Information Collection

Physician Workflow Survey (line 7)

IC 196404 under ICR 201102-0920-016 · OMB 0920-0234.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0234 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Physician Workflow Survey (line 7)	Form
Physician Workflow Survey - EHR/no EHR Supplement 2 PWS_EHRv7 _postCT_SRA.docx	Form
Physician Workflow Survey - EHR/no EHR Supplement 2 PWS_noEHRv7_PostCT (2)_SRA.docx	Form

IC Title:

Physician Workflow Survey (line 7)

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
Form	none	Physician Workflow Survey - EHR/no EHR Supplement 2	PWS_EHRv7 _postCT_SRA.docx		No		Paper Only
Form	none	Physician Workflow Survey - EHR/no EHR Supplement 2	PWS_noEHRv7_PostCT (2)_SRA.docx		No		Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title: Health Resources Utilization Statistics

FR Citation: 49 FR 37693

Number of Respondents: 2,982

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

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	2,982	2,982
Annual IC Time Burden (Hours)	994	994
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.