LCHI476 Exam #3 - Exam Review PDF

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Interoperability to assure common meaning in data exchange is: a. Basic interoperability b. Process interoperability c. Semantic interoperability d. Technical interoperability Vendors usually rely on this type of technology to create a way for disparate systems to exchange data. a. Clinical messaging b. Interfaces c. Standard protocols d. System integration Process interoperability: a. Assigns names to different types of data uses b. Establishes policies to enable end-to-end processing c. Relates data to information for mapping d. Supports usability of information systems Which basic HIE service provides security protocols? a. Identity management b. Patient identification c. Record locator service d. Semantic interoperability If individuals grant permission to have their information exchanged in an HIE, the individuals are: a. Authorizing consent b. Directing consent c. Opting in d. Opting out The federal government's vision for a nationwide health information network is now called: a. eHealth Exchange b. HealthIT.gov c. National health information exchange d. eHealth Interoperability Optimization of EHR refers to: a. Adding components to the EHR b. Consolidating components into a single EHR c. Fine-tuning of EHR to improve outcomes d. Improving rates of use

The term used to indicate the number of nurses needed to treat patients given the nature of their illness is called: a. Nurse staffing by patient acuity b. Resource leveling c. Risk-adjusted staffing d. Unionization of staff nurses Medication reconciliation errors most frequently occur: a. During transfers within a hospital b. On admission to a hospital c. Upon discharge from a hospital d. Within a physician practice In which of the following applications does the system help check that the right drug is being given to the right patient at the right time? a. Bar-code medication administration b. Electronic medication administration c. Medication reconciliation d. Pharmacy information system An adverse effect produced by the use of a medication in the recommended manner is: Select one: a. Adverse drug event b. Adverse drug reaction c. Near miss d. Sentinel event Which of the following is not always a benefit of a CPOE system? a. Critical alert provided at the point-of-care b. Legibility of the order to improve patient safety c. Reduction in medication errors d. Speed with which orders can be typed Clinical decision support systems should be designed to be: a. Difficult to override fatal alerts b. Driven by numerous triggers for maximized use of alerts c. Easy to ignore all alerts d. Optionally used by preference of user In an ambulatory care facility, converting charts from paper to electronic is often accomplished by: a. Abstracting essential data b. Creating a hybrid record of some paper and some electronic c. Scanning all paper into the EHR

d. Remaining on paper as long as needed Physician offices can improve their co-pay collections by having the EHR assist them in: a. Charge capture b. Eligibility checking c. ePrescribing d. Scheduling fewer visits Which of the following is used to send a prescription transaction to a retail pharmacy? a. CPOE portal b. E-prescribing gateway c. Fax machine d. Pharmacy benefits manager VPN A tool that helps a physician keep track of his or her schedule for the day and tasks sent to various members of the staff is: a. In-basket function b. Office work queue c. Patient clinical summary d. Template Which of the following provides an exception "safe harbor" for hospitals to donate a portion of the costs of an EHR to a physician group practice? a. Anti-kickback statutes and Stark Law b. Health Insurance Portability and Accountability Act (HIPAA) c. Centers for Medicare and Medicaid Services (CMS) d. Interoperability What function in an ambulatory EHR system helps providers reach out to patients who have not filled a prescription in order to help them overcome obstacles to improving their health outcomes? a. Care coordination b. Clinical messaging c. Computerized provider order entry d. E-prescribing Use of EHR in specialty care is becoming important to: a. Earn consumer trust in their services b. Keep physicians happy due to their demand for implementation of EHRs c. Share information with hospitals and physician offices d. Ensure acute care facilities stay in business EHR functionality for specialty providers involves: a. Addressing workflow differences b. Duplicating workflow patterns found within the acute and ambulatory settings

