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HIT 160-100, Class 1669 Final Review

Questions from tests on Chapters 1-5, 7, 8,13-16
STUDY
PLAY
The services provided by HIM departments in acute care hospitals usually include all the following except ____.
A) medical transcription
B) medical billing
C) clinical coding
D) release of information
B) medical billing
The first point of data collection and the area where the health record number is most commonly assigned in an acute care hospital is the ____.
Patient registration department
The hospital standardization movement was inaugurated by the ___in ____.
American College of Surgeons; 1918
Which of the following tasks might the HIM department not perform in an electronic health record system?
a) document imaging
b) analysis
c) assembly
d) indexing
c) assembly
The master patient index ______.
a) is the most important index maintained by the HIM department.
b) contains basic demographic information about the patient
c) is commonly part of the admission, discharge, and transfer computer system
d) all of the above
d) all of the above
Consider the following sequence of numbers. What filing system is being used if these numbers represent the health record numbers of three records filed together within the filing system?
37-45-99
38-45-99
39-45-99
Unit
Source-oriented, problem-oriented, and _____ health record formats are commonly used in paper based record systems.
integrated
True or False: The purpose of ACS is to raise the standards of surgery by establishing minimum quality standards for hospitals.
True
The coding of clinical diagnoses and healthcare procedures and services prior to the patients discharge is ____ review.
concurrent
The release of information function requires the HIM professional to have knowledge of ____.
federal and state confidentiality laws
Joe Schmoe, treated as a patient at a multi-hospital system, has three medical record numbers. The term used to describe multiple health records numbers is ____.
Overlap
The term used to describe a combination of paper-based and electronic health records maintained on the same patient is ____.
hybrid
Which of the following is a listing of patients in alphabetical order?
a) accession register
b) master patient index
c) control log
d) order-entry/order management report
b) master patient index
In alphabetic filing, which of the following names would come first?
a) P. M. Jansen
b) P. Matthew Jansen
c) Paul Matthew Jansen
d) P. Jansen
d) P. Jansen
Father Leo Lyman is indexed immediately before _____.
a) Felix Fernandez
b) Frances L'Monte
c) Louise S. Lyman
d) Lois T. Ruiz-L'Monte
c) Louise S. Lyman
The numbering system in which a patient is assigned a new number with each visit and the patient's older medical records are brought forward to the newest number and location is called ______.
serial-unit
The main advantage of a unit numbering system for filing medical records is _______.
It provides for continuity of care.
Data applications, data collection, ____, and data analysis are the four domains of data quality management.
data warehousing
Statements that define the performance expectations and/or structures or processes that must be in place are called ______.
standards
Which index is considered to be the authoritative key to locating a health record?
Master patient index
What is the acronym HIPAA?
Health Insurance Portability and Accountability Act
A statement or guideline that directs decision making or behavior is called a _____.
policy
______ data is extracted from individual health records and combined to form de-identified information about groups of patients.
Aggregate
If there are not any state retention laws in place, a medical facility should consider what when destroying medical records?
medical staff bylaws
Which entity(ies) have established documentation standards?
a) Medicare
b) Joint Commission
c) National Committee for Quality Assurance
d) all of the above
e) a and b only
e) a and b only
An efficient record management system is conducive to all of the following except:
a) quick retrieval of medical records
b) confidentiality of medical records
c) reduction of misfiles
d) reduction of filing equipment costs
d) reduction of filing equipment costs
According to indexing rules for alphabetic storage, personal names are indexed in the what order?
last name, first name, middle name/initial
True or False: The primary purpose of a health record is patient care management.
True
In 2009, the American Recovery and Reinvestment Act was signed into law. The law provided an economic stimulus package that provides reimbursement incentives for _______.
meaningful users of certified electronic health records
Why is the hybrid record so challenging?
You have to manage both electronic media as well as the paper format simultaneously.
IN a paper-based system, individual health records are organized in a pre-established order. What is this process called?
