[Federal Register Volume 84, Number 156 (Tuesday, August 13, 2019)]
[Notices]
[Pages 40065-40066]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-17287]



[[Page 40065]]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[30Day-19-0976]


Agency Forms Undergoing Paperwork Reduction Act Review

    In accordance with the Paperwork Reduction Act of 1995, the Centers 
for Disease Control and Prevention (CDC) has submitted the information 
collection request titled Million Hearts Hypertension Control Challenge 
to the Office of Management and Budget (OMB) for review and approval. 
CDC previously published a ``Proposed Data Collection Submitted for 
Public Comment and Recommendations'' notice on December 12, 2018 to 
obtain comments from the public and affected agencies. CDC received two 
comments. We thank the respondents for these comments. This notice 
serves to allow an additional 30 days for public and affected agency 
comments.
    CDC will accept all comments for this proposed information 
collection project. The Office of Management and Budget is particularly 
interested in comments that:
    (a) Evaluate whether the proposed collection of information is 
necessary for the proper performance of the functions of the agency, 
including whether the information will have practical utility;
    (b) Evaluate the accuracy of the agencies estimate of the burden of 
the proposed collection of information, including the validity of the 
methodology and assumptions used;
    (c) Enhance the quality, utility, and clarity of the information to 
be collected;
    (d) Minimize the burden of the collection of information on those 
who are to respond, including, through the use of appropriate 
automated, electronic, mechanical, or other technological collection 
techniques or other forms of information technology, e.g., permitting 
electronic submission of responses; and
    (e) Assess information collection costs.
    To request additional information on the proposed project or to 
obtain a copy of the information collection plan and instruments, call 
(404) 639-7570 or send an email to [email protected]. Direct written comments 
and/or suggestions regarding the items contained in this notice to the 
Attention: CDC Desk Officer, Office of Management and Budget, 725 17th 
Street NW, Washington, DC 20503 or by fax to (202) 395-5806. Provide 
written comments within 30 days of notice publication.

Proposed Project

    Million Hearts Hypertension Control Challenge (OMB Control Number 
0920-0976, Expiration 12/31/2019)--Revision--National Center for 
Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for 
Disease Control and Prevention (CDC).

Background and Brief Description

    Cardiovascular disease is a leading cause of death for men and 
women in the United States, among the most costly health problems 
facing our nation today, and among the most preventable. Heart disease 
and stroke also contribute significantly to disability. High blood 
pressure, also known as hypertension, is one of the leading causes of 
heart disease and stroke. Currently, about 78 million American adults 
have high blood pressure but only about half (48%) have adequately 
controlled blood pressure. The costs of hypertension are estimated at 
$48.9 billion annually in direct medical costs.
    In September 2011, CDC launched the Million Hearts initiative to 
prevent one million heart attacks and strokes by 2017. In January 2018, 
CDC launched Million Hearts 2022 to continue to prevent one million 
heart attacks, strokes, and related health conditions. In order to 
achieve this goal, at least 10 million more Americans must have their 
blood pressure under control. Million Hearts is working to reach this 
goal through the promotion of clinical practices that are effective in 
increasing blood pressure control among patient populations. There is 
scientific evidence that provides general guidance on the types of 
system-based changes to clinical practice that can improve patient 
blood pressure control, but additional information is needed to fully 
understand implementation practices so that they can be shared and 
promoted.
    In 2013, CDC launched the Million Hearts Hypertension Control 
Challenge, authorized by Public Law 111-358, the America Creating 
Opportunities to Meaningfully Promote Excellence in Technology, 
Education and Science Reauthorization Act of 2010 (COMPETES Act). The 
Challenge is designed to help CDC (1) identify clinical practices and 
health systems that have been successful in achieving high rates of 
hypertension control, and (2) develop models for dissemination. The 
Challenge is open to single practice providers, group practice 
providers, and healthcare systems. Providers whose hypertensive 
population achieves exemplary levels of hypertension control are 
recognized as Million Hearts Hypertension Control Champions.
    Interested clinicians or practices complete a web-based application 
form which collects the minimum amount of data needed to demonstrate 
hypertension control among their adult patients, including: (a) Two 
point-in-time measures of the clinical hypertension control rate for 
the patient population, (b) the size of the clinic population served, 
(c) a brief description of the characteristics of the patient 
population served and geographic location, and (d) a description of the 
sustainable systems and strategies adopted to achieve and maintain 
hypertension control rates. The estimated burden for completing the 
application form is 30 minutes. CDC scientists or contractors review 
each application form and rank applications by reported hypertension 
control rate.
    In the second phase of assessment, applicants with the highest 
preliminary scores are asked to participate in a two-hour data 
verification and validation process. The applicant reviews the 
application form with a reviewer, describes how information was 
obtained from the providers' (or practices') electronic records, chart 
reviews, or other sources, and reviews the methodology used to 
calculate the reported hypertension control rate. Data verification and 
validation is conducted to ensure that all applicants meet eligibility 
criteria and assure accuracy of their reported hypertension control 
rate according to a standardized method. Applicants must have achieved 
a hypertension control rate of at least 80% among their adult patients 
aged 18-85 years with hypertension.
    Up to 35 finalists who pass the data verification and background 
check are selected as Champions. Several Champions participate in a 
one-hour, semi-structured interview and provide detailed information 
about the patient population served, the geographic region served, and 
the strategies employed by the practice or health system to achieve 
exemplary rates of hypertension control, including barriers and 
facilitators for those strategies. Based on the information collected 
for Challenges in 2013 through 2018, CDC recognized a total of 101 
public and private health care practices and systems as Million 
Hearts[supreg] Hypertension Control Champions. The Champions are 
announced roughly annually, approximately six months after the 
Challenge application period ends. The current OMB approval for 
information collection expires December 31, 2019.

