[Federal Register Volume 65, Number 38 (Friday, February 25, 2000)]
[Notices]
[Pages 10095-10096]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-4521]


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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: (AHRQ), formerly known as the Agency for Health Care Policy and 
Research (AHCPR), HHS.

ACTION: Notice.

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SUMMARY: This notice announces the intention of the Agency for 
Healthcare Research and Quality (AHRQ) to request the Office of 
Management and Budget (OMB) to allow the proposed information 
collection project; ``Development and Implementation of National 
Guideline Clearinghouse Evaluation (NGC)''. In accordance with the 
Paperwork Reduction Act of 1995, Public Law 104-13 (44 U.S.C. 
3506(c)(2)(A)), AHRQ invites the public to comment on this proposed 
information collection.

DATE: Comments on this notice must be received by April 25, 2000.

ADDRESSES: Written comments should be submitted to: Cynthia McMichael, 
Reports Clearance Officer, AHRQ, 2101 East Jefferson Street, Suite 500, 
Rockville, MD 20852-4908.
    Comments submitted in response to this notice will be summarized 
and included in the request for OMB approval of the proposed 
information collection. All comments will become a matter of public 
record.
    In accordance with the above cited legislation, comments on the 
AHRQ information collection proposal are requested with regard to any 
of the following: (a) Whether the proposed collection of information is 
necessary for the proper performance of functions of the Agency, 
including whether the information will have practical utility; (b) the 
accuracy of the Agency's estimate of the burden (including hours and 
costs) of the proposed collection 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 on 
respondents, including the use of automated collection techniques or 
other forms of information technology.
    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: Cynthia D. McMichael, AHRQ Reports 
Clearance Officer, (301) 594-3132.

SUPPLEMENTARY INFORMATION:

Proposed Project

Development and Implementation of National Guideline Clearinghouse 
Evaluation (NGC)

    The NGC already reaches many individuals indicating its great 
potential to affect medical practice. In the nine months since it 
became available to the public, the NGC site has processed over 5 
million requests for guideline information, with an average user visit 
lasting seven minutes. Over the last six months, the ``hit volume'' 
(e.g., connection to the Internet site) has been fairly constant with 
approximately 36,000 per day. The majority of users are within the 
United States, but the site is also utilized globally, indicating the 
potential for far reaching effects. As the NGC audience continues to 
grow and the field of best practices develops, the Web site will only 
be effective if it keeps pace with the needs of it users. A small study 
conducted by the American Medical Association (AMA) to gauge NGC 
awareness and satisfaction with the site among their members provides 
the only data to date on how the NGC is currently perceived by uses. 
Although its conclusions were limited by a small sample size of 
physician respondents (e.g., n=44), the AMA survey suggested that 
several functions of the NGC could be improved. These findings support 
the need for a further, more comprehensive evaluation of the site's 
quality and usefulness in order for AHRQ to meet users' needs and to 
promote implementation of guidelines by health care professionals. The 
results of this type of evaluation will assist AHRQ and others to 
understand what user's want and need to utilize clinical guidelines in 
the provision of care. The timeliness and need for this evaluation 
effort is further underscored by the concurrent development of a 
customer satisfaction survey by the NGC Web site developer pursuant to 
its original contract in accordance with widely accepted management 
practices. This electronic survey, is being designed to capture NGC 
audience satisfaction with the interface and format of the Web site, 
which will complement this proposed evaluation of the content, quality, 
and usefulness of information.
    The NGC is intended to serve the needs of a diverse population of 
users. Not only are the user groups different, their expectations and 
uses of the NGC are unique. Moreover, no single sampling or data 
collection technique is efficient to capture the needed information 
from these groups. A survey that attempted to capture the perspectives 
of all groups would be long, complicated, and burdensome. Therefore, we 
propose using a three-tiered data collection scheme designed to get 
distinct types of information in a manner most useful to helping 
evaluate how well the Web site is serving its intended populations. The 
three proposed approaches are survey questionnaire, focus group 
discussions, and unstructured, informational discussions.
    Each will be applied to a subset of all users, as appropriate, to 
capture their unique opinions and best complement the overall data 
collection effort.

Data Confidentiality Provisions

    Although no information on race, income, sexual behavior and 
attitudes, religious beliefs, or other matters commonly considered 
private will be requested, the contractor responsible for conducting 
the study will perform in accordance with the requirements of the 
Agency's confidentiality statute, 42 USC 299c-3(c), to protect 
respondents' privacy and the confidentiality of data collected. All 
results will be reported without attributing responses to any 
individual source. Information gained for the purposes of this data 
collection will only be used for the purposes of this project.

Data Products

    The evaluation goals will be achieved through three types of data 
collection: (1) Written survey questionnaires, (2) focus groups, and 
(3) discussions with individuals working in health care who contribute 
to guideline development and use. Assignments of data collection modes 
to target audience groups are designed to reach the maximum number of 
respondents and the broadest range of groups. Participation will be 
minimally burdensome and is voluntary. Both qualitative and 
quantitative data will be collected to characterize the experiences and 
needs of users in a manner most likely to facilitate improvement 
activities by AHRQ.

[[Page 10096]]

    The project will benefit AHRQ, the medical community, policy 
makers, health service researchers, and ultimately patients in the 
following ways:
     AHRQ will be able to monitor how their current format and 
content are serving their intended audiences;
     AHRQ will be able to assess how the Clearinghouse is 
affecting future development of guidelines and their implementation in 
clinical practices;
     AHRQ will be able to use the evaluation results to refine 
the site, thereby making it more useful for the medical community and 
other professionals who use guidelines in care management;
     Individual clinicians will be better able to obtain timely 
guidance about the management of complex clinical problems;
     Federal, State, and private purchasers will be able to 
encourage contracted or prospective plans and providers to adopt 
clinical practices that are consistent with the best available 
standards of care; and,
     Public policy experts will be better able to obtain 
unbiased, evidence-based guidelines and information for decisionmaking 
and policy purposes.

Method of Collection

    Electronic mail will be used to transmit the written survey 
responses. The written survey will also be linked to the NGC Website. 
Users can complete the survey on-line, and their responses will be 
automatically submitted. By using e-mail and the Web link to target our 
audience we are ensuring that our respondents are Web-based users. This 
approach significantly reduces the burden to non-Web users who would be 
unable to contribute information useful to this data collection. 
Additionally, this use of information technology minimizes the burden 
on the targeted respondents by improving the ease in which they can 
submit their survey responses.

                                       Estimated Annual Respondent Burden
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                                                                Estimated time  Estimated total     Estimated
                 Annual number of respondents                  per  respondent   annual burden    annual cost to
                                                                  (in hours)         hours       the  Government
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1,359........................................................              .5              408         $249,993
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    The survey instrument is short and poses minimal burden on the time 
of respondents. Estimates of time required to complete the survey 
during the pilot phase range from 7 to 20 minutes. The annual hour 
burden calculation assumes each survey will last 15 minutes, therefore 
the total of annualized hourly costs to participants is estimated to be 
$30,040.

    Dated: February 16, 2000.
John M. Eisenberg,
Director.
[FR Doc. 00-4521 Filed 2-24-00; 8:45 am]
BILLING CODE 4160-90-M