Physician Advance Letter template FINAL 10 15 10

	DEPARTMENT OF HEALTH & HUMAN SERVICES	Office of the Secretary
		Office of the National Coordinator for Health Information Technology Washington, D.C. 20201

[COMPANY]

[ADDRESS]

[CITY], [STATE] [ZIP]

November 17, 2010

Dear [ttl] [LAST_NAME]:

The U.S. Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology (ONC) is conducting a study to better understand the likely role that the Health Information Technology for Economic and Clinical Health (HITECH) Act may play in fostering patient-centered medical care. The goal of the research is to assess patients’ experiences and perceptions of the delivery of health care services by primary care providers who are in varying stages of adopting and using electronic health records.

ONC has contracted with Mathematica Policy Research, an independent research company, to conduct a survey and focus groups with patients from 84 randomly selected primary care practices in four states. Your practice was selected at random to represent other primary care practices in your state. A Mathematica representative will call you in the coming week to describe the study in more detail, answer any questions you may have, and request your practice’s participation. Practices that agree to participate in the study will receive $100.

Participation will involve allowing a Mathematica representative to visit your practice for one to two days, talk with patients in the waiting room about the study, and invite them to either complete a 15-minute self-administered questionnaire or to join a 90-minute discussion group. Patients who participate in the survey or discussion groups will receive a gift card ($10 for the survey and $40 for the discussion group). The information gathered from the surveys and discussion groups will be kept private to the extent to which law allows and used for research purposes only; no individual responses will be shared outside the research team and only aggregated responses will be reported.

Enclosed is a fact sheet that provides more information about the study and what your practice’s participation will involve. If you have any further questions about the study, your rights as a study site, or your patients’ rights as study participants, please contact Karen Bogen, the Mathematica Survey Director, toll free at 1-877-863-6139 or by email at [email protected].

We appreciate your considering this request.

Sincerely,

Joy Pritts Betsy Ranslow

Chief Privacy Officer Acting Director

Division of Stakeholder Engagement and State Policy

Office of Policy and Planning

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 0990-0361 and expires 09-30-2013. The time required to complete this information collection is estimated to average 15 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: Office of the National Coordinator for Health Information Technology, Department of Health and Human Services, 200 Independence Ave. SW, Suite 729-D, Washington, DC 20201.