Office for the Advancement of Telehealth Outcome Measures

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
HRSAresponse10-22-07.doc	Supplementary Document	Uploaded 2007-10-22	Available
FINALOATSupportingStatement2.doc	Supporting Statement A	Uploaded 2007-05-31	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
180666	Office for the Advancement of Telehealth Outcome Measures	Instruction	New

ICR Details

OMB Control No: 0915-0311	ICR Reference No: 200706-0915-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: Office for the Advancement of Telehealth Outcome Measures
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 10/23/2007
	Date Received in OIRA: 06/11/2007
Terms of Clearance: This ICR is approved consistent with HRSA memo of 10-22-07. Namely, HRSA will revise the instructions for further clarity; HRSA will collect information on a wider range of A1c results (and not just on the percentage of patients that meet the very high clinical standard of A1c<7.0%); and HRSA will collect process data (e.g. frequency of A1c testing) alongside outcome data (%A1c). This ICR is approved on the understanding that the results will not be publicly reported by individual grantees but only in the aggregate, across all grantees. Individual grantee performance data will be used to tailor technical assistance based on the grantee's particular needs. HRSA recognizes that health outcomes are determined by many factors, not simply the quality of care provided to patients, which is particularly true for at-risk populations like those served by these grantees. Poor health outcomes are not, in themselves, necessarily an indicator of poor performance. As such, the interpretation and use of these outcome data shall be undertaken with appropriate caution.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2010	36 Months From Approved
Responses	1,334	0	0
Time Burden (Hours)	9,338	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The HRSA Office for the Advancement of Telehealth is requesting OMB approval for telehealth outcomes measures of the telehealth grantees. Specifically, HRSA is asking for approval to use a performance measurement tool to collect data from grantees receiving funds under the Telehealth Network Grant Program. These data will be used to identify quality improvements, disparties in health care, health status, and clinical outcome measures.

---

Authorizing Statute(s): PL: Pub.L. 107 - 251 3301 Name of Law: Public Health Service Act, Health Care Safety Net Amendments
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	71 FR 75968	12/19/2006
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 28059	05/18/2007
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Office for the Advancement of Telehealth Outcome Measures

---

ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	1,334	0	0	0	0	1,334
Annual Time Burden (Hours)	9,338	0	0	0	0	9,338
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $25,200

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/11/2007

---