Supplemental Evidence and Data Request on Improving Rural Health Through Telehealth-Guided Provider-to-Provider Communication
| Published date | 02 March 2021 |
| Citation | 86 FR 12190 |
| Record Number | 2021-04187 |
| Section | Notices |
| Court | Agency For Healthcare Research And Quality |
Federal Register, Volume 86 Issue 39 (Tuesday, March 2, 2021)
[Federal Register Volume 86, Number 39 (Tuesday, March 2, 2021)]
[Notices]
[Pages 12190-12191]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-04187]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Agency for Healthcare Research and Quality
Supplemental Evidence and Data Request on Improving Rural Health
Through Telehealth-Guided Provider-to-Provider Communication
AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS.
ACTION: Request for supplemental evidence and data submissions.
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SUMMARY: The Agency for Healthcare Research and Quality (AHRQ) is
seeking scientific information submissions from the public. Scientific
information is being solicited to inform our review on Improving Rural
Health Through Telehealth-Guided Provider-to-Provider Communication,
which is currently being conducted by the AHRQ's Evidence-based
Practice Centers (EPC) Program. Access to published and unpublished
pertinent scientific information will improve the quality of this
review.
DATES: Submission Deadline on or before April 1, 2021.
ADDRESSES:
Email submissions: [email protected].
Print submissions:
Mailing Address: Center for Evidence and Practice Improvement, Agency
for Healthcare Research and Quality, ATTN: EPC SEADs Coordinator, 5600
Fishers Lane, Mail Stop 06E53A, Rockville, MD 20857
Shipping Address (FedEx, UPS, etc.): Center for Evidence and Practice
Improvement, Agency for Healthcare Research and Quality, ATTN: EPC
SEADs Coordinator, 5600 Fishers Lane, Mail Stop 06E77D, Rockville, MD
20857
FOR FURTHER INFORMATION CONTACT: Jenae Benns, Telephone: 301-427-1496
or Email: [email protected].
SUPPLEMENTARY INFORMATION: The Agency for Healthcare Research and
Quality has commissioned the Evidence-based Practice Centers (EPC)
Program to complete a review of the evidence for Improving Rural Health
Through Telehealth-Guided Provider-to-Provider Communication. AHRQ is
conducting this systematic review pursuant to Section 902 of the Public
Health Service Act, 42 U.S.C. 299a.
The EPC Program is dedicated to identifying as many studies as
possible that are relevant to the questions for each of its reviews. In
order to do so, we are supplementing the usual manual and electronic
database searches of the literature by requesting information from the
public (e.g., details of studies conducted). We are looking for studies
that report on Improving Rural Health Through Telehealth-Guided
Provider-to-Provider Communication, including those that describe
adverse events. Telehealth for this review of provider-to-provider
communication is defined as any telecommunications facilitated
interaction among, or support for, healthcare professionals designed to
improve access, quality of care, or health outcomes for rural patients
and populations. This includes a wide range of clinical applications
such as remote ICU management; consultations for inpatient and
outpatient care; and remote rounds or group education and case review
(e.g., Project ECHO, etc.). The entire research protocol is available
online at: https://effectivehealthcare.ahrq.gov/products/rural-telehealth/protocol.
This is to notify the public that the EPC Program would find the
following information on Improving Rural Health Through Telehealth-
Guided Provider-to-Provider Communication helpful:
[ssquf] A list of completed studies that your organization has
sponsored for this indication. In the list, please indicate whether
results are available on ClinicalTrials.gov along with the
ClinicalTrials.gov trial number.
[ssquf] For completed studies that do not have results on
ClinicalTrials.gov, a summary, including the following elements: Study
number, study period, design, methodology, indication and diagnosis,
proper use instructions, inclusion and exclusion criteria, primary and
secondary outcomes, baseline characteristics, number of patients
screened/eligible/enrolled/lost to follow-up/withdrawn/analyzed,
effectiveness/efficacy, and safety results.
[ssquf] A list of ongoing studies that your organization has
sponsored for this indication. In the list, please provide the
ClinicalTrials.gov trial number or, if the trial is not registered, the
protocol for the study including a study number, the study period,
design, methodology, indication and diagnosis, proper use instructions,
inclusion and exclusion criteria, and primary and secondary outcomes.
[ssquf] Description of whether the above studies constitute ALL
Phase II and above clinical trials sponsored by your organization for
this indication and an index outlining the relevant information in each
submitted file.
