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CPHIT

Certified Professional for Health Information Technology; HIT
STUDY
PLAY
What is the difference between HIT and EHR?
HIT is a general concept of using information systems and EHR is a specific concept.
In the framework for Strategic Action, what is one of the ways in which the government views personalizing care?
a. Matching therapy to genomic characteristics
b. Enhanced informed consumer choice
c. Provide physicians context-specific templates to use with patients
d. Provide tailored instructions to patients

Answer - Enhanced informed consumer choice
If a hospital seeks meaningful use incentives by 2012, it stands to receive how much funding?
$2 million, plus Medicare share up to an additional amount of not more than $4.37 million.
Which of the following is NOT a challenge in healthcare computing?
a. Overcoming resistance to change
b. Access to data
c. The nature of the clinical data
d. Cost of HIT

Answer - Access to data
The original purpose of a medical record was....
a. Documentation
b. Knowledge acquisition
c. Communication
d. Reimbursement

Answer - Communication
Among the following, where are legibility issues most important?
a. Medication ordering
b. Discharge summary
c. Physician signature
d. Progress note

Answer - Medication ordering
Healthcare organizations are characterized by...
a. Competitive business models
b. Flat organizational structures
c. Consolidation
d. Divergence of authority

Answer - Divergence of authority
In which form of reimbursement may the patient pay a co-pay or be required to meet a deductable?
a. Medicare
b. Group health insurance
c. Blue Cross Blue Shield
d. All of the above

Answer - All of the above
Which of the following is not considered a part of an EHR, but rather HIT complementary to the EHR?
a. Clinical decision support
b. Point of care documentation
c. Laboratory information system
d. Computerized provider order entry

Answer - Laboratory information system
Which one of the following is not a form of clinical decision support (CDS)?
a. Reminder to administer a medication
b. Using a template to follow a clinical practice guideline
c. Alert about an abnormal lab result
d. Icon that supplies the image of a chest x-ray

Answer - Icon that supplies the image of a chest x-ray
Clinical decision support can be challenging to design because:
a. Source systems are not designed to support their use
b. Clinical guidelines are not conducive to direct incorporation into the software
c. Physicians do not like alerts and reminders
d. There is little evidence that they improve the quality of care

Answer - Clinical guidelines are not conducive to direct incorporation into the software
Hybrid records are the result of:
a. Necessity for implementing EHR components
b. Poor computer design
c. Legal restrictions on what can be automated
d. All of the above

Answer - Necessity for implementing EHR components
In which model of personal health record do individuals have the most access to the provider's record of their care?
a. Separate personal health record
b. Provision of summary information
c. Convergence of records
d. All of the above

Answer - Convergence of records
Laws created by federal agency are also called
a. Administrative Law
b. Regulations
c. Rules
d. All of the above

Answer - All of the above
Which of the following would potentially be in violation of laws restricting referrals?
a. Hospital giving physicians tablet computers for use in the hospital and in their offices
b. Hospital allowing access to dictation via provider portal
c. Laboratory providing access to physician offices to results via electronic fax
d. All of the above

Answer - Hospital giving physicians tablet computers for use in the hospital and in their offices
How does case law impact EHR?
a. EHR may be called into evidence
b. Contractual disputes may arise over implementation
c. Computer crimes may be exacerbated
d. All of the above

Answer - All of the above
In the event of pending litigation, it is advisable to....
a. Restrict any changes to the record
b. Deny access to the EHR to anyone but legal counsel
c. Destroy meta data associated with the EHR
d. All of the above

Answer - Restrict any changes to the record
Health records that are microfilmed or stored in other computer media are accepted into court under...
a. Case Law
b. Best Evidence Rule
c. Doctrine of Admissibility
d. Accuracy of Entries

Answer - Best Evidence Rule
Which of the following forms of signature would be acceptable under ESIGN?
a. Digital
b. Digitized
c. Electronic
d. All of the above

Answer - All of the above
PKI incorporates which of the following types of signatures?
a. Encrypted
b. Digitized
c. Digital
d. Electronic

Answer - Digital
Due to problems associated with email, healthcare providers should...
a. Avoid using email with patients
b. Establish specific policies on appropriate email use
c. Use email with patients whenever they initiate a message
d. Restrict email use only in a medical emergency situation

Answer - Establish specific policies on appropriate email use
Which of the following is a hybrid record?
a. Lab results are only viewable electronically, while the rest of the record is on paper
b. Lab results are viewable electronically and printed for the paper chart
c. Lab results may or may not be printed on paper, but the rest of the chart is on paper
d. All of the above

Answer - All of the above
Ethical issues in clinical decision support include...
a. How rules may be overridden
b. Source of knowledge embedded in the rule
c. Whether others are using clinical decision support
d. All of the above

Answer - All of the above
Which of the following steps in a migration path match the point in the data - information - knowledge continuum?
a. Mentor - information
b. Documentation - information
c. Helper - data
d. Data display - knowledge

Answer - Documentation - information
When should an organization define its vision for EHR?
a. When it decides to implement an EHR
b. At the time of vendor selection
c. During vendor negation
d. None of the above

