Survey of Health Care Providers Participating in Rural Telemedicine Networks

ICR 199506-0915-005

OMB: 0915-0196

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0915-0196 199506-0915-005
Historical Active
HHS/HSA
Survey of Health Care Providers Participating in Rural Telemedicine Networks
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 09/14/1995
Retrieve Notice of Action (NOA) 06/16/1995
This information collection is approved for use through 11/30/96, subject to the changes agreed upon, as demonstrated in the revised submission of 9/11/95. In addition, this information collection is approved under the following conditions: Based on the results of the preliminary survey, PHS will develop a strategy for evaluating health outcomes, patient access, patient demographics, and cost-effectiveness of telemedicine techonology. In addition, PHS will report to OMB on this strategy by 10/31/96. Finally, PHS will undertake measures to increase the anticipated response rate from 75% to 80%, prior to initiating the survey.
  Inventory as of this Action Requested Previously Approved
11/30/1996 11/30/1996
250 0 0
530 0 0
0 0 0

This survey of all health care providers participating in rural medicine projects will provide baseline data on the systems, a minimum data set for future studies, and evaluation methodologies for future evaluations of these sytems.

None
None


No

1
IC Title Form No. Form Name
Survey of Health Care Providers Participating in Rural Telemedicine Networks

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 250 0 0 250 0 0
Annual Time Burden (Hours) 530 0 0 530 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
06/16/1995


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