OMB Submission KSN User Feedback Survey Year 3_Yesenko

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0955-0003)

T ITLE OF INFORMATION COLLECTION: KSN Annual Feedback Survey Year 3 (2012-2013)

PURPOSE: The Knowledge Sharing Network (KSN), developed under the Health Information Technology Resource Center (HITRC) supports the Regional Extension Centers (RECs) in their charge to meaningfully use Electronic Health Records in offices, hospitals and primary care clinics across the United States. The KSN enables knowledge sharing and best practice and innovation development to further the common mission.  The work of the KSN is conducted through Communities of Practice (CoPs). Focused on issues of importance central to the success of the missions of the RECs, the CoPs strive to share and develop knowledge, ideas and resources.

The KSN environment includes the HITRC Portal, on-line discussion forums (WebEx), in-person meetings, CoP and other collaborative groups (e.g. task forces, and panels) and repository of shared resources (e.g. leading practices, lessons learned, tools, solution pages). All of these components aim to provide the resources necessary for collaboration and knowledge sharing of a geographically dispersed, time limited group of individuals across the ONC Programs.

With this project, ONC seeks to collect feedback from RECs on the KSN. The information collected from the survey will help evaluate how useful the KSN is for REC members, and whether participation in the collaborative groups supported by the KSN impacts its perceived value. The results from the survey will be used to determine how the KSN can be improved to better support members of RECs who participate and do not participate in the KSN’s collaborative groups.

DESCRIPTION OF RESPONDENTS: We are targeting 62 RECs based off of a contact list provided by ONC and CoP membership lists. The aggregate sample list contains 1,833 names and associated emails. Individuals were flagged based on KSN CoP participation status; currently participating, formerly participated, or never having participated. Assignments are based on whether the individuals currently or ever appeared on CoP attendance lists. We anticipate that some percentage of individuals will not have been appropriately designated. To address this there will be initial screening questions confirming employment with an REC and inquiring as to participation history with CoPs. Individuals who are not currently employed by RECs will be ineligible for the study. Individuals still members of RECs but not placed in the appropriate CoP participation designation will be reassigned for data analysis.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [X] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus Group [ ] Other: ______________________

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name: Mike Yesenko

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [X] No

2. If Yes, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [ ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [X] No

BURDEN HOURS

We estimate that responding to the survey will take, on average, about 15 minutes per person. Burden hours are based on an expectation of a 15% response rate for 15 minute instrument and 5% response rate of short survey non-response follow-up.

Category of Respondent	No. of Respondents	Participation Time	Burden Hours
Regional Extension Center staff	276	15 min	69
Regional Extension Center Staff	91	5 min	8
Totals	367		77

FEDERAL COST: The estimated annual cost to the Federal government is ____$100,000____.

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [X] Yes [ ] No

If the answer is yes, please provide a description of both below (or attach the sampling plan). If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

We have compiled a list of all currently known REC members with 1,833 names/emails. The breakdown by groups of the list is as follows:

• Current CoP members: 475 (26%);

• Former CoP members: 362 (20%); and

• Never participated CoP: 996 (54%).

As we cannot guarantee response or whether they are all current employees of RECs, we intend to sample the entire list.

Prior to survey administration, forty percent of each CoP status group will be assigned for non-response follow-up. Half of the non-response follow-up group will be assigned to complete the full survey over the phone. The other half of the non-response follow-up group will be assigned to complete a shortened version of the survey just assessing use of the KSN and role in the REC. At the conclusion of the study an analysis will be conducted to determine differences in responses between individuals who underwent non-response follow-up to those that did not.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[X] Web-based or other forms of Social Media

[X] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

Initial mode of survey implementation will be web with invitation and reminders via email. Non-response follow-up for sub-groups will be done by phone.

2. Will interviewers or facilitators be used? [X ] Yes [ ] No

Interviewers will be used for the non-response follow-up. The interviewers will use the Web survey to conduct the interview.

Attachments

1. KSN Annual Feedback Survey Year 3 (Web and phone for full survey non-response follow-up.

2. KSN Annual Feedback Survey Short Non-response Follow-up

3. Email Request and Reminders to take Web Survey

4. Answering Machine Message for non-response follow-up

5. REC Phone Interviewer Introduction for non-response follow-up

6. REC Feedback Interview FAQs.

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0990-0383. The time required to complete this information collection is estimated to average 4 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services, OS/OCIO/PRA, 200 Independence Ave., S.W., Suite 336-E, Washington D.C. 20201, Attention: PRA Reports Clearance Officer

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