c. Incorporating provisions for lack of privacy laws in those service lines d. Requiring federal government to mandate use of EHRs Long-term care facilities make significant use of electronic systems for: a. Clinical decision support b. Mandatory reporting c. Patient education d. Employing more nurses An assisted living center is most likely to take advantage of EHR technology to assistance in: a. Remote patient monitoring b. Completion of MDS documentation c. Conduct group therapy sessions d. GPS functionality Which unique need of a DME provider could be enhanced by the utilization of an EHR? a. GPS functionality b. Completion of the OASIS documentation c. Communication of orders for the equipment that resembles the e-prescribing model d. Closed-loop medication management The Standards Development Organization that serves as a forum for specialists to create functional profiles for EHRs is: a. American Medical Association b. Health Level Seven c. Health Information Management and Systems Society d. National Institute for Standards and Technology A significant benefit of an EHR in a home health agency is: a. Conduct group therapy sessions b. Improved quality of care through care coordination c. CPOE d. Completion of the MDS With respect to adoption of EHRs in specialty care, behavioral health has: a. About the same rate of adoption b. Has the lowest rate of adoption c. Has the most adoption d. Has adoption rates higher than that of acute care Behavioral health specialists are especially concerned that their use of an EHR will be: a. A significant factor in their clients' increased depression b. Difficult to use due to the amount of typing to be performed since they mainly document in narrative form c. A potentially negative effect on the provider-patient relationship that is based on paying

attention and recognizing behavior d. Both B and C e. All of the above. f. None of the above. The predominant standards development organization for healthcare information applications in provider settings is: a. ASC X12 b. DICOM c. HL7 d. IEEE A technique to create representations of information for easier understanding is: a. Data visualization b. Design of templates c. Results management d. Workflow and process improvement A key feature of point-of-care documentation is: a. Ability to provide interdisciplinary care b. Family members in the patient's room can read the nurses' documentation as it is entered c. Alignment of evidence-based guidance at the point of care d. Somewhat reduced delay in the transcribing of nursing documentation into the HER Automating alerts in nurse assessments means: a. Critical actions required of the nurse can be eliminated b. Critical lab values do not have to be memorized c. Physically monitoring patients is no longer necessary d. Nurses can spend less time with patients Which of the following helps ease the burden of data entry for physicians? a. Use of templates b. Scribes c. Voice recognition d. All of the above A 'clinical data repository' is: a. database that integrates data from multiple source systems to provide users with detailed patient-level data and clinical decision support b. a large 'database of databases' that are optimized to perform data analytics c. a SDO, accredited by ANSI, that is working to standardized EHR data formats d. the process of verifying medications at each point of patient transfer Which of the following is TRUE regarding the ordering of medications?

a. CPOE systems send medication orders to retail pharmacies. b. E-prescribing systems send prescriptions electronically to retail pharmacies. c. Medication orders are faxed to retail pharmacies by OC/RR systems. d. Both CPOE and E-prescribing generate paper prescription forms for medications. WGMC currently uses an EHR, however, lab results don't automatically feed into the EHR. The results are so delayed due to the inefficient workaround the vendor built between the EHR and the internal Laboratory Information System (LIS). This has caused extreme frustration amongst the physicians of the facility and well as unsuccessful improvement of patient outcomes. The CIO has just announced that WGMC is in the process of seeking out a new EHR. What will WGMC be looking for in the new EHR system? a. An interfaced solution b. An integrated system c. POC documentaton d. Closed-loop medication management HIMSS has said, “the extent to which systems and devices can exchange data, and interpret that shared data. For two systems to be interoperable, they must be able to exchange data and subsequently present that data such that it can be understood by a user.” What is HIMSS describing in this statement? a. An interface b. Interoperability c. An integrated system d. Clinical decision support The ability of health IT systems to exchange and interpret information — then actively use the information that has been exchanged. What is the term being described here? a. An interface b. Interoperability c. Semantic interoperability d. Computerized Provider Order Entry (CPOE) What can be said about semantic interoperability? a. There's no need for it since healthcare has been managing fine without. b. Semantic interoperability is not as important as that of syntactic interoperability c. Semantic interoperability could result in reduced duplicative testing, enable better-informed clinical decision-making, and avoid adverse health events d. Semantic interoperability is so easy to achieve healthcare has been doing it for years. Who is responsible for standards that offer health IT developers, EHR vendors, and healthcare organizations the means to ensure health IT systems and devices can exchange data successfully? a. CMS b. ONC c. HIPAA

