Agency Information Collection Activities: Proposed Collection; Comment Request

 
CONTENT
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Federal Register / Vol. 85, No. 122 / Wednesday, June 24, 2020 / Notices
immediate inspection at the Federal
Reserve Bank(s) indicated below and at
the offices of the Board of Governors.
This information may also be obtained
on an expedited basis, upon request, by
contacting the appropriate Federal
Reserve Bank and from the Board’s
Freedom of Information Office at
https://www.federalreserve.gov/foia/
request.htm. Interested persons may
express their views in writing on the
standards enumerated in the BHC Act
(12 U.S.C. 1842(c)).
Comments regarding each of these
applications must be received at the
Reserve Bank indicated or the offices of
the Board of Governors, Ann E.
Misback, Secretary of the Board, 20th
Street and Constitution Avenue NW,
Washington DC 20551–0001, not later
than July 9, 2020.
A. Federal Reserve Bank of Chicago
(Colette A. Fried, Assistant Vice
President) 230 South LaSalle Street,
Chicago, Illinois 60690–1414:
1. Katz Acquisition Corporation, LLC,
Tampa, Florida; to become a bank
holding company by acquiring 100
percent of the voting shares of Camp
Grove Bancorp, Inc., and thereby
indirectly acquire Camp Grove State
Bank, both of Camp Grove, Illinois.
Board of Governors of the Federal Reserve
System, June 19, 2020.
Yao-Chin Chao,
Assistant Secretary of the Board.
[FR Doc. 2020–13633 Filed 6–23–20; 8:45 am]
BILLING CODE P
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: ‘‘Patient-
Centered Outcomes Research Clinical
Decision Support: Current State and
Future Directions.’’ This proposed
information collection was previously
published in the Federal Register on
March 25, 2020. AHRQ received no
comments from members of the public.
The purpose of this notice is to allow an
additional 30 days for public comment.
DATES
: Comments on this notice must be
received by 30 days after date of
publication of this notice.
ADDRESSES
: Written comments and
recommendations for the proposed
information collection should be sent
within 30 days of publication of this
notice to www.reginfo.gov/public/do/
PRAMain. Find this particular
information collection by selecting
‘‘Currently under 30-day Review—Open
for Public Comments’’ or by using the
search function.
FOR FURTHER INFORMATION CONTACT
:
Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427–1477, or by
email at doris.lefkowitz@AHRQ.hhs.gov.
SUPPLEMENTARY INFORMATION
:
Proposed Project
‘‘Patient-Centered Outcomes Research
Clinical Decision Support: Current State
and Future Directions’’
Research has shown that health care
quality in the U.S. varies significantly
and only half of adults receive evidence-
based, recommended care. Individuals
with multiple chronic conditions (42%
of adults) and older adults are at
particular risk for negative health
outcomes. Current evidence shows that
clinical decision support (CDS) systems
improve adherence to evidence-based
practices by analyzing patient data and
making appropriate information
available to the physician at the time
they need it. CDS systems are usually
electronic health record (EHR)-based,
encompassing tools like alerts, clinical
guidelines, patient reports and
dashboards, diagnostic support, and
workflow tools. These tools help reduce
clinical errors and allow for
customization to patient needs,
improving quality of care and patient
outcomes.
The AHRQ Patient-Centered (PC) CDS
Learning Network (PC CDS LN) defines
PC CDS as: ‘‘CDS that supports
individual patients and their approved
care givers and/or care teams in health-
related decisions and actions by
leveraging information from PCOR
findings and/or patient-specific
information (e.g., patient-generated
health data).’’ Through PC CDS, AHRQ
seeks to accelerate the movement of
patient-centered outcomes research
(PCOR) evidence into practice and to
make CDS more shareable, standards-
based, and publicly available.
Traditionally, CDS initiatives have
focused on provider-directed guidelines
and increasing the shareability of CDS
artifacts; however, PC CDS targets both
patients (and/or caregivers) and
providers.
AHRQ’s effort to support PC CDS has
included efforts such as the PC CDS LN,
CDS Connect, and other related grants
and contracts. In this project, AHRQ
seeks to conduct a comprehensive
evaluation to assess the impact of
AHRQ’s PCOR CDS Initiative (the
Initiative) on understanding of the
current state of PC CDS and to identify
gaps to guide AHRQ’s future research.
This research has the following goal:
To assess the accomplishments and
opportunities for the Initiative as a
whole, and each of its four individual
components: The PC CDS Learning
Network, CDS Connect, Quantifying
Efficiencies, and the U18 CDS Resource
Grants.
This study is being conducted by
AHRQ through its contractor, NORC at
the University of Chicago, pursuant to
AHRQ’s statutory authority to
disseminate government-funded
research relevant to comparative clinical
effectiveness research. 42 U.S.C. 299b-
37(a)–(c).
Method of Collection
To achieve these goals, the evaluation
team will use key informant interviews
and a web-based survey to gather
information about the programs from
stakeholders, contributors, and users of
the CDS Initiative programs.
