NIST ITL Electronic Health Record Survey Part 1

Generic Clearance for Usability Data Collections

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0693-0043 can be found here:

Documents and Forms

Document Name Document Type
NIST-ITL-EHR-Part1-WebSurveyQuestions-9-27-11.doc Other-null
NIST-ITL-EHR-Part1-FourStandardSurveyQuestions-9-28-11.doc NIST ITL EHR Usabilit Study - Part 1 - SupportingStatement IC Document
NIST-ITL-EHR-Part1-EmailInvitation-9-27-11.docx NIST-ITL-EHR-UsabilityStudy-Part1-Email-Invite IC Document

Information Collection (IC) Details

IC Title:	NIST ITL Electronic Health Record Survey Part 1	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-null			NIST-ITL-EHR-Part1-WebSurveyQuestions-9-27-11.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,600	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 60 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,600	1,600
Annual IC Time Burden (Hours)	1,600	1,600
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
NIST ITL EHR Usabilit Study - Part 1 - SupportingStatement	NIST-ITL-EHR-Part1-FourStandardSurveyQuestions-9-28-11.doc	10/26/2011
NIST-ITL-EHR-UsabilityStudy-Part1-Email-Invite	NIST-ITL-EHR-Part1-EmailInvitation-9-27-11.docx	10/17/2011

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.