d. SDO What allows developers to create apps that can plug into EHR systems and deliver information directly into the provider workflow especially through mobile devices? a. FHIR and API b. Interfaces and Integration c. CCR and CCD d. CPOE and BC-MAR What statement is TRUE regarding the existence of interoperability in healthcare? a. No standards exist to dictate how healthcare facilities need to exchange data b. There are no federal mandates forcing vendors to build systems to accommodate interoperability c. Interfaces are so efficient that any other level of interoperability is not necessary d. Variations in the way standards are chosen, adopted, and implemented limits the success of existing interoperability standards This summary includes only the information [that's] critical to effectively continue a patient's care after transfer. This snapshot of information is broken across multiple sections of specific clinical data, which include specific clinical content as standardized by the SDO. The general intent of the document is to only include information necessary for improved outcomes with the continuity of care. What is being described here? a. HIE b. CCD c. CDS d. BC-MAR To reduce medication errors due to allergies, the hospital has implemented a rules engine that triggers an alert if a prescription is ordered and the patient has a documented allergy on file (i.e. RxNorm code 248550 for codeine). If the pharmacy system is using proprietary codes and the rules engine isn’t able to convert these codes to RxNorm terminology, the rule may not be triggered before the prescription is administered —leading to a possible dangerous situation for the patient who is allergic to codeine. What should be done to remedy this situation? a. HL7 b. Data normalization c. Alert fatigue d. Data visualization A patient had a routine mammogram, but never received a phone call about the results. She thought, “no news is good news,” she went about her life. A year later, during her annual examination, she commented to her physician about her relief on the good mammogram results. Instead, she was informed during that visit that her test results had been incorrectly filed in the chart of a deceased patient with the same name. Not only did she have breast cancer, but it had advanced to a terminal diagnosis. What issue is this scenario describing?

a. Data normalization b. Alert fatigue c. Lack of a NPI d. Lack of a unique healthcare identifier for individuals All of the following are benefits of HIE, EXCEPT: a. Provides a vehicle for improving quality and safety of patient care by reducing medication and medical errors b. Eliminates redundant or unnecessary testing c. Removes the need for consumer education and patients' involvement in their own health care d. Reduces health related costs The practice providers who transitioned or referred their patients to other care providers or care settings provide summaries of care more than 50% of the time. For example, the practice provides clinical summaries to primary care physicians who refer patients with abnormal pap smears, as well as to the patients themselves. This is an example of: a. medication reconciliation b. identity management c. CDS d. care coordination The HIM Director just typed up a job description that identified these responsibilities:  Oversight of organizational compliance with confidentiality and privacy guidelines  Oversight of the right people receiving the appropriate data  Protection and security of the organizational data warehouse 

Personal data de-identification when needed



Data quality upkeep What type of position is the HIM Director looking to fill? a. Chief Information Officer b. Data analyst c. Coder d. Data steward The care coordination process may be automated so that key events, like the posting of test results, a hospital admission, or emergency department visit triggers the sending of patient information to a primary care physician (PCP). What kind of exchange is being described here? a. Directed Exchange b. Query-based Exchange c. Consumer-Mediated Exchange d. ePrescribing This HIE approach aggregates data from multiple organizations into a longitudinal, comprehensive patient record that reflects a patient’s care from across the community. The "request" is initiated from the provider who is looking to access any and all available information

contained in the HIE regarding the patient they are currently caring for. What kind of HIE exchange is this scenario describing? a. Directed Exchange b. Query-Based Exchange c. Consumer-Mediated Exchange d. Consent management How would you describe this image?