Assembly
An ____ _____ _____ is an electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one healthcare organization.
electronic health record
The ____ published a series of "quality chasm" reports addressing medication errors, poor workflow, and other gaps in health care delivery that should be addressed to ensure quality healthcare.
IOM (Institute of Medicine)
I am a patient. My medical history including information from myself and my physician is stored on the Internet via a secure website. This is an example of the ___.
PHR (personal health record)
All of the items mentioned below are capabilities of an EHR system except:
a) order entry/management
b) patient support
c) reporting and population health management
d) registries
b) patient support
The computer system that may serve as the MPI is the ____.
Patient registration system
We had 550 Medicare patients last month. This statement represents which of the following?
a) information
b) data
c) content of the PHR
d) patient-specific information
b) data
Standards are applied to facilities that choose to participate in federal government reimbursement programs such as Medicare and Medicaid.
Conditions of Pariticpation
HL7 has developed guidelines that address which aspect of the EHR?
a standard vocabulary
_____ is an earlier name for a Health Information Organization.
RHIO
True or False: HIM functions are information-focused and involve ensuring security, quality, and availability of patient data.
True
The mdeical record number, 44-37-98, is assigned in a terminal digit filing system. What number is the primary unit for filing?
98
True or False: In a paper record, any errors should be completely obliterated.
False
How are documents from other facilities maintained in the EHR?
They are scanned and filed in the EHR.
True or False: A retraction involves moving the document from one episode of care to a different episode of care within the same patient record.
False
In alphabetic filing, which of the following is a reason for cross-referencing?
a) A married woman prefers to use her professional name.
b) Names that sound alike, but are spelled differently.
c) Use of nicknames, I.e. Jim for James, Beth for Elizabeth, etc.
d) all of the above
d) all of the above
In terminal digit filing, the number 25-10-12 would come immediately after:
a) 240912
b) 241012
c) 250911
d) 260912
b) 241012
In middle digit filing, which number would be filed last?
a) 771502
b) 761601
c) 751602
d) 761600
c) 751602
For efficient purging of medical records, color coding of the year the patient was last seen would provide sufficient information for ____.
identification of inactive medical records
What promotes high standards of HIM practice?
The AHIMA Code of Ethics
Which of the following is not a benefit of a HIE?
a) Provides a vehicle for improving quality and safety of patient care.
b) Stimulate consumer education and patients' involvement in their own health care.
c) Allows patient information to freely populate the Internet Explorer with unnecessary safeguards.
d) Helps public health officials meet their commitment to the community(ies) they serve.
c) Allows patient information to freely populate the Internet Explorer with unnecessary safeguards.
____ is scheduled for implementation October 1, 2014.
ICD-10
These are part of the volunteer structure of AHIMA; organized in every state plus Washington, DC and Puerto Rico.
CSAs (Component State Associations)
A credential offered by AHIMA; individuals must pass a certification examination after successfully completing a CAHIIM accredited 2-year program.
RHIT
True or False: The PHR and EHR are synonyms.
False
In an integrated health record, documentation by health professionals is organized how?
Intermixed in chronological order
Which is not a rule in alphabetical filing?
a) Something always comes before nothing.
b) Disregard spaces between words or prefixes.
c) Ignore punctuation and special symbols
d) Titles may be used as the last filing unit after the first name.
a) Something always comes before nothing.
One of the most sought after accreditation distinction by healthcare facilities is offered by the ______.
Joint Commission
Patients Alex Keaton, Jr. and Alec Keaton, Sr. have both been treated at the same hospital. During one hospital encounter for Alec Keaton, Sr., the registration clerk notices Mr. Alex Keaton's demographic information has been entered in Mr. Alec Keaton, Sr.'s record. This is a/an ___ record.
overlay
Step-by-step instructions on how to complete a specific task are called_____.
procedures
A patient receives a unique health record number at the time of the first encounter and keeps the same number for all subsequent encounters is an example of what type of numbering system?
