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Federal Register / Vol. 86, No. 39 / Tuesday, March 2, 2021 / Notices confidential; marketing materials; study types not included in the review; or information on indications not included in the review cannot be used by the EPC
Program. This is a voluntary request for information, and all costs for complying with this request must be borne by the submitter.
The draft of this review will be posted on AHRQs EPC Program website and available for public comment for a period of 4 weeks. If you would like to be notified when the draft is posted, please sign up for the email list at:
https
www.effectivehealthcare.ahrq.gov/
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The systematic review will answer the following questions. This information is provided as background. AHRQ is not requesting that the public provide answers to these questions.
Key Questions KQs KQ 1. What is the effectiveness of provider-to-provider telehealth for rural patients?
a. What is the impact of provider-toprovider telehealth on rural patient and population outcomes?
b. What is the impact of provider-toprovider telehealth on healthcare providers?
c. What is the impact of provider-toprovider telehealth on private and public ex. CMS, TriCare, VA, etc.
payers?
d. What adverse events or unintended consequences are associated with provider-to-provider telehealth for rural patients?
e. What are the methodological weaknesses of the identified effectiveness studies of provider-toprovider telehealth for rural patients and what improvements in study design e.g., focus on relevant comparisons and outcomes might increase the impact of future research?

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KQ 2. What is the effectiveness of implementation strategies for providerto-provider telehealth in rural areas?
a. What is the uptake of different types of provider-to-provider telehealth in rural areas?
Who are the current patients, providers, and payers engaged in provider-to-provider telehealth in rural areas?
What factors affect whether provider-to-provider telehealth in rural areas can be sustained?
b. Which barriers and facilitators impact adoption and implementation of provider-to-provider telehealth in rural areas?

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c. Which strategies are effective in sustaining provider-to-provider telehealth in rural areas?
d. What are the methodological weaknesses of the identified studies of implementation and sustainability of provider-to-provider telehealth in rural areas and what improvements in study design e.g., focus on relevant comparisons and outcomes might increase the impact of future research?
Populations, Interventions, Comparators, Outcomes, Settings Populations Rural individual patients, patient families/care partners, and patient populations.
Healthcare providers individuals and organizations who provide health care services to rural patients or populations.
Providers include any profession or occupation providing formal, paid services.
Family or informal care partners are not considered providers.
Payers who pay for healthcare services for rural patients or populations.
Interventions Provider-to-provider telehealth defined as: Any telecommunications facilitated interaction among, or support for, healthcare professionals designed to improve access, quality of care, or health outcomes for rural patients and populations.
Comparators KQ1: Other telehealth facilitated care not provider-to-provider, usual in-person provider-to-provider supports, no interaction or no care.
KQ2: Different strategies for dissemination, implementation, or spread; no strategies; time periods prior to implementation.
Outcomes KQ1: Clinical outcomes for the identified conditions patient-reported outcomes, mortality, morbidity, such as function, illness recovery, infection;
Economic outcomes such as return on investment, cost, volume of visits, and resource use, including length of stay and readmissions; Intermediate Outcomes; Patient satisfaction, behavior such as care-seeking and compliance, and decisions such as completion of treatment, or satisfaction with less travel to access healthcare; Provider satisfaction, behavior, and decisions such as choice of treatment or antibiotic stewardship; Access measures and indicators including but not limited to time to diagnosis or time to treatment.

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KQ2: Indicators and measures of uptake e.g., rates of use, timing to implementation and characteristics of users; categories and descriptors of barriers and facilitators; categories and descriptors of strategies.
Settings Outpatient primary care and specialty care, inpatient, prehospital and emergency care, post-acute and long-term care.
Civilian, Veterans Administration, or military.
Health care and non-healthcare settings where health services are delivered including in the home.
U.S. relevant settings Note that studies from countries with significantly different healthcare systems and fewer resources e.g., low-income countries are excluded.
Dated: February 24, 2021.
Marquita Cullom, Associate Director.
FR Doc. 202104187 Filed 3121; 8:45 am BILLING CODE 416090P

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