a. data normalization b. data visualization c. CPOE d. CDS In order to understand where potential continuous quality improvement opportunites exist in utilization of an EHR, a facility must establish metrics to track and monitor. The results of this monitoring will serve as the target for enhanced EHR optimization efforts. What are we referring to in this statement? a. The way in which to engage stakeholders towards EHR optimization b. Tracking the "M" of SMART goals to determine where further EHR optimization may exist c. The way in which to secure leadership buy-in from the top-down d. The way in which the facility celebrates large and small successes The physician enters this order directly into the EHR: Bactrim DS tablets, #20 tabs, take one tab bid for 10 days. The nurse on duty receives the order as a task within her workflow process and accesses the EMAR to view the order electronically. The nurse then visits the medication

dispensing cabinet on the unit where verification of the EMAR releases the Bactrim appropriately from the cabinet. The nurse's COW lost power hours ago so she decides to enter the patient's room and simply ask the patient her name before administering the medication. Analyze this scenario: a. Closed-loop medication management is accomplished in this scenario b. Closed-loop medication management is not accomplished because CPOE does not exist in the scenario c. Closed-loop medication management is not accomplished because EMAR does not exist in the scenario d. Closed-loop medication management is not accomplished because BC-MAR does not exist in the scenario Of the following, which statement appropriately describes best-practice for successful buy-in for physicians with utilization of CPOE? a. Discourage the use of a physician champion because physicians never trust them. b. Have the c-suite members stay out of sight because physicians feel their motives are questionable. c. Refrain from revising order entry policies and procedures until at least 6 months following the implementation of CPOE. d. Have medical staff departments develop order sets because this will develop trust from the physicians when utilizing CPOE. This is an event or events that cause a decision support rule to be invoked. a. Trigger b. Alert c. CDS d. Alert fatigue The Consolidated Clinical Document Architecture is a: a. Combination of content and document markup standard for various types of clinical documents b. Ensures privacy and security of clinical documentation c. Allows healthcare facilities to exchange billing and coding information d. Provides a PHR to patients You are the HIM director of a physician’s office that is implementing an EHR system. You call a meeting to discuss the possible solution to the need for clinicians to access the patients’ longitudinal medical record. What would you suggest as a possible solution to the problem? a. There is no problem since access to old medical records is not a need of clinicians within a physician office setting. b. You call the local hospital where most of your patients are referred to ask for access to the facility’s PHR. c. You will bring in a vendor to begin the process of installing mHealth equipment within the physician’s office.

d. You ask the clinicians to come to a consensus regarding the most accessed documentation from old charts and organize a project to back scan an abstracted version of old charts into the EDMS. All of the following should facilitate the adoption of health IT within the nursing home setting, EXCEPT a. Nursing home data requirements are more highly regulated. b. The acuity of patients within nursing homes is not as high as in acute care. c. Many nursing homes are a part of a large, for-profit chain that have standardized procedures. d. EHR systems for nursing home settings are extremely cheap. Which of the following is the most frequently cited benefit of using an EHR within the nursing home setting? a. Nursing home have a low rate of adoption of EHRs b. Increased time required to fill out the MDS assessment form c. Eliminates the requirement to fill out the MDS assessment form at all d. Decreased time required to fill out the MDS assessment form Which of the following statements is TRUE regarding adoption of EHRs within specialty specific settings? Select one: a. Workflow in each specialty-specific setting is identical therefore implementation of an EHR is very popular in all specialty-specific settings b. The utilization of an EHR will NEVER be of benefit to any specialty-specific facility. c. EHRs for nursing home, home health, and hospice care settings are among the more widely adopted EHRs. d. The adoption of EHRs within the behavioral health environment is greater than that of the acute care setting....