Unit numbering system
A patient receives a unique numerical identifier for each encounter with the healthcare facility is an example of what type of numbering system?
Serial numbering system
The patient receives a unique numerical identifier for each encounter with the healthcare facility, but previous medical records are brought forward and filed under the last assigned number is an example of what type of numbering system?
serial-unit numbering system
The future role of the HIM professional is expected to change due to:
a)advances in technology
b)implementation of new clinical coding system
c) evolution of the EHR
d) all of the above
d) all of the above
True or False: AHIMA's Board of Directors provides members with local access to professional education, networking, and representation, and is a forum for communicating information relevant to national issues and informing members of regional affairs that affect health information management.
False; CSA makes the statement true.
True or False: Health Information Management (HIM) has been recognized as an allied health profession since 1928.
True
________ is the expectation that the personal information shared by an individual with a healthcare provider during the course of care will be used for its intended purpose.
Confidentiality
Using a hospital discharge database, a physician does a study of diabetes mellitus comparing age of onset with response to a specific drug regimen. The physician has gathered ___ from the database.
information
Which of the following is not covered by Medicare?
a) long-term nursing
b) skilled nursing care
c) hospice nursing care
d) home health care
a) long-term nursing
The increased collection and use of healthcare data was most profoundly influenced in the 1960s by the _____.
development of computers capable of storing and processing large amounts of data
Upon which criterion is Medicaid eligibility based?
Income
What is the name of the federally funded program that pays the medical bills of the spouses and dependents of person on active duty in the uniformed services?
TRICARE
Once hospital discharge abstract systems were developed and their ability to provide comparative data to hospitals was established, it became necessary to develop ____.
data sets
What two purposes do data sets serve?
1) to identify data elements to be collected about each patient.
2) to provide uniform data definitions.
____ is the amount charged for a medical insurance policy
Premium
What is the name of the program funded by the federal government to provide medical care to people on public assistance?
Medicaid
The governmental agency most closely involved in the development of healthcare data sets and information standards is the ______.
National Centers for Health Statistics
Mary Smith, RHIA, has been charged with the responsibility of designing a data collection form to be used on admission of a patient to the acute care hospital in which she works. The first resource that she should use is ______.
UHDDS
Which payment method reimburses healthcare providers in the form of lump sums for all healthcare services delivered to a patient for a specific illness?
capitation
_____is the type of coding utilized when a CPT/HCPCS codes is assigned directly through the charge description master for claim submission and bypasses the record review and code assignment by the facility's coding staff.
Hard-coding
IN the 1980s, which of the following trends necessitated the development of data sets in addition to the UHDDS?
a) inpatient admissions dramatically increased
b) inpatient lengths of stay increased
c) ambulatory services and procedures proliferated
d) ambulatory lengths of stay increased
c) ambulatory services and procedures proliferated
List characteristics of the common healthcare data sets such as UHDDS and UACDS.
1) They define minimum data elements to be collected.
2) They provide a frame work for data collection to which an individual facility can add data items.
3) The federal government recommends, but does not mandate, implementation of most of the data sets.
Define case-mix.
Categories of patients treated
Define complication.
Coexisting condition.
Define principal diagnosis.
Condition established after study to be the reason for hospitalization.
Define comorbidity.
Coexisting condition.
Define present on admission.
Condition present at the time the order for admission was written.
_____ is used as an assessment tool to determine a care plan at the time of admission.
MDS
True or False: Medicare Severity-Diagnosis related groups represent a prospective payment system implemented by CMS to reimburse hospitals a predetermine amount for all outpatient stays.
False; MS-DRGs apply to inpatient stays.
A __________ during the data collection process in long--term care identifies a resident issue or the need for further assessment.
RAP trigger
The _____ data set is mandated for use in facilities that participate in the Medicare and Medicaid programs.
