Information Collection Request

Barriers to Meaningful Use in Medicaid

ICR 201106-0935-003 · OMB 0935-0186 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form Form #4 Moderator's Guide for Use with Virtual Focus Groups with EHR Non-Users Form and Instruction New Available
Form Form #3 Moderator's Guide for Use with Virtual Focus Groups with EHR Users Form and Instruction New Available
Form Form #2 Moderator's Guide for Use with In-Person Focus Groups with EHR Users Form and Instruction New Available
Form Form #1 Screening Questionnaire and Participant Information Form Form and Instruction New Available
Response to OMB comments on Barriers to Meaningful Use in Medicaid project.docx Supplementary Document Uploaded 2011-09-26 Available
Attachment E -- Moderators Guide for Use with Virtual Focus Groups with EHR Non-Users_8-16-2011.docx Supplementary Document Uploaded 2011-09-26 Available
Supporting Statement Part B -- Barriers to Meaningful Use in Medicaid_8-16-2011.docx Supporting Statement B Uploaded 2011-09-26 Available
Attachment N -- AHRQs Response to Public Comments.docx Supplementary Document Uploaded 2011-06-03 Available
Attachment M -- Public Comments.pdf Supplementary Document Uploaded 2011-06-03 Available
Attachment L -- Pretest Study Report.pdf Supplementary Document Uploaded 2011-06-03 Available
Attachment K -- Fact Sheet.docx Supplementary Document Uploaded 2011-06-03 Available
Attachment J -- Confirmation Letter.docx Supplementary Document Uploaded 2011-06-03 Available
Attachment I -- Study Announcement.docx Supplementary Document Uploaded 2011-06-03 Available
Attachment H -- Consent Form.docx Supplementary Document Uploaded 2011-06-03 Available
Attachment G -- Federal Register Notice.pdf Supplementary Document Uploaded 2011-06-03 Available
Attachment F -- Show Cards.docx Supplementary Document Uploaded 2011-06-03 Available
Supporting Statement Part A -- Barriers to Meaningful Use in Medicaid_8-16-2011.docx Supporting Statement A Uploaded 2011-09-26 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
198007 Virtual Focus Groups EHR Non-users only Form and Instruction NewModerator's Guide for Use with Virtual Focus Groups with EHR Non-Users
198006 Virtual Focus Groups EHR Users only Form and Instruction NewModerator's Guide for Use with Virtual Focus Groups with EHR Users
198005 In-Person Focus Groups EHR Users only Form and Instruction NewModerator's Guide for Use with In-Person Focus Groups with EHR Users
198004 Screening Questionnaire Form and Instruction NewScreening Questionnaire and Participant Information Form

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
10/31/2013 24 Months From Approved
389 0 0
228 0 0
0 0 0





Reginfo record details
4
table that charts list of burden
IC Title Form No. Form Name
In-Person Focus Groups EHR Users only Form #2
Screening Questionnaire Form #1
Virtual Focus Groups EHR Non-users only Form #4
Virtual Focus Groups EHR Users only Form #3

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 389 0 0 389 0 0
Annual Time Burden (Hours) 228 0 0 228 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No