[Federal Register Volume 76, Number 214 (Friday, November 4, 2011)]
[Notices]
[Pages 68464-68465]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-28580]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[30 Day-12-0234]


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 email to 
[email protected]. 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. 03/31/2013)--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 2012-2014 survey period. On July 13, 2010, a 
notice was published in the Federal Register (pages 39947-39948) which 
notified the public that the President's fiscal year 2011 budget 
requested Congress to consider a budget increase. It also mentioned 
that budget increases might be forthcoming from other sources. Funds 
have now been received from the Patient Protection and Affordable Care 
Act to significantly increase the survey sample size to produce state 
estimates for 34 states. The 2012 NAMCS will include an additional 
sample of over 15,600 physicians/providers. 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.
    Additionally, NAMCS data collection will transition to computerized 
data collection, so that induction interviews and patient record 
information will be entered into laptops that meet the government's 
security requirements. This effort will greatly reduce paperwork and 
will increase efficiency in data processing. Data collection 
activities, including questions asked, will be similar to current 
procedures.
    NAMCS will also add questions concerning the physician's use of 
complementary alternative medicine, conduct an asthma management 
supplement as well as a lookback module based on successful pretests in 
2011.
    Specifically, the information on the physician's utilization of 
complementary and alternative medicine (CAM) will be collected through 
additional questions added to the Physician Induction Interview. Adding 
these questions will allow the National Institutes of Health/National 
Center for Complementary and Alternative Medicine (NCCAM) to estimate 
the frequency of referrals and use of CAM by conventional providers, 
which has never been collected before on a large-scale national survey. 
Because the majority of providers who use CAM do so in conjunction with 
conventional medicine, it is important to find out the extent to which 
conventional providers are integrating CAM into their treatment plans.
    The asthma supplement will collect information on the clinical 
decisions providers make when confronted with a patient suffering from 
asthma. The lookback module will collect additional information from 
the 12 month period prior to a sampled visit, which will identify risk 
factors and clinical management of patients with conditions that put 
them at high risk for heart disease and stroke.
    A supplemental mail survey on the adoption and use of electronic 
health records (EHRs) 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

[[Page 68465]]

(ONC), Department of Health and Human Services, to measure progress 
toward goals for EHR adoption. The mail survey will collect information 
on characteristics of physician practices and the capabilities of EHRs 
used in those practices. Additional information on physician 
experiences with EHRs will continue to be collected through the 
Physician Workflow Supplement (PWS), which was added in 2011. The PWS 
collects information on experiences physicians are having with EHRs in 
terms of benefits and barriers, costs, attitudes, and impact of EHRs on 
their clinical workflow.
    In 2012, NAMCS plans on conducting a pretest for assessing the 
feasibility of developing nationally-representative estimates of 
payments for care in physician offices through the collection of 
Current Procedural Terminology (CPT) codes.
    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. NCHS is seeking OMB approval to 
extend this survey for an additional three years.
    There is no cost to respondents other than their time to 
participate. The total estimated annualized burden hours are 59,998.

                                        Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                                     Number of
         Type of form               Type of         Form name        Number of     responses per     Hours per
                                  respondent                        respondents     respondent       response
----------------------------------------------------------------------------------------------------------------
Core NAMCS Forms.............  Office-based      Physician                16,237               1           35/60
                                physicians/CHC    Induction
                                providers.        Interview
                                                  (NAMCS-1).
                               Community Health  Community                 2,008               1           20/60
                                Center            Health Center
                                Directors.        Induction
                                                  Interview
                                                  (NAMCS-201).
                               Office-based      Patient Record            3,248              30           14/60
                                physicians/CHC    form (NAMCS-
                                providers.        30).
                               Office/CHC staff  Pulling, re-             12,989              30            1/60
                                                  filing Patient
                                                  Record form
                                                  (NAMCS-30).
                               Office-based      Lookback module           5,683              15           10/60
                                physicians/CHC
                                providers.
                               Office-based      Asthma                   10,554               1           20/60
                                physicians/CHC    Supplement.
                                providers.
National Electronic Health     Office-based      NEHRS form.....           4,344               1           20/60
 Records Survey (NEHRS).        physicians.
Physician Workflow Survey      Office-based      PWS form.......           2,645               1           30/60
 (PWS).                         physicians.
Pretest NAMCS Forms..........  Office-based      Physician                    17               1           35/60
                                physicians.       Induction
                                                  Interview
                                                  (NAMCS-1).
                               Office-based      Patient Record               17              30           14/60
                                physicians.       form (NAMCS-
                                                  30).
----------------------------------------------------------------------------------------------------------------


    Dated: October 28, 2011.
Daniel Holcomb,
Reports Clearance Officer, Centers for Disease Control and Prevention.
[FR Doc. 2011-28580 Filed 11-3-11; 8:45 am]
BILLING CODE 4163-18-P