The CAHIMS Exam Preparation Course and the CAHIMS exam are the result of collaboration between the Life Science Informatics Center at Bellevue College and the Healthcare Information and Management Systems Society (HIMSS). Significant content found in the CAHIMS Exam Preparation Course stems from the Office of the National Coordinator for Health Information Technology. Creation of the CAHIMS Exam Preparation Course and the CAHIMS exam was made possible through support from the National Science Foundation (NSF).
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Curriculum Team:
Margaret Schulte, DBA
Michèle Royer, PhD
Nathan Savage, MLIS
Section 2 - Technology Environment
Lesson 2.3 - Clinical and Financial Applications
Assessment Questions Answer Key
Lectures 6 & 7
1. Which of the following is not a component of a knowledge-based patient monitoring system?
a. Data acquisition
b. Presentation
*c. Coding system
d. Database
Answer: c. According to Wang, Kohane, Bradshaw, & Fackler, there are four components of a knowledge-based monitoring system, i.e., data acquisition, presentation, database, and intelligent components.
Lecture/Slide: 6/9
2. Which of the following is a patient monitoring application?
a. e-prescribing
b. Computerized order entry
c. Electronic charting
*d. Glucometers
Answer: d. Remote patient monitoring systems include monitoring devices such as weight scales, glucometers, implantable cardioverter‐defibrillators, and blood pressure monitors.
Lecture/Slides: 6/14-15
3. One way in which data integration assists in medical decision making is by accelerating the flow of critical information.
*a. True
b. False
Answer: a. Integrating data from many sources and having systems with algorithms that help put into context the vast amount of data collected provides guidance in patient management and assists in medical decision making by accelerating the flow of critical information.
Lecture/Slide: 6/17
4. Which of the following is not one of the general areas where telehealth supports clinical care with communication technologies?
a. Long-distance clinical health care
*b. Payer and provider coordination of care
c. Patient and professional health-related education
d. Public health and health administration
Answer: b. Telehealth supports clinical care by allowing long-distance health care, providing patient and professional health-related education, and allowing connections of healthcare professionals to various individuals involved in public health and health administration.
Lecture/Slides: 7/8-11
5. A benefit of telehealth is increased number of home visits by the nurse in order to link patients to specialists.
a. True
*b. False
Answer: b. Telehealth can decrease the number of home visits by the nurse because of the ability to monitor the patient’s status remotely.
Lecture/Slide: 7/12
6. Which of the following is part of smart technology as it would be used in the home?
*a. Remote patient monitoring
b. Patient monitoring
c. Physician monitoring
d. Payer monitoring
Answer: a. Smart technology in the home would involve the use of telehealth and remote patient monitoring devices integrated with health information systems.
Lecture/Slide: 7/16
Lectures 4 & 5
7. Which of the following early clinical decision support systems used computer-based decision aids based on the Bayesian probability theory?
a. MYCIN system
b. HELP system
*c. Leeds Abdominal Pain System
d. LDS system
Answer: c. The Leeds Abdominal Pain System was built based on “computer-based decision aids using Bayesian probability theory” (Musen, Shahar, & Shortliffe, 2006, p. 702). The theorem is based on rules of predictive probability. A clinical decision support system may use Bayesian logic in its inference engine.
Lecture/Slide: 4/5
8. Which of the following is not a fundamental requirement of a clinical decision support system?
a. Inference engine
*b. Clinical workflow tools
c. Knowledge base
d. Communication mechanism
Answer: b. The components are the knowledge base, inference engine, and communication mechanism. Each component provides a piece that is important for clinical decision support interventions to occur. For example, clinical decision support could provide suggestions for possible diagnoses (knowledge base) that match a patient’s signs and symptoms (inference engine) and communicate this to the provider through a ranked list of diagnoses that might explain the patient’s signs and symptoms (communication mechanism).
Lecture/Slides: 4/8-11
9. The clinical decision support system generates an alert for a needed therapeutic intervention based on a clinical practice guideline and patient-specific factors. The benefit this alert would have is in helping to enforce standards of care.
*a. True
b. False
Answer: a. The benefits to alerts and reminders include “provide immediate notification of errors and hazards related to new data or orders entered by clinical information system (CIS) user or the CIS itself (such as when abnormal lab result is posted) or passage of a time interval during which a critical event should occur; help enforce standards of care. Effectiveness requires careful attention to workflow, high value of information to end user, and other factors”(Osheroff et al., 2005).
Lecture/Slides: 4/19
10. The challenges to achieving the five rights to clinical decision support (CDS) differ depending on how closely the CDS is tied to what the clinician already intends to do.
*a. True
b. False
Answer: a. Berner (2009) states “Achieving the five rights for CDS presents challenges, and the challenges differ depending on how closely the CDS is tied to what the clinician already intends to do. Clinicians may initially want certain reminders or, after performance assessments, agree that they need other reminders, but in either situation they are choosing to receive the reminders. The key issue in reminding the user about things they choose to be reminded about is the timing of the reminder. For instance, should reminders for preventive care be given to the physician in advance of the patient visit (e.g., the day before), or should the reminders appear during the patient’s visit” (p. 7-8)?
Lecture/Slide: 5/4
Lectures 2 & 3
11. Which CPOE function is considered advanced functionality?
*a. Drug-drug interaction checks
b. Transmit the order to the appropriate location
c. Return status of order
d. Return results of order execution
Answer: a. More advanced CPOE applications have some form of clinical decision support. An example of simple clinical decision support is the capability to perform drug-drug interaction checks.
Lecture/Slide: 2/15-16
12. CPOE use is restricted to inpatient medications orders.
a. True
*b. False
Answer: b. CPOE is also not limited to medication orders. Order types, such as those for tests, procedures, and other clinical processes, fall under the umbrella of CPOE.
