COVID-19 Critical Care Drug Monitoring Survey Portal Reference Guide

OMB Control No. 0910-0500
Expiration Date: 9/30/2023
Paperwork Reduction Act Statement: According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information
collection is 0910-0500 and the expiration date is 09/30/2023. The time required to complete this information collection is estimated to average 15
minutes, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the collection of information.
Send comments regarding this burden estimate or any other aspects of this collection of information, including suggestions for reducing burden, to
[email protected]. The survey we are conducting is on behalf of the U.S. Food and Drug Administration (FDA).

Reference Guide

Click here to access the portal.
Supported Browsers: Google Chrome*, Mozilla Firefox, Microsoft Edge, and Apple Safari
*Preferred for optimal functionality.

COVID-19 Critical Care Drug Monitoring Survey
Introduction
The Food and Drug Administration (FDA) plays a vital role in helping to address the Coronavirus Disease (COVID-19)
pandemic and recognizes the critical role of your organization. Currently, FDA is working to identify critical care
drugs essential for the care and management of hospitalized patients with COVID-19, particularly for those
managed in the intensive care units.
Input from you and organizations like yours help to identify drugs that may be at risk of a regional or national
shortage. We are requesting for you or another member of your organization to complete a brief survey on a
weekly basis. The initial survey will require that you register in FDA’s secure portal and complete a quick survey as
soon as possible. The information you provide to us should be to the best of your knowledge at the time you
complete the survey for the week that the survey is sent, and will be used to help ensure these drugs remain
available to meet the needs of your state and our nation.
For any questions or if you would like to speak to someone at the FDA to assist in providing the information in the
survey, please reach out to Stephanie Omokaro at the following email: [email protected].

COVID-19 Critical Care Drug Monitoring Survey
Portal Homepage

Step 1. Once you land on the Portal homepage,
Click New to begin the COVID-19 Critical Care Drug
Monitoring Survey.

COVID-19 Critical Care Drug Monitoring Survey
Hospital/Organization Information
For New Users:
Step 1. Select + New Hospital Organization.
Step 2. From the pop-up window complete
the information requested:
• Enter the Hospital Organization name.
• Enter the Address.
• Enter the City.
• Select the State from the dropdown box.
• Enter the Zip or Postal Code.
Mandatory fields (*) are required to
proceed.
Step 3. Click Save.

For returning users, select the
Add multiple
Hospital Organization from the
search filters!
bar and continue with
the survey.

COVID-19 Critical Care Drug Monitoring Survey
Hospital/Organization Information
Step 4. Verify your Hospital/Organization was
entered successfully.
Step 5. Complete the information requested:
• Select your Role from the dropdown
• Enter the Number of Hospitals/Organization
represented in the survey.
• Enter the Number of Hospital Beds.
• Select Yes or No from the dropdown if there is
an Intensive Care Unit (ICU).
• Enter the Number of ICU Beds.
• Select the State(s) represented in the survey
• From the Available column, highlight
the State(s). Click forward ( ) arrow
to move the selections to the Choose
column.
• To deselect State(s), highlight State(s)
from the Choose column, hit the reverse
( ) arrow to move the selections to
the Available column.
• Enter the Number of ICU COVID-19 Patients
non-ventilated
• Enter the Number of ICU COVID-19 Patients
ventilated
Step 6. Click Save.

COVID-19 Critical Care Drug Monitoring Survey
FDA Critical Care Drug List
Step 7. From the dropdown menu,
select the Number of Days that
correspond to your On-Hand Day
Supply for the current week for each
drug listed.
Additionally,
• Select the Yes or No checkbox to
indicate if your organization has
changed its medical practice to
manage the inventory for each
drug listed.
• Select the Yes or No checkbox to
indicate if your organization is
experiencing delays in receiving
each drug listed.

COVID-19 Critical Care Drug Monitoring Survey
Optional Survey
Step 8. Provide information on drugs
that are currently on FDA’s Drug
Shortages List. From the dropdown
menu, select the Number of Days
that correspond to the drug(s) listed
with your On-Hand Day Supply for the
current week.
Additionally,
• Select the Yes or No checkbox to
indicate if your organization has
changed its medical practice to
manage the inventory for each
drug listed.
• Select the Yes or No checkbox to
indicate if your organization is
experiencing delays in receiving
each drug listed.

COVID-19 Critical Care Drug Monitoring Survey
Additional Drugs Not Listed
Step 9. Click New to report
information on Additional Drug(s) not
listed.
Step 10. From the pop-up window
complete the information requested:
• Enter the Drug Name.
• Select your On-Hand Day Supply
from the dropdown.
• Click the checkbox to indicate if
your organization is changing its
medical practice to manage the
supply for the drug.
• Click the checkbox to indicate if
your organization is experiencing
delays in receiving the drug.
Step 11. Click Save.

COVID-19 Critical Care Drug Monitoring Survey
Additional Comments
Step 12. Add Additional Comments.

Submit the Survey
Step 13. Click the checkbox to verify
the information submitted is for the
current week.
Step 14. Click Submit Notification of
Drug Demand.
Step 15. Click OK to confirm
submission.

Receiving Notification(s) from FDA
You will receive an email confirming
your submission of the COVID-19
Critical Care Drug Monitoring Survey.