MDS
Which of the following types of hospitals is excluded from the Medicare inpatient prospective payment system?
a) pediatric
b) acute inpatient
c) psychiatric
d) alcohol/drug rehab
a) pediatric
They don't meet the age requirement.
After an episode of emergency care, data is entered into a specialized database for the purpose of developing a health history for the patient. This data is part of _____.
DEEDS
The sum of a hospital's total relative DRG weights for a year was 15,192 and the hospital had 10,471 total discharges for the year. What would be the hospital's case-mix index for that year?
1.45
A corporation is evaluating several health plans for its benefits package. The data set that provides comparison information about health plan performance is ____.
HEDIS
The organization that coordinates the collection of performance data for managed care plans is the _______.
National Committee for Quality Assurance
How many benefit periods are covered by hospital insurance during a Medicare beneficiary's lifetime?
Unlimited
In Outpatient Prospective Payment System (OPPS), which code set is the APC system primarily based on for outpatient procedures and services including devices, drugs, and other items?
CPT and HCPCS codes
The data set designed to organize data for public release about the outcomes of care is ___________.
HEDIS
Data collected to evaluate facility performance in designated core measure areas in order to achieve accreditation is _____.
ORYX
An example of data collected by the JCAHO for the ORYX initiatives is ______.
a) intrahospital mortality data
b) financial data
c) health plan performance data
d) patient demographic data
a) intrahospital mortality data
OASIS data is used to assess the ____ of home health services.
outcomes
The person responsible for the ill, such as a parent or guardian is referred to as the ____.
guarantor
List the key focuses of healthcare information standards development.
1) linking data from disparate computer systems
2) providing common definitions for data elements
3) responding to the information needs of users
The MS-DRG system creates a hosptial's case-mix index based on the relative weights of the MS-DRG. The case-mix can be figured by multiplying the relative weight of each MS-DRG by the number of _____ within that MS-DRG.
discharges
Information standards that provide clear descriptors of data elements to be included in computer-based patient record systems are called ____ standards.
structure and content
In designing an electronic health record, one of the best resources to use in helping to define the content of the record as well as to standardize data definitions is the E1384 standard promulgated by the ______.
American Society for Testing and Measurement
The number of days Medicare will cover SNF inpatient care is limited to which of the following:
a) 21
b) 60
c) 30
d) 100
d) 100
In processing a Medicare payment for outpatient radiology exams, a hospital outpatient would receive payment under what?
OPPS (Outpatient Prospective Payment System)
AHIMA strongly opposes the use of ____ as a patient identifier in an electronic environment.
Social Security Number
An example of clinical data representation is an ____.
ICD-9-CM code
What is the primary purpose of the Continuity of Care Record?
To allow healthcare providers to readily access information about a patient's healthcare at any point in time.
The exchange of digitized images such as X rays, CT scans, and MRIs is supported by _____.
DICOM
Activities of daily living (ADL) are components of ______.
MDS and OASIS
The key data element for linking data about an individual who is seen in a variety of care settings is the ____.
unique patient identifier
The best resource to use in defining the structure of an EHR is the ____.
HL7 Functional Model
The ____ mandated the development of standards for electronic medical records.
Health Insurance Portability and Accountability Act of 1996
Messaging standards for electronic data interchange in healthcare have been developed by ____.
HL7
A recent breakthrough in the development of a universal language to aid storage and transmission of Web-based data is ____.
XML
As a health information professional, you've become involved in developing an HIE in your region. the agency that would provide the best resources for HIE development is ___.
ONC (Office of the National Coordinator of Health Information Technology)
The inpatient data set that has been incorporated into federal law and is required for Medicare reporting is the ___.
Uniform Hospital Discharge Data Set (UHDDS)
While the focus of inpatient data collection is on the principal diagnosis, the focus of outpatient data collection is on ___.
reason for encounter.
Reimbursement for home health services is dependent of data collected from ____.
