Information Collection

Performance Improvement Measurement System for the Office for the Advancement of Telehealth

IC 180666 under ICR 202008-0915-001 · OMB 0915-0311.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0311 can be found here:

Documents and Forms

Document Name Document Type
Form 1 Performance Improvement Measurement System for the Office for the Advancement of Telehealth Form
OAT PIMS Instructions.docx Instruction
1 PIMS Measures FINALPIMS measures july2020-revisions highlighted8.12.20.docx Form
2 Tele-Emergency Measures Tele-Emergency measures july2020.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Performance Improvement Measurement System for the Office for the Advancement of Telehealth	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	PIMS Measures	FINALPIMS measures july2020-revisions highlighted8.12.20.docx	Yes	No	Fillable Fileable
Form	2	Tele-Emergency Measures	Tele-Emergency measures july2020.pdf	Yes	Yes	Fillable Fileable
Instruction			OAT PIMS Instructions.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 29	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	29	8	21
Annual IC Time Burden (Hours)	203	56	147
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.