Letters

Att G - Letters
(Email request to take web survey – survey link)
Dear Dr. Doe,
You have been randomly selected to participate in a brief survey on the adoption and use of electronic health records (EHRs)
and electronic exchange of health information in office-based practices. Your email address was obtained from a database of
physicians. The National Center for Health Statistics (NCHS), a Federal Statistical Agency, collects data from physicians to
help health services researchers and policy makers understand changes in physician work environments and related topics.
This includes clinicians’ experience with electronic prescribing of controlled substances, the use of prescription drug
monitoring programs, participation in value-based payment programs, provider burden associated with documentation and
EHR use, and the use of EHRs and how it affects the delivery of health care in the United States.
Participation in this 30-minute survey is voluntary, and you may stop at any time. You are not being asked to provide any
patient information. All information we collect is voluntary and used for statistical purposes only. There are no penalties for
nonparticipation. We may carry out additional health care research by linking your survey responses to administrative medical
information and other related records. The NCHS Ethics Review Board has approved this survey.
NCHS complies with numerous federal laws to protect your data, privacy, and confidentiality, as described in detail below.
Data collection is authorized under Section 306 of the Public Health Service Act (42 U.S.C. 242k). NCHS is required to keep
your survey data confidential in accordance with Section 308(d) of the Public Health Service Act (42 U.S.C. 242m(d)) and the
Confidential Information Protection and Statistical Efficiency Act (CIPSEA, Title 5 of PL 107-347). Data will be used for
statistical purposes only.
The most efficient and easy way to respond is over the Internet at https://www.cdc.gov/nchs/nehrs/. The user ID and password
to access the survey will be sent to you in a separate email for confidentiality reasons.
If you have questions or comments regarding this study, or you do not receive the second email, please call the study
coordinator at (xxx) xxx-xxxx. If you have questions about your rights as a research participant, please call the NCHS Ethics
Review Board at (800) 223-8118 and say you are calling about Protocol #2016-07.
Thank you in advance for your participation in this important study.
Sincerely,

Jennifer Madans, PhD
Acting Director
National Center for Health Statistics

1

Att G - Letters
Frequently Asked Questions
1.

WHO WILL SEE MY ANSWERS?

We take your privacy very seriously. The answers you give us are used for statistical research only. This means that your
answers will be combined with other people’s answers in a way that protects everyone’s identity. As required by federal law,
only those NCHS employees and our specially designated agents (such as the U.S. Census Bureau) who must use your
personal information for a specific reason can see your answers.
Strict laws prevent us from releasing information that could identify you to anyone else without your consent. A number of
federal laws require that all information we collect be held in strict confidence: Section 308(d) of the Public Health Service Act
(42 U.S.C. 242m(d)), the Confidential Information Protection and Statistical Efficiency Act (CIPSEA, Title 5 of Public Law 107347), and the Privacy Act of 1974 (5 U.S.C. § 552a). Every NCHS employee, contractor, and agent has taken an oath to keep
your information private. Anyone who willfully discloses ANY identifiable information could get a jail term of up to five years, a
fine of up to $250,000, or both.

2

Att G - Letters
(Email request to take web survey – user ID and password)
Dear Dr. Doe,
You have been randomly selected to participate in a brief survey on the use and adoption of electronic health records (EHRs)
and electronic exchange of health information in office-based practices. The National Center for Health Statistics (NCHS), a
Federal Statistical Agency, collects data from physicians to help health services researchers and policy makers understand
changes in physician work environments and related topics, including the use of EHRs and how it affects the delivery of health
care in the United States.
This survey covers a diverse array of topics, including: electronic exchange of health information; clinicians’ experience
electronic prescribing of controlled substances, including the use of prescription drug monitoring programs; participation in
value-based payment programs; and provider burden associated with documentation and EHR use.
A separate email was sent to you with the survey link to access the survey. When prompted, enter the user ID and password
provided below.
User ID: [user-name-here]
Password: [6-char-password-here]
NCHS complies with numerous federal laws to protect your data, privacy, and confidentiality, as described in detail below.
Data collection is authorized under Section 306 of the Public Health Service Act (42 U.S.C. 242k). NCHS is required to keep
your survey data confidential in accordance with Section 308(d) of the Public Health Service Act (42 U.S.C. 242m(d)) and the
Confidential Information Protection and Statistical Efficiency Act (CIPSEA, Title 5 of PL 107-347). Data will be used for
statistical purposes only.
If you have questions or comments regarding this study, please call the study coordinator at (xxx) xxx-xxxx. If you have
questions about your rights as a research participant, please call the NCHS Ethics Review Board at (800) 223-8118 and say
you are calling about Protocol #2016-07.
Thank you in advance for your participation in this important study.
Sincerely,