OASIS (Outcomes and Assessment Information Set)
Data that are collected on large populations of individuals and stored in databases are referred to as ___.
aggregate data
Standardizing medical terminology to avoid differences in naming various medical conditions and procedures is one purpose of ____.
vocabulary standards
True or False: Most healthcare informatics standards have been implemented by state regulations.
True
Both HEDIS and the Joint Commission's ORYX program are designed to collect data to be used for _____.
performance improvement programs
Laboratory data is successfully transmitted back and forth from Community Hospital to three local physician clinics. this successful transmission is dependent on what standards?
LOINC (Logical Observations, Identifiers, Names, and Codes)
two official HHS advisory committees established as a result of ARRA are ___ and ___.
HIT Policy; HIT Standards
The HIPAA provides a federal floor for ____ ____.
healthcare privacy
The content of the health record is defined by what three things?
state licensing rules and laws,
accrediting body standards, and
medical staff bylaws
The length of time health information is retained is determined by what?
state retention laws,
accrediting body standards, and
needs of the healthcare facility
What type of law defines the rights and duties among people and private businesses?
private law
Law enacted by a legislative body is called a ____.
statute
An individual who brings a lawsuit is called the ____.
Plaintiff
Which stage of the litigation process focuses on how strong a case the opposing party has?
discovery
Which document directs an individual to bring originals or copies of records to court?
subpoena duces tecum
Errors in the health record should be corrected by ____.
a) drawing a single line in ink through the incorrect entry
b) printing the word "error" at the top of the entry
c) date, time, reason for change, and signature and title of person making the correction
d) all of the above
d) all of the above
The physical health record is usually considered the property of _____.
the organization or provider that maintains and stores the record
Under the HIPAA privacy rule, the term covered entities refers to whom?
healthcare providers, healthcare clearinghouses, and health plans
Under the HIPAA privacy rule, ___ are excluded from the privacy protection rules.
a) paper records
b) electronic records
c) oral communications
d) none of the above
d) none of the above
Under usual circumstances, a covered entity must act on a patient's request to review or copy his or her health information within how many days?
30
The HIPAA privacy rule requires that covered entities limit use, access, and disclosure of PHI to the least amount necessary to accomplish the intended purpose. What concept is this an example of?
minimum necessary
Which of the following does not have to be included in a covered entity's notice of privacy practice?
a) Description with one example of disclosures made for treatment, payment, and healthcare operations
b) Description of all the other purposes for which a covered entity is permitted or required to disclose PHI without consent or authorization
c) Statement of individual's rights with respect o PHI and how the individual can exercise these rights
d) Signature of the patient and date the notice was given to the patient
d) Signature of the patient and date the notice was given tot he patient
Which of the following is not true of the notice of privacy practices?
a) it must be made available at the site where the individual is treated
b) it must be posted in a prominent place
c) its content that cannot be changed
d) it must be prominently posted on the covered entity's web site if the entity has one
c) its content that cannot be changed
True or False: A consent for use and disclosure of information must be obtained from every patient.
False
In what instances can PHI be used without patient authorization?
release to an insurance company for payment, release to another healthcare provider for treatment, and release to public health authorities as required by law
True or False: The covered entity must inform the individual that certain information is maintained in a facility patient directory and to whom this information may be disclosed.
True
Which of the following is not true about a BA (business associate) agreement?
a) It prohibits the BA from using or disclosing PHI for any purpose other than that described in the contract with the covered entity.
b) It allows the BA to maintain PHI indefinitely after termination of the contract
c) It prohibits the BA from using or disclosing PHI in any way that would violate the HIPAA privacy rule
d) It requires the BA to make available all of its books and records relating to PHI use and disclosure to the HHS or its agents
b) It allows the business associate to maintain PHI indefinitely after termination of the contract
How many days does a covered entity have to respond to an individual's request for access to his or her PHI when the PHI is stored off-site?