Answer - When it decides to implement an EHR
What is the best way to learn about an EHR?
a. Vendor fairs
b. Site visits
c. Literature
d. All of the above

Answer - All of the above
Which one of the following goals would be most helpful in an HIT vendor selection and implementation process?
a. Reduce nurse time on processing refills
b. An e-prescribing system must be compliant with national standards and able to send RXs to retail pharmacies, manage refills
c. Improve patient safety
d. Reduce 70% of pharmacy call backs by transmitting a complete and legible RX to the pharmacy

Answer- Reduce 70% of pharmacy call backs by transmitting a complete and legible RX to the pharmacy
Which of the following is the best way to describe an application on an EHR migration path?
a. Provider portal
b. Access to data
c. EZ access
d. Any of the above

Answer - Provider portal
EHRs in hospitals are typically more complex than those for physician practices due to...
a. Size of hospital
b. Physician decision making
c. Loosely coordinated workflow
d. Multiple data sources

Answer - Multiple data sources
Which of the following is false concerning EHRs?
a. They only produce full value when used
b. They are imperfect tools
c. They relieve clinicians from professional judgment
d. They take time to learn how to use

Answer - They relieve clinicians from professional judgment
An example of a driving strategy might be...
a. Cost reduction
b. Patient safety
c. Competitiveness
d. All of the above.

Answer - All of the above
Which of the following change strategies depends on peer pressure?
a. Adoption-based
b. Incentive-based
c. Norm-based
d. Sanction-based

Answer - Norm-based
Why is a technically-oriented physicians not the best to be the EHR champion?
a. "Techno-doc" may want to modify the EHR to revert to existing processes
b. "Techno-doc" has too much knowledge about technology to make an unbiased selection
c. "Techno-doc" is an innovator who will be the first to use an EHR
d. "Techno-doc" may not be able to relate to peers who are resistant to new technology

Answer - "Techno-doc" may not be able to relate to peers who are resistant to new technology
When an organization refuses to pull charts routinely for physicians after implementing an EHR, it is...
a. Freezing behavior
b. Changing behavior
c. Refreezing behavior
d. Unfreezing behavior

Answer - Refreezing behavior
The first step in process improvement for EHR is to...
a. Build teams of persons who actually perform processes
b. Acquire and implement an EHR
c. Obtain baseline data to identify processes to be mapped
d. Map current processes at a high level

Answer - Build teams of persons who actually perform processes
A tool that is especially useful for illustrating roles of each person in a process is...
a. Swim lane
b. Flow process chart
c. Systems flow chart
d. Process diagram

Answer - Swim lane
In mapping the actual process, what is the most often overlooked step?
a. Those performed mentally
b. Those impacting the paper chart
c. Those involving patients
d. Those that reflect decision points

Answer - Those performed mentally
The purpose of collecting forms and reports as part of a process mapping is?
a. To ultimately identify all data requirements
b. To sequence alternatives
c. To ensure they are replicated in the EHR
d. All of the above

Answer - To ultimately identify all data requirements
How might baseline data be captured for clinical processes?
a. Stopwatch time study
b. Estimating time it takes to perform various tasks
c. Sampling tasks over a period of time
d. All of the above

Answer - All of the above
The purpose of documenting the "before" and "after" process maps is...
a. To explain to others
b. To ensure changes are made
c. To recognize improvements
d. All of the above

Answer- All of the above
To ensure appropriate communications in the EHR project...
a. There should be a single messenger
b. The vendor implementation plan needs to be adhered to strictly
c. Executive management needs to talk to every user
d. None of the above

Answer - None of the above
When is "penicillin" structured data?
a. When it is selected from a drop down menu in an EHR
b. When it is dictated into a data entry field
c. When it is typed into a blank field
d. All of the above

Answer - When it is selected from a drop down menu in an EHR
Which of the following is an example of structured data?
a. Pick list to record whether the blood pressure was taken sitting or standing
b. Sentence describing the nature of a patients pain
c. An email message saved to an electronic health record
d. Recording of digital dictation

Answer - Pick list to record whether the blood pressure was taken sitting or standing
In which database structure would it be most effective to determine nurse staffing requirements from clinical data?
a. Hierarchical database
b. Clinical data repository
c. Clinical data warehouse
d. Electronic health record

Answer - Clinical data warehouse
Which form of interoperability carries an associated terminology to describe the meaning of the message?
a. Semantic
b. Syntactical
c. Technical
d. Vocabulary

Answer - Semantic
Which standards development organization provides protocols for digital x-rays?
a. DICOM
b. ANSI
c. HL7
d. IEEE

Answer - DICOM
Which of the following is a terminology maintained under the auspices of standards development organization?
a. LOINC
b. Medcin
c. DSM
d. CPT

Answer - LOINC
Which form of input technology would be most suitable for a family practice physician to use in routine office visits?
a. Speech recognition
b. Tablet PC
c. Wireless on wheels
d. Bar code

Answer - Tablet PC
To overcome the risk of backups getting lost in transit, which of the following may be an effective disaster recovery process?
a. Redundant servers
b. Storage area network
c. Storage service provider
d. Redundant array of inexpensive disks

