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Privacy Impact Assessment Form
v 1.43
	
Status Draft Form Number F-54643 Form Date 9/18/2013 10:56:01 AM
	
Question Answer
	
OPDIV: TEST
PIA Unique Identifier: P-5860043-506903
2a Name: Test 9-18-01
	
	
	
	
	
	
The subject of this PIA is which of the following?
	
	
	
	
3a Identify the Enterprise Performance Lifecycle Phase of the system.
	
3b Is this a FISMA-Reportable system?
	
Does the system include a Website or online
General Support System (GSS) Major Application
Minor Application (stand-alone) Minor Application (child) Electronic Information Collection Unknown
Operations and Maintenance
	
Yes No
Yes
application available to and for the use of the general
public? No
	
			Agency Contractor 
	
	
POC Title Head of Clinical and Translational Informatics
	
	
	
Point of Contact (POC):
POC Name Jose Galvez, MD POC Organization NCI CBIIT
	 POC
	Email	jose.galvez@nih.gov
POC
	Email	jose.galvez@nih.gov
	
POC Phone 240-276-5206
			New Existing 
			Yes No 
8a Date of Security Authorization 4/10/2014
	
	
	
	
	
	
	
	
	
Describe the purpose of the system.
The CTRP Database provides a comprehensive real-time view of the state of NCI-funded cancer clinical trials, which enables NCI to make informed prioritization decisions via disease- specific steering committees. Accordingly, this resource allows the NCI to manage its portfolio of cancer clinical research investments effectively; consolidate and streamline existing reporting to individual programs within the NCI by aggregating the information already collected and eliminating the need for redundant submissions to the NCI; comply with regulatory reporting requirements when acting as the sponsor of FDA-regulated clinical investigations; prepare the detailed performance, financial management and administrative accountability reports required of Executive Branch agencies, including those required by Executive Orders or OMB Circulars, Memoranda and Guidelines; and provide appropriate public access to cancer research information.
	
	
	
	
		Information collected
		includes the
		trial protocol
		document, the
		template informed consent document, and IRB approval
		documentation, and related protocol/lead organization information
		including NIH funding information, trial/ organization
		contact information,
		trial status
		information, and
		IND/IDE information. 
		Throughout a
		trial, ongoing
		trial status
		information is
		collected as well as study subject accrual information
		including demographic data. 
collect, maintain (store), or share. (Subsequent questions will identify if this information is PII and ask
about the specific data elements.)
	
	
	
	
	
	
	
	
		The Clinical
		Trials Reporting
		Program (CTRP)
		is a
		web-based program to
		submit data
		about cancer-related
		clinical trials
		and to
		search for
		data concerning
		cancer-related clinical
		trials. The CTRP
		system is
		an electronic
		resource that
		is intended
		to serve as a
		single, definitive source of information about all NCI- supported
		clinical research.
		Deployment of
		this resource
		will allow the
		NCI to
		consolidate reporting,
		aggregate information
		and reduce redundant submissions. Information will be submitted
		by clinical
		research coordinators
		as designees
		of clinical investigators who conduct NCI-supported clinical
		research. 
information it will collect, maintain (store), or share, either permanently or temporarily.
	
	
	
	
	 
	
Does the system collect, maintain, use or share PII?
Yes No
	
	
	
	
	
	
	
	
	
	
	
Indicate the type of PII that the system will collect or maintain.
Social Security Number Date of Birth
	 Name	Photographic
	Identifiers Driver's License
	Number	Biometric Identifiers Mother's
	Maiden Name	Vehicle
	Identifiers
Name	Photographic
	Identifiers Driver's License
	Number	Biometric Identifiers Mother's
	Maiden Name	Vehicle
	Identifiers
E-Mail Address Mailing Address
Phone Numbers Medical Records Number
Medical Notes Financial Account Info
Certificates Legal Documents
Education Records Device Identifiers
Military Status Employment Status
	 
		Zip code 
Gender
Ethnicity
 
		 
	
Race
 
	
	
	
	
Indicate the categories of individuals about whom PII is collected, maintained or shared.
Employees Public Citizens
Business Partners/Contacts (Federal, state, local agencies) Vendors/Suppliers/Contractors
Patients
	
	
Other
	
How many individuals' PII is in the system? 100,000-999,999
	
	
			The information is collected for purposes of portfolio management,
			compliance with
			regulatory and
			administrative reporting
			obligations and
			appropriate
			dissemination of
			cancer research
			information to
			the public. 
	
	
	
	
Describe the secondary uses for which the PII will be used (e.g. testing, training or research)
The PII collected is part of a set of study subject information which the NCI will use to determine accrual demographics across the NCI portfolio, helping to ensure equal access to NCI trials.
	
	
			 N/A 
			
	
	
		 N/A 
		
	
Identify legal authorities governing information use and disclosure specific to the system and program.
	
