Test Bank For Health Informatics, 3rd Edition 2024 Lynda R. Hardy Chapter 1-33
Chapter 01: An Introduction to Health Informatics MULTIPLE CHOICE 1. Dr. James, in studying patient safety in U.S. hospitals, found that the number of
preventable adverse events leading to serious harm fell in the approximate range of ____________ to _____________ cases per year. a. 4.4 million; 8.8 million b. 440,000; 880,000 c. 1 million; 5 million d. 40,000; 100,000 ANS: B
Dr. James found some 440,000 cases of lethal harm each year and estimated that the incidence of serious (but not lethal) harm was 10 to 20 times that figure. DIF: Cognitive Level: Analyze 2. Health informatics is both a ___________ as well as a(n) ____________. a. discipline; field of study b. profession; practice c. field of study; art d. profession; discipline ANS: D
Health informatics is a discipline, or field of study, in the same sense that ―medicine,‖ ―sociology,‖ and ―pharmacy‖ are fields of study. It is also a profession, practiced by thousands of informaticians in a number of varied roles within the healthcare industry. DIF: Cognitive Level: Remember 3. What is the main idea of the subsection titled ―Why Informatics Is Needed in Healthcare:
An Example‖? a. An interoperable healthcare system that provides clear, concise patient data and information among institutions is lacking in many facilities, and its presence would greatly facilitate things such as patient transfers. b. The quality of discharge communication during transfers of geriatric patients from hospital to nursing home is generally high. c. Skilled nursing facilities aren’t trained enough to identify the information they need to facilitate a high-quality transition of a patient into their facility. d. Healthcare informaticians alone are responsible for building interoperable systems that will facilitate communication between and among healthcare facilities.
ANS: A
This subsection takes the specific case of the transfer of geriatric patients from a hospital setting to a long-term skilled nursing facility (SNF) and uses it to illustrate the great need for an interoperable healthcare system that allows patient data to be transferred quickly, clearly, and concisely among facilities. DIF: Cognitive Level: Analyze 4. The ________ is one of the oldest—and still widely used—methods for building and
implementing software applications in IT arena. a. TUG b. clinical decision support system c. HIPAA d. SLC ANS: D
Though it’s been through a number of iterations and adjustments, the software development life cycle remains the tested and tried-and-true method for studying, building, implementing, and maintaining a health information system. DIF: Cognitive Level: Remember 5. Informatics allows clinicians to see real time data and allows user to ________ for public
health approaches to care in healthcare. a. Meaning b. Manage c. Materialize d. Mapping ANS: B
With continuing progression in the use of technology and healthcare, clinicians can predict and improvement healthcare outcomes. DIF: Cognitive Level: Understand 6. Health informaticians must be able to conceptual organize a variety of _______ to better
understand data analysis. a. Components b. Concepts c. Ideas d. Algorithms ANS: A
Informaticians utilize healthcare knowledge, visualization, and outcome prediction to access raw information and turn it into meaningful use data. DIF: Cognitive Level: Understand 7. Achievable competencies developed by the IOM that should be achieved by clinicians to
deliver patient-centered care include: a. Collaboration, reduction of errors, patient centered, data collection b. Independent, evidence-based practice, reduction of hospital readmissions, use of
informatics c. Collaboration, evidence-based practice, quality improvement, use of informatics d. Collaboration, individual practice, quality improvement, use of Informatics ANS: C
In 2003 the IOM identified core measures that healthcare professionals should achieve in order to deliver patient-centered care. DIF: Cognitive Level: Remember MULTIPLE RESPONSE 1. Patient care tools are very popular for patients. Examples of a patient care tool is: (Select
all that apply.) a. Fitness app b. Smart watch c. Continuous glucose monitoring d. Wireless monitoring device e. Blood pressure cuff f. Triage center ANS: A, B, C, D
Technology now allows patients to take control and monitor their health with the use of smart phones, smart watches, remote wireless monitoring that provides patient data into a cloud type device. DIF: Cognitive Level: Apply 2. The HITECH Act primary purpose was to encourage healthcare providers to adopt EHR
systems for what reasons: (Select all that apply.) a. Financial incentives b. Mortality reduction c. Data governance d. Decrease fraudulent billing ANS: A, B, C