Answer - Storage service provider
Which of the following is a technology that secures WAN connectivity widely used in the retail industry?
a. IPSec
b. SSL
c. IEEE 802.11a
d. VPN

Answer - SSL
Which of the following with respect to software is an important consideration when selecting an EHR?
a. The EHR should be Windows-based
b. Source code is able to be changed
c. Tools should be available to help customize the application
d. The same language should be used to program all parts of the application

Answer - Tools should be available to help customize the application
HIPAA's security regulation is...
a. Overall guidance that organizations may or may not choose to follow
b. A strict set of requirements for security services
c. A risk based framework for security practices
d. A security standard that establishes best practices

Answer - A risk based framwork for security practices
Which of the following is more characteristic of a project than a program or the management of a department?
a. Matrix reporting structure
b. Repetitive sequence of tasks
c. Focus on organizational mission
d. Scope reflects limitation of authority/responsibility

Answer - Matrix reporting structure
The need to address project management early and completely for EHR project derives from the fact that...
a. EHR is the integration of data from multiple sources
b. EHR projects can get off course easily
c. Focus on formal project management helps achieve continuity of effort
d. EHR is a very expensive proposition that cannot fail

Answer - EHR is the integration of data from multiple sources
A team comprised of all "explorers" may...
a. Never complete their task
b. Be interested in building their own EHR
c. Want to direct the entire task
d. Spend their time rationalizing their decisions

Answer - Never complete their task
A disadvantage of hiring a consultant to help with an HIT or EHR project is...
a. Leaves an EHR knowledge deficit
b. Lacks knowledge of internal politics
c. May not have a project management background
d. Is committed to leaving when the project is done

Answer - Leaves an EHR knowldege deficit
The goal of harmonizing the organization's project plan with the vendors is to...
a. Coordinate tasks and monitor milestone accomplishment
b. Make them the same so that the organization can monitor task completion
c. Correct the vendor's plan if steps are missing
d. All of the above

Answer - Coordinate tasks and monitor milestone accomplishment
A tool that matches staffing with project status is...
a. Budget
b. Gantt chart
c. Critical path
d. Resource leveling

Answer - Resource leveling
A good way to get people to convert decisions into actions following a meeting is to...
a. Track completion of actions following the meeting
b. Convert the meeting into performing the action itself or a related document
c. Allow people to make their own decisions
d. Assign responsibilities for action completion

Answer - Convert the meeting into performing the action itself or a related document
Which of the following statements concerning communication is FALSE...
a. Project managers should communicate project status regularly to executive leadership using a detailed project plan
b. Using a detailed communication plan helps assure that communications support change management
c. Communication should be centrally coordinated but delivered by many
d. Communication extends beyond the project itself in order to reinforce operation of the system

Answer - Project managers should communicate project status regularly to executive leadership using a detailed project plan
Change control...
a. Assures that all changes are performed at once
b. In an organization has no impact on the systems vendor
c. Helps reduce the amount of change made in a system
d. Assures that a change in one part of a system does not have a negative ripple effect

Answer - Assures that a change in one part of a system does not have a negative ripple effect
ROI is a description of?
a. Economic value of a project
b. Alignment of project with strategic imperatives
c. Tangible and intangible benefits
d. All of the above

Answer - Economic value of a project
Which of the following describes how the results of HIT would impact organizational functions?
a. Cost/benefit analysis
b. Value assessment
c. ROI
d. Business case

Answer - Business case
The process of ensuring that ROI from HIT is achieved is...
a. Managing ROI
b. Estimating ROI
c. Determining feasibility of ROI
d. Calculating ROI

Answer - Managing ROI
For knowledge work, benefits metrics are often...
a. Time savings
b. Quantity
c. Distance Measures
d. Error reduction

Answer - Error reduction
When a provider can keep more of its revenue, the financial benefit is said to be...
a. Revenue increase
b. Contribution to profit
c. Cost avoidance
d. Productivity improvement

Answer - Contribution to profit
Which of the following is an intangible benefit of an EHR?
a. Following practice guidelines will increase quality of care
b. Patient wait times will be reduced by better workflow
c. Referrals will be made on a more timely basis
d. All of the above

Answer - Following practice guidelines will increase quality of care
Licensing the right to use an EHR application is included in which of the following costs?
a. Implementation
b. Maintenance
c. Software
d. Hardware

Answer - Software
An ROI calculation that is usually reserved for long term investments is...
a. Payback period
b. Cash flow
c. Internal rate of return
d. Net present value

Answer - Net present value
Which source of funds is generally NOT available for not-for-profit providers?
a. Tax advantages
b. Debt and equity financing
c. Group purchasing
d. Cash flow from operations

Answer - Tax advantages
One of the most important advantages of the ASP for SaaS model of financing an EHR is...
a. Managing service level agreements
b. Lowest monthly cost
c. Records stored off-site
d. Control over product customization

