161 Practice exam questions
Terms in this set (122)
What best defines the broad term "eHealth" in Canada?
Health informatics: the application of information technology to facilitate the creation and use of health-related data, information and knowledge
In Canada, what is the most commonly known term used for "Health Informatics"?
According to the different terms used in the Information Hierarchy, what is an example of "Knowledge"?
Information that is justifiably true (declining hemoglobin suggests bone marrow dysfunction)
According to the different terms used in the Information Hierarchy, what best describes "observations or symbols"?
You receive a faxed prescription transfer from another pharmacy. Prior to entering this new prescription into your computer, what level of data is it?
Level 1 data (paper documents)
Data warehouses that contain financial information are likely collecting what source of eHealth data?
What is one possible advantage of using eHealth in clinical practice rather than the traditional pen-and-paper?
- Increase in efficiency in work
- Improved and standardized patient care (and therefore patient health outcomes)
- Lower costs
- Detect trends in sales/prescribing
What is one of the main reasons why eHealth implementation has failed in the past?
- Inadequate time, information, expertise/people, money/ROI, interoperability between systems
- Data rich but information poor
- Change workflow
- Individual resistance to change
- Privacy concerns
What type of network is MOST likely to be used by a clinician to access office files remotely from home?
Virtual private network
You are setting up a new clinic and want to be able to securely connect directly to your server and access files. What type of network would be most appropriate to create?
1. VPN (virtual private network - shares LAN or WLAN with other users and enables patient charts from work to be accessed via home computer)
A large clinic has 5 computers, 2 printers and 1 fax machine connected. What type of network has this clinic set up?
A large clinic has 5 computers, 2 printers and 1 fax machine connected, along with a patient-accessible wireless Internet access. What type of network has this clinic set up?
The World Wide Web enables the browsing of content that is available on the internet.
The Internet is considered the network of choice for any transmission of data given the ability to layer other
technologies and standards.
Browsers are used to translate content from the World Wide Web for users to view on screen.
What is one reason why the Internet is the preferred network for transmitting data?
- Large scale use and availability
- Bandwidth capability
- Ability to layer other technologies and standards
For online retailers such as Amazon, inventory service, shopping cart service, and payment service are examples of key elements of what form of system?
What is one advantage of using a service-oriented architecture?
- Reduction in paperwork and data-entry activities
- Consistent information across the entire system
- Faster response to any future system changes and the implementation of new capabilities
What is one goal of using a service-oriented architecture concept?
Aims to configure software systems to maximize efficiency and reduce redundancy and minimize errors and cost
What is 1 advantage of using service-oriented architecture?
To reduce paperwork & data entry / yield consistent
information across entire system / and allow for faster
response to future system changes
Securing your computers to the floor with a lock is a good way to prevent theft and maintain what basic security principle
Confidentiality: Preventing data loss.
The use of backup power generators is a good way to ensure you maintain what basic security principle?
Implementing archival tools and routine data backups are good ways to ensure you maintain what basic security principle?
The use of CWL (Campus Wide Login) at UBC can be an effective security tool.
Access control lists
What is one reason why an organization may choose to implement a sophisticated authentication system rather than a basic system?
Sensitivity of data
Basic authentication exists in varying levels and can be based on what factors?
Sensitivity of data and available resources
What is one major disadvantage to using Smart Cards as a method for authentication?
Lack of standardization and positive identification
In order for a digital signature to be verified and received, what needs to be done that is different from receiving a "wet" signature?
Sender's private key creates signature and sender's public key verifies signature
Under the BC eHealth Act, the Ministry of Health can exempt Health Information Banks from giving individuals the right to limit the disclosure of my information.
What is one of the key initiatives under the BC eHealth Act (Personal health Information Access and Protection of Privacy Act)?
- Minister designates any public health data base as an information bank
- gives people to limit the information disclosed to different health information
- allows heath information banks to exempt from above limitation
In the case of the Affinity Health Plan case of security breach of 2010, which of the following simple data
protection methods would have been MOST helpful in preventing the breach?
Clean computers before discarding
Avoiding the use of social media is one way to protect your personal data.
The goal of data analytics in healthcare should be:
Surgical patients have a reduced risk of developing TE if they are prophylactically taking anticoagulation therapy, this is an example of
You are tasked with assessing your pharmacy's financial performance using prescriptive data analytics. What would you expect to achieve with this type of data analytics?
What to do to optimize finances
The modeling of data with predictive value in the care of a patient is considered data mining.
False (it is personalized medicine)
One of the key components of an electronic health record is the ability to send messages to personal health records.
