HCUPSupporting Statement PartA comments 2019-05-07

HCUPSupporting Statement PartA comments 2019-05-07.doc

Online Application Order Form for Products from the Healthcare Cost and Utilization Project (HCUP)

OMB: 0935-0206

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SUPPORTING STATEMENT


Part A







Online Application Order Form for Products from the Healthcare Cost and Utilization Project (HCUP)





Version 12/6/2018






Agency for Healthcare Research and Quality (AHRQ)



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Table of contents


A. Justification 3

1. Circumstances that make the collection of information necessary 3

2. Purpose and use of information 4

3. Use of Improved Information Technology 5

4. Efforts to Identify Duplication 5

5. Involvement of Small Entities 5

6. Consequences if Information Collected Less Frequently 5

7. Special Circumstances 5

8. Consultation outside the Agency 5

9. Payments/Gifts to Respondents 6

10. Assurance of Confidentiality 6

11. Questions of a Sensitive Nature 7

12. Estimates of Annualized Burden Hours and Costs 7

13. Estimates of Annualized Respondent Capital and Maintenance Costs 8

14. Estimates of Annualized Cost to the Government 8

15. Changes in Hour Burden 9

16. Time Schedule, Publication and Analysis Plans 9

17. Exemption for Display of Expiration Date 9

List of Attachments 9




A. Justification


1. Circumstances that make the collection of information necessary


The mission of the Agency for Healthcare Research and Quality (AHRQ) set out in its authorizing legislation, The Healthcare Research and Quality Act of 1999 (see http://www.ahrq.gov/hrqa99.pdf), is to enhance the quality, appropriateness, and effectiveness of health services, and access to such services, through the establishment of a broad base of scientific research and through the promotion of improvements in clinical and health systems practices, including the prevention of diseases and other health conditions. AHRQ shall promote health care quality improvement by conducting and supporting:


1. Research that develops and presents scientific evidence regarding all aspects of health care; and


2. The synthesis and dissemination of available scientific evidence for use by patients, consumers, practitioners, providers, purchasers, policy makers, and educators; and


3. Initiatives to advance private and public efforts to improve health care quality.


Also, AHRQ shall conduct and support research and evaluations, and support demonstration projects, with respect to (A) the delivery of health care in inner-city areas, and in rural areas (including frontier areas); and (B) health care for priority populations, which shall include (1) low-income groups, (2) minority groups, (3) women, (4) children, (5) the elderly, and (6) individuals with special health care needs, including individuals with disabilities and individuals who need chronic care or end-of-life health care.


The Healthcare Cost and Utilization Project (HCUP, pronounced "H-Cup") is a vital resource helping the Agency achieve its research agenda, thereby furthering its goal of improving the delivery of health care in the United States. HCUP is a family of health care databases and related software tools and products developed through a Federal-State-Industry partnership and sponsored by AHRQ. HCUP includes the largest collection of longitudinal hospital care data in the United States, with all-payer, encounter-level information beginning in 1988. The HCUP databases are annual files that contain anonymous information from hospital discharge records for inpatient care and certain components of outpatient care, such as emergency care and ambulatory surgeries. The project currently releases seven types of databases created for research use on a broad range of health issues, including cost and quality of health services, medical practice patterns, access to health care programs, and outcomes of treatments at the national, State, and local market levels. HCUP also produces a large number of software tools to enhance the use of administrative health care data for research and public health use. Software tools use information available from a variety of sources to create new data elements, often through sophisticated algorithms, for use with the HCUP databases.


HCUP's objectives are to:

• Create and enhance a powerful source of national, state, and all-payer health care data.

• Produce a broad set of software tools and products to facilitate the use of HCUP and other administrative data.

• Enrich a collaborative partnership with statewide data organizations (that voluntarily participate in the project) aimed at increasing the quality and use of health care data.

• Conduct and translate research to inform decision making and improve health care delivery.


HCUP achieves these objectives by implementing the data collection instrument

https://www.distributor.hcup-us.ahrq.gov/SpecialPages/Shoppingcart.aspx and training at https://www.hcup-us.ahrq.gov/DUA/dua/index.html.



This project is being conducted by AHRQ through its primary contractor and subcontractor, IBM Watson Health and Social & Scientific Systems, Inc., pursuant to AHRQ’s statutory authority to conduct and support research on healthcare and on systems for the delivery of such care, including activities with respect to the outcomes, cost, cost-effectiveness, and use of health care services and access to such services. 42 U.S.C. 299a(a)(3).