Answer - Lowest monthly cost
The first step in EHR vendor selection should be...
a. Conduct site visits
b. Send RFPs to selected vendors
c. Identify 2 or 3 vendors with which to negotiate
d. Compile functional requirements for HIT, EHR, and HIE

Answer - Compile functional requirements for HIT, EHR, and HIE
What will help the organization ensure fair business practices in EHR vendor selection?
a. Selecting HIT, EHR and HIE experts for the selection committee
b. Using a code of conduct
c. Engaging a vendor selection consultant
d. Inviting a large number of vendors to respond to an RFP

Answer - Using a code of conduct
A good source of vendors that specifically match your environment is?
a. Peer experience
b. Product certification
c. Recommendation lists from professional societies
d. None of the above

Answer - None of the above
How many vendors offer "ambulatory EHR products" today?
a. Too many
b. Close to 1,000
c. Many 1,000s
d. Fewer than 50

Answer - Close to 1,000
In which of the following environments is it most likely to find a comprehensive EHR from a single vendor?
a. Physician practice
b. Health plans
c. Hospital
d. All of the above

Answer - Physician practice
In selecting an HIT, EHR or HIE functional requirements, an organization may be best served by...
a. Developing a short list of critical differentiators
b. Summarizing functionality using high level criteria such as those from the Institute of Medicine
c. Specifying in detail by every function desired by the organization
d. Any of the above

Answer - Developing a short list of critical differentiators
Which of the following solicits a formal proposal that is the basis for contract negotiation?
a. Request for Proposal
b. Request for Information
c. Technical Specifications
d. Functional Requirements Inventory

Answer - RFP
Which of the following should not be a key selection criteria prior to performing vendor due diligence?
a. Cost
b. Functionality
c. Technology
d. Vendor Culture

Answer - Cost
At what point in the due diligence may a vendor be rejected by the organization seeking to buy HIT, EHR, or HIE product?
a. Any time
b. Not until all due diligence has been performed on every vendor
c. When a vendor does not respond to the RFP
d. None of the above

Answer - Any time
Vendors price HIT, EHR, and HIE products according to...
a. Variety of factors
b. Service level agreements
c. Value of software
d. Number of users

Answer - Variety of factors
Which turnover strategy often results in a hybrid record?
a. Straight
b. Parallel
c. Phased
d. Pilot

Answer - Phased
Which conversion strategy would be suitable for a provider with a low readmission or revisit rate?
a. Continue to pull paper records
b. Abstract key data from paper records
c. Scan paper records
d. None of the above

Answer - Continue to pull paper records
To ensure a successful implementation of application software a vendor may require...
a. Audit of hardware configuration
b. Hardware to be purchased from a specific vendor
c. Installation of software by certified installers only
d. None of the above

Answer - Audit of hardware configuration
Configuration management encompasses...
a. Change control
b. Customization to user preferences
c. System build
d. All of the above

Answer - All of the above
Metadata is...
a. Data about data
b. Data dictionary
c. Data repository
d. Data customization

Answer - Data about data
Which of the following is NOT a form of clinical decision support?
a. Clinical practice guideline used for charting
b. Alert to a contraindication
c. Data entry template
d. Report format

Answer - Report format
The simulation of an extremely high volume of activity on the system at the same time is called?
a. Stress testing
b. Acceptance testing
c. Unit testing
d. System testing

Answer - Stress testing
Training which is continuously available to users is?
a. Classroom
b. Online
c. Help Desk
d. Peer-to-Peer

Answer - Online
Benefits realization is difficult to perform because...
a. Baseline data must be available for benchmarking
b. Intervening variables may influence benefits
c. Length of time to achieve EHR is long
d. All of the above

Answer - All of the above
Health information exchange refers to...
a. A vendor that supports system integration
b. An organization formed to facilitate continuity of care
c. Seamless exchange of health information across organizations
d. A form of interoperability that requires machine-interpretable data

Answer - Seamless exchange of health information across organizations
A significant barrier to adoption of HIE is?
a. Mobility of patients
b. Limited capacity for interoperability
c. Multiple care settings
d. Lack of leaderships

Answer - Limited capacity for interoperability
What is the primary purpose of the FHA?
a. Support funding for private sector adoption of federal standards
b. Provide transparency in HIE
c. Coordinate federal agency initiatives to support adoption of HIT
d. Develop standards for use ultimately in all areas of HIT and EHR

Answer - Coordinate federal agency initiatives to support adoption of HIT
Which of the following is the most popular organization model for HIOs?
a. Nationwide Health Information Network
b. Federated architecture
c. Integrated delivery network
d. PHR-centric

Answer - Federated architecture
With respect to HIPAA, HIOs...
a. Serve as an important means to achieve strong security
b. Could jeopardize patient confidentiality
c. May not be permitted
d. That consolidate data are in violation of HIPAA

Answer - Serve as an important means to achieve strong security
The CCR is a standard that addresses...
a. Content of records for transportability
b. Electronic health records
c. Personal health records
d. All of the above

Answer - Content of records for transportability
The most widely supported means to identify patients in an HIO is...
a. Continuity of care record
b. Matching algorithm
c. Record locator service
d. Unique identifier