What is one key component of electronic health record systems
- Information & data can be accurately recorded
- capable of managing results from labs, imaging, and specialist consults - able to manage new prescription ordering, referrals, and blood work
- provides alerts & reminders
- messaging communication feature though portals
- support PT education
- scheduling, billing, automated feature, reporting metrics
- immunization status
- C&S reports
One advantage of using pharmacogenomics is the ability to identify effective treatment ahead of time. What is another advantage of pharmacogenomics?
Allows for personalized medicine
What is one reason why pharmacists play a critical role in implementing pharmacogenomics projects?
- Proximity to patients
- Existing network of 9000 pharmacies
- Reliable healthcare professionals providing 24/7 services
- Link between patient and prescriber
- Make critical drug decisions everyday
What is one identified barrier to the widespread use and adoption of pharmacogenomics?
- No incentives for clinicians to conduct tests that may prevent ADR
- Few studies have proven cost effectiveness of pharmacogenomics testing
- Vague guidelines for translating gene variants into action
- Lack of clinician education
- Concerns about incidental findings
- Inertia in health care systems
What form of sequencing will provide a patient with the most potential health value in the future?
Whole exome sequencing
What is an example of the use of prescriptive data analytics to optimize patient outcomes?
- Prescriptive data uses descriptive and predictive data to help determine what to do in a given situation to optimize outcomes
- Goal of analytics in healthcare
- If someone has high CV risk [genes, diet, exercise], taking a statin should lower their chance for heart attack or stroke
What is one key component of electronic health record systems?
- Health information and data that can be accurately recorded
- Manage results from labs, imaging, specialist consults
- Manage ordering new Rx, referrals, blood work requisitions
- Provide decision support w/ alerts & reminders
- Communication feature through messaging or connections w/ web portals (ex. PHR)
- Patient support via education and information output to PHRs
- Admin functions including scheduling, billing, automated features, reporting of metrics
- Manage reporting for Public Health w/immunization status/culture/sensitivity reports
When considering whether a clinic should switch from paper-based notes to an electronic medical record system, what would be two advantages that need to be considered?
- Improved legibility of notes
- Can improve access anytime, anywhere
- Eliminates missing files
- Reduced duplication of automation
- Reminders of overdue tests and visits
- Clinical decision support tools embedded in the program
- Electronic lists for diagnoses, allergies, medications, etc
- Enables data analytics
What health professional would you expect would use the most number of features in an EHR?
You are tasked with assessing your pharmacy's financial performance using prescriptive data analytics. What would you expect to achieve with this type of data analytics?
- Most sophisticated, uses descriptive and predictive data to help determine what to do given a situation to optimize outcomes
- Acquire information to make optimal financial choices for the pharmacy in the future from past financial data. From the predictive data, one can model trends from past financial information
Goal of data analytics in health care
If everyone in the class was given an individual assignment to create an analytics system to track the amount of "study time" you spend doing "non-study" activities, what would be one of the challenges that need to be overcome before the results of the data can be utilized?
- Incomplete data
- Data time-stamped doesn't mean the patient experienced it at that time
- Ethical concerns of data ownership
- Transforming the data to suit other purposes such as billing
What is an example of an electronic medical record (EMR) database?
1. Local pharmacy records (specific to one HC organization)
What is one example of a limitation seen in the use of the PharmaNet allergy field for adverse drug reporting
- Infrequent use
- Unable to enter data from hospital
- Free text
- Quality of information highly variable
A patient experiencing an unintentional unknown side effect from a drug would be
experiencing an adverse drug event
A patient experiencing an unintentional medication side effect from an inappropriate dose would be experiencing an adverse drug reaction.
False - they would be experiencing an adverse drug event
Which of the following is an advantage of paper-based records (when compared to electronic health records)?
Does not require additional training for users
What is the difference between ePrescribing and computerized provider order entry (CPOE)?
- A CPOE is a feature in EHR that helps process any order (medication, labs, consults) and it is a system that relies on coding whereas eprescribing is specific to medication orders only
The integration of interaction checkers and decision-support tools in to electronic health records is enabled by what feature?
Poor implementation of computerized provider order entry (CPOE) could lead to increased mortality.
The coding language ICD9 is an example of semantics
What is the best way to describe the difference between the syntax and the semantics of a language?
Syntax is the formatting ruled of language whereas semantics is the meaning / interoperating of language
The syntax of any coding language can be considered one of the foundational pieces for what kind of data standard?
Content standard: how the data being transported is packaged (HL7 - a type of syntax)
What is one difference between SNOMED and ICD9 coding?
SNOWMED allows you to stack codes to be very specific about a condition whereas ICD9 has a finite number of codes
What is one advantage of SNOMED over ICD9 coding?
Allows for unlimited codes
Training and support for new users is not an important part of successful EHR implementation.
