OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Evaluation of the SAMHSA PDMP Electronic Health Record Integration and Interoperability Expansion Program

ICR 201311-0920-010 · OMB 0920-1008 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Interview Guide for End Users Form and Instruction New Available
Interview Guide for Key Project Staff and Stakeholders Form and Instruction New Available
PEHRIIE Evaluation Supporting Statement B - 11-4-2013 - Clean.docx Supporting Statement B Uploaded 2013-11-07 Available
Attachment 9 - NCIPC IRB Human Subjects Research Determination - Final.pdf Supplementary Document Uploaded 2013-11-07 Available
Attachment 8 - Documentation of Consultation with CDR Jinhee Lee - Final for ICRO.docx Supplementary Document Uploaded 2013-11-07 Repair queued
Attachment 6 - PEHRIIE Evaluation Plan Summary - Final.docx Supplementary Document Uploaded 2013-11-07 Available
Attachment 2 - PEHRIIE Evaluation Published 60-day Notice - Final.pdf Supplementary Document Uploaded 2013-11-07 Available
Attachment 5 - Tabular Description of Respondent Universe - Final.docx Supplementary Document Uploaded 2013-11-07 Available
Attachment 1 - Authorizing Legislation - Final.docx Supplementary Document Uploaded 2013-11-07 Available
Attachment 7 - Initial Contact and Scheduling Email Templates - 9-26-2013 - Final.docx Supplementary Document Uploaded 2013-11-07 Repair queued
PEHRIIE Evaluation Supporting Statement A - 11-4-2013 - clean.docx Supporting Statement A Uploaded 2013-11-07 Available
IC Document Collections
IC IDCollectionTypeStatusForm
209349 Clinical End Users Recruiters Instruction New
209348 Interview Guide for End Users Form and Instruction New
209347 Interview Guide for Key Project Staff and Stakeholders Form and Instruction New
ICR Details
0920-1008 201311-0920-010
Historical Active
HHS/CDC 20877
Evaluation of the SAMHSA PDMP Electronic Health Record Integration and Interoperability Expansion Program
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 01/15/2014
Retrieve Notice of Action (NOA) 11/14/2013
  Inventory as of this Action Requested Previously Approved
01/31/2016 24 Months From Approved
132 0 0
119 0 0
0 0 0
CDC proposes a qualitative evaluation of the Prescription Drug Monitoring Program (PDMP) Electronic Health Record (EHR) Integration and Interoperability Expansion (PEHRIIE) program. The program is a collection of state initiatives funded by 2012 Prevention and Public Health Funds cooperative agreements through DHHS, SAMHSA. CDC is conducting an evaluation of the program to understand the processes, challenges, and successes in implementing and sustaining integration of PDMP data with Health Information Technology systems and interoperability of PDMP systems across states. The collection will capture the experiences of clinical end users with the systems being upgraded under the PEHRIIE program and their recommendations for how the goals of the PEHRIIE program could have been better accomplished.
US Code: 42 USC 301 Name of Law: PHSA
  
None
Not associated with rulemaking
  78 FR 43206 07/19/2013
78 FR 68074 11/13/2013
No
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 132 0 0 132 0 0
Annual Time Burden (Hours) 119 0 0 119 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new information collection.
$129,386
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Shari Steinberg 404 639-4942 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
11/14/2013