Are records on the system retrieved by one or more
	
	
	
		N/A 
PII data elements? No
	
	
	
	
22a
	
Identify the number and title of the Privacy Act System of Records Notice (SORN) that is being used to cover the system or identify if a SORN is being developed.
Published: Published: Published:
	
	
	
	
	
	
In Progress
	
	
Directly from an individual about whom the information pertains
	
	
	
	
	
	
Identify the sources of PII in the system.
	
	
	
	
	
	
Government Sources
	
	
	
	
	
	
	
Non-Government Sources
In-Person Hard Copy: Mail/Fax
Email Online Other
	
Within the OPDIV Other HHS OPDIV State/Local/Tribal
Foreign Other Federal Entities
Other
	
Members of the Public
	
	
	
	
	
	
	
	
23a Identify the OMB information collection approval number and expiration date.
Commercial Data Broker Public Media/Internet
Private Sector
	 
		 OMB Approval #:
		0925-0600. Expiration Date: 05/31/2016 
		
	
	
	 
	
Is the PII shared with other organizations?
Yes No
Within HHS
	
	
	
	
	
	
	
	
	
24a Identify with whom the PII is shared or disclosed and for what purpose.
Only designated, appropriate NCI program and administrative employee and contractor staff will have full access to the data within the CTRP Database for purposes of portfolio management and compliance with regulatory and administrative reporting obligations. Access will be limited to those with a direct need to access the data. Access will be granted to non-Federal staff under a non-disclosure agreement and staff will be given mandatory privacy and security training
	
Individual submitters to the CTRP Database will have full access to information they have submitted.
Other Federal Agency/Agencies
State or Local Agency/Agencies
	
	
	 
		 N/A 
		
		
	
	
	
	
24b
Describe any agreements in place that authorizes the information sharing or disclosure (e.g. Computer Matching Agreement, Memorandum of Understanding (MOU), or Information Sharing Agreement (ISA)).
	
	
	
	
	
	
	
	
	
24c
Describe the procedures for accounting for disclosures
	
	
	
	
	
	
	
	
		Study Subject
		PII is
		collected from
		the Principal
		Investigator or
		Study Coordinator, and not supplied directly by the study
		subject. The
		Principal Investigator
		and/or Study
		Coordinator are
		notified by
		posted notices
		on the
		website. 
		NCI will
		post written
		notices on
		the web
		site portal
		for the CTRP
		system to inform clinical investigators/research coordinators
		of: 
			major changes
			that occur
			to the
			CTRP system
			that affect
			disclosure and/or
			uses of
			PII in
			the CTRP
			system; 
			changes in
			the type
			of PII
			to be
			collected from
			study subjects; and 
			any changes
			to how
			PII is
			used or
			shared (from
			current practice of
			making PII
			collected from
			study subjects
			available only to
			designated,
			appropriate NCI
			employee and
			contractor staff on a “need to know” basis for
			purposes of portfolio management and compliance with regulatory
			and administrative reporting
			obligations). 
 
		
			
Describe the process in place to notify individuals
that their personal information will be collected. If no prior notice is given, explain the reason.
	
		 Is
		the
		submission
		of
		PII
		by
		individuals
		voluntary
		or mandatory?
Is
		the
		submission
		of
		PII
		by
		individuals
		voluntary
		or mandatory?
	
Describe the method for individuals to opt-out of the
collection or use of their PII. If there is no option to object to the information collection, provide a
reason.
Voluntary Mandatory
PII is not collected directly from individuals, but from the Principal Investigator or Study Coordinator. The information required from the individual is agreed upon during the Informed Consent process of enrollment.
Describe the process to notify and obtain consent from the individuals whose PII is in the system when major changes occur to the system (e.g., disclosure
and/or data uses have changed since the notice at the time of original collection). Alternatively, describe why they cannot be notified or have their consent obtained.
Describe the process in place to resolve an individual's concerns when they believe their PII has
been inappropriately obtained, used, or disclosed, or that the PII is inaccurate. If no process exists, explain why not.
Describe the process in place for periodic reviews of
PII contained in the system to ensure the data's integrity, availability, accuracy and relevancy. If no
processes are in place, explain why not.
	
	
NCI has no means to identify or contact the individuals whose PII is in the system. The Principal Investigator and/or Study Coordinator would be notified via the CTRP website and could contact the individuals.
	
		If individuals believe their PII has been inappropriately obtained,
		used or
		disclosed, they
		can file
		a complaint
		to the Office
		of Civil
		Rights (OCR)
		within 180
		days of
		the alleged
		violation. This
		complaint must
		be in
		writing and
		submitted either by
		e-mail, postal
		mail, or
		fax. 
  
	
	
The system owner checks the PII in the system. The agency will request annual self-assessment to ensure confidentiality, integrity, and availability.
 