What is considered a common myth in successfully implementing an electronic health record system?
- New EHR will fix all current problems
- Mobile platforms are best
- EHR will eliminate errors
- I don't need training, how hard can it be
- Not including other clincians in planning and implementation
- Thinking one person can still use paper-based where everyone else uses EHR
What are 3 examples of "rights" that a good medication administration system should strive to achieve?
- Right patient
- Right drug
- Right dose
- Right route
- Right time
What is one example of how medication administration can be controlled by pharmacists in the outpatient setting?
What is one example of how medication distribution can be controlled by pharmacists in the outpatient setting?
Daily/weekly dispense (patient's administer meds on their own - e.g. vials, blister packs)
What is one example of how an electronic medication administration record (eMAR) can improve patient care in a closed-loop system?
- Can sync for automatic updating
- Can be linked electronically to correct patient and drug (barcoding)
Handwritten - hard to read - another source of error
One of the 35 NAPRA requirements for all pharmacy practice management systems (PPMS) includes the ability
to integrate with lab tests.
Two of the 35 NAPRA requirements for all pharmacy practice management systems (PPMS) includes the ability to integrate with lab tests and allow for clinical documentation.
What is one feature of Pharmacy practice management systems (PPMS) that is not seen in electronic health records (EHR)?
- Support billing and dispensing
- Patient information appears to be free text fields / Can see current inventory and when it was last updated
What is one advantage of having a good technology-enabled inventory system in a pharmacy?
Paying for an item at cost and selling it before you need to pay for it vs not selling the product but eventually needing to pay vendor
Point of care testing can be defined as:
medical diagnostic testing performed outside conventional clinical laboratory in the immediate vicinity of the patient to provide rapid results, where the results of the test is used for clinical decision making
What are 2 advantages of point-of-care testing?
- Less invasive/more convenient
- Can act right away
- Multifunctional machines
- Doesn't require a clinical setting
- Minimally invasive
- Less invasive/more convenient
- Monitoring of chronic illness can be done by patient
- Easy to use
- Can be done everywhere
- Faster modification of care
- Cost savings
- Doesn't have to comply with lab requirements
What did the 2012 CADTH Systematic Review
comparing point-of-care testing (POCT) versus
conventional lab testing between anticoagulation and
glycemic monitoring find?
Comparable accuracy / Money savings / Increase QoL & patient satisfaction
What is one of the most clinically important enabling features of PharmaNet?
- Access to consolidated patient records
- Real-time drug dispensing information
Online claims processing and adjudication
What is one reason why a medication given to a patient might not show up on PharmaNet?
- Drugs given in hospital or mental health centres
- Samples from a clinician
- BC Cancer Agency/BC Centre for Excellence in HIV/AIDS, BC Transplant Society, BC Renal Agency
A patient can opt out of PharmaNet participation.
Billing and claims data captured on PharmaNet is available to all other users who have access to PharmaNet.
What is one example of a healthcare professional that does not have access to PharmaNet?
- Naturopathic doctor
- Pharmacist outside a dispensary
What is one way a patient could restrict access to his/her PharmaNet record from healthcare providers?
What is one requirement that a healthcare provider must meet before access to PharmaNet can be granted?
Access granted by Ministry of Health (need to come and inspect the physical area that is going to access PharmaNet - cannot be laptop, has to be computer in a secure area that is private/confidential) / Signed confidentiality agreement / Unique identifier prior to access every time
What are two claimed updates for physicians when the PharmaNet modernization project is completed?
- Add sample medications
- Download data from pharmanet
- Send electronic prescriptions
- Search for prescriptions by prescriber
- Check for adapted prescriptions
Health information access layer (HIAL) is a large repository of data used as a central electronic record.
Health information access layer (HIAL) can be defined as:
An architecture system that allows multiple point of service systems to request and connect with others, the backbone on an EHR system and not a repository of data
What are two advantages of a health information access layer (HIAL) system over a one-by-one system?
- Greater integration capability with lower costs
- Provides a secure and organized method of queuing and sequencing requests
Given the one-by-one systems integration, what would be a better way to connect the different users?
An access control layer
Consumer health informatics (CHI) includes any electronic tool or system that:
- Primary designed to interact with health information users of consumers
- Interacts directly with the consumer who provides personal health information to the CHI system and receives personalized health information back
- Data, information, recommendations or other benefits provided to the consumer that may be used with a healthcare professional but is not dependent on a healthcare professional
What are two reasons for the growth of Consumer Health Informatics?
- Availability (and marketing of health information) directly to consumers
- Rise of chronic diseases and the need for patient self-management
- Increasing strains on the current health systems designed to treat acute symptoms
- Patients less willing to automatically accept opinion of HC provider
What are three considerations when evaluating an online source of health information?
