HITECH) Act, Title XIII of Division A and Title IV of Division B of
the American Recovery and Reinvestment Act of 2009 (ARRA) (Pub. L. 111-
5), provides for financial incentives for Medicaid providers to adopt
and meaningfully use certified electronic health record (EHR)
technologies. To ensure that eligible professionals (EPs) are able to
qualify for and access these incentives, AHRQ proposes a two-year
project with the objective of understanding the barriers that Medicaid
health providers encounter along the way to achieving the meaningful
use of EHRs. This proposed information collection will allow AHRQ to
synthesize knowledge regarding the barriers that BPs encounter when
attempting to achieve meaningful use and translate that knowledge to
develop technical assistance and support implementation and use of
EHRs.
Further, health care providers who serve Medicaid beneficiaries are
serving many of AHRQ's priority populations: Inner city; rural; low
income; minority; women; children; elderly; and those with special
health care needs. The project is designed to solicit actionable
recommendations on what activities can best help Medicaid providers
take advantage of incentive payments, achieve meaningful use, and
ultimately use health IT to improve health care for the Medicaid
population. The information gathered under this project will also be
used to inform the development of the Stage 2 and 3 Meaningful Use
criteria.
In order to gather, analyze, and synthesize information on the
barriers to the meaningful use criteria experienced by Medicaid
providers this research has the following goals:
(1) Identify the barriers to eligibility for the incentive
payments; barriers to adoption, implementation, or upgrading of ERR
systems; and barriers to achieving meaningful use.
(2) Develop actionable recommendations to overcoming the barriers
identified in 1 above, including, but not limited to,
technical assistance that could be made available to Medicaid
providers.
(3) Provide data to inform the meaningful use objectives being
developed by the Center for Medicare & Medicaid Services (CMS) for
Stages 2 and 3 of the EHR Incentive Program.
This study is being conducted by AHRQ through its contractor, RTI
International, pursuant to AHRQ's statutory authority to conduct and
support research to advance both training for health care practitioners
in the use of information systems and the use of computer-based health
records. 42 U.S.C. 299b-3(a)(2) and (6).
[[Page 2912]]
Method of Collection
To achieve the goals of this project the following data collections
will be implemented:
(1) A screening questionnaire will be used to identify eligible
participants, as part of the sampling procedure for the focus groups.
Appended to the screening questionnaire is a series of questions for
individuals who have agreed to participate in the focus groups, in
order to collect descriptive and demographic information prior to the
focus group session, and as part of the analysis plan.
(2) Nine focus groups will include 6-11 EPs per group, containing a
mix of pediatricians, other physicians, dentists, nurse practitioners,
and certified nurse midwives. Focus groups with community health center
(CHC) and rural health center (RHC)-based providers will also include
physician assistants and administrators. Four of the focus groups will
include providers in private practice (excluding dentists), an
additional four will include providers working in CHCs or RHCs, and the
final group will be comprised of private practice dentists. Private
practice dentists are being considered separately due to the fact that
their practice patterns are likely to vary substantially from those of
primary care physicians and non-physician providers. The purpose of
these focus groups is to gather information about adoption issues
(factors in the decision to adopt an EHR), implementation issues
(organizational or environmental factors that facilitate EHR
implementation and training), upgrade issues (challenges to
transitioning to certified EHRs), and challenges to achieving
meaningful use of ERRS as defined for Stage 1 in the final rule for the
Medicare and Medicaid ERR Incentive Program (75 FR 44314) (particular
functions that are problematic, the source of the challenge). Responses
will also address topics related to participants' knowledge of the ERR
incentive program and other factors that may facilitate EHR use. The
focus group moderator will use a moderator's guide to guide discussion.
Show cards will provide key reminders of content for discussion.
The information will be used to develop actionable recommendations
to overcoming barriers to meaningful use of EHRs for Medicaid
providers, including but not limited to technical assistance that could
be made available to Medicaid providers. Furthermore, the data gathered
through this research will inform the meaningful use objectives being
developed by CMS for Stages 2 and 3 of the EHR Incentive Program. Three
types of information will be collected: List of potential focus group
participants, descriptive and demographic information about focus group
participants, and the information gathered at each focus group related
to the barriers to meaningful use. The information will be synthesized
to provide information to the Federal government to inform the future
meaningful use regulations and understand any disparities potentially
resulting from the implementation of the incentive programs.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated annualized burden hours for the
respondents' time to participate in this research. The screening
questionnaire will be completed by 300 clinicians and will take 12
minutes to complete on average. Focus groups will be conducted with not
more than 89 clinicians and will last about 2 hours. The total annual
burden hours are estimated to be 238 hours.
Exhibit 2 shows the estimated annualized cost burden associated
with the respondents' time to participate in this research. The total
annual cost burden is estimated to be $15,902.
Exhibit 1--Estimated Annualized Burden Hours
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Number of
Data collection Number of responses per Hours per Total burden
respondents respondent response hours
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Screening Questionnaire......................... 300 1 12/60 60
Focus Groups.................................... 89 1 2 178
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Total....................................... 389 na na 238
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Exhibit 2--Estimated Annualized Cost Burden
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Number of Total burden Average hourly Total cost
Data collection respondents hours wage rate * burden
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Screening Questionnaire......................... 300 60 66.82 $4,009
Focus Groups.................................... 89 178 66.82 11,893
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Total....................................... 389 238 na 15,902
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* Hourly wage rate is the weighted average of hourly rates of the types of professionals who will be
participating in the focus groups. The weighted average includes the following occupational codes and wage
rates: 29-1065 (Pediatricians, General), $78.67; 29-1069 (Physicians and Surgeons, All Other), $97.35; 29-1021
(Dentists, General), $76.61; 29-1111 (Registered Nurses), $32.35; 11-9111 (Medical and Health Services
Managers), $40.85; 29-1071 (Physician Assistants), $41.86. Source: ``National Compensation Survey:
Occupational wages in the United States 2009,'' U.S. Department of Labor, Bureau of Labor Statistics.
Estimated Annual Costs to the Federal Government
Exhibit 3 shows the estimated total and annualized cost to the
government for conducting this research. The total cost is estimated to
be $424,493.
[[Page 2913]]
Exhibit 3--Estimated Total and Annualized Cost
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Annualized
Cost component Total cost cost
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Project Development..................... $79,313 $39,657
Data Collection Activities.............. 99,464 49,732
Data Processing and Analysis............ 49,732 24,866
Publication of Results.................. 38,415 19,208
Project Management...................... 37,601 18,801
Overhead................................ 119,968 59,984
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Total............................... 424,493 212,247
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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 healthcare research and healthcare 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: January 4, 2011.
Carolyn M. Clancy,
Director.
[FR Doc. 2011-410 Filed 1-14-11; 8:45 am]
BILLING CODE 4160-90-M