Jennifer Madans, PhD
Acting Director
National Center for Health Statistics

3

Att G - Letters
Frequently Asked Questions
1.

WHO WILL SEE MY ANSWERS?

We take your privacy very seriously. The answers you give us are used for statistical research only. This means that your
answers will be combined with other people’s answers in a way that protects everyone’s identity. As required by federal law,
only those NCHS employees and our specially designated agents (such as the U.S. Census Bureau) who must use your
personal information for a specific reason can see your answers.
Strict laws prevent us from releasing information that could identify you to anyone else without your consent. A number of
federal laws require that all information we collect be held in strict confidence: Section 308(d) of the Public Health Service Act
(42 U.S.C. 242m(d)), the Confidential Information Protection and Statistical Efficiency Act (CIPSEA, Title 5 of Public Law 107347), and the Privacy Act of 1974 (5 U.S.C. § 552a). Every NCHS employee, contractor, and agent has taken an oath to keep
your information private. Anyone who willfully discloses ANY identifiable information could get a jail term of up to five years, a
fine of up to $250,000, or both.

4

Att G - Letters
(LETTER in US Mail to take web survey)
John Doe, MD
Position (if provided, i.e. Director, Chief, etc)
Practice Name (if provided)
5 Smith Street
Nowhere, NC 99999-1111
Dear Dr. Doe,
You have been randomly selected to participate in a brief survey by the National Center for Health Statistics (NCHS) on the
use of electronic health records (EHRs) in office-based practices. Results from the National Electronic Health Records Survey,
which is affiliated with the National Ambulatory Medical Care Survey, will be used to inform health services researchers and
policy makers about clinicians’ experience with electronic prescribing of controlled substances, the use of prescription drug
monitoring programs, participation in value-based payment programs, provider burden associated with documentation and
EHR use, and the use of EHRs and how it affects the delivery of health care in the United States.
Participation in this 30-minute survey is voluntary, and you may stop at any time. You are not being asked to provide any
patient information. All information we collect is voluntary and used for statistical purposes only. You may stop participation at
any time. There are no penalties for nonparticipation. We may carry out additional health care research by linking your survey
responses to administrative medical information and other related records. The NCHS Ethics Review Board has approved this
survey.
NCHS complies with numerous federal laws to protect your data, privacy, and confidentiality, as described in detail on the
back of this page. Data collection is authorized under Section 306 of the Public Health Service Act (42 U.S.C. 242k). NCHS is
required to keep your survey data confidential in accordance with Section 308(d) of the Public Health Service Act (42 U.S.C.
242m(d)) and the Confidential Information Protection and Statistical Efficiency Act (CIPSEA, Title 5 of PL 107-347). Data will
be used for statistical purposes only.
The most efficient and easy way to respond is over the Internet at https://www.cdc.gov/nchs/nehrs/. Enter the user ID and
password provided below.
User ID: [user-name-here]
Password: [6-char-password-here]
If you have questions or comments regarding this study, please call the study coordinator at (xxx) xxx-xxxx. If you have
questions about your rights as a research participant, please call the Ethics Review Board at the National Center for Health
Statistics at (800) 223-8118 and say you are calling about Protocol #2016-07.
Thank you in advance for your participation in this important study.
Sincerely,

Jennifer Madans, PhD
Acting Director
National Center for Health Statistics

5

Att G - Letters
Frequently Asked Questions
1.

