NHAMCS 2010 NS Change supp Stat. 121709

Request for Approval of a Non-Substantive Change:

NATIONAL HOSPITAL AMBULATORY MEDICAL CARE SURVEY

OMB No. 0920-0278

(Expires 08/31/2012)

Contact Information:

David A. Woodwell

Lead Statistician, Ambulatory and Hospital Care Statistics Branch

Division of Health Care Statistics

National Center for Health Statistics/CDC

3311 Toledo Road, Room 3329

Hyattsville, MD 20782

301-458-4592

301-458-4693 (fax)

daw0@cdc.gov

December 17, 2009

SUPPORTING STATEMENT

NATIONAL HOSPITAL AMBULATORY MEDICAL CARE SURVEY

This request is for the approval of a non-substantive change to an approved data collection, the ongoing National Hospital Ambulatory Medical Care Survey (NHAMCS) (OMB No. 0920-0278). On August 7, 2009, NHAMCS was approved to collect data for the three years 2010, 2011, and 2012. The NHAMCS is a national survey of hospital ambulatory medical care conducted by the Centers for Disease Control and Prevention (CDC)’s National Center for Health Statistics (NCHS).

The Office of the National Coordinator for Health Information Technology (ONC), Department of Health and Human Services (DHHS) has asked NCHS to modify questions on the facility induction forms for hospitals (NHAMCS-101) and freestanding ambulatory surgery centers (ASCs) (NHAMCS-101(FS)) related to adoption of electronic medical records (EMR)/electronic health records (EHR). The EMR/EHR questions are part of an ongoing project that involves the American Recovery and Reinvestment Act of 2009 (ARRA). Approval is requested for the following non-substantive changes to approved data collection materials:

• Revise current questions about the capabilities of EMR/EHR systems: new proposed NHAMCS-101 (Attachment A), item 14d; and NHAMCS-101(FS) (Attachment B), item 15h.

• Add questions relating to incentive payments for meaningful use of health information technology: NHAMCS-101 (Attachment A), items 11f, 14a, 14b2, 14e, 14t, 14u2, 14x, 15e, 15f2, 15i; and NHAMCS-101(FS) (Attachment B), items 15e, 15f2, 15i.

• Delete selected questions related to EMR/EHR from previously approved induction forms: NHAMCS-101 (Attachment C), items 14c, Check Item C2, 14e, 14t, Check Item D2, 14x, 15g, Check Item G, and 15i; and NHAMCS-101(FS) (Attachment D), items 15g, Check Item G, and 15i.

As a result of questions being deleted from the induction forms, there will be no change in burden to the respondent. The new questions to be added to the NHAMCS induction forms are identical to those proposed for collection in the 2010-2012 NAMCS (OMB 0920-0234).

A. Justification

1. Circumstances Making the Collection of Information Necessary

Policymakers’ interest in the progress of health information technology adoption by health care providers has increased since 2004 when the federal government set the goal for most Americans to have electronic health records by 2014. The American Recovery and Reinvestment Act (ARRA) in early 2009 may accelerate the pace of electronic medical records/electronic health records (EMR/EHR) adoption by health care providers, since it includes funding to promote adoption and use of electronic systems. NCHS, through its ambulatory care surveys, is helping to monitor the progress of EMR/EHR adoption by surveying physician offices, hospitals and ambulatory surgery centers. Data on EMR adoption is currently collected through NCHS’s National Ambulatory Medical Care Survey (NAMCS), which surveys physician offices and community health centers. NHAMCS asks the same questions about EMR/EHR adoption to hospital emergency and outpatient departments as well as to both hospital-based and freestanding ambulatory surgery centers.

2. Purpose and Use of Information Collection

NHAMCS data on EMR adoption in hospitals supplements data from the NAMCS on office-based physician EMR adoption rates. The questions pertaining to EMR adoption in the surveys are critical toward meeting the President’s goal for getting most Americans access to an interoperable EHR by 2014. Some of the questions we hope to answer with the electronic medical record data include: (1) what are the predictors of EMR/EHR adoption; (2) do provider practice characteristics (e.g., location, organization type, specialty, vulnerable population mix) and EMR/EHR functionality explain the gaps currently found in EMR/EHR adoption rates; and (3) how much progress are we making toward the national goal over time. Answers to these questions will help the Office of the National Coordinator for Health Information Technology (ONC) better understand how to better meet the goal and what obstacles they must overcome for those providers reluctant to adopt such a system.

Attachments:

A. New National Hospital Ambulatory Medical Care Survey NHAMCS-101 Hospital Induction Form (dated 12-10-2009 under the title NHAMCS-101)

B. New National Hospital Ambulatory Medical Care Survey NHAMCS-101(FS) Ambulatory Surgery Center Induction Form (dated 12-10-09 under the title NHAMCS-101(FS))

C. Old National Hospital Ambulatory Medical Care Survey NHAMCS-101 Hospital Induction Form (dated 9-1-2009 under the title NHAMCS-101)

D. Old National Hospital Ambulatory Medical Care Survey NHAMCS-101(FS) Ambulatory Surgery Center Induction Form (dated 9-14-2009 under the title NHAMCS-101(FS))

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