PIA Form

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Privacy Impact Assessment Form
v 1.47.4
Status Draft

Form Number

F-23707

Form Date

Question

Answer

1

OPDIV:

CDC

2

PIA Unique Identifier:

P-6136115-121183

2a Name:

1/30/2017 8:25:26 AM

Quality Assessment Program (QAP)
General Support System (GSS)
Major Application

3

Minor Application (stand-alone)

The subject of this PIA is which of the following?

Minor Application (child)
Electronic Information Collection
Unknown

3a

Identify the Enterprise Performance Lifecycle Phase
of the system.

Operations and Maintenance
Yes

3b Is this a FISMA-Reportable system?

4

Does the system include a Website or online
application available to and for the use of the general
public?

5

Identify the operator.

6

Point of Contact (POC):

7

Is this a new or existing system?

8

Does the system have Security Authorization (SA)?

8a Date of Security Authorization

No
Yes
No
Agency
Contractor
POC Title

PUBLIC HEALTH ADVISOR

POC Name

Todd Mercer

POC Organization NCEZID
POC Email

[email protected]

POC Phone

404-639-4489
New
Existing
Yes
No

Feb 5, 2014

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Save
The Quality Assessment Program (QAP) system was developed
by the Division of Global Migration and Quarantine (DGMQ),
Immigrant, Refugee and Migrant Health Branch to ensure the
quality of overseas medical screening examinations conducted
by physician panel sites. DGMQ teams, composed of physicians
and laboratorians, recommend remediation or removal for
over 600 sites across various countries, and provide training
and consultation to over 650 physicians. The system manages
information obtained during the DGMQ site visits.

11 Describe the purpose of the system.

The system maintains information obtained during the DGMQ
site visits with regard to panel physician and facility
evaluations. The evaluator may provide narratives on the
Describe the type of information the system will
vaccinations and laboratory components, including radiology
collect, maintain (store), or share. (Subsequent
12
questions will identify if this information is PII and ask and phlebotomy among the points of interests.
about the specific data elements.)
Also captured are the onsite physician’s contact information
(e.g., address, fax, website, etc.) and the laboratory and
radiology contact information, if off-site facilities are used.

Provide an overview of the system and describe the
13 information it will collect, maintain (store), or share,
either permanently or temporarily.

The Quality Assessment Program (QAP) was developed by the
Division of Global Migration and Quarantine, Immigrant,
Refugee and Migrant Health Branch to ensure the quality of
overseas medical screening examinations conducted by
physician panel sites. The site visits are based on the volume of
migrants and disease prevalence rates of tuberculosis. The
system stores information obtained during these DGMQ site
visits, and maintains panel physician and facility evaluations.
Information captured during the site visits are compiled into a
report. In the report, the evaluator may provide narratives on
the vaccinations and laboratory components, radiology, and
phlebotomy among other points of interests. Also captured are
the onsite physician’s contact information (e.g., address, fax,
website, etc.) and the laboratory and radiology contact
information, when off -site facilities are used.

14 Does the system collect, maintain, use or share PII?

Yes
No

General Comments

OPDIV Senior Official
for Privacy Signature

Beverly E.
Walker -S

Digitally signed by Beverly E. Walker -S
DN: c=US, o=U.S. Government,
ou=HHS, ou=CDC, ou=People,
0.9.2342.19200300.100.1.1=10014403
43, cn=Beverly E. Walker -S
Date: 2017.02.27 19:15:06 -05'00'

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