Answer - Matching algorithm
Canada, U.K. and USA all have what type of EHR model?
a. Consolidated
b. Federated
c. Independent
d. None of the above

Answer - None of the above
Which of the following is a key difference in the definition of EHR between the USA and other parts of the world?
a. Adoption of standards
b. Controlled vocabulary
c. Agreement on interoperability needs
d. Use of clinical decision support

Answer - Use of clinical decision support
As used in US federal initiatives, EHR means...
a. Specific focus of interoperable systems used at point of care
b. Personally maintained health information
c. Application that focuses on patient safety
d. Broad concept of health information technology

Answer - Specific focus of interoperable systems used at point of care
Which of the following purposes of health records is virtually impossible without an EHR
a. Communication
b. Evidence of care provided
c. Documentation
d. Knowledge management

Answer - Knowledge management
Health information exchange (HIE) is...
a. Product that enables data integration and connectivity
b. Vendor provides data integration
c. Organization that formally enables exchange health data
d. Seamless exchange of health data

Answer - Seamless exchange of health data
Which of the following is required to earn federal incentives for EHR?
a. Applies only to CMS
b. Focuses on federal activities to achieve nationwide implementation of technology
c. Provides mandates for use of EHR
d. All of the above

Answer - Focuses on federal activities to achieve nationwide implementation of technology
Which of the following is NOT an application generally considered to comprise an EHR?
a. Point of care documentation system
b. Bar-code medication administration record system
c. CPOE system
d. Electronic document management system

Answer - Electronic document management system
eRX refers to...
a. Network that enables exchange of medication information
b. Automated drug reference
c. Process of ordering medications in any care delivery organization
d. Support for drug selection and transmission of prescriptions to retail pharmacies

Answer - Support for drug selection and transmission of prescriptions to retail pharmacies
Which of the following exemplifies clinical decision support?
a. Clinician work list
b. Drug-drug contraindication
c. Health maintenance reminder
d. All of the above

Answer - All of the above
The primary benefit of PHR for clinicians is...
a. Releasing information without patient authorization
b. Making it easy to supply access to the record without requiring patient consent
c. Reducing liability for incorporating patient-supplied documents into business record
d. Coordination of care among multiple providers

Answer - Coordination of care among multiple providers
In hospitals, the EHR is largely a...
a. Document imaging
b. Clinical messaging
c. Clinical data repository
d. Set of components

Answer - Set of components
Widespread focus on clinical computing for healthcare largely started in the...
a. 2000s
b. 1990s
c. 1960s-70s
d. 1980s

Answer - 2000s
Law relating to EHR is derived from...
a. Case law
b. Government regulation
c. State statutes
d. All of the above

Answer - All of the above
Guidance pertaining to signatures on prescribing comes from...
a. Comprehensive Drug Abuse Prevention and Control Act
b. Medicare Prescription Drug, Improvement & Modernization Act
c. State licensure laws
d. All of the above

Answer - All of the above
EHRs must be retained...
a. For as long as the Medicare Conditions of Participation require
b. In accordance with state statutes of limitations
c. For the duration of the organization's existence
d. For at least 10 years

Answer - In accordance with state statutes of limitations
The spoliation of evidence doctrine refers to...
a. Not destroying records pending investigation
b. Introducing hearsay records into court
c. Making corrections to a record
d. None of the above

Answer - Not destroying records pending investigation
One way to prove the durability of the media on which an EHR is stored is to...
a. Use a records management company for storage
b. Test its ability to be restored
c. Bring it to court
d. Witness its creation

Answer - Test its ability to be restored
Which of the following is an example of metadata?
a. Description of a data element in a database
b. Programs that support data entry
c. Source of clinical decision support rules
d. All of the above

Answer - All of the above
Health records that are microfilmed or stored in other computer media are accepted into court under...
a. Best Evidence Rule
b. Accuracy of Entries
c. Case Law
d. Doctrine of Admissibility

Answer - Best Evidence Rule
Which of the following forms of signature provides for both document integrity and authentication?
a. Electronic
b. ESIGN
c. Digital
d. Digitized

Answer - Digital
The need for decision support in an EHR may be determined by...
a. State statute
b. Case law precedent
c. Hospital policy
d. Patient condition

Answer - Case law precedent
An ethical dilemma surrounding vendor selection has to do with...
a. Biasing selection committee members
b. Believing the vendor's salesperson
c. Paying top price
d. Conducting reference checks

Answer - Biasing selection committee members
The purpose of a migration path for EHR is to...
a. Determine EHR ROI
b. Define EHR functional specs
c. Identify steps in implementing an EHR
d. Provide a roadmap to the EHR goal

Answer - Provide a roadmap to the EHR goal
Strategic IT planning should...
a. Support organizations mission
b. Focus on specific IT purchases
c. Identify information system applications for the next 18 months
d. Minimize changes in processes and workflow

Answer - Support organizations mission
Which of the following in the Gartner Generations where there must machine organizable data?
a. Collector
b. Colleague
c. Documenter
d. Helper

Answer - Helper
A migration path helps an organization...
a. Establish priorities
b. Avoid process changes
c. Select an EHR vendor
d. Install an EHR on time