The HITECH Act that was signed into law in 2009 was enacted to promote meaningful use in technology to help lower mortality rates, increase quality patient care, reduce errors, and collection of patient health data analytics for Medicare and Medicaid patients. DIF: Cognitive Level: Understand
Chapter 02: Theoretical Frameworks Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE 1. What is the primary difference between an open and closed system? a. An open system has no boundary, and therefore there are no limits to the inputs
and outputs between an open system and the environment. b. An open system has a semipermeable boundary and therefore will filter both inputs
and outputs when interacting with the environment. c. A closed system has a semipermeable boundary and therefore will filter both inputs and outputs when interacting with the environment. d. A closed system does not have a boundary and therefore will not interact with the environment. ANS: B
With an open system the boundary is semipermeable, thereby controlling what will be accepted as input and what will be permitted to leave the system. DIF: Cognitive Level: Understand 2. The primary characteristics used to analyze an open system include: a. structure, purpose, and functions. b. subsystem, target system, and supersystem. c. boundary, attributes, and environment. d. hierarchical, web, and hybrid. ANS: A
Using these three characteristics, one can determine why the system exists, what functions it performs to achieve its purpose, and how it is structured to achieve its purpose. DIF: Cognitive Level: Remember 3. You have altered the menu of food items served to your patients. However, the change has
greatly expanded the number of refrigerated items needed on hand. You need to buy a new refrigerator, but the electric circuit in the kitchen cannot handle the extra load and needs to be upgraded at significant expense. This set of unintended consequences down the line, produced by an initial change, is called: a. dynamic homeostasis. b. semi-planned change. c. negentropy. d. reverberation. ANS: D
Change within any part of a system will be reflected across the total system through a process termed reverberation. Reverberation can be intended or unintended consequences of change. DIF: Cognitive Level: Analyze
4. The ―butterfly effect‖ describes a situation in which a minor change in input (eg, a
butterfly flapping its wings in one part of the world) can have a major effect on output (eg, a windstorm developing in another part of the world). This aspect of chaotic systems illustrates their property of: a. the reiterative feedback loop. b. linearity. c. preordained periodic behavior. d. the fractionation of outputs. ANS: A
Chaotic systems are dynamic systems with reiterative feedback loops. A minor change in input can create a major change in output. This is often described as the butterfly effect. A butterfly’s flapping wings in California can over time become a hurricane in New York. DIF: Cognitive Level: Analyze 5. Which statement describes the measurement of information as defined by the Shannon and
Weaver model? a. The amount of information is measured by the amount of data in the message. b. The amount of information is measured by the number of meanings that can be assigned to a message. c. The amount of information is measured by the extent the message decreases entropy. d. The amount of information is measured by the number of characters used to create the message. ANS: C
By decreasing entropy one decreases uncertainty. Shannon, a telephone engineer, sought to overcome the technical problems of moving information across communication channels by determining how to minimize entropy. DIF: Cognitive Level: Remember 6. On its own, the number 190 is an example of: a. data. b. information. c. knowledge. d. wisdom. ANS: A
The number 190 could refer to anything such as a person’s weight, blood glucose level, or systolic blood pressure reading and therefore has no meaning by itself. DIF: Cognitive Level: Apply 7. Knowing when and how to use knowledge is referred to as: a. procedural knowledge. b. cognitive knowledge. c. decision support system. d. wisdom. ANS: D
Wisdom is defined as the appropriate use of knowledge in managing or solving human problems. It is knowing when and how to use knowledge in managing patient need(s) or problem(s). DIF: Cognitive Level: Remember 8. Which group will test out new technology but are not usually seen as leaders within an
organization? a. Innovators b. Early adopters c. Early majority d. Late majority ANS: A
