Health IT Tool Evaluation

Forms and Documents

Document Name	Status
Form Form #4 Discussion Groups Form and Instruction	New
Form Form #3 Usability Testing Form and Instruction	New
Form Form #2 Needs Assessment Form and Instruction	New
Form Form #1 Screening Questionnaire Form and Instruction	New
Supporting Statement Part B - Health IT Tool Evaluation 6-2-2011.docx Supporting Statement B	2011-06-06
Attachment A -- Healthcare Research and Quality Act of 1999.pdf Supplementary Document	2011-06-06
Attachment J -- Public Comment and AHRQs Response.docx Supplementary Document	2011-06-06
Attachment I -- Federal Register Notice.pdf Supplementary Document	2011-06-06
Attachment H -- Recruiting Communication Scheduling Protocol.docx Supplementary Document	2011-06-06
Attachment G -- Recruiting Communication Flyer.docx Supplementary Document	2011-06-06
Attachment F -- Recruiting Communication Request to Organizations.docx Supplementary Document	2011-06-06
Supporting Statement Part A - Health IT Tool Evaluation 6-2-2011.docx Supporting Statement A	2011-06-06

IC Document Collections

IC ID	Document Title	Status
198045	Discussion Groups Form and Instruction	New
198044	Usability Testing Form and Instruction	New
198043	Needs Assessment Form and Instruction	New
198042	Screening Questionnaire Form and Instruction	New

ICR Details

OMB Control No: 0935-0182	ICR Reference No: 201106-0935-004
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/AHRQ	Agency Tracking No:
Title: Health IT Tool Evaluation
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 without change	Conclusion Date: 08/11/2011
	Date Received in OIRA: 06/09/2011
Terms of Clearance: As discussed in the supporting documentation, the goals of this study are limited to gathering information that can be used by HHS to improve the Health IT Survey Compendium. The results of this study will not be published/reported or otherwise used to generate statistics that would inform policy decisions in other contexts.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2013	24 Months From Approved
Responses	220	0	0
Time Burden (Hours)	147	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Agency for Healthcare Research and Quality (AHRQ) is a lead Federal agency in developing and disseminating evidence and evidence-based tools on how health IT can improve health care quality, safety, efficiency, and effectiveness. In support of the health IT initiative, AHRQ developed the National Resource Center (NRC) for Health IT Web site. This site contains a range of information and evidence-based tools that support the health IT initiative's work and aims. With this project AHRQ is conducting an evaluation to assess whether these tools are reaching their intended audiences, are easy to use, and provide the information that users expect and need. The current project is an evaluation of one of the tools available on the NRC site: the Health IT Survey Compendium.

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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:
	76 FR 13412	03/11/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 30170	05/24/2011
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 4

IC Title	Form No.	Form Name
Screening Questionnaire	Form #1	Screening and Demographics Questionnaire
Needs Assessment	Form #2	Needs Assessment Interview Guide
Usability Testing	Form #3	Usability Testing Interview Guide
Discussion Groups	Form #4, Form #5	Discussion Groups Interview Guide for Users ,   Discussion Groups Interview Guide for Non-Users

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ICR Summary 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	220	0	0	220	0	0
Annual Time Burden (Hours)	147	0	0	147	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 new information collection request.

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Annual Cost to Federal Government: $205,821

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]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

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: 06/09/2011

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