[Federal Register Volume 77, Number 17 (Thursday, January 26, 2012)]
[Notices]
[Pages 4036-4038]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-1402]
[[Page 4036]]
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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: ``Assessing the Feasibility of Disseminating Effective Health
Center Products through Mobile Phone Applications.'' In accordance with
the Paperwork Reduction Act, 44 U.S.C. 3501-3521, AHRQ invites the
public to comment on this proposed information collection.
This proposed information collection was previously published in
the Federal Register on November 15th, 2011 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.
DATES: Comments on this notice must be received by February 27, 2012.
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
email 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 email at
[email protected].
SUPPLEMENTARY INFORMATION:
Proposed Project
Assessing the Feasibility of Disseminating Effective Health Center
Products Through Mobile Phone Applications
The Agency for Healthcare Research and Quality (AHRQ) requests that
the Office of Management and Budget (OMB) approve, under the Paperwork
Reduction Act of 1995, this collection of information from users of
work products and services initiated by the John M. Eisenberg Clinical
Decisions and Communications Science Center (Eisenberg Center).
AHRQ is the lead agency charged with supporting research designed
to improve the quality of healthcare, reduce its cost, improve patient
safety, decrease medical errors, and broaden access to essential
services. AHRQ's Eisenberg Center's mission is improving communication
of findings to a variety of audiences (``customers''), including
consumers, clinicians, and health care policy makers. The Eisenberg
Center compiles research results into useful formats for customer
stakeholders. The Eisenberg Center also conducts investigations into
effective communication of research findings in order to improve the
usability and rapid incorporation of findings into medical practice.
The Eisenberg Center is one of three components of AHRQ's Effective
Health Care (EHC) Program. The collections proposed under this
clearance include activities to assess the feasibility of using
specific media and awareness-raising processes to encourage consumers
who are at risk for selected health problems for which EHC Program
materials are available to access information about such materials
using mobile phone technologies. The project will specifically focus on
promoting awareness of eight consumer guides developed through the EHC
Program. The guides are all published in English and Spanish-language
versions. All of the guides are designed to help decision makers,
including clinicians and health care consumers, use research evidence
to maximize the benefits of health care, minimize harm, and optimize
the use of health care resources.
The project will test the feasibility of using mobile telephone
technology for the dissemination of EHC Program materials to
underserved health consumer populations using: (a) Short message
services (SMS), usually referred to as texting, that can be provided to
people with basic cell phone service and texting support; and (b)
mobile Web access that provides access to the Internet via a mobile
interface.
Different methods and/or vehicles will be used to promote awareness
of opportunities to obtain cell phone- or smart phone-based information
about the availability of EHC Program materials including: (1) Wall
posters in patient service areas of the three (3) participating
clinics; (2) flyers about the products distributed in magazine racks
and through patient kiosks in some areas of the clinics; (3) flyers/
announcements given to patients at checkout from the clinic; and (4)
health fairs convened to address general health issues, where the
information can be provided. Promotional materials will invite
potential users to send a specific text message with the keyword
associated with the relevant health condition to the advertised number.
Subjects will receive a response text with a brief message about the
condition and an invitation to either (a) request a printed consumer
guide or (b) access the mobile Web site to view the guide.
This project has the following goals:
(1) Summarize marketing efforts in terms of total numbers of
posters, flyers, and information sheets distributed through specific
venues (e.g., patient waiting areas, patient check-out processes) and
numbers of individuals contacted through health fairs and related
activities;
(2) Summarize the extent to which persons in targeted patient
populations responded to marketing efforts;
(3) Assess patient satisfaction with: (a) The means by which
patients were alerted as to the availability of EHC Program materials;
(b) the methods patients used to request and access the EHC Program
materials; and (c) the value and relevancy of the information that they
obtained;
(4) Characterize perceptions of clinical care providers and
clinical staff persons in terms of: (a) The value of efforts to promote
patient awareness of EHC Program materials using marketing techniques
described in this feasibility project; and (b) the effect of these
efforts on workflow issues and related aspects of clinic operations.
