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Aug 7 -- The National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention (CDC) invites comments to OMB by September 7, 2023 regarding the extension of the National Electronic Health Records Survey (NEHRS). NEHRS will collect information about the use of electronic health records (EHRs) systems, documentation of social determinants of health or social needs, interoperability, exchange of patient health information with public health agencies, and use of telemedicine technology among office-based and outpatient physicians in the United States.

NCHS is requesting approval to collect data for 2024, 2025, and 2026 NEHRS cohorts. NEHRS is a national survey of office-based physicians conducted by NCHS, Centers for Disease Control and Prevention (CDC). NEHRS is sponsored by the Office of the National Coordinator for Health Information Technology (ONC), Department of Health and Human Services (HHS). Although there are other surveys that collect information from United States office-based physicians, NEHRS is unique in that it provides nationally representative information about the use of electronic health records (EHR) and other health information technologies. Additional justifications for conducting future rounds of NEHRS include the need for more complete data to study: (1) documentation of social needs; (2) trends in interoperability; (3) the exchange of patient health information with public health agencies; and (4) the use of telemedicine technology. The new data collections will reestablish trends of patient health information exchange with public health agencies, telemedicine technology use, as well as the evolving engagement in interoperability; particularly with respect to electronically sending, receiving, integrating, and searching for patient health information through these systems. Improving interoperability of electronic health information is a major priority for ONC, and NEHRS can provide ONC with data on physicians' experience with interoperability.  
  
The last NEHRS data collection was fielded in 2021. The 2021 NEHRS collection incorporated a shortened 4-page instrument, web and mail modes, and tracing to improve sampled physician response. There were no unweighted nonresponse survey items that exceeded 5% in the 2021 NEHRS data collection.
 
The purpose of this survey is to collect information on the use of EHR systems, social determinants of health or social needs of patients, interoperability, exchange of patient health information with public health agencies, and use of telemedicine technology, among office-based and outpatient physicians. ONC uses NEHRS data for evaluating progress toward the Health Information Technology for Economic and Clinical Health (HITECH) Act and the 21st Century Cures Act of 2016 program goals related to interoperability. To that end, ONC uses the NEHRS data to update Congress on a regular basis on EHR use and interoperability, including barriers to health information exchange and interoperability specifically. ONC also uses the data to provide updates regarding the state of EHR use among to its leadership and stakeholders, sharing findings through data briefs and peer-reviewed publications in scientific journals. ONC has also shared key findings with HHS agency partners, such as the CDC, Health Resources and Services Administration (HRSA), and Centers for Medicare & Medicaid Services (CMS) on various topics covered by the survey. The Medicare Payment Advisory Commission uses data from NEHRS for a Congressional Report on acceptance of Medicare and Medicaid insurance for new patients.

NEHRS has provided a range of baseline data on the characteristics of United States physicians practicing office-based and outpatient medical care. The proposed NEHRS collections will allow the ability to track the use of EHRs as well as new health information technologies, such as telemedicine technology, across various physician and practice characteristics (e.g., specialty, office type, practice size, and ownership) over time. These data, together with other trend data, may be used to monitor the effects of change in the health care system, provide new insights into office-based and outpatient medical care, and stimulate further research on the use, organization, and delivery of outpatient or office-based medical care. Additionally, NEHRS is uniquely positioned as the only nationally representative survey to have telemedicine technology data before the COVID-19 pandemic. The future NEHRS will add additional datapoints for trend analysis.
 
NEHRS information is also useful to health planning agencies, managers of health care delivery systems, and others concerned with planning, monitoring, and managing health care resources for health information exchange (HIE), care coordination, safety implications, and the use of health information technology. It is valuable to those who develop and evaluate new and modified health care systems and arrangements. It also provides valuable information about the speed and effectiveness with which certain advances occur in HIE, such as EHR functions, are adopted by the office-based and outpatient physicians.   

Users of NEHRS include numerous federal governmental agencies, state and local governments, medical schools, schools of public health, health care industry professionals, colleges and universities, private businesses, non-profit foundations, corporations, and professional associations, as well as individual practitioners, researchers, administrators, and health policymakers. Uses vary from the inclusion of a few selected statistics in a large research effort to an in-depth analysis of the entire NEHRS data set covering multiple years.  
 
NEHRS: https://www.cdc.gov/nchs/nehrs/about.htm
CDC submission to OMB: https://www.reginfo.gov/public/do/PRAViewICR?ref_nbr=202308-0920-002 Click IC List for information collection instrument, View Supporting Statement for technical documentation. Submit comments through this webpage.
FRN: https://www.federalregister.gov/d/2023-16758

For AEA members wishing to submit comments, "A Primer on How to Respond to Calls for Comment on Federal Data Collections" is available at https://www.aeaweb.org/content/file?id=5806

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