[Federal Register Volume 76, Number 29 (Friday, February 11, 2011)]
[Pages 7858-7859]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-3083]



Centers for Disease Control and Prevention


Agency Forms Undergoing Paperwork Reduction Act Review

    The Centers for Disease Control and Prevention (CDC) publishes a 
list of information collection requests under review by the Office of 
Management and Budget (OMB) in compliance with the Paperwork Reduction 
Act (44 U.S.C. Chapter 35). To request a copy of these requests, call 
the CDC Reports Clearance Officer at (404) 639-5960 or send an e-mail 
to omb@cdc.gov. Send written comments to CDC Desk Officer, Office of 
Management and Budget, Washington, DC or by fax to (202) 395-5806. 
Written comments should be received within 30 days of this notice.

Proposed Project

    National Ambulatory Medical Care Survey (NAMCS) (OMB No. 0920-0234 
exp. 07/31/2012)--Revision--National Center for Health Statistics 
(NCHS), Centers for Disease Control and Prevention (CDC).

Background and Brief Description

    Section 306 of the Public Health Service (PHS) Act (42 U.S.C. 
242k), as amended, authorizes that the Secretary of Health and Human 
Services (DHHS), acting through NCHS, shall collect statistics on the 
utilization of health care provided by nonfederal office-based 
physicians in the United States. This revision is to notify the public 
of significant changes proposed for NAMCS for the 2011-2013 survey 
period. A three-year clearance is requested.
    NAMCS was conducted annually from 1973 to 1981, again in 1985, and 
resumed as an annual survey in 1989. The purpose of NAMCS, a voluntary 
survey, is to meet the needs and demands for statistical information 
about the provision of ambulatory medical care services in the United 
States. Ambulatory services are rendered in a wide variety of settings, 
including physician offices and hospital outpatient and emergency 
departments. The NAMCS target universe consists of all office visits 
made by ambulatory patients to non-Federal office-based physicians 
(excluding those in the specialties of anesthesiology, radiology, and 
pathology) who are engaged in direct patient care. In 2006, physicians 
and mid-level providers (i.e., nurse practitioners, physician 
assistants, and nurse midwives) practicing in community health centers 
(CHCs) were added to the NAMCS sample, and these data will continue to 
be collected. NAMCS provides a range of baseline data on the 
characteristics of the users and providers of ambulatory medical care. 
Data collected include the patients' demographic characteristics, 
reason(s) for visit, provider diagnoses, diagnostic services, 
medications, and visit disposition.
    The President's fiscal year 2011 budget requests that Congress 
consider a budget increase for this survey for 2011. If the budget 
increase is approved by Congress, an increase in the sample size of 
approximately 1,000 physicians and 30,000 visit records is requested. 
NCHS is also increasing the sample by 500 physicians funded through the 
Patient Protection and Affordable Care Act (ACT) of 2010. Currently 
NAMCS produces national and regional estimates. These increases will 
greatly improve the ability to track providers' practice patterns, 
including their adoption and meaningful use of health information 
technology (HIT).
    A supplemental mail survey on the adoption and use of electronic 
medical records (EMRs) in physician offices was added to NAMCS in 2008, 
and will continue. These data were requested by the Office of the 
National Coordinator for Health Information Technology (ONC), 
Department of Health and Human Services, to measure progress toward 
goals for EMR adoption. The mail survey will collect information on 
characteristics of physician practices and the capabilities of EMRs 
used in those practices. To complement the EMR mail survey, NCHS plans 
to introduce a provider-based mail survey to assess physician workflow 
before and after EMR implementation. The EMR workflow mail survey is 
also sponsored by ONC and will evaluate the progress of meeting the 
President's goal for most Americans to have access to an interoperable 
electronic health record by 2014.
    Scheduled to begin in 2012, a proposed asthma supplement will be 
administered to primary care physicians, physicians likely to see 
asthma patients, and all CHC providers. This supplement will provide a 
more accurate picture of the uptake and implementation of specific 
asthma management guidelines. Also beginning in 2012, questions are 
being added to the NAMCS induction form to collect information on the 
frequency of referrals and use of complementary and alternative 
medicine (CAM) by conventional providers. These questions will show the 
extent to which conventional providers are integrating CAM into their 
treatment plans.
    In 2011, NAMCS will include an additional sample of 300 physicians 
to pretest the asthma supplement, CAM questions, and computerized 
assisted interviewing instruments that will mimic current NAMCS forms. 
If the pretest is successful, NCHS will add the new CAM items, asthma 
supplement, and computerized instruments for data collection beginning 
in 2012.
    Users of NAMCS data include, but are not limited to, Congressional 
offices, Federal agencies, State and local governments, schools of 
public health, colleges and universities, private industry, nonprofit 
foundations, professional associations, clinicians, researchers, 
administrators, and health planners.
    There is no cost to respondents other than their time to 
participate. The total estimated annualized burden hours are 12,179.

                                        Estimated Annualized Burden Hours
                                                                                     Number of
         Type of respondent                   Form name              Number of     responses per     Hours per
                                                                    respondents     respondent       response
    Office-based physicians/CHC      Physician Induction                   5,012               1           28/60
     providers.                       Interview (NAMCS-1).
    Community Health Center          Community Health Center                 104               1           20/60
     Directors.                       Induction Interview (NAMCS-

[[Page 7859]]

    Office-based physicians/CHC      Patient Record form (NAMCS-           1,017              30           11/60
     providers/staff.                 30).
    Office/CHC staff...............  Pulling, re-filing Patient              893              30            1/60
                                      Record form (NAMCS-30).
    Office-based physicians/CHC      Asthma Supplement..........             669               1           15/60
    Office-based physicians........  EMR/EHR Mail Survey........           5,460               1           20/60
    Office-based physicians........  Physician Workflow Survey..           2,982               1           20/60
Pretest NAMCS forms:
    Office-based physicians........  Physician Induction                     100               1           35/60
                                      Interview (NAMCS-1).
    Office-based physicians........  Asthma Supplement..........             100               1           15/60
    Office-based physicians/staff..  Patient Record form (NAMCS-             100              30           14/60

    Dated: February 7, 2011.
Carol E. Walker,
Acting Reports Clearance Officer, Centers for Disease Control and 
[FR Doc. 2011-3083 Filed 2-10-11; 8:45 am]