60 days
Which of the following provides a complete description to patients about how PHI is used in a healthcare facility?
a) Notice of privacy practices
b) Authorization
c) Consent for treatment
d) Consent for operations
a) Notice of privacy practices
True or False: A notice of privacy practices must be provided to every individual at the first time of contact or service with the covered entity.
True
True or False: Individuals must be given an opportunity to restrict or deny permission to place information about them in a covered entity's directory of patients.
True
In which of the following situations can PHI be disclosed without providing the opportunity for an individual to object or to provide an authorization?
a) for disclosures for public health purposes as required by law
b) for dislosure to health oversight agencies as requried by law
c) for reporting certain types of wounds or other physical injuries as required by law
d) all of the above
d) all of the above
Define deposition.
Sworn testimony usually collected before a trial
compulsory disclosure of pertinent facts or documents to the opposing parties in a civil case is called ________.
discovery
Define tort.
civil wrongdoing
Define arbitration.
proceeding in which disputes are submitted to a 3rd party or a panel of experts outside the judicial trial system
Define administrative law.
rules developed by administrative bodies empowered by law to regulate specific activities
The professional liability of healthcare providers in the delivery of care to patients is called _____.
medical malpractice
Rules and principles that define rights and duties among individuals or organizations are called ____.
private laws
Written permission to use or disclose patient-identifiable health information is called an ____.
authorization
define statute
law enacted by a legislative body
Define express contract
spoken or written permission to provide treatment; given by a patient to a healthcare provider
The process by which a lawsuit is initiated is called what?
complaint
define breach of contract
failure to meet the conditions specified under legal agreement
When a patient voluntarily submits to healthcare treatment, permission is inferred. What is this called?
implied consent
This written document directs and individual to furnish documents and other records to a court.
subpoena duces tecum
Define minimum necessary
use, access, or disclosure of health information limited to the amount needed for the intended purpose
A law that involves the government and its relationships with individuals or organizations is called what?
public law
the individual or party who is the object of a lawsuit is called the ___.
defendant
True or False: In all cases, a covered entity may deny an individual's request to restrict the use or disclosure of his or her PHI.
False
Name the three sources of laws.
statutes and constitutions, judicial decisions, and administrative laws
What are the three tiers of the federal court system?
I)district courts
II) courts of appeal
III) Supreme court
Describe the district courts of the federal court system.
Lowest tier of federal court system, hears cases involving felonies and misdemeanors that fall under federal statue and suits in which a citizen of one state sues a citizen of another state
Describe courts of appeal.
Branch of the federal court system that has the power to hear appeals on the final judgments of district courts
The Supreme Court of the federal court system does what?
hears appeals from the U.S. court of appeal and from the highest state courts in cases generally involving federal statues, treaties, or the U.S. Constitution.
List the three tiers of the state court system.
I) trial courts
II) Appellate courts
III) Supreme court
Describe trial courts.
lowest tier of the state court system and divided into two courts: court of limited jurisdiction (cases involving less sever crimes and low amounts of money) and court of general jurisdiction (cases involving more serious crimes and higher amounts of money)
Describe Appellate court systems.
The court that hears appeals of final judgements from state trial courts.
What does the Supreme court of the state court system do?
It hears appeals from the appellate courts or from trial courts when the state does not have appellate courts.
The form and content of the health record are determined by:
accreditation standards and public health reporting requirements,
the needs of individual healthcare organizations, and
state and federal laws and regulatory requirements
True or False: When a healthcare provider purposely commits a wrongful act that results in injury to a patient, the provider can be held responsible for an intentional tort.
True
T or F: the JC sets the official record retention standards for hospitals and other healthcare facilities.
F
T or F: Stricter state statues related to the confidentiality of healthcare information take precedence over the provisions of the HIPAA privacy rule.
T
T or F: A notice of privacy practices should include a statement that explains that individuals may complain to the secretary of the HHS if they believe that their privacy rights have been violated.
