memo

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

T ITLE OF INFORMATION COLLECTION: Awardee interviews for the evaluation of the Advance Interoperable Health Information Technology to Support Health Information Exchange program

PURPOSE:

As part of the evaluation of the Advance Interoperable Health Information Technology to Support Health Information Exchange program (AHIE) program, ONC’s contractor will conduct 12 interviews involving 36 individuals across 12 awardees who have received cooperative agreements. The interviews will have durations of 90 minutes each and take place via telephone. Topics of interest include techniques awardees used to engage health care providers, awardee program benefits to providers, implementation challenges, and strategies to address challenges. The interviews will be semi-structured in nature, and the information we collect will help us gain a better understanding of the program and of health information exchange in general.

The interviews are to be recorded for note taking purposes to facilitate accurate descriptions of each program in the evaluation report. Individuals’ names from each of the organizations will not be associated with any responses in the report. However, the names of awardee organizations may be used in the report. The recordings will be destroyed after the evaluation is complete.

In addition to the interviews, the contractor will send to a representative of each awardee a one page logic model tailored to describe the particular awardee’s program. The awardee representative will be asked to respond within two weeks with feedback about the accuracy of the logic model’s description of the awardee’s program.

DESCRIPTION OF RESPONDENTS:

ONC’s contractor will interview 36 respondents representing 12 awardees, across 12 different states. The respondents include state government and private sector employees who have worked on implementing each of the programs sponsored under cooperative agreements with ONC.

TYPE OF COLLECTION: (Check one)

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

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

[ ] Focus Group [x] Other: Semi-structured interviews

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: _ ___Larry T. Jessup, MHA____________________________________________

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

Category of Respondent	No. of Respondents	Participation Time	Burden
Private Sector	6	1.5 hours	9 hours
State, local, or tribal governments	6	1.5 hours	9 hours
Totals	12		18 hours

FEDERAL COST: The estimated annual cost to the Federal government is $6,238.

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