WHO WILL SEE MY ANSWERS?

We take your privacy very seriously. The answers you give us are used for statistical research only. This means that your
answers will be combined with other people’s answers in a way that protects everyone’s identity. As required by federal law,
only those NCHS employees and our specially designated agents (such as the U.S. Census Bureau) who must use your
personal information for a specific reason can see your answers.
Strict laws prevent us from releasing information that could identify you to anyone else without your consent. A number of
federal laws require that all information we collect be held in strict confidence: Section 308(d) of the Public Health Service Act
(42 U.S.C. 242m(d)), the Confidential Information Protection and Statistical Efficiency Act (CIPSEA, Title 5 of Public Law 107347), and the Privacy Act of 1974 (5 U.S.C. § 552a). Every NCHS employee, contractor, and agent has taken an oath to keep
your information private. Anyone who willfully discloses ANY identifiable information could get a jail term of up to five years, a
fine of up to $250,000, or both.

6

Att G - Letters
(First Mailing of Questionnaire)
John Doe, MD
Position (if provided, i.e. Director, Chief, etc)
Practice Name (if provided)
5 Smith Street
Nowhere, NC 99999-1111
Dear Dr. Doe,
About two weeks ago, we contacted you about participating in a brief survey on the adoption and use of electronic health
records (EHRs) and electronic exchange of health information in office-based practices. As of this mailing, we have not
received your completed survey. Results from the enclosed National Electronic Health Records Survey, which is affiliated with
the National Ambulatory Medical Care Survey (NAMCS), will provide information about clinicians’ experience with electronic
prescribing of controlled substances, the use of prescription drug monitoring programs, participation in value-based payment
programs, provider burden associated with documentation and EHR use, and the use of EHRs and how it affects the delivery
of health care in the United States. Please take the time to answer the questions and return the questionnaire in the enclosed
envelope.
If you are unable to complete the survey yourself, an office manager or another staff member familiar with your workload and
experiences with your EHR system could complete the survey on your behalf. If you choose not to participate, please answer
Questions 2 and 4 and return it to us in the enclosed envelope.
You are not being asked to provide any patient information for this mail survey and participation is voluntary. You may stop
participation at any time. There are no penalties for nonparticipation. Data will be used for statistical purposes only.
NCHS complies with numerous federal laws to protect your data, privacy, and confidentiality, as described in detail on the
back of this page. Data collection is authorized under Section 306 of the Public Health Service Act (42 U.S.C. 242k). We are
required to keep your survey data confidential in accordance with Section 308(d) of the Public Health Service Act (42 U.S.C.
242m(d)) and the Confidential Information Protection and Statistical Efficiency Act (CIPSEA, Title 5 of PL 107-347).
Please accept the enclosed pen as a token of our gratitude for completing this 30-minute research survey. If you have
questions or comments regarding this study, please call the study coordinator at (xxx) xxx-xxxx. If you have questions about
your rights as a research participant, please call the Ethics Review Board at the National Center for Health Statistics at (800)
223-8118 and say you are calling about Protocol #2016-07.
Thank you for your valuable assistance with this important study.
Sincerely,

Jennifer Madans, PhD
Acting Director
National Center for Health Statistics

7

Att G - Letters
Frequently Asked Questions
1.

WHO WILL SEE MY ANSWERS?

We take your privacy very seriously. The answers you give us are used for statistical research only. This means that your
answers will be combined with other people’s answers in a way that protects everyone’s identity. As required by federal law,
only those NCHS employees and our specially designated agents (such as the U.S. Census Bureau) who must use your
personal information for a specific reason can see your answers.
Strict laws prevent us from releasing information that could identify you to anyone else without your consent. A number of
federal laws require that all information we collect be held in strict confidence: Section 308(d) of the Public Health Service Act
(42 U.S.C. 242m(d)), the Confidential Information Protection and Statistical Efficiency Act (CIPSEA, Title 5 of Public Law 107347), and the Privacy Act of 1974 (5 U.S.C. § 552a). Every NCHS employee, contractor, and agent has taken an oath to keep
your information private. Anyone who willfully discloses ANY identifiable information could get a jail term of up to five years, a
fine of up to $250,000, or both.