Answer - Establish priorities
Knowledge is created by...
a. Transforming knowledge into business intelligence
b. Adding experience to information
c. Database vendors
d. Processing data into information

Answer - Adding experience to information
An organization's readiness for HIT, EHR or HIE can be assessed through...
a. Migration path
b. Vendor selection
c. Visioning exercise
d. Strategic IT planning

Answer - Visioning exercise
Goals for HIT, EHR and HIE should be...
a. Measurable
b. Outcome oriented
c. Specific to organization
d. All of the above

Answer - All of the above
Which of the following is an example of information that may be included in an organization's migration path...
a. That the organization has started process improvement
b. Implementation plans for applications
c. Brand name of proposed applications
d. Vendor selection process

Answer - That the organization has started process improvement
Which of the following is most likely to represent a dependency in plotting where a CPOE entry implementation should occur?
a. Ancillary source systems
b. Clinical decision support
c. Physician adoption strategies
d. All of the above

Answer - All of the above
An important part of constructing a migration path is to...
a. Critically assess appropriateness of all elements
b. Establish specific dates for accomplishing each element
c. Identify specific tasks for each member of the steering committee
d. All of the above

Answer - Critically assess appropriateness of all elements
EHR change management is about...
a. Appreciating that EHR is a tool to be learned
b. Invoking a fundamental change in communication
c. Recognizing EHR is not just an automated charg
d. All of the above

Answer - All of the above
A tool used to identify specific causes of change is...
a. Decision table
b. Force field analysis
c. Pareto chart
d. Workflow analysis

Answer - Force field analysis
Which change management strategy utilizes peer pressure to adopt EHR?
a. Incentive-based
b. Norm-based
c. Sanction-based
d. Adoption-based

Answer - Norm-based
A good candidate for leading EHR change is...
a. Physician chair of quality improvement
b. Techno-doc
c. Information technology leader
d. Curmudgeon physician

Answer - Physician chair of quality improvement
The step most often not mapped well in clinical process is...
a. Interviewing patients
b. Security controls
c. Decision making
d. Documentation

Answer - Decision making
In process improvement, duplicate steps should be...
a. Retained as an important control point
b. Always eliminated
c. Evaluated for their clinical/quality pertinence
d. Not mapped

Answer - Evaluated for their clinical/quality pertinence
If an "improved" process map has more steps or more time than the "present," it...
a. Should be shortened to reduce steps or time
b. Includes workarounds
c. Will never get adopted
d. Needs to illustrate importance of change

Answer - Needs to illustrate importance of change
In communicating about EHR, messages should...
a. Be frequent, delivered by appropriate sources, in multiple media
b. Come from the same source for consistency
c. Follow organization policy for announcing important events
d. Convey changes after they have been made to reduce fear factor

Answer - Be frequent, delivered by appropriate sources, in multiple media
A key element in communicating with patients while using the EHR is...
a. Explain what you are doing with the computer as you talk with the patient
b. Do not show the patient the computer
c. Suggest that you do not like the computer to put the patient at ease
d. All of the above

Answer - Explain what you are doing with the computer as you talk with the patient
Which process mapping tool is best to start busy clinicians in mapping current processes...
a. Force field analysis
b. Flow process chart
c. Process diagram
d. Sticky notes

Answer - Sticky notes
For healthcare professionals on a busy nursing unit with a lot of data to access at any one time, which of the following human-computer interfaces would provide the most ubiquitous access to EHR?
a. Personal digital assistants (PDAs)
b. Desktops on nursing stations
c. Ceiling mounted monitors
d. Wireless on wheels (WOWs)

Answer - Wireless on wheels (WOWs)
A computer that requires another computer for operation of applications is a...
a. Thin Client
b. Server
c. Notebook computer
d. USB drive

Answer - Thin Client
Storage devices that are managed independently of application servers are...
a. Storage Area Network (SAN)
b. Redundant Array of Inexpensive Disks (RAID)
c. Storage Service Provider (SSP)
d. Primary storage

Answer - Storage Area Network (SAN)
An intranet is...
a. A local area network utilizing internet protocols
b. The portion of the internet most used by the public to browse various sources of information
c. A secure tunnel thorough the internet
d. Telephone service provided through the internet

Answer - A local area network utilizing internet protocols
Which of the following structures is most commonly used to collect data in an EHR?
a. Data Repository
b. Data Warehouse
c. Decision support system
d. Data Mart

Answer - Data Repository
Which of the following is TRUE concerning structured vs unstructured data?
a. Natural language processing commonly converts unstructured data to structured data
b. Both need to be accommodated in an EHR
c. Only unstructured data can be accommodated in an EHR
d. Unstructured data is difficult to enter in an EHR

Answer - Both need to be accommodated in an EHR
The IT acquisition architecture where an organization has bought applications from many different vendors is...
a. Best of suite
b. Best of breed
c. Dual core
d. Best of fit

Answer - Best of breed
HL7 standards help manage communication of scanned health records via...
a. Common encoding specifications
b. Clinical templates
c. Document architecture
d. Information models