Innovators will test out a new technology; however, they are too far ahead of the social group to be seen as leaders by other members of the social system. Early adopters are seen as much more discreet in their selection of new technology and are therefore better at selling a new technology to a group of potential users. DIF: Cognitive Level: Understand 9. When utilizing Kurt Lewing’s change theory, and example of refreezing would be: a. Updated employee handbooks. b. Survey employees of thoughts of new process. c. Rounding on employees to view the newly implemented process in action. d. Display education and posters of upcoming process change. ANS: A
Planned process change must go threw three steps. These steps include unfreezing, moving, and refreezing. During the unfreezing step behaviors are observed and predicted for the upcoming change. This will assist in understanding potential obstacles or mind steps that may sabotage the change. During the moving step the change is implemented. During this step monitor the behaviors, feelings and thoughts of staff in order to positively move forward with the change. Lastly, refreezing involves the change becoming permeant by changing education material, employee handbooks, contracts, and protocols. DIF: Cognitive Level: Apply MULTIPLE RESPONSE 1. The Staggers and Nelson systems life cycle (SLC) is a guide for informatics projects. Its
phases include: (Select all that apply.) a. implementation. b. planning. c. evaluation. d. security. e. diagnosis. ANS: A, B, C
The seven phases of the Staggers and Nelson SLC are analyze; plan; develop or purchase; test; implement or go-live; maintain and evolve; and evaluate.
DIF: Cognitive Level: Remember
Chapter 03: Health Systems and Information Flow Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE 1. Patient medical records on paper provide fragmented or no data related to: a. Patient identity b. Patient information c. Patient decision making d. Patient communication ANS: C
Patient medical records on paper were used prior to the electronic health record and are still used in some facilities. Paper medical records disrupt the ability to provide the patient with improved healthcare decisions that are relevant to the disease process, laboratory studies, and imaging results. DIF: Cognitive Level: Understand 2. A data warehouse is a type of data storage system that is beneficial to which type of
setting? a. Healthcare setting b. Business setting c. Education setting d. Government setting ANS: B
A data warehouse stores processed data that is structured with specific information. This type of data storage works well for a business setting that needs to evaluate inventory or managing customers. DIF: Cognitive Level: Remember 3. When a healthcare clinician scans a patient’s armband, this is an example of what type of
data entry? a. Point-of-care b. Clinical intelligence c. CDS tool d. Observational research ANS: A
Point-of-care data provides automated information into the patient electronic health record. An example of automated instrument use is patient barcode scanning. DIF: Cognitive Level: Remember 4. Visualization techniques, such as dashboards, display patient data in the electronic health
record and are a by-product of: a. Algorithms
b. Benchmarking c. Data flow d. Enterprise data warehouse (EDW) ANS: D
The enterprise data warehouse (EDW) serves as a place to store data. This data can be transformed into visual information that can be represented in the EHR as dashboards. The EDW needs support from information technology for the data to be meaningful to the end user. DIF: Cognitive Level: Apply 5. The enterprise data warehouse has faced obstacles while integrating patient data. What is
this obstacle? a. Compliance b. Standardization c. Privacy d. Financial ANS: B
Because of the lack of structure in data warehousing, it is difficult to have a standard in place to process and store data that has been collected. This lack of standardization has caused different formats being provided and supported in healthcare systems. DIF: Cognitive Level: Remember 6. Data mining can produce assistance to the patient’s profile and improve: a. Patient outcomes b. Patient knowledge c. Patient network d. Patient interaction ANS: A
Patient data mining is a key component for the informaticist to understand specific patient data information. This specific information can improve patient care by improving patient outcomes. DIF: Cognitive Level: Apply 7. An informaticist can assist the health care provider by presenting meaningful data. Which
type of usable data is a list of patients who have not filled their diabetic insulin prescription in the last 3 months? a. Illness prevention b. Promote wellness c. Aid in healthcare decision-making d. Care cohesion ANS: A
An informaticist uncovers findings with the use of technology and data mining. When this data is analyzed, it is empowering and can make a significant impact on patient care. Illness prevention is the ability to identify patients who are at high risk of advancing their disease process.
