EHR Adoption in Ambulatory Physician Care Practices

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Appendix C EHR Adoption in Ambulatory Physician Care Practices	Form	New	Available
Form Appendix B EHR Adoption in Ambulatory Physician Care Practices	Form	New	Available
EHR 3	Supplementary Document	Uploaded 2007-06-22	Available
EHR 2	Supplementary Document	Uploaded 2007-06-22	Available
EHR 1	Supplementary Document	Uploaded 2007-06-22	Available
0990-XXXX ehradoption B 5.14.2007 doc.doc	Supporting Statement B	Uploaded 2007-05-14	Available
Appendix D.doc	Supplementary Document	Uploaded 2007-05-14	Available
Appendix A 5.14.2007.pdf	Supplementary Document	Uploaded 2007-05-14	Available
0990-XXXX ehradoption A SS 5.14.2007.doc	Supporting Statement A	Uploaded 2007-05-14	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
180148	EHR Adoption in Ambulatory Physician Care Practices	Form	New
180147	EHR Adoption in Ambulatory Physician Care Practices	Form	New

ICR Details

OMB Control No: 0990-0312	ICR Reference No: 200705-0990-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: EHR Adoption in Ambulatory Physician Care Practices
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/25/2007
	Date Received in OIRA: 05/14/2007
Terms of Clearance: Approved consistent with HHS response to OMB questions and comments.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2008	12 Months From Approved
Responses	6,000	0	0
Time Burden (Hours)	1,500	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: On April 27, 2004, the President issued an executive order (EO) announcing his commitment to the use of health information technology (HIT) in order to reduce medical errors, lower costs, and provide better information for consumers and physicians. The EO directed the Secretary of Health and Human Services to establish within the Office of the Secretary the position of National Coordinator for Health Information Technology. Executive Order 13335 gave the Office of the National Coordinator the authorization to conduct studies to collect information to advance the development, adoption and promotion of Health Information Technology.

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Authorizing Statute(s): EO: EO 13335 Name/Subject of EO: Incentives for the use of HIT and Establishing the Office of the National Coordinator
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 6244	02/09/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 21020	04/27/2007
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
EHR Adoption in Ambulatory Physician Care Practices	Appendix B	Physician Survey
EHR Adoption in Ambulatory Physician Care Practices	Appendix C	Practice Manager Survey

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ICR Summary of Burden

table that charts list of burden

	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	6,000	0	0	6,000	0	0
Annual Time Burden (Hours)	1,500	0	0	1,500	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new data collection.

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Annual Cost to Federal Government: $497,869

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 05/14/2007

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