Information Collection

2014 EHR Survey (Expanded)

IC 211318 under ICR 201501-0920-002 · OMB 0920-1015.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1015 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att D_ 2014 EHR survey_Extension_FINAL formatted.pdf	Other-WORD

IC Title:

2014 EHR Survey (Expanded)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation: 42 CFR 242k (To search for a specific CFR, visit the Code of Federal Regulations.)

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-WORD			Att D_ 2014 EHR survey_Extension_FINAL formatted.pdf		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title: Health Resources Utilization Statistics

FR Citation: 49 FR 37693

Number of Respondents: 1,717

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	1,717	1,717
Annual IC Time Burden (Hours)	859	859
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.