DIF: Cognitive Level: Apply MULTIPLE RESPONSE 1. Health information technology in healthcare allows health information to improve quality
patient care by: (Select all that apply.) a. Improving the clinical decision support b. Reducing medical errors c. Managing patient care d. Implementing process improvement measures e. Reducing reckless practice ANS: A, B, C, D
The need for improved patient care was recognized by the Joint Commission after noticeable preventable patient errors were found. The electronic health record allows health information to become managed and explored. DIF: Cognitive Level: Understand 2. Examples of structed data include: (Select all that apply.) a. Patient phone number b. Patient medical record number c. Patient clinical summary d. Patient birth date e. Patient gender ANS: A, B, D, E
Structured data includes numbers, dates, lab values, and medical coding. Unstructured data is free text. DIF: Cognitive Level: Remember 3. Accessing data and electronic health records requires permission from the IT department.
Role-based access provides which type of privileges? (Select all that apply.) a. User name b. Password c. VPN d. Email ANS: A, B
Role-based access has the fewest privileges and is the most widely used. Therefore, it has minimum login access requirements. DIF: Cognitive Level: Understand
Chapter 04: Informatics-Related Standards and Standard Setting Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE
1. The NIC system includes: a. interventions for illness prevention. b. medication administration records (MARs). c. 30 domains with 7 classes each. d. nursing outcomes. ANS: A
The NIC system includes interventions for illness prevention. DIF: Cognitive Level: Understand 2. Which organization recognizes nursing terminologies as supporting nursing practice? a. NANDA-I b. International Health Terminology Standards Development Organization
(IHTSDO) c. American Nurses Association (ANA) d. Alliance for Nursing Informatics (ANI) ANS: C
The organization that recognizes nursing terminologies as supporting nursing practice is the American Nurses Association. DIF: Cognitive Level: Remember 3. The NANDA-I classification is a: a. standardized classification of patient/client outcomes. b. set of nursing diagnoses of actual problems, risks, and health enhancement needs. c. standardized classification of interventions. d. unified nursing language system into which nursing terminologies can be
cross-mapped. ANS: B
The NANDA-I classification is a set of nursing diagnoses of actual problems, risks, and health enhancement needs. DIF: Cognitive Level: Remember 4. International Classification of Nursing Practice is a: a. standardized classification of patient/client outcomes. b. set of nursing diagnoses. c. standardized classification of interventions. d. unified nursing language system into which nursing terminologies can be
cross-mapped. ANS: D
The ICNP is a unified nursing language system into which nursing terminologies can be cross-mapped. DIF: Cognitive Level: Remember 5. Which terminology serves as a resource to represent domain knowledge of interest and
thus facilitates data collection, processing, and aggregation using computer processing?
a. b. c. d.
Ontology Classification Reference terminology Nomenclature
ANS: C
Reference terminology serves as a resource to represent domain knowledge of interest and thus facilitates data collection, processing, and aggregation using computer processing. DIF: Cognitive Level: Understand 6. ICD-9 and ICD-10 are examples of which category of terminology? a. Nursing terminology b. Billing code c. Clinical classification d. Multidiscipline terminology used for clinical coding within an EHR ANS: B
ICD-9 and ICD-10 are examples of billing codes—codes used for reimbursement. DIF: Cognitive Level: Remember 7. Standard terminologies can be used to do all of the following, except: a. design user interfaces using terminologies. b. support data retrieval and exchange. c. decrease system-wide susceptibility to malware and hacking. d. monitor the quality of care. ANS: C
The use of standard terminologies brings many benefits across the healthcare spectrum, but it does not offer any added protection against computer malware or attacks by hackers. DIF: Cognitive Level: Remember MULTIPLE RESPONSE 1. Which terminology contains nursing languages? (Select all that apply.) a. SNOMED b. Logical Observations Identifiers Names and Codes (LOINC) c. Omaha System d. NANDA e. eMAR ANS: A, C, D
The terminologies that contain nursing languages include SNOMED, the Omaha System, and NANDA. DIF: Cognitive Level: Understand 2. Which terminologies are recognized by the ANA? (Select all that apply.) a. ICNP b. NOC
c. LOINC d. RxNorm e. CCC ANS: A, B, C, E
ANA-recognized nursing terminologies include ICNP, NOC, CCC, and LOINC. RxNorm is not a nursing terminology. DIF: Cognitive Level: Remember 3. Which languages does the nursing profession consider national and international ―data