8

Att G - Letters
(Second Mailing of Questionnaire)
John Doe, MD
Position (if provided, i.e. Director, Chief, etc)
Practice Name (if provided)
5 Smith Street
Nowhere, NC 99999-1111
Dear Dr. Doe,
About three weeks ago, we sent you a questionnaire from the National Electronic Health Records Survey, which is an
important study on the adoption and use of electronic health records (EHRs) and electronic exchange of health information in
office-based practices. As of this mailing, we have not received your survey. If you are unable to complete the survey yourself,
an office manager or another staff member familiar with your workload and experiences with your EHR system could complete
the survey on your behalf. I urge you to complete the survey and return it in the enclosed envelope. It should take about 30minutes to complete. If you are no longer in practice or do not provide care for ambulatory patients, please answer Question 2
on the survey and return it in the postage-paid envelope. If you choose not to participate, please answer Questions 2 and 4
and return it in the envelope.
The National Center for Health Statistics (NCHS) collects data from physicians to help health services researchers and policy
makers understand changes in the environments physicians work, including clinicians’ experience with electronic prescribing
of controlled substances, the use of prescription drug monitoring programs, participation in value-based payment programs,
provider burden associated with documentation and EHR use, and the use of EHRs and how it affects the delivery of health
care in the United States. Your participation is extremely important. We need to hear from you, as we cannot substitute your
unique insight and experiences with those from another physician. You are not being asked to provide any patient information.
The NCHS Ethics Review Board has approved this survey.
NCHS complies with numerous federal laws to protect your data, privacy, and confidentiality. Data collection is authorized
under Section 306 of the Public Health Service Act (42 U.S.C. 242k). NCHS is required to keep your survey data confidential
in accordance with Section 308(d) of the Public Health Service Act (42 U.S.C. 242m(d)) and the Confidential Information
Protection and Statistical Efficiency Act (CIPSEA, Title 5 of PL 107-347).
All information will be used for statistical purposes only. Also, we intend to do additional health care research by linking your
responses to this survey to available administrative medical information and other related records. Your participation is
voluntary. You may stop participation at any time. There are no penalties for nonparticipation.
Thank you in advance for your time, effort, and contribution to this important study. If you have questions or comments
regarding this study, please do not hesitate to contact the study coordinator at (xxx) xxx-xxxx. If you have questions about
your rights as a research participant, please call the Ethics Review Board at the National Center for Health Statistics at (800)
223-8118 and say you are calling about Protocol #2016-07.
Sincerely,

Jennifer Madans, PhD
Acting Director
National Center for Health Statistics

9

Att G - Letters
Frequently Asked Questions
1.

WHO WILL SEE MY ANSWERS?

We take your privacy very seriously. The answers you give us are used for statistical research only. This means that your
answers will be combined with other people’s answers in a way that protects everyone’s identity. As required by federal law,
only those NCHS employees and our specially designated agents (such as the U.S. Census Bureau) who must use your
personal information for a specific reason can see your answers.
Strict laws prevent us from releasing information that could identify you to anyone else without your consent. A number of
federal laws require that all information we collect be held in strict confidence: Section 308(d) of the Public Health Service Act
(42 U.S.C. 242m(d)), the Confidential Information Protection and Statistical Efficiency Act (CIPSEA, Title 5 of Public Law 107347), and the Privacy Act of 1974 (5 U.S.C. § 552a). Every NCHS employee, contractor, and agent has taken an oath to keep
your information private. Anyone who willfully discloses ANY identifiable information could get a jail term of up to five years, a
fine of up to $250,000, or both.