2. Purpose and Use of Information

Information collected in the HCUP Application process will be used for two purposes only:

1. Business Transaction: In order to deliver the HCUP databases and software contact information is necessary for shipping the data on disk (or any other media used in the future).

2. Enforcement of the HCUP Data Use Agreement (DUA): The HCUP DUA contains several restrictions on use of the data. Most of these restrictions have been put in place to safeguard the privacy of individuals and establishments represented in the data. For example, data users can only use the data for research, analysis, and aggregate statistical reporting and are prohibited from attempting to identify any persons in the data. Contact information on HCUP DUAs is retained in the event that a violation of the DUA takes place requiring legal remedy.

3. Use of Improved Information Technology

The HCUP online application order form uses a software based data entry process to collect the required information and eliminate the need to print and mail the application form. Automating the HCUP database ordering process (as opposed to the previous paper-based system) has streamlined the ordering process for the public and facilitated more accurate and cost efficient record keeping for the Agency.


4. Efforts to Identify Duplication

No other source of data is available to allow AHRQ to deliver data to purchasers or allow follow up in the event of a DUA violation. This information collection does not duplicate any other effort and the information cannot be obtained from any other source.

5. Involvement of Small Entities

The information being requested has been held to the absolute minimum required for the intended use.

6. Consequences if Information Collected Less Frequently

Collection of information will take place one time for each application for data. To reduce burden, multiple products may be ordered using one application order form.

Without collection of information using the application ordering form, it would not be possible to implement an electronic ordering process and the opportunity to improve Agency efficiency and improve public access to research data.

7. Special Circumstances

This request is consistent with the general information collection guidelines of 5 CFR 1320.5(d)(2). No special circumstances apply.

8. Federal Register Notice and Outside Consultations



8.a. Federal Register Notice


As required by 5 CFR 1320.8(d), notice was published in the Federal Register on December 18, 2018 on page 64835for 60 days (see Attachment B).

8.b. Outside Consultations

AHRQ did not consult with any outside individual or agency with respect to this new information collection. The information collection required for the online application ordering process is an absolute minimum for conducting the transaction and is modeled on a process already established by the National Technical Information Service (NTIS) at http://www.ntis.gov/about/index.aspx. AHRQ is unable to utilize NTIS for dissemination of HCUP databases and software because of special circumstances required for release of the data; 1) the need to review applications for state-level data to ensure that the planned use is consistent with HCUP policies and with the HCUP data use requirements, and 2) the need to retain copies of signed DUAs.



9. Payments/Gifts to Respondents

No payment, gift or remuneration will be provided to respondents.

10. Assurance of Confidentiality

The confidentiality of information about individuals and organizations is protected under Section 934(c) of the Public Health Service Act, 42 USC 299c-3(c).  The public is informed of the purposes for which the information is collected and that, in accordance with this statute, any identifiable information about them will not be used or disclosed for any other purpose.

 

Information that can directly identify respondents is collected.  Information collected includes name, organization, street address, phone number, and e-mail address. All information collected is necessary for the commercial transaction including shipment of the data request and for follow up in the event of a potential violation of the DUA.

 

The identifiable information collected will be transmitted to the hosting server via an encrypted Secure Socket Layer (SSL) connection.  Access to the database housing the identifiable information is accomplished through individual authorized administrative accounts. The server housing the identifiable information is located in a data center owned by Social & Scientific Systems and is located in Ashburn, Va.  The datacenter is protected via 24/7 guards at all entrances, video monitoring systems, biometric hand readers, cage locks, and system firewalls.

•       The information stored is captured and transmitted over an SSL connection for secure encrypted transmission.

•       Access to the database is only permissible at the administrator level and is done so for either a) in order to fulfill the applicants request, b) for system maintenance, or c) in the event of a DUA violation.

•       The server housing the system is located in a secure facility with 24/7 guards at the entrance points, camera monitoring systems, biometric hand readers, and cage locks.

The information system has been categorized as a FISMA LOW per the FIPS 199 system categorization form.  SSS has obtained a Security Authorization utilizing the NIST 800-53 R4 control sets for a low categorization under the Federal Information Security Management Act (FISMA).  The controls required for a low system provide adequate assurance that the confidentiality, integrity and availability of the information system are met as required by FISMA.

The information collected by the electronic form will be stored in a secure database.  Data stored in the database will remain there indefinitely until requested by AHRQ.  At the conclusion of the contract, the information system as well as a current copy of the database can be provided to AHRQ by request.

