Justification for Change

Change Request

April 8, 2014

Information Collection Request: Million Hearts® Hypertension Control Challenge

(OMB no. 0920-0976, exp. date 7/31/2016)

Background and Justification

CDC is currently approved to collect information for three years to conduct annual Million Hearts® Hypertension Control Challenges in 2013, 2014, and 2015. The Challenge, under the authority of the America Creating Opportunities to Meaningfully Promote Excellence in Technology, Education and Science Reauthorization Act of 2010 (COMPETES Act), Public Law 111- 358, allows CDC to select and recognize Million Hearts® Hypertension Control Champions to motivate, inspire, and further the agency’s mission by attracting more interest and attention to hypertension control. Specifically, identifying and recognizing exemplary clinical practices will (a) lead to deeper understanding about how to achieve better control rates, (b) bring widespread attention to achievable exemplar rates, (c) motivate clinicians to strive for better hypertension control rates, and (d) bring prestige to a wide range of organizations that invest in hypertension control. CDC proposes to formally recognize a small number of Champions from the private sector, up to 30 annually, and develop translation documents that describe processes and sustainable systems that support exemplary clinical hypertension control rates. The 2013 Challenge was launched in August of 2013 and nine Champions were announced in February 2014.

CDC collects three types of information to support the Challenge:

1. Web-based Million Hearts® Hypertension Control Champion Nomination Form. This form is used by clinicians or clinical programs to voluntarily self-nominate their or another practice or health care system for Million Hearts® recognition. CDC uses the information submitted on the nomination form to score nominees and identify up to 30 finalists for further consideration.

2. Million Hearts® Hypertension Control Champion Data Verification Form. This form facilitates review and verification of information submitted for finalists. CDC’s data collection contractor works with nominees to clarify inaccuracies or inconsistencies.

3. Million Hearts® Hypertension Control Champion Interview Guide. This form guides a discussion with each finalist to document the processes used to achieve success in controlling hypertension.

Based on experience with the information collection in 2013, CDC proposes minor changes to the Nomination Form and the Data Verification Form. The changes are intended to improve clarity and usability for respondents, to improve the quality of information submitted to CDC, and to facilitate the verification process conducted by CDC’s contractor. The proposed changes do not alter the scope of the information collection, the number of respondents, the estimated burden per response, or the frequency of data collection.

CDC plans to begin administering the revised forms in 2014.  OMB approval is requested, effective immediately.

Discussion and Examples of Itemized Changes in Form Content

Million Hearts® Hypertension Control Champion Nomination Form

In the initial submission to OMB, form content was provided in a Word (.DOC) file (Attachment 3a) and screen shots were provided in a .PDF file (Attachment 6). To facilitate review of proposed changes, see Attachment 3a (revised) in which changes are noted in track-changes format. Two examples of the types of changes to be implemented are provided below.

Example 1: The question “Describe patient demographics that support the practice or health system’s care for a population with a high prevalence of hypertension” provides an opportunity for the nominee to add other characteristics, such as age. In 2013, nominees did not add age demographics which is a contributor to the prevalence of hypertension in a practice. In 2014, the following will be added to prompt nominees to consider age:

• Percent of patients: Age 18 – 39 __________

Age 40 – 59 __________

Age 60 + ____________

Example 2: In 2014, the question “What is the Hypertension Control Rate for the practice or healthcare system’s adult hypertensive population?” has been revised to walk the nominee through the calculation in a systematic way that also allows reviewers to identify errors or inconsistencies for follow up. The revision is:

Nominees are asked to provide two hypertension control rates: a current rate for a 12-month period and a rate for a 12 month period a year or more previous.

For the current Hypertension Control Rate:

What is the Reporting Period (e.g., 1/1/2013 to 12/31/2013)? ________________.

How many adult patients (18 – 85 years old) were seen at least once during the reporting period? ______________________

Of these, how many were diagnosed with hypertension? ________

Of these, how many are included in the control rate denominator (are not in an excluded category)? _____________

Million Hearts® Hypertension Control Champion Data Verification Form

In the initial submission to OMB, form content was provided in a Word (.DOC) file (Attachment 4). There are no corresponding screen shots. To facilitate review of proposed changes, see Attachment 4 (revised) in which changes are noted in track-changes format. The changes coincide with the revisions on the Nomination Form, and are primarily directed at the tasks of the contracted validator, not the public respondents.

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