Information Collection

Evaluation of the Electronic Health Records Demonstration (Discussion Guide for participating pratices)

IC 192044 under ICR 201002-0938-006 · OMB 0938-1072.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
A-EHRD Site Visit Discussion Guides - Treatment Group 2-1-10.doc	Other-GUIDE FOR PARTICIPATING TREATM
B-EHRD Site Visit Discussion Guides - Control Group 2-1-10.doc	Other-GUIDE FOR CONTROL GROUP PRACTI

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-GUIDE FOR PARTICIPATING TREATMENT GROUP PRACTICES			A-EHRD Site Visit Discussion Guides - Treatment Group 2-1-10.doc		Yes	Yes	Paper Only
Other-GUIDE FOR CONTROL GROUP PRACTICES			B-EHRD Site Visit Discussion Guides - Control Group 2-1-10.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 144

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	72	72
Annual IC Time Burden (Hours)	54	54
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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