T
The _____ spells out the powers of the three branches of the federal government.
U.S. Constitution
T or F: A breach of contract, an intentional tort, and negligence are considered to be a professional liability.
T
AHIMA's record retention guidelines recommend that the diagnostic images such as x-rays be maintained for how long?
at least 5 years
AHIMA's record retention guidelines recommend that the MPI be maintained for how long?
at least 10 years
AHIMA's record retention guidelines recommend that the health records of adults be maintained for how long?
At least 10 years after the most recent encounter
What should be considered first when establishing health record retention policies?
state retention requirements
The term that means the HIM professional applies rules consistently is ____.
justice
Which of the following threatens the need-to-know principle?
a) backdating progress notes
b) blanket authorization
c)HIPAA regulations
d) Surgical consent
b) blanket authorization
An individual stole and used another person's insurance information to obtain medical care. This action is known as ___.
medical identity theft
___ is the right of an individual to be left alone.
Privacy
A HIM professional's ethical obligations _____.
a) apply regardless of employment site.
b) are limited to the employer and location
c) apply to the patient only
d) are limited by state or federal laws
a) apply regardless of employment site
In which of the following situations must a covered entity provide an appeal process for denials to requests from individuals to see their own health information?
a)When access to psychotherapy notes is requested
b) when the covered entity is a correctional institution
c) when a licensed healthcare professional has determined that access to PHI would endanger someone
d) when the covered entity has acted under the direction of a correctional instituion
c) when a licensed healthcare professional has determined that access to PHI would endanger someone
T or F: A cost-based fee may be charged for making a copy of the PHI.
T
Which of the following is an example of ethical issues related to coding:
a) inaccurate performance data
b) fraud and abuse
c) Release of sensitive data
d) mistreatment of vulnerability population
b) fraud and abuse
T or F: Protecting the work environment for HIM staff is part of advocacy.
T
T or F: The advocacy role requires an HIM professional to understand HIM practices, ethics, and patient bill of rights.
T
T or F: Individuals must be given an opportunity to restrict or deny permission to place information about them in the directory.
T
The first computer systems used in healthcare were used primarily to perform payroll and ___ ____ functions.
patient accounting
The concept of systems integration refers to the healthcare organization's ability to:
combine information from systems outside the organization
In addition to patient care, clinical information systems may be used for:
peer review, research, and quality improvement
In hospitals, automated systems for registering patients and tracking their encounters are commonly known as ___ systems.
ADT
The chief information officer is a senior-level executive who is responsible for:
leading the organizations strategic IS planning process
Which of the following systems is designed primarily to support patient care by providing healthcare professionals access to timely, complete, and relevant information for patient care purposes?
a) administrative information system
b) clinical information system
c) management support system
d) strategic information system
b) clinical information system
What information system is used for collecting, verifying, and reporting test results?
laboratory information system
What information system is used to assist healthcare providers in the actual diagnosis and treatment of patients?
clinical decision support system
What information system is considered an administrative information system?
Financial information system
Which information system focuses on providing reports and information to managers for day-to-day operations of the organization?
management information system
The concept of information resource management assumes what?
That information is a valuable resource that must be managed no matter what form it takes.
Dr. Perez is sitting in his home office and reviewing digital images from a patient's MRI. He must be using a(n) _____.
picture archival communication system
This person oversees the development, implementation, and enforcement of the healthcare organization's policies and processes for complying with all federal, state, and accreditation rules and regulations related to the confidentiality and privacy of health-related information.
chief privacy officer
This person oversees the healthcare organization's information resource management functions and leading the strategic information systems planning process.
Chief information officer
This person oversees the development, implementation, and enforcement of the healthcare organization's policies and processes for protecting patient identifiable information from unauthorized access or disclosure.
chief security officer
Which of the following elements is not considered a basic component of every information system?
a) input/output
b) users
c) processing
d) none of the above
d) none of the above
Input/output devices are also known as _____.
human-computer interfaces
What is the purpose of databases?