Your contribution is very beneficial to the Program. Materials
submitted must be publicly available or able to be made public.
Materials that are considered
[[Page 12191]]
confidential; marketing materials; study types not included in the
review; or information on indications not included in the review cannot
be used by the EPC Program. This is a voluntary request for
information, and all costs for complying with this request must be
borne by the submitter.
The draft of this review will be posted on AHRQ's EPC Program
website and available for public comment for a period of 4 weeks. If
you would like to be notified when the draft is posted, please sign up
for the email list at: https://www.effectivehealthcare.ahrq.gov/email-updates.
The systematic review will answer the following questions. This
information is provided as background. AHRQ is not requesting that the
public provide answers to these questions.
Key Questions (KQs)
KQ 1. What is the effectiveness of provider-to-provider telehealth for
rural patients?
a. What is the impact of provider-to-provider telehealth on rural
patient and population outcomes?
b. What is the impact of provider-to-provider telehealth on
healthcare providers?
c. What is the impact of provider-to-provider telehealth on private
and public (ex. CMS, TriCare, VA, etc.) payers?
d. What adverse events or unintended consequences are associated
with provider-to-provider telehealth for rural patients?
e. What are the methodological weaknesses of the identified
effectiveness studies of provider-to-provider telehealth for rural
patients and what improvements in study design (e.g., focus on relevant
comparisons and outcomes) might increase the impact of future research?
KQ 2. What is the effectiveness of implementation strategies for
provider-to-provider telehealth in rural areas?
a. What is the uptake of different types of provider-to-provider
telehealth in rural areas?
[cir] Who are the current patients, providers, and payers engaged
in provider-to-provider telehealth in rural areas?
[cir] What factors affect whether provider-to-provider telehealth
in rural areas can be sustained?
b. Which barriers and facilitators impact adoption and
implementation of provider-to-provider telehealth in rural areas?
c. Which strategies are effective in sustaining provider-to-
provider telehealth in rural areas?
d. What are the methodological weaknesses of the identified studies
of implementation and sustainability of provider-to-provider telehealth
in rural areas and what improvements in study design (e.g., focus on
relevant comparisons and outcomes) might increase the impact of future
research?
Populations, Interventions, Comparators, Outcomes, Settings
Population(s)
[cir] Rural individual patients, patient families/care partners,
and patient populations.
[cir] Healthcare providers (individuals and organizations) who
provide health care services to rural patients or populations.
Providers include any profession or occupation providing
formal, paid services.
Family or informal care partners are not considered
providers.
[cir] Payers who pay for healthcare services for rural patients or
populations.
Interventions
[cir] Provider-to-provider telehealth defined as: Any
telecommunications facilitated interaction among, or support for,
healthcare professionals designed to improve access, quality of care,
or health outcomes for rural patients and populations.
Comparators
[cir] KQ1: Other telehealth facilitated care (not provider-to-
provider), usual (in-person) provider-to-provider supports, no
interaction or no care.
[cir] KQ2: Different strategies for dissemination, implementation,
or spread; no strategies; time periods prior to implementation.
Outcomes
[cir] KQ1: Clinical outcomes for the identified conditions
(patient-reported outcomes, mortality, morbidity, such as function,
illness recovery, infection); Economic outcomes such as return on
investment, cost, volume of visits, and resource use, including length
of stay and readmissions; Intermediate Outcomes; Patient satisfaction,
behavior (such as care-seeking and compliance), and decisions such as
completion of treatment, or satisfaction with less travel to access
healthcare; Provider satisfaction, behavior, and decisions such as
choice of treatment or antibiotic stewardship; Access measures and
indicators including but not limited to time to diagnosis or time to
treatment.
[cir] KQ2: Indicators and measures of uptake (e.g., rates of use,
timing to implementation) and characteristics of users; categories and
descriptors of barriers and facilitators; categories and descriptors of
strategies.
Settings
[cir] Outpatient (primary care and specialty care), inpatient,
prehospital and emergency care, post-acute and long-term care.
[cir] Civilian, Veterans Administration, or military.
[cir] Health care and non-healthcare settings where health services
are delivered including in the home.
[cir] U.S. relevant settings [Note that studies from countries with
significantly different healthcare systems and fewer resources (e.g.,
low-income countries) are excluded.]
Dated: February 24, 2021.
Marquita Cullom,
Associate Director.
[FR Doc. 2021-04187 Filed 3-1-21; 8:45 am]
BILLING CODE 4160-90-P
