Form 0917-0036 Clinical Decision Support Usability Assessment

Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery: IHS Customer Service Satisfaction and Similar Surveys

Clinical Decision Support Usability Assessment - Local Clinical Reminders Su

Clinical Decision Support Usability Assessment

OMB: 0917-0036

Document [pdf]
Download: pdf | pdf
Clinical Decision Support Usability Assessment - Local Clinical Reminders Survey


Clinical Decision Support Usability Assessment - Local Clinical
Reminders


Exit this
survey


1.
Default
Section
Indian Health Service (IHS) FY15  Clinical Decision Support Usability Assessment
Form Approved
OMB Form No.. 0917-0036
Expiration Date: 05/31/2015
 
According to the Paperwork Reduction Act of 1995, no persons are 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 0917-0036.  The time
required to complete this information collection is estimated to average 5 minutes per response, including the time to review
instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you
have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S.
Department of Health & Human Services, OS/OCIO/PRA, 200 Independence Ave., S.W., Suite 336E, Washington D.C. 20201,
Attention: PRA Reports Clearance Officer.

This information will assist EHR Clinical Reminders Team and Distributed Terminology Services (SNOMED) team in
assessing need for additional SNOMED subsets to support local reminders.

*
1.
Enter site and contact information

Name:

Facility:

State:

-- select
-- --selectstate
state


Email Address:

*
2.
Do you use any locally created Reminder Definitions?

No

I copied National Reminders into local names and edited.

I created my own reminders.

*
3.
Do you use any locally created Reminder Taxonomies?

https://www.surveymonkey.com/r/C5GXP66[3/16/2015 1:53:33 PM]

Clinical Decision Support Usability Assessment - Local Clinical Reminders Survey


No

Yes


4.
If you use locally created Reminder Taxonomies, please list each taxonomy, what it contains and how it is used in
your reminder logic.
Example:  TEST-HEP C DX, contains diagnosis codes for Hepatitis C, used to exclude patients with a diagnosis of Hep C
from the cohort of a Hepatitis C screening reminder

Thank you for participating in our survey.

Don

Done
e

Powered by SurveyMonkey
Check out our sample surveys and create your own now!

https://www.surveymonkey.com/r/C5GXP66[3/16/2015 1:53:33 PM]


File Typeapplication/pdf
File TitleClinical Decision Support Usability Assessment - Local Clinical Reminders Survey
File Modified2015-05-12
File Created2015-03-16

© 2024 OMB.report | Privacy Policy