This study is being conducted by AHRQ through its contractor, the
Eisenberg Center--Baylor College of Medicine, pursuant to AHRQ's
statutory authority to conduct and support research, and disseminate
information, on healthcare and on systems for the delivery of such
care, including activities with respect to both the quality,
effectiveness, efficiency, appropriateness and value of healthcare
services and clinical practice. 42 U.S.C. 299a(a)(1) and (4).
Method of Collection
To achieve the goals of this project the following data collections
will be implemented:
(1) Focus Groups with Clinicians. A focus group will be conducted
at each of the three participating clinics during regularly scheduled
internal clinic meetings, to determine how the introduction of
marketing materials and related resources influenced, if at all,
delivery of care in the clinical settings. Special emphasis will be
placed on determining if introduction of the project materials changed
the ways in which patients interacted with clinicians. It is expected
that each focus
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group will include no more than 10 clinical professionals (e.g.,
physicians, physician assistants, nurses and nurse practitioners,
pharmacists).
(2) Focus Groups with Support Staff. A focus group will be
conducted with support staff working in each of the three participating
clinics, during regularly scheduled meetings, to determine if the
introduction of the project materials altered clinic workflows. It is
expected that each focus group will include no more than 12 support
staff (e.g., receptionists, nursing assistants, other personnel who
interact with patients).
(3) Patient Interviews. In-person interviews conducted immediately
after the patient exits the clinic will be used to determine if
patients: (a) Saw and understood the marketing materials (e.g., posters
and flyers) in clinic settings; (b) were encouraged by the marketing
materials to text and request information about their health issue(s);
(c) could identify specific reasons why they did or did not text; and
(d) have suggestions about how marketing materials might be changed so
that they would be more likely to encourage patients like themselves to
text.
(4) Feedback Questionnaire for Patients Requesting Mailed Guides.
All persons that respond to the marketing materials by requesting any
of the eight guides to be mailed to them will be asked to complete a
brief paper questionnaire included with the guides. The purpose of the
questionnaire is to assess the extent to which the guides were easy to
read and understand, whether the guides provided the information they
sought, and any suggestions for improving and delivering the guides.
(5) Feedback Questionnaire for Patients Visiting the Mobile Web
Site. All persons that access the guides via the mobile Web site will
be asked to complete a brief online questionnaire. Only subjects
exposed to the promotion materials will receive the address of the
mobile Web site during the text message conversation, and therefore we
expect no other individuals to visit this site. The purpose of the
questionnaire is to determine if the guides were useful, the mobile Web
site was easy to use, whether they found the information they needed
and experienced any difficulty in accessing the guides through their
cell phone.
(6) Usage Log Data. Data from automated electronic log systems will
be collected from two sources: (1) Mobile Commons, the contractor that
manages the cell phone-related message delivery and cell phone-based
communication; and (2) the Eisenberg Center at Baylor College of
Medicine that manages the EHC Web site visits. Usage log data gathered
from the cell phone service contractor will include: (1) Counts of text
messages received from persons requesting information about consumer
guides; (2) the distribution of message counts across originating
clinics tracked through the use of distinctive call-in or short code
numbers assigned to each clinic; and (3) the numbers and originating
clinic-specific distributions of follow-up texts Because text
communications will be date and time stamped, Eisenberg Center staff
will be able to calculate mean durations in time from receipt of the
initial messages and follow-ups, which may be useful in determining
navigation patterns and suggesting connectivity barriers. Usage log
data gathered from the mobile Web site will allow for identification
of: (1) The number of visitors that originate from a specific uniform
record locator (URL) associated with each clinic; (2) the duration of
visits to the EHC Web site to gather desired information and explore
other resources available through the Web site; (3) the number of pages
viewed by each visitor; and (4) the number of downloads of the full
report associated with each guide, which will also be made available.