Authority, Accuracy, Scope
The current state of online medical information is outstanding for consumers.
What is one common feature of a patient portal?
- Online registration (updating demographic info, check doctor schedule and make appointment)
- Submit med refill requests
- Receive, track, input lab requests
- Patient education materials
- PHR including patient updates of status and uploading clinically relevant findings
- Secure messaging with HC team
What are two common issues affecting both personal health records (PHRs) and electronic health records (EHRs)?
- Needs to be interoperable/transferable
- Security concerns
- Data that is captured needs to be in readable format
What is one of the key principles of Public Health in BC?
- Focus on prevention vs treatment
- Address needs of population rather than individual
What is the role of Public Health in British Columbia?
To protect and promote health in a population with a focus on prevention
Public Health surveillance is the key enabler of effective Public Health overall and can be mandated for specific diseases/conditions.
What are two examples of what can be enabled by Public Health Surveillance?
- Estimate the significance of a problem
- Determine distribution of illness
- Detect epidemics
- Identify laboratory research needs
- Evaluate programs and control measures
- Monitor changes in health practices and behaviors
What type of surveillance system reports data on individual events usually by interview or medical exam?
What type of surveillance system reports data on individual events based on previously identified criteria?
What is one example of a non-traditional health data source that would be useful in Public Health Informatics?
- Environmental (weather or temperature)
- Transportation logistics
- Global factors (animal migration patterns...etc)
What is one challenge of Public Health Informatics (PHI) over other informatics systems?
- Data needs to be accurate and rapidly accessible for it to be usable
- PHI systems have to look at population level data rather than patient-specific data
What is the specific term for providing medical information electronically between different sites?
Telehealth can be defined as
The use of technology to support long-distance clinical health care
Telehealth can be integrated in all aspects of care, including with patient portals.
What is one driving factor for the rise of telehealth?
- Rising costs to provide healthcare services
- Shortage of clinicians
- Stresses on current system
- Patient expectations of technology enabled services
- Improve access in remote areas
What is NOT a driving factor for the expansion of telehealth?
Cost savings to the system
Of the four possible methods of remote monitoring, what is considered to be the one that uses the most sophisticated devices that can capture patient status and report it?
A blood pressure monitor connected via wifi to the physicians EMR that automatically sends results to the
clinician is considered what form of remote monitoring?
A patient accesses care through virtual visits, but finds it difficult to book pharmacist appointments because of odd hours at work. What would be the most appropriate communication mode for the patient
Patient-portal secure messaging
A "bridge" may be required to connect one network to another for purposes of secure telehealth. What is one example of when a bridge would be required to connect?
Between different provincial telehealth networks (MedIR / eNG / FNH / PPN)
A telehealth call between 5 healthcare providers in different sites, all using different UBC MedIT networked computers would be classified as what type of connection?
What are 2 possible barriers to the use and implementation of telehealth?
- Lack of reimbursement models
- High cost of implementing hardware
- Limited availability of capable networks and bandwidth
- Lack of standards (patient devices used to access telehealth)
- Potential for increased cost in a consumer driven system
What is one goal of the First Nations Telehealth Expansion Project of 2013?
- Link first nations communities with health centers to a comprehensive telehealth network
- Integrate with systems of health authorities - allow first nations to participate in professional development programs
What are 2 reasons that have led up to the expansion of telehealth services in British Columbia by
the First Nations Health Authority
Transformative Change accords in 2006 / First Nations Telehealth expansion of 2013 / Prime Minister Justin Trudeau 2015 plan followed-up by his 2016 budget
According to the Food and Drug Administration, what is one characteristic of a mobile medical application?
Mobile app that is intended to be used as an accessory to a regulated medical device or to transform a mobile platform into a regulated device
What are two examples of how mobile apps can be used in healthcare?
- Help patient with disease self-management
- Provide patient with simple tools to track health info
- Provide info related to pts health conditions or treatments
- Pts document, show or communicate potential medical conditions to healthcare providers
- Automate simple tasks for HC providers
- Allow interaction with personal health records
- Transfer, store or convert medical device data
The presence of reference citation is an important characteristic when
evaluating a mobile application in a clinical setting?
What is an example of a mobile medical application?
RxCalc / Opioids Dosage Conversion / Opioid Dose Conversion Calculator / CDC Opioid Guideline / TMD Calculator
Big Data cannot be collected or used by a small company.
What are two characteristics of Big Data?
- High volume
- High rate of data capture/receiving
- High variety
1. Metadata can also be known as what term?
Discrete data can be defined as
Any data that is both measurable and reportable
Receiving these questions ahead of time helps my learning. What is the name of my favourite pharmacy instructor?