[Federal Register Volume 79, Number 19 (Wednesday, January 29, 2014)]
[Notices]
[Pages 4721-4722]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-01710]


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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: ``SelectMD 2.0 Clinician Choice Experiment.'' 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 March 31, 2014.

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

SUPPLEMENTARY INFORMATION: 

Proposed Project

SelectMD 2.0 Clinician Choice Experiment

    This study builds on previous research conducted as part of the 
Consumer Assessment of Healthcare Providers and Systems (CAHPS) program 
to explore new ways of integrating patient comments with other 
performance metrics in web-based quality reports for consumers to 
support their choice of physicians. Our previous consumer choice study, 
referred to as SelectMD 1.0 (approved by OMB on 3/8/10 under OMB 
Control Number 0935-0161), revealed important risks and opportunities 
of using patient comments that require additional research in order to 
develop effective guidance for report sponsors. Sponsors of performance 
reports in both the public and private sectors, including Federal 
agencies such as the Centers for Medicare & Medicaid Services (CMS), 
have indicated strong interest in receiving such guidance on strategies 
for effectively incorporating patient comments to increase consumers' 
use of public reports and to enhance their ability to interpret CAHPS 
and other performance measures.
    This follow-on study (referred to as SelectMD 2.0) will use an 
experimental design to test different methods of incorporating patient 
comments along with CAHPS survey results, the Healthcare Effectiveness 
Data and Information Set (HEDIS)-like measures of effective clinical 
treatments, and indicators of patient safety in web-based physician 
quality reports. The study will help AHRQ understand how people choose 
a doctor as their regular source of medical care and advice.
    The study has three stages. In the first stage, respondents will be 
asked some questions about their health care experiences and how they 
go about choosing a doctor. In the second stage the respondents will 
log onto an experimental Web site that has information about a 
fictitious set of doctors from which to choose. Respondents will be 
asked to use the information on the Web site to select a doctor who 
they think would be the best for their health care needs. Although they 
will not really be selecting a doctor, they will be asked to consider 
the choice as carefully as if they were making it for themselves. In 
the third stage, following their selection of a doctor, respondents 
will answer a set of questions about how they made their choice of 
doctor, how useful they found the Web site, and how confident they were 
in the choice they made.
    This research has the following goals:
    (1) To expand on the findings from AHRQ's previous choice 
experiment regarding how including narrative patient comments in web-
based physician quality reports influences the ways in which consumers 
learn about and select among clinicians, and
    (2) to assess whether and how patient comments can be presented in 
a way that promotes learning about physician quality and complements 
rather than detracts from standardized measures of quality.
    This study is being conducted by AHRQ through its contractors, RAND 
and Yale University, pursuant to AHRQ's statutory authority to conduct 
and support research on healthcare and on systems for the delivery of 
such care, including activities with respect to the quality, 
effectiveness, efficiency, appropriateness and value of healthcare 
services and with respect to quality measurement and improvement. 42 
U.S.C. 299a(a)(1) and (2).

Method of Collection

    To achieve the goals of this project the following data collections 
will be implemented over the three stages of the experiment:
    (1) Pre-Choice Survey--The purpose of this survey is to measure the 
respondents' previous exposure to information on health care provider 
performance and how they go about choosing a physician.
    (2) Experimental Web site--The purpose of this site is to present 
different combinations and displays of performance information that 
respondents will use to select a doctor. Respondents will be randomly 
assigned to one of eight different versions of the experimental 
SelectMD Web site that will vary according to the level of detail 
presented, how patient comments are grouped and labeled, whether 
respondents can choose which and how much information to review, and 
whether respondents have access to live telephone assistance when 
making their choices.
    (3) Post-Choice Survey--The purpose of the post-choice survey is to 
assess how respondents made their doctor selection, how useful the Web 
site version assigned to them was in helping

[[Page 4722]]

to make their choice, and how confident they are in the choice they 
made. Responses to the post-choice survey will provide insights into 
which of the experimental Web site versions are more effective in 
supporting consumer choice of doctors and why.
    The results of this study will be used to develop recommendations 
for helping consumers to better understand and more effectively use 
complex information to select health care providers, with the aim of 
making performance information less burdensome and more accessible, 
useful, and transparent to the public. In particular, the study 
findings will inform the design and content of the growing number of 
Web-based reports on provider performance incorporating patient 
comments along with other measures of quality. By adding to the 
evidence base on the types and combination of information that are most 
salient and useful to consumers in choosing among provider options, the 
study will make a significant contribution to improving current 
reporting initiatives. In addition, the simulated Web-based reports 
will be made available as examples for other report developers to use.

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated annualized burden hours for the 
respondents' time to participate in this experiment. The portion of the 
experiment involving respondent participation will take place over a 
period of approximately two months, once OMB approval has been 
received. All participants will complete the pre-choice survey, which 
is estimated to take 10 minutes. To assess the impact of their exposure 
to the SelectMD Web site, several questions on the initial pre-choice 
survey are replicated on the post-choice questionnaire. To reduce the 
likelihood that respondents will simply repeat the answers that they 
provided on the pre-choice survey (in an effort to appear consistent), 
it is essential to allow some time to elapse between the two surveys. 
Consequently, participants will not have access to the SelectMD Web 
site until one week after completing the pre-choice survey. Since we 
expect that about 5% of participants taking the pre-choice survey will 
not return to participate in the experiment one week later, the number 
of respondents initially required is 5% higher (1,575) than the full 
sample of 1,500 required for the experiment. We estimate based on our 
previous experience with the SelectMD 1.0 experiment that participants 
will require about 10 minutes to review the information on the Web site 
and select their preferred physician from the set of doctors available. 
The average time required to complete the post-choice survey is 
estimated to be 20 minutes. Consequently, respondents will average 
about 40 minutes completing all three phases of the study.
    Exhibit 2 shows the respondents' cost burden for their time to 
participate in this experiment. The total cost burden is estimated to 
be $22,297.

                                  Exhibit 1--Estimated Annualized Burden Hours
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                                                                     Number of       Hour per
                    Form name                        Number of     responses per  response  (min/  Total burden-
                                                    respondents     respondent          60)            hours
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Pre-Choice Survey...............................            1575               1           10/60             263
Time on Website (Choosing MD)...................            1500               1           10/60             250
Post-Choice Survey..............................            1500               1           20/60             500
                                                 ---------------------------------------------------------------
    Total Hours.................................           4,575              na              na           1,013
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                                   Exhibit 2--Estimated Annualized Cost Burden
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                                                                                      Average
                    Form name                        Number of     Total burden     hourly wage     Total cost
                                                    respondents        hours          rate *          burden
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Pre-Choice Survey...............................            1575             263          $22.01          $5,789
Time on Website (Choosing MD)...................            1500             250           22.01           5,503
Post-Choice Survey..............................            1500             500           22.01          11,005
                                                 ---------------------------------------------------------------
    Total Cost..................................  ..............  ..............  ..............          22,297
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* Based upon the national mean hourly wage for all occupations from the ``May 2012 Occupational Employment and
  Wage Estimates'', U.S. Department of Labor, Bureau of Labor Statistics.

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 health care research and 
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 16, 2014.
Richard Kronick,
AHRQ Director.
[FR Doc. 2014-01710 Filed 1-28-14; 8:45 am]
BILLING CODE 4160-90-P