The information system uses a defense-in-depth strategy when it comes to user access.  Users are assigned individual credentials along with role based least-privileged user account (LUA).  The LUA approach ensures that users follow the principle of least privilege and always log on with limited user accounts. This strategy also aims to limit the use of administrative credentials to administrators, and then only for administrative tasks.

Public users of the information system will establish their credentials upon entry to the system by using their e-mail address as the user ID and specifying their own password. That password will be securely stored in the system’s database. The credentials are needed so that a public user can return to an incomplete data request, to reference their order history, and complete the order. If a user forgets his/her password, the system will reset it and convey that information via e-mail. The public user will have to change that default password upon reentry to the system. Administrative users of the information system will have credentials assigned to them by the system administrator. Various role levels will be defined, each allowing the administrative user permissions to perform specific functions.

The information system will allow applicants to specify a payment option of credit card,  purchase order or wire transfer. Information to complete credit card transactions will be collected by the information system and transmitted securely to a PCI-compliant payment gateway for approval. The payment gateway product will process the transaction and cause the funds to be transferred when the transaction is captured at the time of shipment. While the credit card information will be collected by the information system, the credit card information will not be stored in the information system’s database. Payments by purchase order, or wire transfer will be handled by fax or mail.


11. Questions of a Sensitive Nature


No questions of a sensitive nature will be asked.


12. Estimates of Annualized Burden Hours and Costs


Exhibit 1 shows the estimated annualized burden associated with the applicants’ time to order any of the HCUP databases. An estimated 1,500 persons will order HCUP data annually. Each of these persons will complete Online Application Order Form for Products from the HCUP (30 minutes). The total burden for the Online Application Order Form is estimated to be 750 hours annually.


Exhibit 2 shows the estimated annualized cost burden associated with the applicants’ time to order HCUP data. The total cost burden is estimated to be $29,662 annually.










Exhibit 1.  Estimated annualized burden hours

Form Name

Number of respondents

Number of responses per respondent

Hours per response

Total burden hours

Total for the HCUP Data Purchase Ordering Form

1,500

1

30/60

750

 


Exhibit 2. Estimated annualized cost burden


Number of respondents

Total burden hours

Average hourly wage rate*

Total cost burden

Total

1,500

750

$42.86

$32,145

*Based upon the mean of the average wages for Life Scientists, All Other (19-1099), National Compensation Survey:

Occupational Employment Statistics, May 2018 National Occupational Employment and Wage Estimates United States, U.S. Department of Labor, Bureau of Labor Statistics. https://www.bls.gov/oes/current/oes_nat.htm#19-0000




13. Estimates of Annualized Respondent Capital and Maintenance Costs

There are no direct costs to respondents other than their time to submit the online application order form.


14. Estimates of Annualized Cost to the Government


Exhibit 3 shows the estimated total and annualized cost to process HCUP database applications and maintain the ordering system over the 3 years covered by this information collection request. It is estimated to cost $18,318 annually to operate and maintain the ordering system.


Exhibit 3.  Estimated Total and Annualized Cost

Cost Component

Total Cost

Annualized Cost

Order Review

$15,942

$5,314

Monthly Updates—Product Catalog

$2,043

$681

System Maintenance

$15,201

$5,067

Customer Inquiries

$4,530

$1,510

Management/Troubleshooting

$17,238

$5,746

Total

$54,954

$18,318








Exhibit 4. Federal Government Personnel Cost

Activity

Federal Personnel

Hourly Rate*

Estimated Hours

Cost

Data Collection Oversight

1 (GS-13 Step 7)

$57.02

440

$25,089

Review of Results

1 (GS-15 Step 5)

$74.86

132

$9,882

Total

$34,970

* Based on annual salaries from the 2019 OPM Pay Schedule for Washington/DC area:

https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2019/DCB_h.pdf


15. Changes in Hour Burden

An increase in public use of the system has taken place; however, there has been no change in the estimated hour burden per person.

16. Time Schedule, Publication and Analysis Plans

Implementation of the online application order system began in the fall of 2012 and is on-going.

17. Exemption for Display of Expiration Date

AHRQ does not seek this exemption.


List of Attachments:

Attachment A -- Online Application Order Form for Products (the Questionnaire/Instrument):


The data collection instrument is available at https://www.distributor.hcup-us.ahrq.gov/SpecialPages/Shoppingcart.aspx


HCUP Training URL: https://www.hcup-us.ahrq.gov/DUA/dua/index.html



Attachment B: Federal Register Notice




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