standards‖ that they wish to cross-map their own terminologies to? (Select all that apply.) a. LOINC b. HL7 c. SNOMED CT d. RxNorm e. ICNP ANS: A, C
LOINC and SNOMED CT are widely adopted and are considered data standards nationally and internationally. The nursing profession has participated actively in harmonization efforts through terminology cross-mapping and integration of nursing terminologies into SNOMED CT and LOINC. DIF: Cognitive Level: Remember
Chapter 05: Evaluation of Health Information Systems – Purposes, Theories, and Methods Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE 1. An example of an assigned nursing intervention code is: a. CAB b. CE2 c. 356 d. XXI ANS: B
Use of nursing intervention codes are reported as an alphanumeric code. DIF: Cognitive Level: Apply 2. Healthcare clinical data is complex in nature. For data to be understood, which type of
terminology is used? a. CPTs b. NANDA c. Cross -mapping d. CDSS ANS: C
Terminology harmonization allows EHR programs to understand the variations of information put in by the user. In order to blend the meaning of the inputted information, a standardization of terminology must be used. LOINC, SNOWMED, ICD-10, and HL7 allow for a cross-reference of terminology to be used. DIF: Cognitive Level: Understand 3. Which standard has been developed to encourage data to be integrated using a complex
computer language? a. HL7 b. XML c. Metathesaurus d. NLP ANS: A
HL7 is a standard to regulate data exchange. It is a comprehensive framework that encourages data retrieval and data exchange. DIF: Cognitive Level: Understand 4. A large multilingual vocabulary database known as the UMLS Metathesaurus is updated
by the National Library of Medicine every six months for what purpose? a. Billing codes b. Procedural codes c. Concepts and research d. Classification changes ANS: C
The UMLS Metathesaurus is updated every 6 months because of the rapid changes in evidence-based practice. More than 4.4 million concepts are updated. The database also cross references other unique identifiers of the same concept. DIF: Cognitive Level: Understand 5. Which challenge prevents the reduction of healthcare costs when implementing a
nationwide Learning Health System (LHS)? a. Substandard interface b. Substandard guidelines c. Substandard specifications d. Substandard protocols ANS: A
With the introduction of the electronic health record, the ultimate goal was to improve patient care and reduce medical errors through the use of standardized healthcare forms. Additionally, Medicare and Medicaid would benefit with cost reductions by implementing a nationwide learning health system. This system utilizes patient electronic record data to generate predictive data to help prevent extended sick visits from occurring. The challenge is poor interoperability among the variety of software EHR systems and poor data being entered. DIF: Cognitive Level: Understand
6. Cognitive theoretical perspectives involve human cognition or psychological processes
that include ____ a. Social, motivation, technical b. Cognition, motivation, behavior c. Assessment, motivation, behavior d. Plan, develop, implement ANS: B
Cognitive framework measures how people make decisions. Cognitive theoretical perspectives involve both the cognitive and psychological processes that humans work through. DIF: Cognitive Level: Remember MULTIPLE RESPONSE 1. Identifying terms and concepts that express a specific meaning and standard terminology
is necessary for standardization of a electronic health record. The identified multidisciplinary terminologies use which components to regulate these terminologies within a system? (Select all that apply.) a. LOINC b. CDSS c. NMDS d. SNOMED ANS: A, D
Medical terminology within an electronic system requires standards to define entries and categories for information to be stored correctly. The American Nurses Association recognizes two specific datasets known as LOINC and SNOMED. Snomed determines global standards and health care terms for electronic language. LOINC is a database that standardizes laboratory observations. DIF: Cognitive Level: Apply | Cognitive Level: Understand 2. An example of quality of care monitoring includes which of the following? (Select all that
apply.) a. Wrong medication given b. Types of medications a patient is taking c. Results of a radiology report d. Medication reconciliation e. Nurse staffing ratio ANS: A, B, D, E
Quality patient care and benchmark standards are established by examining gaps in care and practice patterns. Inputed information on a patient’s health record can assist in identifying the gaps needed to improve patient care. DIF: Cognitive Level: Apply | Cognitive Level: Understand 3. An example of qualitative research involves: (Select all that apply.) a. One-on-one interview
b. c. d. e.