Key Informant Interviews: The
evaluation team will conduct semi-
structured interviews with people
involved in the Initiative’s components,
including representatives from
academia, industry, health systems, and
government. Key informants will
include the following groups:
Leaders: Includes AHRQ project
officers, contractor’s senior staff, and
senior consultants to Initiative
components. Leaders are expected to
have set the direction of the components
or activities and to be familiar with the
activities, the processes of
implementation, and their outputs in
their entirety.
Contributors: Includes lead authors or
content developers for a product or
output of a component, and may overlap
with leaders. Examples of contributors
from the PC CDS LN include lead
authors of the Trust Framework, Opioid
Action Plan, or Patient Blogs; examples
from the CDS Connect include
individuals who contributed CDS
artifacts to the repository.
Participants: Includes individuals
who participated in workgroups of
either the PC CDS LN or CDS Connect,
or participated in the development of
one of the products.
Consumers: Includes individuals who
have used a product developed by the
Initiative, including artifacts found on
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the CDS Connect repository and the
CDS Connect Authoring Tool in
particular. Individuals will be identified
from interviews with leaders,
contributors, and participants, and
through literature review for authors
making references to Initiative products
(i.e., reports or artifacts).
AHRQ and the evaluation contractor
will create a list of eligible key
informants that reflect the appropriate
mix of roles and depth of experience to
ensure comprehensive evaluation. Key
informants will receive invitational
emails that explain the scope and allow
candidates to ask questions before
declining or accepting the invitation.
We will include clinical staff in our
sample of participants in the
Quantifying Efficiencies grant program,
the U18 grants and the two opioid-
related CDS projects. Involving staff at
clinical sites will also be critical to
understanding the value of PC CDS in
the context of provider workflows and
burdens.
Web Survey: The purpose of the web
survey is to understand more about who
the users of CDS Connect resources are,
their reasons for using the resources,
how they use these resources, and their
perceptions about their value. The CDS
Connect resources of interest include
the CDS Authoring Tool, artifacts in the
CDS Connect Repository and open-
source CDS Connect resources available
on Github, a platform for developing
and sharing software. Respondents will
be identified through a chain-referral
methodology. The first set of survey
invitations will be sent to a list of email
addresses of known contributors or
users of CDS Connect as well as a group
of potential users of CDS Connect. At
the end of the survey, each respondent
will be asked to provide names and
email addresses for up to four other
users of CDS Connect resources. After
the list of names from all referrals is
deduplicated, a survey invitation will be
sent to these referrals.
The survey instrument includes
multiple choice questions that capture
important data points about use of CDS
Connect resources, specifically the CDS
Authoring tool, GitHub resources, and
artifacts from the CDS Repository.
Respondents will only be presented
with more detailed questions about CDS
Connect resource usage based on their
responses to initial screening questions.
The survey will take ten minutes on
average to complete based on in-house
testing.
This mixed methods evaluation seeks
to answer the following research
questions about the Initiative as a
whole:
1. To what extent has the Initiative
promoted the dissemination and
implementation of PCOR findings
through sharable, standards-based, and
publicly available CDS and how?
2. What activities carried out through
each component (e.g., webinars,
workgroups, in-person meetings,
repositories, CDS artifacts and
development tools, final reports or
plans) were found to be most successful
in furthering the various goals of the
Initiative?
3. What do stakeholders perceive to
be the impacts of the Initiative to date,
including reflection on their own
involvement in it, and current or
potential achievements, such as the
development of a common definition of
PC CDS and growth of interest in and
capacity for developing these types of
CDS among stakeholders?
4. How does the Initiative address
federal policies for the dissemination
and implementation of evidence-based
research funded by the PCOR Trust
Fund, and how do they interact with
other federal policy initiatives designed
to promote widespread use,
interoperability and patient access to
information from EHRs with advanced
CDS.
5. What can AHRQ learn from the
Initiative that is relevant to other
initiatives aimed at disseminating and
implementing clinical evidence and
evidence-based practices? How can the
lessons learned here inform future
research, implementation, and
dissemination initiatives?
Information collected by the study
will inform strategies to promote the
adoption of PCOR evidence into
practice through CDS developed by
AHRQ and other Department of Health
and Human Services agencies, including
the Centers for Medicare & Medicaid
Services (CMS) and the Office of the
National Coordinator for Health IT, as
well as state and local governments and
private health care organizations.
Findings from the evaluation can help
identify and shape strategies to promote
more effective implementation of PCOR
CDS in order to accelerate the
movement of evidence into clinical
practice and support patient-centered
decision making by clinicians with their
patients.
Estimated Annual Respondent Burden
Key Informant Interviews. Key
informant interviews will be conducted
with up to 147 key informants across a
variety of organizations involved in
each component of the Initiative. NORC
will use one of 14 interview protocols
based on the component the key
informant is involved in and their role
in that component. As shown in Exhibit
1, the interview form names include the
type of role of the key informant in the
project. All interviews are expected to
last one hour. Some key informants may
serve multiple roles or work on multiple
projects. In these cases, the relevant
protocols will be combined and
streamlined so that the informant only
completes one interview. Some of the
key informant interviews for the sites or
Opioid-related grants may be conducted
during the course of site visits at the
implementation sites, either with
individuals or small groups of
respondents.