Lecture/Slide: 2/21
13. Which of the following is NOT a value of CPOE?
a. Reduce variations in health care
*b. Reduce variations in provider workflow
c. Improve patient safety
d. Improve efficiency of health care delivery
Answer: b. CPOE impacts workflow and process of all caregivers and ancillary personnel. It changes the ordering process but may not reduce variations in provider workflow.
Lecture/Slides: 3/7-8
14. A major barrier to CPOE adoption is its cost.
*a. True
b. False
Answer: a. While costs may differ depending on hospital size and level of existing IT infrastructure, CPOE is costly to implement and maintain. For example, organizational staff is needed to provide testing for upgrades and enhancements.
Lecture/Slide: 3/8
15. CPOE implemented independent of other technologies is likely to have limited benefits.
*a. True
b. False
Answer: a. Use of CPOE should not be executed by itself as limited benefit may result. For example, CPOE needs to include clinical decision support to reach its full value.
Lecture/Slide: 3/14
Lecture 8
16. Image modalities differ in their storage requirements, depending on
*a. The contrast and spatial resolution needed
b. The number of integrations with other systems
c. Whether data expansion techniques are used
d. Both a and b
Answer: a. According to Greenes and Brinkley (2006), storage requirements differ depending on the contrast and spatial resolution needed.
Slide: 10
17. A physician is reviewing digital images from a patient’s CT scan at her home office. What systems need to be integrated for this to occur?
a. Information Technology System and Picture Archiving and Communication System
b. Radiology Information System and Electronic Documentation System
*c. Picture Archiving and Communication System and Radiology Information System
d. Electronic Documentation System and Picture Archiving and Communication System
Answer: c. PACS deals with storage and communication of medical images. Integration is necessary between PACS and RIS in order for the physician to review the digital images.
Slides: 14-15
Lectures 9 & 10
18. Which is a strategy used by health care organizations to ensure integration of functions?
*a. Data preservation
b. Data destruction
c. Data scrutiny
d. Data testing
Answer: a. One of the two strategies identified by Vogel and Perreault (2006) was one for data preservation.
Lecture/Slide: 9/13
19. Which of the following is not a critical element needed in integrated billing, financial, and clinical systems?
a. Information is available when and where it is needed
*b. Users must have separate views
c. Data must have a consistent interpretation
d. Adequate security must be in place
Answer: b. Critical elements needed in integrated billing, financial, and clinical systems include that the information is available when and where it is needed, the data must have a consistent interpretation, and adequate security must be in place.
Lecture/Slide: 9/17
20. A core element of the master patient index is the patient’s insurance.
a. True
*b. False
Answer: b. Patient insurance is not considered a core element of the master patient index.
Lecture/Slides: 10/9-11
21. Computerized provider order entry requires health care information systems integration.
*a. True
b. False
Answer: a. Computerized provider order entry is typically a module of an integrated information system where clinical-event monitors integrate with results-reporting applications in order for alerts to be triggered.
Lecture/Slide: 9/12
22. HIPAA regulations require unique identification numbers that can be used across information systems.
*a. True
b. False
Answer: a. HIPAA regulations require unique identification numbers that can be used across information systems although an individual patient identifier (UPI) has not been adopted due to a number of factors, specifically privacy and security concerns.
Lecture/Slides: 10/14
Lecture 1
23. The __________ allows ancillary systems in a hospital setting to connect with other systems.
a. PIS
*b. Interface engine
c. Registration system
d. CDS
Answer: b
Lecture(s)/Slide(s): 1/9,10
24. __________ is an example of an expert system used in healthcare.
a. Registration
b. Interface engine
*c. Clinical decision support
d. Laboratory information system
Answer: c
Lecture(s)/Slide(s): 1/4,5
25. Information systems in hospitals include dozens of systems involving every aspect of business operations and healthcare.
*a. True
b. False
Answer: a
Lecture(s): Slide(s): 1/8
Lecture 8
26. One of the three processes used in imaging systems in health care is interpretation of the images.
*a. True
b. False
Answer: a. The three processes used in imaging systems in health care are acquiring images, interpreting images, and communicating the interpretations.
Slide: 7
27. Image modalities differ in their storage requirements, depending on
*a. The contrast and spatial resolution needed
b. The number of integrations with other systems
c. Whether data expansion techniques are used
d. Both a and b
Answer: a. According to Greenes and Brinkley (2006), storage requirements differ depending on the contrast and spatial resolution needed.
Slide: 10
28. The technological and human engineering factors associated with digital displays are the same for the radiologist and the referring clinicians.
a. True
*b. False
Answer: b. Because of different needs, the technological and human engineering factors associated with digital displays are not the same for the radiologist and the referring clinicians.
Slide: 12
29. A physician is reviewing digital images from a patient’s CT scan at her home office. What systems need to be integrated for this to occur?
a. Information Technology System and Picture Archiving and Communication System
b. Radiology Information System and Electronic Documentation System
*c. Picture Archiving and Communication System and Radiology Information System
d. Electronic Documentation System and Picture Archiving and Communication System
Answer: c. PACS deals with storage and communication of medical images. Integration is necessary between PACS and RIS in order for the physician to review the digital images.
Slides: 14-15
30. A factor in the future direction of imaging systems is the development of exchange standards.
*a. True
b. False
Answer: a. Factors that will affect the future direction of imaging systems include advances in medical imaging technology, development of exchange standards, and changes in health IT regulations.
Slides: 17-19
This work is funded by the National Science Foundation
Advanced Technological Education Grant 1003223
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