Information Collection

National Survey of Health Information Exchange Organizations (HIO)

IC 233372 under ICR 201810-0955-001 · OMB 0955-0019.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0955-0019 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 0000 National Survey of Health Information Exchange Organizations (HIO)	Form and Instruction
0000 National Survey of Health Information Exchange Organizat 2018 HIE Survey.doc	Form and Instruction

IC Title:

National Survey of Health Information Exchange Organizations (HIO)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 5 CFR 1320.8(d)

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
Form and Instruction	0000	National Survey of Health Information Exchange Organizations	2018 HIE Survey.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	67	67
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.