Personally identifiable information will be made available to designated, appropriate NCI employee and contractor staff for purposes of
	
	
	
	
	
	
Identify who will have access to the PII in the system and the reason why they require access.
Users
portfolio management and compliance with regulatory and administrative reporting obligations. Individual submitters will have full access to information they have submitted.
Administrators System Administration
	
Developers
	
	
	
Contractors
Perform services as required, primarily management of submitted data by clinical protocol abstraction staff
	
	
Others
	
		Access will
		be limited
		to those
		with a
		direct need
		to access
		the data. Access
		will be
		granted to
		non-Federal staff
		under a
		non- disclosure agreement and staff will be given mandatory
		privacy and
		security training. 
system users (administrators, developers, contractors, etc.) may access PII.
	
		Level of access to PII will depend on role and users will be
		required to
		undergo training
		for the
		role responsibility.
		System audit logs will facilitate accountability enforcement
		for user transactions. 
access to PII to only access the minimum amount of information necessary to perform their job.
	
	 Identify
	training and awareness provided to personnel
	(system owners,
	managers, operators,
Identify
	training and awareness provided to personnel
	(system owners,
	managers, operators,
contractors and/or program managers) using the system to make them aware of their responsibilities
for protecting the information being collected and maintained.
Describe training system users receive (above and
beyond general security and privacy awareness training).
	
		
		
All personnel take mandatory NIH IT Security Training to ensure they are aware of their responsibility for protecting the information collected.
 
	
N/A
Do contracts include Federal Acquisition Regulation
and other appropriate clauses ensuring adherence to privacy provisions and practices?
		National Institutes of Health, NIH System Life Cycle requirements
		require destruction
		of PII
		upon the
		termination of the
		system. 
regard to the retention and destruction of PII. Cite specific records retention schedules.
Yes No
	
	
	
		The PII will be secured by management, operational, and technical
		controls. Some of these controls include user identification and
		authentication, the concept of least privilege,
		and firewalls.
		Infrastructure product,
		username and
		password, annual
		risk assessments,
		background checks
		on administrative
		employees, key
		locks and
		keycards necessary
		to enter server
		rooms. 
be secured in the system using administrative, technical, and physical controls.
	
	
	
 Identify
		the publicly-available
		URL:
		Identify
		the publicly-available
		URL:
		
	
	
	
Does the website have a posted privacy notice?
	
Is the privacy policy available in a machine-readable
Yes No
Yes
40a
	
	
41
format?
	
Does the website use web measurement and customization technology?
No Yes No
Technologies Collects PII?
Yes
	
	
	
	
	
	
41a
	
	
	
	
Select the type of website measurement and customization technologies is in use and if it is used to collect PII. (Select all that apply)
Web beacons
	
	
Web bugs Session Cookies
Persistent Cookies
	
	
Other...
No Yes No Yes No Yes No Yes No
Does the website have any information or pages directed at children under the age of thirteen?
	
Does the website contain links to non- federal government websites external to HHS?
Yes No
Yes No
 
	
	
REVIEWER QUESTIONS: The following section contains Reviewer Questions which are not to be filled out unless the user is an OPDIV Senior Officer for Privacy.
	
	
Reviewer Questions Answer
Yes
1 Are the questions on the PIA answered correctly, accurately, and completely?
No
	
	
	
Reviewer
Notes
Reviewer Questions Answer
	
	
2
	
Reviewer
Notes
	
3
	
Reviewer
Notes
Does the PIA appropriately communicate the purpose of PII in the system and is the purpose justified by appropriate legal authorities?
	
	
	
Do system owners demonstrate appropriate understanding of the impact of the PII in the system and provide sufficient oversight to employees and contractors?
Yes No
	
	
Yes No
	
	
Yes
Does the PIA appropriately describe the PII quality and integrity of the data?
	
Reviewer
Notes
	
Is this a candidate for PII minimization?
	
Reviewer
Notes
	
Does the PIA accurately identify data retention procedures and records retention schedules?
	
Reviewer
Notes
	
Are the individuals whose PII is in the system provided appropriate participation?
	
Reviewer
Notes
	
Does the PIA raise any concerns about the security of the PII?
	
Reviewer
Notes
No
	
	
	
Yes No
	
	
Yes No
	
	
Yes No
	
	
Yes No
	
	
9
	
Reviewer
Notes
Is applicability of the Privacy Act captured correctly and is a SORN published or does it need to be?
Yes No
	
	
Yes
 Is
		the
		PII
		appropriately
		limited
		for
		use
		internally
		and
		with
		third
		parties?
Is
		the
		PII
		appropriately
		limited
		for
		use
		internally
		and
		with
		third
		parties?
	
Reviewer
Notes
	
Does the PIA demonstrate compliance with all Web privacy requirements?
	
Reviewer
Notes
No
	
	
	
Yes No
 
	 
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| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document | 
| Author | Abdelmouti, Tawanda (NIH/OD) [E] | 
| File Modified | 0000-00-00 | 
| File Created | 2021-01-15 |