Physician Letter Template _1_19_2011

Physician Letter Template _1_19_2011.docx

Patient Perpective of Delivery of Health Care Through the use of an Electronic Health Record Survey

Physician Letter Template _1_19_2011

OMB: 0955-0011

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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]

January 19, 2011


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.

A representative from ONC will call you in the coming week to describe the study in more detail and offer an opportunity to answer any questions you may have. They will request your practice’s participation offering $100 to practices that agree to participate.

To complete the study, ONC has contracted with Mathematica Policy Research, an independent research company. They will complete the data collection with patients from 42 randomly selected primary care practices across multiple states. Your practice was selected at random to represent other primary care practices in your state. Participation will involve allowing a Mathematica representative to make a short visit to your practice (one to three days) and talk with patients in the waiting room briefly about the study. Patients would then be invited 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 and used only for research purposes; no individual responses will be shared outside the research team and only aggregated responses will be reported.

Enclosed is a fact sheet about the study and how your practice can help ONC to better understand the likely role that the health information technology policy may play in fostering patient-centered medical care for all Americans.

If you have any further questions about the study, your rights as a study site, or your patients’ rights as study participants, please contact Kate Tipping at ONC, 202-260-0052 or katetipping@hhs.gov, or Karen Bogen, the Mathematica Survey Director, toll free at 1-877-863-6139, or kbogen@mathematica-mpr.com.

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.





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AuthorDepartment of Health and Human Services
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