Answer - Document architecture
A vocabulary that represents names of clinical drugs is...
a. LOINC
b. RxNorm
c. SNOMED
d. NDC

Answer - RxNorm
Security for EHR systems should focus on...
a. Encryption of all data
b. Perimeter protection
c. Layers of security measures
d. Network security devices

Answer - Layers of security measures
When an HIT project is getting behind, even though people appear to be working hard, the project may have:
a. Feature creep
b. Effort creep
c. Scope creep
d. Hope creep

Answer - Effort creep
Which of the following is a characteristic of a PROJECT in comparison to a program?
a. Single defined goal
b. Line and staff organizational structure
c. Focus is on organizational mission
d. Ongoing processes are pursued

Answer - Single defined goal
Which of the following is usually NOT a role of the EHR project manager?
a. Managing project on-time and on-budget completion
b. Helping manage the change brought about by the EHR
c. Chairing the EHR steering committee
d. Building stakeholder relationships

Answer - Chairing the EHR steering committee
In an EHR project, the team most likely to represent users in building the system to meet specific needs is:
a. Ongoing maintenance team
b. Training team
c. Steering committee
d. Clinical domain team

Answer - Clinical domain team
Which of the following is a good way to keep people from wandering off a topic during a meeting?
a. Urge people to store personal agendas in a parking lot
b. Arrange for a gatekeeper to apply quality controls
c. Avoid discussing controversial topics
d. Create a document instead of discussing a document

Answer - Urge people to store personal agendas in a parking lot
Which of the following is the most common form of project plan?
a. Gantt chart
b. Flow process chart
c. Microsoft
d. PERT CPM

Answer - Gantt chart
The critical path in a project plan is that which:
a. Must be done first
b. Has the most tasks
c. Is in jeopardy of being late
d. Has no slack

Answer - Has no slack
Which tool would be most effective in ensuring that an EHR implementation problem is not forgotten?
a. Agenda
b. Minutes
c. Status report
d. Issues log

Answer - Issues log
Change control refers to:
a. Prioritizing and assuring proper changes
b. Approval process for upgrading HIT
c. Minimizing changes in an EHR
d. None of the above

Answer - Prioritizing and assuring proper changes
Physicians interested in a career that focuses on HIT may learn more through:
a. Agreeing to serve as the EHR physician champion
b. Taking a job with an EHR vendor
c. Enrolling in a workforce training program
d. Subspecialty training in clinical informatics

Answer - Subspecialty training in clinical informatics
Responsibility for managing HIT ROI rests with...
a. CFO
b. Executive management
c. Users
d. All of the above

Answer - All of the above
The tool that focuses strictly on estimating cost savings and expenditures to determine HIT feasibility is?
a. Value assessment
b. Net present value
c. Cost/benefit analysis
d. Internal rate of return

Answer - Cost/benefit analysis
Pro forma financial statements refers to...
a. Financial analysis of benefits
b. Projected change in financial statements
c. Formal cost/benefit analysis
d. All of the above

Answer - Projected change in financial statements
The most accurate source for estimating benefits is...
a. Internal process mapping
b. Vendor value proposition
c. Case studies from vendor clients
d. References from other clients

Answer - Internal process mapping
It is estimated that a new storage location or warehousing will be needed to house paper records next year. If an EHR is acquired, the financial benefit is referred to as...
a. Cost avoidance
b. Financing
c. Productivity improvement
d. Value proposition

Answer - Cost avoidance
In budgeting for an EHR, into which cost category does ongoing cost of outsourced IT staff fall...
a. Support
b. Software
c. Maintenance
d. Implementation

Answer - Support
Which of the following is the most appropriate strategy for estimating ROI...
a. Estimate benefits high
b. Estimate costs low
c. Estimate costs at their highest possible price
d. None of the above

Answer - None of the above
The ROI measure that considers time value of money is...
a. Cash flow
b. Payback period
c. Internal rate of return
d. None of the above

Answer - Internal rate of return
When evaluating an HIT project, CEOs are likely to compare it to...
a. IT budgets of other healthcare organizations
b. Property enhancements desired by facility
c. Salary increases for staff
d. All of the above

Answer - Property enhancements desired by facility
Which of the following sources of funding generally results in the greatest total cost for acquiring an EHR...
a. ASP model of EHR
b. Philanthropy
c. Use of reserves
d. All of the above

Answer - ASP model of EHR
What strategy is an organization employing when it wants to use one vendor for most applications?
a. Closed architecture
b. Best of breed
c. Dual core
d. Best of fit

Answer - Best of fit
Which statement about EHR products is TRUE?
a. They are easy to purchase and install
b. Good salespeople will oversee the EHR implementation
c. Their asking prices can rarely be negotiated
d. They are not commodities

Answer - They are not commodities
It is estimated that the number of vendors claiming to sell ambulatory EHR products in the market TODY is approximately...
a. 700
b. 1000s
c. 50s
d. 10s

Answer - 700
To approximately how many vendors should a request for information (RFI) be sent?
a. 5
b. 100-500
c. 10-15
d. 50

