Memo

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” HHS Online Customer Surveys (OMB Control Number: 0990-0379)

TITLE OF INFORMATION COLLECTION: HealthIT.gov Website Satisfaction Survey

PURPOSE: The Office of the National Coordinator for Health IT (ONC) hosts healthIT.gov and other web properties. While we collect user behavior data using google analytics, it’s been very helpful to collect qualitative feedback on our content. To this end, we have implemented, and received PRA clearance for, a page and site level content satisfaction surveys. The purpose of these surveys to assist with delivering quality content to our users.

DESCRIPTION OF RESPONDENTS:

The respondents for this web survey will be visitors to healthIT.gov. There is nothing that distinguishes these respondents from anyone else. Users have the option to respond to the survey when they land on each page they visit, but there is no requirement to do so.

TYPE OF COLLECTION: (Check one)

[X] Customer Comment Card/Complaint Form [ ] 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: Peter Keesey

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

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden hour
Website Users.	5,121	1 10/60	853.5
Totals			853.5

FEDERAL COST: The estimated annual cost to the Federal government is _0_

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? [ ] Yes [X] 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?

Administration of the Instrument

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

[X] Web-based or other forms of Social Media See appendix for survey instrument

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

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

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