[Federal Register Volume 76, Number 107 (Friday, June 3, 2011)]
[Notices]
[Pages 32207-32209]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-13740]
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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. 3501-3521,
[[Page 32208]]
AHRQ invites the public to comment on this proposed information
collection.
This proposed information collection was previously published in
the Federal Register on March 11th, 2011 and allowed 60 days for public
comment. One comment was received. The purpose of this notice is to
allow an additional 30 days for public comment.
DATES: Comments on this notice must be received by July 5, 2011.
ADDRESSES: Written comments should be submitted to: AHRQ's OMB Desk
Officer by fax at (202) 395-6974 (attention: AHRQ's desk officer) or by
e-mail at [email protected] (attention: AHRQ's desk
officer).
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
[email protected].
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 2-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 EPs 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 EHR
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).
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) A total of 13 focus groups will be conducted with eligible
Medicaid providers. Eight focus groups will include a mix of
pediatricians, other physicians, dentists, nurse practitioners,
physician assistants, and certified nurse midwives who have adopted an
EHR. Four of the focus groups will include providers who have not
adopted an EHR, 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 EHRs as defined in Federal regulations for
Stage 1 (particular functions that are problematic, the source of the
challenge). Responses will also address topics related to participants'
knowledge of the EHR incentive program and other factors that may
facilitate EHR use. The focus group moderator will use the moderator's
guide to guide discussion. The 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, except for the
focus groups with non-users, which will last about 90 minutes. The
total annual burden hours are estimated to be 228 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 $16,795.
Exhibit 1. Estimated Annualized Burden Hours
[[Page 32209]]
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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
In-Person Focus Groups EHR Users only........... 40 1 2 80
Virtual Focus Groups EHR Users only............. 29 1 2 58
Virtual Focus Groups EHR Non-users only......... 20 1 1.5 30
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Total....................................... 389 na na 228
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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 73.66 $4,420
In-Person Focus Groups EHR Users only........... 40 80 73.66 5,893
Virtual Focus Groups EHR Users only............. 29 58 73.66 4,272
Virtual Focus Groups EHR Non-users only......... 20 30 73.66 2,210
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Total....................................... 389 228 na $16,795
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*Hourly wage rate is the weighted average of hourly rates of the types of professionals who will complete the
screening questionnaire and participate 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 others), $97.35; 29-1021 (Dentists, General), $76.61; 29-1111 (Registered Nurses, includes Certified Nurse
Midwives), $32.35; 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.
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 Paperwork Reduction Act, 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 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: May 20, 2011.
Carolyn M. Clancy,
Director.
[FR Doc. 2011-13740 Filed 6-2-11; 8:45 am]
BILLING CODE 4160-90-M