Focus groups Observations Survey percentages Survey responses
ANS: A, B, C, E
Qualitative studies are designed around categorical information. These types of studies allow researchers to move the data into the categories of their choice. Quantitative studies include data that is numerical. DIF: Cognitive Level: Apply 4. Examples of process measures are: (Select all that apply.) a. Prophylactic antibiotic therapy b. Fibrinolytic use for acute myocardial infarctions c. Satisfaction score d. Decrease in hospital readmissions e. Umbrella charges ANS: A, B
Process measures are actions, guidelines, or responses involved in a patient’s care. DIF: Cognitive Level: Apply
Chapter 06: Technical Infrastructure Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE 1. Which item is an example of information that might be found in an EHR’s clinical data
repository? a. A physician’s surgical schedule b. The list of medications available in a hospital’s formulary c. The result of a patient’s microbiology laboratory test d. Monthly billing charges for the radiology department ANS: C
The result of a patient’s microbiology laboratory test is an example of information found in a CDR. The other items would be found in other administrative databases. DIF: Cognitive Level: Understand 2. Which factor would strongly influence the reliability of an EHR’s repository? a. The redundancy of storage hardware b. Clinician training on EHR applications c. The coding system used for laboratory results d. The use of strong passwords ANS: A
Architectural and procedural models such as the redundancy of storage hardware and access routes contribute to the reliability of an EHR’s data repository.
DIF: Cognitive Level: Understand 3. Which statement describes a repository with central storage of a longitudinal record? a. Patient data are from a single hospital’s data for the most current encounters. b. Data from multiple hospitals are kept compact and efficient by deleting old data. c. Portions of a patient’s lifetime medical record are stored in databases at the facility
where the data was collected. d. The information collected by the organization is stored in a single database no matter when or where the patient was seen. ANS: D
The information collected by an organization that is stored in a single database no matter when or where the patient was seen is an example of a repository with central storage of a longitudinal record. DIF: Cognitive Level: Apply 4. Within the distributed model and the centralized model of data sharing networks, a
network must be able to utilize this function between organizations. a. Retrieve data b. Match patients c. Connect to internet d. Self-support ANS: B
When an organization is retrieving data for a specific patient, the distributed and centralized models must be able to match a patient within the central storage repository to provide adequate information regarding a patient. The patient’s MPI attributes the correct data to a specific patient. DIF: Cognitive Level: Understand 5. A method for exchanging patient data among healthcare organizations that is endorsed by
the federal government is: a. copying information to a secure USB drive and giving it to another organization. b. providing EHR log-in accounts to providers outside the organization. c. implementing a secure internet connection using components of the eHealth Exchange. d. The federal government does not endorse sharing health information among organizations. ANS: C
The eHealth Exchange (formerly the Nationwide Health Information Network) is a method for exchanging data endorsed by the federal government and used by organizations from all 50 states as well as four federal agencies. DIF: Cognitive Level: Remember 6. A significant challenge to technical infrastructures in healthcare environments is: a. Implementing a data repository that will be able to handle unanticipated new
information and advances in medicine
b. Arranging data entry components properly in a documentation application to
improve data collection efficiency c. Training clinicians to use EHRs effectively d. Agreeing on policies for sharing information among healthcare organizations ANS: A
A significant challenge to technical infrastructure in healthcare environments is implementing a data repository that will grow with changes in medicine and the information needed to be stored. DIF: Cognitive Level: Understand MULTIPLE RESPONSE 1. Which functions are characteristic of a master person index? (Select all that apply.) a. Store the current and former names of a patient b. Store the most recent vital sign information for each patient c. Coordinate the various identifiers a patient uses, such as medical record number,
insurance account number, and driver’s license ID d. Provide a unique identifier for each patient that is used by components of the EHR