10

Att G - Letters
(Third mailing of Questionnaire)
John Doe, MD
Practice Name (if provided)
5 Smith Street
Nowhere, NC 99999-1111
Dear Dr. Doe,
We have been trying to reach you about an important study on electronic health records (EHRs) and electronic exchange of
health information in office-based practices. Results from the enclosed questionnaire will be used to inform health services
researchers and policy makers about clinicians’ experience with electronic prescribing of controlled substances, the use of
prescription drug monitoring programs, participation in value-based payment programs, provider burden associated with
documentation and EHR use, and the use of EHRs and how it affects the delivery of health care in the United States.
This study period is drawing to a close, and a concern is that physicians who have not responded to the survey may have
different experiences from those who responded. We need to hear from all types of physicians, and we cannot substitute
responses from another physician for your responses. If you are unable to complete the survey yourself within the next week,
then an office manager or another staff member familiar with your workload and experiences with your EHR system could
complete the survey on your behalf. It should take about 30-minutes to complete. If you are no longer in practice or do not
provide care for ambulatory patients, please answer Question 2 on the survey and return it in the postage-paid envelope. If
you choose not to participate, please answer Questions 2 and 4 and return it to us in the enclosed envelope.
You are not being asked to provide any patient information, and participation is voluntary. You may stop participation at any
time. There are no penalties for nonparticipation. Data will be used for statistical purposes only. Also, we intend to do
additional health care research by linking your survey responses to available administrative medical information and other
related records. The National Center for Health Statistics Ethics Review Board has approved this survey.
NCHS complies with numerous federal laws to protect your data, privacy, and confidentiality. Data collection is authorized
under Section 306 of the Public Health Service Act (42 U.S.C. 242k). NCHS is required to keep your survey data confidential
in accordance with Section 308(d) of the Public Health Service Act (42 U.S.C. 242m(d)) and the Confidential Information
Protection and Statistical Efficiency Act (CIPSEA, Title 5 of PL 107-347).
Thank you in advance for your time, effort, and contribution to this important study. If you have questions or comments
regarding this study, please do not hesitate to contact the study coordinator at (xxx) xxx-xxxx. If you have questions about
your rights as a research participant, please call the Ethics Review Board at the National Center for Health Statistics at (800)
223-8118 and say you are calling about Protocol #2016-07. I urge you to complete the survey and return it in the postage-paid
envelope.
Sincerely,

Jennifer Madans, PhD
Acting Director
National Center for Health Statistics

11

Att G - Letters
Frequently Asked Questions
1.

WHO WILL SEE MY ANSWERS?

We take your privacy very seriously. The answers you give us are used for statistical research only. This means that your
answers will be combined with other people’s answers in a way that protects everyone’s identity. As required by federal law,
only those NCHS employees and our specially designated agents (such as the U.S. Census Bureau) who must use your
personal information for a specific reason can see your answers.
Strict laws prevent us from releasing information that could identify you to anyone else without your consent. A number of
federal laws require that all information we collect be held in strict confidence: Section 308(d) of the Public Health Service Act
(42 U.S.C. 242m(d)), the Confidential Information Protection and Statistical Efficiency Act (CIPSEA, Title 5 of Public Law 107347), and the Privacy Act of 1974 (5 U.S.C. § 552a). Every NCHS employee, contractor, and agent has taken an oath to keep
your information private. Anyone who willfully discloses ANY identifiable information could get a jail term of up to five years, a
fine of up to $250,000, or both.

12

Att G - Letters
Post Card Thank You/Reminder
Last week a questionnaire was mailed to you requesting your participation in an important study of electronic health records
and electronic exchange of health information in office-based practices.
If you returned the questionnaire, thank you for your contribution to this research. If not, please do so today. Your participation
is critical and helps improve our understanding of electronic health records systems and electronic exchange of health
information use in the United States.
If you did not receive the questionnaire or have misplaced it, please call our toll-free number at (xxx) xxx-xxxx, and we will be
happy to send you another one. If you have questions about your rights as a research participant, please call the Ethics
Review Board at the National Center for Health Statistics at (800) 223-8118 and say you are calling about Protocol #2016-07.
Thank you for your participation.

Jennifer Madans, PhD
Acting Director
National Center for Health Statistics

13