[Federal Register Volume 73, Number 34 (Wednesday, February 20, 2008)]
[Notices]
[Pages 9334-9335]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 08-737]


-----------------------------------------------------------------------

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.

-----------------------------------------------------------------------

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: Technical Assistance for Health IT and Health Information 
Exchange in Medicaid and SCHIP. In accordance with the Paperwork 
Reduction Act of 1995, 44 U.S.C. 3506(c)(2)(A), AHRQ invites the public 
to comment on this proposed information collection.

DATES: Comments on this notice must be received by April 21, 2008.

ADDRESSES: Written comments should be submitted to: Doris Lefkowitz, 
Reports Clearance Officer, AHRQ, by e-mail at 
[email protected].
    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

``Technical Assistance for Health IT and Health Information Exchange in 
Medicaid and SCHIP''

    AHRQ proposed a three year project to (1) assess the challenges 
facing Medicaid and State Children's Health Insurance Programs (SCHIP) 
agencies nationwide as they plan and implement health information 
technology (health IT) and health information exchange (HIE) programs 
and (2) provide the agencies with technical assistance to help them 
overcome these challenges. Health IT refers to the set of electronic 
tools and methods used for managing information about the health and 
health care of individuals, groups of individuals, and communities. HIE 
refers to organized efforts at the local, state, or regional levels to 
establish the necessary policy, business, operating, and technical 
mechanisms and structures that allow, support, and promote the exchange 
of health care information electronically across organizations. Health 
IT and HIE hold great promise for improving the quality and efficiency 
of health care in the United States. Medicaid and SCHIP agencies, which 
receive federal and state funding, serve the most medically and 
financially vulnerable populations. More than sixty percent of Medicaid 
beneficiaries have one or more chronic or disabling diseases. In 
addition, Medicaid and SCHIP beneficiaries frequently experience gaps 
in eligibility for benefits that cause beneficiaries to seek care from 
multiple settings, which compromises the accuracy and completeness of 
their health care records. These populations have much to gain from the 
coordination of care that can be realized from the adoption of health 
IT and HIE. Furthermore, as the largest health care purchaser in the 
United States, Medicaid can influence the adoption of health IT and HIE 
by providers of care. However, Medicaid and SCHIP agencies face 
considerable challenges in the implementation of health IT and HIE 
(Alfreds ST, Tutty M, Savageau JA, Young S. Himmelstein J (2006-2007). 
``Clinical Health Information Technologies and the Role of Medicaid.'' 
Health Care Financing Review Vol. 28, No. 2, pp. 11-20.).
    A needs assessment of the Medicaid and SCHIP agencies in all fifty 
six states and territories, including the District of Columbia, will be 
conducted to gauge the need for technical assistance. The needs 
assessment will be updated in the second year of the project to assure 
that the program of technical assistance that is developed will be of 
maximum utility to the Medicaid and SCHIP agencies.
    AHRQ will develop and provide a wide range of technical assistance

[[Page 9335]]

through workshops and web-based seminars to assist Medicaid and SCHIP 
agencies to adopt, implement and evaluate health IT and HIE to improve 
the quality of care for Medicaid and SCHIP beneficiaries. Based on the 
results of the needs assessment, workshops and web-based seminars, AHRQ 
will develop additional tools and resources, such as printed technical 
materials, to further facilitate the adoption of health IT and HIE 
among Medicaid and SCHIP agencies.

Method of Collection

    The needs assessments will be conducted by telephone or in-person 
interviews with the directors of each Medicaid and SCHIP agency or with 
the persons designated by the director as most knowledgeable about 
their IT systems and planned or current health IT or HIE programs. The 
content of the needs assessment will be the same whether it is 
conducted by telephone or in person, and will be pre-populated to the 
extent possible with information gathered from other sources to reduce 
the burden on respondents, who can then simply verify that the 
information is correct. Workshop and seminar participants will be asked 
to complete a short evaluation of the material presented.

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated annualized burden for this three-year 
project. The needs assessment will be conducted with an average of 
thirty agencies per year and will require approximately four hours and 
ten minutes per agency. Approximately seven workshops will be conducted 
each year with five agencies participating in each. The workshop 
evaluations will take approximately fifty minutes to complete. An 
average of ten web-based seminars will be conducted each year with 
twenty-five agencies participating in each. The seminar evaluations 
will take approximately twenty-five minutes to complete. The total 
annual burden for the respondents to provide the requested information 
is 260 hours.
    Exhibit 2 shows the estimated annualized cost burden to the 
respondents for their time to provide the requested information. The 
total annualized cost burden is estimated to be $10,506.

                                     Exhibit 1.--Estimated Annualized Burden
----------------------------------------------------------------------------------------------------------------
                                                     Number of       Number of    Average burden
                 Data collection                    respondents    responses per     hours per     Total burden
                                                    (agencies)      respondent       response          hours
----------------------------------------------------------------------------------------------------------------
Needs Assessment................................              30               1          410/60             125
Workshop evaluations............................               5               7           50/60              30
 
Web-based seminar evaluations...................              25              10           25/60             105
                                                 ---------------------------------------------------------------
    Total.......................................              60              na              na             260
----------------------------------------------------------------------------------------------------------------


                                  Exhibit 2.--Estimated Annualized Cost Burden
----------------------------------------------------------------------------------------------------------------
                                                     Number of
                    Form name                       respondents    Total burden     Hourly wage     Total cost
                                                    (agencies)         hours           rate           burden
----------------------------------------------------------------------------------------------------------------
Needs Assessment................................              30             125           40.41          $5,051
Workshop evaluations............................               5              30           40.41           1,212
Web-based seminar evaluations...................              25             105           40.41           4,243
                                                 ---------------------------------------------------------------
    Total.......................................              60             260  ..............          10,506
----------------------------------------------------------------------------------------------------------------
* Based upon the mean hourly wage estimate for NAICS 999000--Federal, State, and Local Government (OES
  designation) occupation 11-1021 General and Operations Managers, Department of Labor, Bureau of Labor
  Statistics.

Estimated Annual Costs to the Federal Government

    The projected total cost to the Federal Government for this project 
is $2,990,592 over a three-year period. The projected annual average 
cost is $996,864. The projected annual cost to design and implement the 
needs assessment is $180,799. The projected annual cost to develop and 
implement with workshops is $271,254. The projected annual cost to 
develop and implement the seminars is $98,187. The projected annual 
cost to analyze the data and report findings is $132,005. The projected 
annual administrative cost is $41,973, and the projected annual cost 
for other technical assistance support is $272,645.

Request for Comments

    In accordance with the above-cited Paperwork Reduction Act 
legislation, 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 health care research and health care 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 to be collected; and (d) ways to minimize the burden of the 
collection of information on he 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: February 8, 2008.
Carolyn M. Clancy, MD
Director
[FR Doc. 08-737 Filed 2-19-08; 8:45 am]
BILLING CODE 4160-90-M