Overcoming Barriers to Expanded Health Information Exchange (HIE) Participation in Indiana

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Form #3 Telephone Follow-up Interview	Form and Instruction	New	Available
Form Form #2 Web-based Questionnaire	Form and Instruction	New	Available
Form Form #1 Screener	Form and Instruction	New	Available
Responses to OMB 6-10-2009.doc	Supplementary Document	Uploaded 2009-07-08	Available
Attachment E -- Phone Interview Guide 7-7-2009.doc	Supplementary Document	Uploaded 2009-07-08	Available
Attachment D -- Communication Packet 6-8-2009.doc	Supplementary Document	Uploaded 2009-07-08	Available
Attachment C -- Screener script 6-8-2009.doc	Supplementary Document	Uploaded 2009-07-08	Available
Supporting Statement Part B--Overcoming Barriers to HIE 06-10-2009.doc	Supporting Statement B	Uploaded 2009-07-08	Available
Supporting Statement Part A--Overcoming Barriers to HIE 06-08-10.doc	Supporting Statement A	Uploaded 2009-07-08	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
187573	Telephone Follow-up Interview	Form and Instruction	New
187572	Web-based Questionnaire	Form and Instruction	New
187571	Screener	Form and Instruction	New

ICR Details

OMB Control No: 0935-0150	ICR Reference No: 200812-0935-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/AHRQ	Agency Tracking No:
Title: Overcoming Barriers to Expanded Health Information Exchange (HIE) Participation in Indiana
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 07/13/2009
	Date Received in OIRA: 12/17/2008
Terms of Clearance: This ICR is approved for 18 months consistent with revised supporting statements and instruments. To reduce burden on respondents and maximize the strengths of qualitative methods, AHRQ has agreed to streamline the questionnaire and interviews into a single, more in-depth interview that will elicit richer, more nuanced information from respondents (revised attachment E).

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2011	12 Months From Approved
Responses	380	0	0
Time Burden (Hours)	66	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: AHRQ, through its contractor, the Regenstrief Institute at Indiana University, proposes to assess the barriers to participation in health information exchange (HIE) in Indiana. The Regenstrief Institute will use its experience to date working with a variety of organizations to establish specific barriers to engagement in HIE cited by stakeholders, define the barriers and evaluate them. The Regenstrief Institute will develop and implement a questionnaire and survey process to identify barriers that may exist throughout the State of Indiana to participation in the Indiana Network of Patient Care (INPC). The INPC is a local health information infrastructure that includes information from five major hospital systems (fifteen separate hospitals), the county and State public health departments, and Indiana Medicaid and RxHub. The INPC began operation seven years ago and is one of the first examples of a local health information infrastructure.

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Authorizing Statute(s): US Code: 42 USC 299 Name of Law: Healthcare Research and Quality Act of 1999
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 32711	06/10/2008
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 74721	12/09/2008
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Screener	Form #1	Screener
Web-based Questionnaire	Form #2	Web-based Questionnaire
Telephone Follow-up Interview	Form #3	Telephone Follow-up Interview

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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	380	0	0	380	0	0
Annual Time Burden (Hours)	66	0	0	66	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This is a request for a new information collection.

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Annual Cost to Federal Government: $120,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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: 12/17/2008

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