Web Survey. For the web survey, it is
estimated that 453 CDS Connect users
will respond to the 10-minute survey.
The total annual burden hours for the
key informant interviews and surveys is
estimated to be 224 hours as shown in
Exhibit 1.
E
XHIBIT
1—E
STIMATED
A
NNUALIZED
B
URDEN
H
OURS
Form name Number of
respondents Hours per
response Total burden
hours
PC CDS Learning Network—Leader ........................................................................................... 7 1 7
PC CDS Learning Network—Governance/Non-Executive Steering Committee ......................... 3 1 3
PC CDS Learning Network—Contributor .................................................................................... 8 1 8
CDS Connect—Leader ................................................................................................................ 5 1 5
CDS Connect—Contributor ......................................................................................................... 20 1 20
CDS Connect—Consumer/Patient .............................................................................................. 25 1 25
CDS Connect—Participant .......................................................................................................... 10 1 10
Quantifying Efficiencies—Leader ................................................................................................. 5 1 5
Quantifying Efficiencies—Informaticist ........................................................................................ 4 1 4
Quantifying Efficiencies—Clinician .............................................................................................. 8 1 8
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Federal Register / Vol. 85, No. 122 / Wednesday, June 24, 2020 / Notices
E
XHIBIT
1—E
STIMATED
A
NNUALIZED
B
URDEN
H
OURS
—Continued
Form name Number of
respondents Hours per
response Total burden
hours
PC CDS Projects—Site Leader ................................................................................................... 18 1 18
PC CDS Projects—Informaticist .................................................................................................. 10 1 10
PC CDS Projects—Clinician ........................................................................................................ 20 1 20
PC CDS Projects—Patient .......................................................................................................... 4 1 4
Web Survey of CDS Connect Users ........................................................................................... 453 .17 77
Total ...................................................................................................................................... 600 ........................ 224
Exhibit 2 shows the estimated annual
cost burden associated with the
respondents’ time to participate in this
information collection, which comes to
$14,371.85.
E
XHIBIT
2—E
STIMATED
A
NNUALIZED
C
OST
B
URDEN
Form name Number of
interviews* Total burden
hours
Average
hourly wage
rate**
Total cost
burden
PC CDS Learning Network—Leader ............................................................... 7 7
1
$59.54 $416.78
PC CDS Learning Network—Governance/Non-Executive Steering Com-
mittee ............................................................................................................ 3 3
1
59.54 178.62
PC CDS Learning Network—Contributor ........................................................ 8 8
1
59.54 476.33
CDS Connect—Leader .................................................................................... 5 5
1
59.54 297.71
CDS Connect—Contributor ............................................................................. 20 20
1
59.54 1,190.82
CDS Connect—Consumer ............................................................................... 25 25
1
59.54 1,488.53
CDS Connect—Participant .............................................................................. 10 10
1
59.54 595.41
Quantifying Efficiencies—Leader ..................................................................... 5 5
1
59.54 297.71
Quantifying Efficiencies—Informaticist ............................................................. 4 4
1
59.54 238.16
Quantifying Efficiencies—Clinician .................................................................. 8 8
2
101.43 811.46
PC CDS Projects—Site Leader ....................................................................... 18 18
1
59.54 1,071.74
PC CDS Projects—Informaticist ...................................................................... 10 10
1
59.54 595.40
PC CDS Projects—Clinician ............................................................................ 20 20
2
101.43 2,028.60
PC CDS Projects—Patient .............................................................................. 4 4
3
24.98 99.93
Web Survey of CDS Connect Users ............................................................... 453 77
1
59.54 4,584.66
Total .......................................................................................................... 600 224 ........................ 14,371.85
** Wage rates were calculated using the mean hourly wage from the U.S. Department of Labor, Bureau of Labor Statistics, May 2018 National
Occupational Employment and Wage Estimates for the United States, https://www.bls.gov/oes/current/oes_nat.htm.
1
Average rate for Computer Information and Research Scientists
2
Average rate for Physicians and Surgeons
3
Average rate for All Occupations
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’s 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 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: June 18, 2020.
Virginia L. Mackay-Smith,
Associate Director.
[FR Doc. 2020–13574 Filed 6–23–20; 8:45 am]
BILLING CODE 4160–90–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Community Living
Agency Information Collection
Activities; Submission for OMB
Review; Public Comment Request;
National Beneficiary Survey of State
Health Insurance Assistance Program
(SHIP) OMB# 0985–0057
AGENCY
: Administration for Community
Living, Department of Health and
Human Services (HHS).
ACTION
: Notice.
SUMMARY
: The Administration for
Community Living (ACL) is announcing
that the proposed collection of
information listed above has been
submitted to the Office of Management
and Budget (OMB) for review and
clearance as required under the
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