Answer - 10-15
The source of how you identify your organization's functional requirements should be...
a. HL7 EHR System Functional Model
b. Organization's migration path
c. Vendor literature
d. IOM Core Functionality

Answer - Organization's migration path
The number of functional specifications a RFP describes is usually...
a. Up to the organization
b. Around 10-15
c. In the thousands
d. Depends on the vendor

Answer - Up to the organization
To evaluate responses to an RFP, the organization should...
a. Establish selection criteria
b. Select the lowest price bidder
c. Rate vendors by number of positive references
d. Rank vendors on which addresses the most functional specifications

Answer - Establish selection criteria
A vendor selection committee must...
a. Agree on a single candidate
b. Reach consensus on a vendor of choice
c. Negotiate price before making a recommendation to board of directors
d. Make recommendations for 3 candidates to executive committee

Answer - Reach consensus on a vendor of choice
Which of the following would NOT be an element included in an EHR contract...
a. Support for implementation
b. Nursing unit reconstruction
c. Software from a third party supplier to the vendor
d. Ongoing maintenance

Answer - Nursing unit reconstruction
When pricing software by number of users, vendors usually count number of...
a. Physician users
b. Unique userIDs
c. Workstations
d. Any of the above

Answer - Any of the above
In which turnover strategy does the organization NOT commit to full implementation of the EHR...
a. Pilot
b. Parallel
c. Straight
d. Phased

Answer - Pilot
In which phase of implementation is the EHR customized to meet user specifications?
a. Site preparation
b. Support for go-live
c. Software installation
d. System build

Answer - System build
The purpose of change control is to...
a. Set up hardware
b. Design data center
c. Document changes
d. Prevent changes

Answer - Document changes
The purpose of the data management aspect of system build is to...
a. Convert paper-based data to electronic
b. Track changes in software
c. Build clinical decision support rules
d. Ensure date compatibility throughout the system

Answer - Ensure date compatibility throughout the system
Which control helps aid in reducing data entry errors...
a. Acceptable values
b. Authentication measures
c. Check sums
d. Conversion programming

Answer - Acceptable values
In which type of testing is the ability of the EHR to handle peak loads tested?
a. Performance testing
b. Unit testing
c. Function testing
d. System testing

Answer - Performance testing
User interactions with system are tested during...
a. Integrated system testing
b. Function testing
c. Stress testing
d. All of the above

Answer - Integrated system testing
Which of the following is a method used for converting paper-based information into discrete electronic data...
a. Abstracting
b. Conversion
c. Scanning
d. All of the above

Answer - Abstracting
The best method for training users to use the EHR...
a. Relies on online demonstration
b. Tailors training to user needs
c. Offers help desk assistance
d. Requires classroom orientation

Answer - Tailors training to user needs
Recognizing that a goal of the EHR has not been met is most likely to be determined in...
a. Benefits realization
b. Acceptance testing
c. Go-live
d. All of the above

Answer - Benefits realization
HIE is...
a. Seamless exchange of information across the continuum of care
b. Network service provider that supports standard protocols
c. Ability for discrete systems to exchange meaningful data
d. Organization that manages interoperability of health data

Answer - Seamless exchange of information across the continuum of care
What contributed the most to the surge of interest in EHR in the US?
a. Formation of the NHIN
b. E-Gov initiative on health care transparency
c. Institute of Medicine patient safety report
d. HIPAA

Answer - Institute of Medicine patient safety report
In the Health Affairs taxonomy, the ultimate goal for HIE is...
a. View lab reports
b. Transmit clinical documents
c. Adopt EHR by all providers
d. Exchange lab results

Answer - Exchange lab results
The Medicare Improvements for Patients & Providers Act (MIPPA) of 2008 provides incentives for...
a. VistA-Office EHR Project
b. Ambulatory EHR certification
c. eRx
d. Meaningful use of EHR

Answer - eRx
The continuity of care record is...
a. Minimum data set for clinical repository
b. Personal health record standard
c. Core data for transferring patient care
d. Universally accessible means for HIE

Answer - Core data for transferring patient care
The most common technology proposed for person identification within a US HIO is...
a. Unique identifier
b. Personal health record
c. CCR
d. Algorithmic matching

Answer - Algorithmic matching
A regional HIO where data are locally retained but shared among members is...
a. Consolidated
b. Centralized
c. Federated
d. Hybrid

Answer - Federated
US rate of adoption of EHR in hospitals that would qualify them for MU is approximately...
a. 25%
b. 75%-90%
c. 50%
d. 2%

Answer - 25%
Which statement is TRUE concerning international EHR adoption?
a. US and international healthcare communities are behind other industries in adopting IT
b. Europe & US have same vision of EHR
c. Europe is ahead of US in EHR adoption
d. Europe has less penetration of EHR than US

Answer - US and international healthcare communities are behind other industries in adopting IT
The vision for the NHIN as promoted by the ONC for HIT is...
a. Non-proprietary public domain technology for HIE
b. Community based programs to consolidate health data for population studies
c. National repository of claims data
d. All of the above

Answer - Non-proprietary public domain technology for HIE