a. PACT “Telehealth in the Parkinson's Disease Research, Education and Clinical Center (PADRECC): The Key to the Patient-Centered Medical Home?”, VA Form 10-0533.
b. Geriatric Depression Scale (GDS) Short Form, VA Form 10-5033a.
c. Quality of Life in Parkinson's Disease, VA Form 10-0533b.
d. Cost and Patient Outcomes Questions, VA Form 10-0533c.
OMB Control Number:2900—New (VA Form 10-0533a-c).
Type of Review:New data collection.
Abstract:The data collected on VA Forms 10-0533a-c will be used to obtain data on the cost, clinical outcomes, and patient satisfaction associated with expanded access to PADRECC care through the use of telehealth. VA will use the information to assess whether or not the use of telehealth is feasible, cost-effective, and clinically equivalent alternative to routine face-to-face care for patients with Parkinson's disease.
Affected Public:Individuals or households.
Estimated Annual Burden:116 burden hours.
Estimated Average Burden per Respondent:4.4 minutes.
Frequency of Response:On occasion.
Estimated Number of Respondents:400.
Estimated Number of Responses:1,600.
Dated: August 16, 2012.
By direction of the Secretary.
Program Analyst Director, Enterprise Records Service.