Development of a Health Information Rating System (HIRS)

Forms and Documents

Document Name	Status
Form Form #4 Health Education Materials & Questionnaire - Colonoscopy Form and Instruction	Modified
Form Form #3 Health Education Materials & Questionnaire - Inhaler Form and Instruction	Modified
Form Form #2 S-TOFHLA Questionnaire Form and Instruction	Modified
Form Form #1 Demographic Questionnaire Form and Instruction	Modified
Supporting Statement B -- Development of a Health Information Rating System 1-17-2013.doc Supporting Statement B	2013-01-17
Attachment I - Consent Form.doc Supplementary Document	2013-01-17
Attachment G - Federal Register Notice.pdf Supplementary Document	2013-01-17
Attachment B - Health Information Rating System (HIRS).docx Supplementary Document	2013-01-17
Attachment A - Description of All Project Tasks.docx Supplementary Document	2013-01-17
Attachment H -- Public Comment & AHRQs Response.docx Supplementary Document	2013-01-17
Supporting Statement A -- Development of a Health Information Rating System 9-18-2012.doc Supporting Statement A	2013-01-17

IC Document Collections

IC ID	Document Title	Status
204410	Health Education Materials & Questionnaire - Colonoscopy Form and Instruction	Modified
204409	Health Education Materials & Questionnaire - Inhaler Form and Instruction	Modified
204408	S-TOFHLA Questionnaire Form and Instruction	Modified
204407	Demographic Questionnaire Form and Instruction	Modified

ICR Details

OMB Control No: 0935-0207	ICR Reference No: 201301-0935-002
Status: Historical Active	Previous ICR Reference No: 201210-0935-001
Agency/Subagency: HHS/AHRQ	Agency Tracking No:
Title: Development of a Health Information Rating System (HIRS)
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: 02/11/2013
	Date Received in OIRA: 01/18/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2013	6 Months From Approved
Responses	192	0	0
Time Burden (Hours)	58	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: In order to fulfill the promise of EHRs for all patients, especially for persons with limited health literacy, clinicians should have a method to determine how easy a health education material is for patients to understand and act on, have access to a library of easy-to-understand and actionable materials, understand the relevant capabilities and features of EHRs to provide effective patient education, and be made aware of these resources and information. Therefore, AHRQ developed a project that includes the following four major tasks: 1) develop a valid and reliable Health Information Rating System (HIRS), 2) create a library of patient health education materials, 3) review EHR's patient education capabilities and features, and 4) educate EHR vendors and users. This project relates to the first task only; a description of the other tasks is provided in Attachment A.

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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:
	77 FR 19667	04/02/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 60997	10/05/2012
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
Demographic Questionnaire	Form #1	Demographic Questionnaire
S-TOFHLA Questionnaire	Form #2	Short Test of Functional Health Literacy in Adults (S-TOFHLA)
Health Education Materials & Questionnaire - Inhaler	Form #3	Health Education Materials & Questionnaire - Asthma/Inhaler
Health Education Materials & Questionnaire - Colonoscopy	Form #4	Health Education Materials & Questionnaire - Colonoscopy

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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	192	0	0	192	0	0
Annual Time Burden (Hours)	58	0	0	58	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 new information collection request.

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Annual Cost to Federal Government: $174,982

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: 01/18/2013

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