Information Collection Request

Health IT Community Tracking Study 2009

ICR 200909-0935-002 · OMB 0935-0159 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form Form #8 Interview Protocol 8 - Other E-prescribing Experts Form and Instruction New Available
Form Form #7 Interview Protocol 7 - E-prescribing Connectivity and Content Vendor Representatives Form and Instruction New Available
Form Form #6 Interview Protocol 6 - E-prescribing System Vendor Representative Form and Instruction New Available
Form Form #5 Interview Protocol 5 - Pharmacy IT Vendor Representative Form and Instruction New Available
Form Form #4 Interview Protocol 4 - State Pharmacy Association Representative Form and Instruction New Available
Form Form #3 Interview Protocol 3 - Pharmacy Pharmacist-In-Charge Form and Instruction New Available
Form Form #2 Interview Protocol 2 - Physician Practice Medical Director or Physician User Form and Instruction New Available
Form Form #1 Interview Protocol 1 - Physician Practice IT Administrator or Office Manager Form and Instruction New Available
Attachment Q - Response to Public Comments FINAL 1 14 10.docx Supplementary Document Uploaded 2010-01-21 Available
Attachment P - Public Comment Surescripts.pdf Supplementary Document Uploaded 2010-01-21 Available
Attachment O - Public Comment Nelson King.pdf Supplementary Document Uploaded 2010-01-21 Available
Attachment N - Public Comment NACDS.pdf Supplementary Document Uploaded 2010-01-21 Available
Attachment M - Public Comment APhA.pdf Supplementary Document Uploaded 2010-01-21 Available
Attachment L - Public Comment American Academy of Pediatrics.pdf Supplementary Document Uploaded 2010-01-21 Available
Supporting Statement B--Health IT Community Tracking Study 2009 06-19-2009.docx Supporting Statement B Uploaded 2010-01-21 Available
Attachment A -- Healthcare Research and Quality Act of 1999.pdf Supplementary Document Uploaded 2010-01-21 Available
Attachment J -- Confidentiality of Data Agreement.docx Supplementary Document Uploaded 2010-01-21 Available
Attachment I -- Confidentiality Pledge.docx Supplementary Document Uploaded 2010-01-21 Available
Attachment H -- 60 Day FR Notice.pdf Supplementary Document Uploaded 2010-01-21 Available
Attachment G -- Thank you Letter.docx Supplementary Document Uploaded 2010-01-21 Available
Attachment F -- Confirmation Letter.docx Supplementary Document Uploaded 2010-01-21 Available
Attachment E -- Invitation Letter - Other Respondent Types.docx Supplementary Document Uploaded 2010-01-21 Available
Attachment D -- Invitation Letter - Pharmacy.docx Supplementary Document Uploaded 2010-01-21 Available
Attachment C -- Invitation Letter - Physician Practice FINAL 1 13 2010.docx Supplementary Document Uploaded 2010-01-21 Available
Supporting Statement A-Health IT Community Tracking Study 2009 FINAL 1142010.doc Supporting Statement A Uploaded 2010-01-21 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
190639 Interview Protocol 8 - Other E-prescribing Experts Form and Instruction NewInterview Protocol 8 - Other E-prescribing Experts
190638 Interview Protocol 7 - E-prescribing Connectivity and Content Vendor Representatives Form and Instruction NewInterview Protocol 7 - E-prescribing Connectivity and Content Vendor Representatives
190637 Interview Protocol 6 - E-prescribing System Vendor Representative Form and Instruction NewInterview Protocol 6 - E-prescribing System Vendor Representative
190636 Interview Protocol 5 - Pharmacy IT Vendor Representative Form and Instruction NewInterview Protocol 5 - Pharmacy IT Vendor Representative
190635 Interview Protocol 4 - State Pharmacy Association Representative Form and Instruction NewInterview Protocol 4 - State Pharmacy Association Representative
190634 Interview Protocol 3 - Pharmacy Pharmacist-In-Charge Form and Instruction NewInterview Protocol 3 - Pharmacy Pharmacist-In-Charge
190633 Interview Protocol 2 - Physician Practice Medical Director or Physician User Form and Instruction NewInterview Protocol 2 - Physician Practice Medical Director or Physician User
190632 Interview Protocol 1 - Physician Practice IT Administrator or Office Manager Form and Instruction NewInterview Protocol 1 - Physician Practice IT Administrator or Office Manager

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
01/31/2012 24 Months From Approved
67 0 0
57 0 0
0 0 0





Reginfo record details
8
table that charts list of burden
IC Title Form No. Form Name
Interview Protocol 1 - Physician Practice IT Administrator or Office Manager Form #1
Interview Protocol 2 - Physician Practice Medical Director or Physician User Form #2
Interview Protocol 3 - Pharmacy Pharmacist-In-Charge Form #3
Interview Protocol 4 - State Pharmacy Association Representative Form #4
Interview Protocol 5 - Pharmacy IT Vendor Representative Form #5
Interview Protocol 6 - E-prescribing System Vendor Representative Form #6
Interview Protocol 7 - E-prescribing Connectivity and Content Vendor Representatives Form #7
Interview Protocol 8 - Other E-prescribing Experts Form #8

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 67 0 0 67 0 0
Annual Time Burden (Hours) 57 0 0 57 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No