These data will be obtained using automated systems already in place,
and no special effort will be needed to generate these data; this task
is not included in the burden estimates in Exhibit 1 below.
The Eisenberg Center will determine the feasibility of this
approach to encouraging patients and anyone else viewing the marketing
materials to access information that may be helpful to them in
understanding health care choices and engaging more fully in their own
health care, and whether this approach should be pursued further. This
information will be used to determine the feasibility of: (a) Mounting
broader efforts to distribute consumer guides, as well as other EHC
Program products, using mobile technologies as tools to heighten
awareness of these resources by potential users who rely on mobile
communication devices for information access; and (b) initiating
additional studies to identify factors that encourage or deter
effective use of increasingly pervasive communication modalities (e.g.,
cell phones, smart phones) in communicating with care providers and
others and to access information from the Internet and health-related
Web sites.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated annualized burden for the
respondents' time to participate in this research. Focus groups will be
conducted with about 10 clinicians per each of the 3 participating
clinics (30 total) and about 12 clinical support staff per clinic (36
total), and will last 45 minutes. Interviews will be conducted with
about 100 patients per clinic (300 total) upon exit from the clinical
visit, with each interview lasting about 15 minutes. The Feedback
Questionnaire for the Mailed Guides will be completed by approximately
200 persons and will take 10 minutes to complete and the Feedback
Questionnaire for the Mobile site will be completed by about 200
persons and also requires 10 minutes to complete. The total annual
burden is estimated to be 191 hours. Exhibit 2 shows the estimated
annualized cost burden associated with the respondent's time to
participate in this research. The total annual cost burden is estimated
to be $5,320.
Exhibit 1--Estimated Annualized Total Burden Hours
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Number of
Type of data collection respondents per Number of Hours per Total burden
respondent responses response hours
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Focus Groups with Clinicians............ 30 1 45/60 23
Focus Groups with Support Staff......... 36 1 45/60 27
Patient Interviews...................... 300 1 15/60 75
Feedback Questionnaire for Patients 200 1 10/60 33
Requesting Mailed Guides...............
Feedback Questionnaire for Patients 200 1 10/60 33
Visiting Mobile Web site...............
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Total............................... 766 na na 191
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Exhibit 2--Estimated Annualized Total Cost Burden
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Number of Total burden Average hourly Total cost
Type of data collection respondents hours wage rate * burden
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Focus Groups with Clinicians............ 30 23 $83.59 $1,923
Focus Groups with Support Staff......... 36 27 14.31 386
Patient Interviews...................... 300 75 21.35 1,601
Feedback Questionnaire for Patients 200 33 21.35 705
Requesting Mailed Guides...............
Feedback Questionnaire for Patients 200 33 21.35 705
Visiting Mobile Web site...............
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Total............................... 766 191 na 5,320
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* Based upon the mean wages for clinicians (29-1062 family and general practitioners), clinical team members (31-
9092 medical assistants) and consumers (00-0000 all occupations), National Compensation Survey: Occupational
wages in the United States May 2010, ``U.S. Department of Labor, Bureau of Labor Statistics.''
Estimated Annual Costs to the Federal Government
The maximum cost to the Federal Government is estimated to be
$203,531 annually. Exhibit 3 shows the total and annualized cost by the
major cost components.
Exhibit 3--Estimated Total and Annualized Cost
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Cost component Total cost Annualized cost
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Project Development................. $146,175 $73,088
Data Collection Activities.......... 85,425 42,713
Data Processing and Analysis........ 65,375 32,688
Project Management.................. 47,588 23,794
Overhead............................ 62,500 31,250
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Total........................... 407,063 203,531
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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: January 17, 2012.
Carolyn M. Clancy,
Director.
[FR Doc. 2012-1402 Filed 1-25-12; 8:45 am]
BILLING CODE 4160-90-M