To store and retrieve data.
In a network environment, a database shared among several end-user workstations would be stored on a _____.
server computer
Which of the following is an example of a network operating system?
a) internet
b) extranet
c) WAN
d) Windows 7
Windows 7
T or F: Medical identity theft is often perpetrated by strangers via the internet.
False
HISPC is acronym for?
Health Information Security and Privacy Collaboration
Which of the following is not a network protocol?
a) TCP/IP
b) ALU
c) HTTP
d) FTP
b) ALU
Which of the following connects devices across a large geographical area, such as a state?
a) Intranet
b) LAN
c) Server
d) WAN
d) WAN
Who is the top information executive responsible for strategic information systems planning and overseeing the organization's information resources management?
Chief information officer
Which of the following IS positions has evolved into a more important position since the passage of HIPAA regulations?
a) CIO
b) CSO
c) HIA
d) ISA
b) CSO
Which of the following is NOT a characteristic of a DSS?
a) provides ad hoc reports
b) provides day-to-day reports
c) uses statistical modeling
d) answers what-if questions
b) provides day-to-day reports
Which of the following is used primarily for monitoring performance?
a) DSS
b) EIS
c) ES
d) MIS
d) MIS
T or F: An EIS produces periodic, exception, and demand reports.
T
This is a large storage of data used for strategic decision support.
Data warehouse
The coding supervisor wants a daily report of health records that need to be coded. Which of the following systems would be best in meeting the supervisor's needs?
a) CDSS
b) DSS
c) EIS
d) MIS
d) MIS
A physician wants an automated system that allows input of signs, symptoms and results of laboratory test and provides a list of provisional diagnoses. Which of the following would best meet the physician's needs?
a) CDSS
b) DSS
c) EIS
d) MIS
a) CDSS
The average length of stay for Hospital A is 4.3 and for Hospital B is 5.1. This an example of what type of information:
comparative information
A number of healthcare organizations share information. These organizations have disparate systems. This describes a(n):
health information exchange
The physician records his findings while still in the patient's room. This is called ______ documentation.
point of care
______ is data that can be combined to provide summary information.
aggregate data
_____ is data that can be linked to specific clinical cases.
patient-specific data
_____is data that has the same attributes but are from different sources.
comparative data
____ is data that can be used in decision support systems.
expert knowledge-based data
This provides a snap shot in time and consolidates data from multiple sources to enhance decision making.
data warehouse
I just received a new job. I have the responsibility of leading physicians in the adoption of clinical information systems. My title must be:
Chief Medical Informatics Officer
I am looking to purchase an information system that identifies patterns in data. What system should I purchase?
data mining
I am looking to purchase a system that will be used by the physicians to order medications, tests, and other treatment. This system must use alerts and reminders. I must be looking to purchase what type of system?
Clinical provider entry
As an HIM professional, I am involved in data collection, developing the data dictionary, and building edits. What role do I have?
Data quality
What system would you expect to perform drug compatibility checks, have information on contraindications, and control inventory?
Pharmacy information system
As an HIM professional, I am involved in screen design and system functionality. What role do I have?
electronic system design and development
Which of the following is an example of data collected by a patient monitoring system?
a) demographic information
b) vital signs
c) lab results
d) radiology report
b) vital signs
In the HL7 EHR functional model, the section that provides the functionality for public health and performance improvement is the ________.
supportive section
I work for a 10 hospital chain that is purchasing five more hospitals. Many of these hospitals have different vendors supplying their information systems. This has resulted in concerns regarding _____.
interoperability
As a nurse, there are clinical practice guidelines that I should follow in caring for my patients. Where can I find these?
Embedded in the EHR
I have been asked to justify my request for a document imaging system. Which of the following would I use?
a) EHR
b) space savings
c) search capabilities
d) embedded guidelines
b) space savings