National Pulse Survey Information Sheet Form

Protocol Information
Attached to Protocol: IRB-AAAT4200
Principal Investigator: Sarah Rossetti (sac2125)
IRB Protocol Title: 25 by 5 Task Force to Reduce Documentation Burden

General Information
Consent Number: CF-AACX0175
Participation Duration: 5
Anticipated Number of Subjects: 10000
Research Purpose: The purpose of this study is to understand the levels of perceived excess documentation burden
experienced by healthcare professionals across all disciplines and trend changes over time.

Contacts
ContactTitle

Contact Information

Sarah Rossetti

Principal InvestigatorPhone:781-801-9211

Email:

sac2125@cumc.columbia. edu

Information on Research
We are asking you to take part in a survey to better understand health professional perceptions of excessive
documentation burden. The survey is expected to take 5 minutes to complete and can be taken from a mobile phoneor from a desktop. This study is from the Department of Biomedical Informatics at Columbia University.

Risks
The risks associated with the anonymous survey are minimal. A risk of taking part in this study is the possibility of aloss of confidentiality or privacy. Loss of privacy means having your personal information shared with someone who isIRB-AAAT4200 (Y01M04)
IRB Exemption Date: 04/02/2024

not on the study team and was not supposed to see or know about your information. The study team plans to protect
your privacy to the best of our ability.

Benefits
You may or may not personally benefit from this study. Your participation may help us gain valuable data to learn more
about levels of perceived excess documentation burden experienced by health professionals across all disciplines.

Alternative Procedures
You may choose not to participate in this study at any time.

Confidentiality
No personal or identifiable information will be collected in the anonymous survey. The only information being collected
are your survey responses. There will be an option to provide demographic information which, although not direct
identifiers, could cause you to be inadvertently identified. However, no attempts to identify you will be made by thestudy team. Additionally, you will be given an option to provide your email address for further communication about theannual symposium if you would like to be included. Your email address will be available in Qualtrics but will be deleted
from the exported dataset to de-identify you and protect your personal information. To minimize any security or privacy
risks, only members of the CUIMC study team, approved by the IRB at CUIMC, and external collaborators from theAMIA 25x5 Task Force will have access to your survey data.

Compensation
There is no compensation for participating in this survey.

Additional Costs
There are no anticipated additional costs to you.

IRB-AAAT4200 (Y01M04)
IRB Exemption Date: 04/02/2024

Voluntary Participation
Taking part in this study is your choice. You can decide not to take part in or stop being in the study at any time. Youmay refuse to take part in the study or withdraw from the study at any time without jeopardizing your employment,
student status, or any other rights. Your choice to participate or not in this study is voluntary and will have no impact on
your employment.

Additional Information
If you have any questions or concerns about this study, you may contact the principal investigator, Sarah Rossetti, at
sac2125@cumc.columbia.edu. For questions regarding your rights or responsibilities as research participants, pleasecontact the Columbia University Human Research Protection Office (HRPO) via email at irboffice@columbia.edu or via
phone at 212-305-5883.

Statement of Consent
By taking this survey you agree that you have read this information sheet and consent to your responses being
collected. You also understand the risk of data being potentially identifiable if you share your email.
Please read this information sheet which includes information about the nature and the purpose of the study, as well
as a description of study procedures. If you have any questions, please discuss them with the investigator or study
staff. The explanation that you are given should mention both the possible risks and benefits to participating in thestudy and the alternatives to participation. You are free to not participate in the study or to withdraw at any time. Yourdecision to not participate, or to withdraw from the study, will not affect your employment status.

IRB-AAAT4200 (Y01M04)
IRB Exemption Date: 04/02/2024