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    CDC plans to conduct the Million Hearts Hypertension Control 
Challenge annually through 2022. The 2020 Challenge is planned to 
launch in February 2020, coinciding with American Heart Month. The 
application period will be open for approximately 45-60 days, with 
recognition of the 2020 Champions in the fall of 2020. A similar 
calendar year schedule is planned for 2021 and 2022. Revision for 2020, 
2021, and 2022 includes a reduction in the estimated number of 
respondents. During the period of this revision request, on an annual 
basis, CDC estimates that information will be collected from up to 200 
applicants using the application form, at most 40 data verifications, 
and at most 35 semi-structured interviews. There is an overall 
reduction in estimated annualized burden hours.
    The overall goal of the Million Hearts initiative is to prevent one 
million heart attacks and strokes, and controlling hypertension is one 
focus of the initiative. CDC will use the information collected through 
the Million Hearts Hypertension Control Challenge to increase 
widespread attention to hypertension at the clinical practice level, 
improve understanding of successful and sustainable implementation 
strategies at the practice or health system level, bring visibility to 
organizations that invest in hypertension control, and motivate 
individual practices to strengthen their hypertension control efforts. 
Information collected through the Million Hearts Hypertension Control 
Challenge will link success in clinical outcomes of hypertension 
control with information about strategies that can be used to achieve 
similar favorable outcomes so that the strategies can be replicated by 
other providers and health care systems.
    OMB approval is requested for three years. Participation is 
voluntary. The total estimated annualized burden hours are 215. There 
are no costs to the respondents other than their time.

                                        Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                                                      Average
                                                                     Number of       Number of      burden per
          Type of respondents                   Form name           respondents    responses per   response  (in
                                                                                    respondent          hr)
----------------------------------------------------------------------------------------------------------------
Clinicians, practices, and healthcare   Million Hearts[supreg]               200               1           30/60
 systems.                                Hypertension Control
                                         Champion Application
                                         form.
Finalists.............................  Data Verification Form..              40               1               2
Champions.............................  Semi-structured                       35               1               1
                                         interview guide.
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Jeffrey M. Zirger,
Lead, Information Collection Review Office, Office of Scientific 
Integrity, Office of Science, Centers for Disease Control and 
Prevention.
[FR Doc. 2019-17287 Filed 8-12-19; 8:45 am]
 BILLING CODE 4163-18-P