Fast-Track Template

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB#: 0925-0648 Exp. Date: 03/31/2018)

TITLE OF INFORMATION COLLECTION: NLM MedlinePlus Connect Customer Survey

PURPOSE: The purpose of this study is to gain a better understanding of the users of MedlinePlus Connect and to identify their needs in order to improve the service. This study will conduct a survey questionnaire, via web-based, telephone, or in-person interview. Data from this survey will be analyzed to identify themes and make recommendations about outreach activities, communication strategies, and technical developments that may accommodate user needs. MedlinePlus Connect is a free service of the National Library of Medicine that allows health organizations and health IT providers to link patient portals and electronic health record (EHR) systems to MedlinePlus, the consumer health information website of the National Institute of Health (NIH).

DESCRIPTION OF RESPONDENTS: Respondents will be users of MedlinePlus Connect, primarily health IT vendors who have implemented the API.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [X] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus Group [ ] Other: ___________________

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name: _Loan Nguyen, Jennifer Jentsch______________________________________

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [X] No

2. If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

3. If Applicable, has a System or Records Notice been published? [ ] Yes [ ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [X] No

ESTIMATED BURDEN HOURS and COSTS

Category of Respondent	No. of Respondents	No. of Responses per Respondent	Time per Response (in hours)	Total Burden Hours
Private Sector	50	1	1	50
Totals	50	50		50

Category of Respondent	Total Burden Hours	Wage Rate*	Total Burden Cost
Private Sector (Computer Occupation)	50	$40.31	$2,015.50
Totals	50		$2,015.50

*Cite source per bls.gov if applicable

http://www.bls.gov/oes/current/oes_nat.htm#15-0000

FEDERAL COST: The estimated annual cost to the Federal government is $1,671.95.

Staff	Grade/Step	Salary	% of Effort	Fringe (if applicable)	Total Cost to Gov’t
Federal Oversight
Librarian	GS-12/1	$77,490	0.5		$387.45
Contractor Cost
Interviewer @ $25.69 x 50 hours					$1,284.50
Travel
Other Cost
Total					$1,671.95

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [X] Yes [ ] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

A user list was previously created from different sources: the Certified Health IT Product List, current list of users on the MedlinePlus Connect website, and past users who have contacted NLM. Sampling from this list will include approximately 10 local (within 50 miles of NLM) customers. The remaining 40 users will be recruited based on specialty (e.g. behavioral health, chiropractic, etc.), size of organization (small practice, international-based, etc.) and various regions in U.S.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[ ] Web-based or other forms of Social Media

[X] Telephone

[X] In-person

[ ] Mail

[X] Other, Explain: Skype

2. Will interviewers or facilitators be used? [X] Yes [ ] No

Please make sure that all instruments, instructions, and scripts are submitted with the request.

Attachment 1_NLM SurveyInstrument MedlinePlusConnect

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