Patient Semi-Structured Interviews

Using Health Information Technology in Practice Redesign: Impact of Health Information Technology on Workflow

OMB: 0935-0208

IC ID: 205427

Information Collection (IC) Details

View Information Collection (IC)

Patient Semi-Structured Interviews
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction Form #4 Patient Interview Guide Attachment F -- Patient Interview Guide.doc Yes Yes Paper Only

Health Public Health Monitoring

 

64 0
   
Individuals or Households
 
   0 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 64 0 64 0 0 0
Annual IC Time Burden (Hours) 64 0 64 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Attachment M -- Consent Form to Participate in Patient Interview Attachment M -- Consent Form to Participate in Patient Interview.docx 01/11/2013
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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