OMB Control No. 0693-0043 – NIST Generic Clearance for Usability Data Collections
Project title: Study of Electronic Health Records (EHR) Usability
Please indicate your age range.
18 - 24
25 - 34
35 - 44
45 - 54
55 - 64
65 or older
Which one of the following educational background descriptions applies to you?
Some high school
G.E.D. (General Education Development)
High school diploma
College degree
Associate's degree
Undergraduate degree; specify which one (e.g., BA, BS)
Graduate degree; specify which one (e.g., MA, MS, PhD, MD, RN)
Special certifications; specify which ones
Other; describe
What is your occupational title?
How many years have you worked as a [occupation title]?
Describe your primary job responsibilities.
What is your comfort level using computers in the workplace
Low: I am somewhat intimidated using computers
Medium: I am relatively comfortable using computers
High:
I am very comfortable using computers
What is your comfort level using computers at home?
Low: I am somewhat intimidated using computers
Medium: I am relatively comfortable using computers
High:
I am very comfortable using computers
How frequently do you use computers outside of work?
Rarely: Less than once a month
Infrequently: Several times a month
Regularly: Several times a week or more
How long have you have you been interacting with your current electronic health record system (what we will now refer to as an EHR)?
Did you have any prior experience with other EHR systems before you started using your current system? [If yes], in what ways are these EHR systems different?
[If yes], did you find that certain EHR functions or EHR-facilitated tasks were easier to perform using one EHR system than the other(s)? Please explain.
In general, do you like or dislike the EHR? Why?
What characteristics make your current EHR particularly easy to use?
What characteristics make your current EHR particularly difficult to use?
Describe the environment(s) in which you use your EHR (e.g., in the exam room with the patient, during rounds, in an office, at an open workstation in the unit, at home)?
On what kinds of device(s) do you interact with your EHR (e.g., workstation, workstation on wheels, laptop computer, PDA, smartphone)?
How do you interact with your EHR (e.g., touchscreen, mouse and keyboard, keypad, stylus, voice entry)?
NOTE: This questionnaire contains collection of information requirements subject to the Paperwork Reduction Act (PRA). Notwithstanding any other provisions of the law, no person is required to respond to, nor shall any person be subject to penalty for failure to comply with, a collection of information subject to the requirements of the PRA, unless that collection of information displays a currently valid OMB Control Number. The estimated response time for this questionnaire is 10 minutes. The response time includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this estimate or any other aspects of this collection of information, including suggestions for reducing the length of this questionnaire, to the National Institute of Standards and Technology, Attn., Svetlana Lowry, svetlana.lowry@nist.gov, (301) 975-4995. The OMB Control No. is 0693-0043, which expires on 10/31/2012.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Maureen |
File Modified | 0000-00-00 |
File Created | 2021-01-30 |