Information Collection

NIST ITL Electronic Health Record (EHR) Survey - Part 1

IC 203380 under ICR 201206-0693-003 · 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⚠️ Notice: This information collection may be referencing outdated material.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-7-19-12.doc	Other-Survey
NIST-ITL-EHR-Part1-EmailInvitation-7-19-12.docx NIST - ITL - EHR Usability Study - Part 1 - Email Invitation	IC Document
NIST-ITL-EHR-Part-1-FourStandardSurveyQuestions-7-25-12.doc NIST - ITL - EHR Usability Study - Part 1 - Supporting Statement	IC Document

IC Title:

NIST ITL Electronic Health Record (EHR) 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-Survey			NIST-ITL-EHR-Part1-WebSurveyQuestions-7-19-12.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
	Requested	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 Usability Study - Part 1 - Email Invitation	NIST-ITL-EHR-Part1-EmailInvitation-7-19-12.docx	07/19/2012
NIST - ITL - EHR Usability Study - Part 1 - Supporting Statement	NIST-ITL-EHR-Part-1-FourStandardSurveyQuestions-7-25-12.doc	07/25/2012

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