Information Collection

NIST ITL Electronic Health Record Survey Part 1

IC 199764 under ICR 201109-0693-006 · OMB 0693-0043.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0693-0043 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
NIST-ITL-EHR-Part1-WebSurveyQuestions-9-27-11.doc	Other-null
NIST-ITL-EHR-Part1-FourStandardSurveyQuestions-9-28-11.doc NIST ITL EHR Usabilit Study - Part 1 - SupportingStatement	IC Document
NIST-ITL-EHR-Part1-EmailInvitation-9-27-11.docx NIST-ITL-EHR-UsabilityStudy-Part1-Email-Invite	IC Document

IC Title:

NIST ITL Electronic Health Record Survey Part 1

Agency IC Tracking Number:

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-null			NIST-ITL-EHR-Part1-WebSurveyQuestions-9-27-11.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,600

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 60 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,600	1,600
Annual IC Time Burden (Hours)	1,600	1,600
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
NIST ITL EHR Usabilit Study - Part 1 - SupportingStatement	NIST-ITL-EHR-Part1-FourStandardSurveyQuestions-9-28-11.doc	10/26/2011
NIST-ITL-EHR-UsabilityStudy-Part1-Email-Invite	NIST-ITL-EHR-Part1-EmailInvitation-9-27-11.docx	10/17/2011

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