to positively identify the patient e. Report potential drug interactions from new prescriptions to the medical facility
and patient’s pharmacy ANS: A, C, D
Storing current and former names of a patient, coordinating various identifiers a patient uses, and providing a unique identifier for each patient are characteristics of a master person index (MPI). The MPI is not used to store or report clinical information. DIF: Cognitive Level: Remember 2. The use of remote storage systems often referred to as a cloud must take extra steps to
ensure cyber security, including: (Select all that apply.) a. Data encryption b. User authentication c. Secure protocols d. Two-way authenticators e. Weak password ANS: A, B, C, D
Security is essential for cloud-based repository storage. Regulations for HIPAA and the HITECH Act require patient security methods to be secure. Users must be mindful of phishing schemes and other social hacking concepts. DIF: Cognitive Level: Apply 3. EHR systems are equipped with many patient safety features. Some of these features
include: (Select all that apply.) a. Medication safeguards b. Patient safety alerts c. Disease process order sets
d. Predictable behaviors ANS: A, B, C
Tools placed within the EHR are designed to assist the clinicians in providing quality patient care. These safety features can provide medication interaction alerts, recognize trending behaviors through vital signs, and more. DIF: Cognitive Level: Apply
Chapter 07: The Electronic Health Record and Precision Care Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE 1. Which description best defines the electronic health record (EHR)? a. An electronic version of the traditional paper record created and used by the
healthcare provider b. An electronic stand-alone database implemented and used in hospitals c. An electronic version of a patient’s medical record used in the clinical setting d. An electronic record of patient health information created by encounters across
multiple settings ANS: D
The Healthcare Information Management Systems Society (HIMSS) provides a definition of the EHR as a longitudinal electronic record of patient health information produced by encounters in one or more care settings. Every person will have a birth to death (and even postmortem) record of health-related information in electronic form from multiple sources, such as physician office visits, inpatient and outpatient hospital encounters, medications, allergies, and multiple other medical services to support care. All other answers refer to a single facility use, which is not the EHR but a potential component of the EHR. DIF: Cognitive Level: Remember 2. The Health Information Management Systems Society (HIMSS) developed an EMR
adoption model that includes eight stages toward creating a paperless patient record environment. All application capabilities within each stage must be operational before the next stage can be achieved. Your organization has implemented systems for Stages 1 and 2. Which system should your organization consider as Stage 3 adoption? a. Computerized provider order entry (CPOE) and clinical decision support b. Nursing/clinical documentation (flow sheets) and clinical decision support c. Closed-loop medication administration d. Physician-structured documentation and clinical decision support ANS: B
Stage 1 includes the installation of ancillaries (lab, radiology, pharmacy). Stage 2 includes clinical data repository (CDR), controlled medical vocabulary, and clinical decision support system (CDSS) and may also include document imaging and health information exchange. Stage 3 would require clinical documentation (flow sheets), CDSS (error checking), and a picture archiving system (PACS) available outside radiology. DIF: Cognitive Level: Apply
3. Which system is recommended as a method to address patient safety and reduce errors that
occur during the actual administration of medicines? a. Computerized provider order entry (CPOE) b. Barcode medication administration (BCMA) c. Electronic medication administration record (eMAR) d. Electronic prescribing (ePrescribing) ANS: B
Barcode medication administration (BCMA) is a method used to address patient safety and reduce errors that occur during the actual administration of medicines. CPOE is used to decrease transcription errors during the ordering process. ePrescribing is also used by the physician to order the medication (not administer). The eMAR is used to document the medications that are given. DIF: Cognitive Level: Apply 4. Which would be considered a niche application? a. Computerized provider order entry (CPOE) b. Laboratory information system (LIS) c. Clinical decision support system (CDSS) d. Surgical information system (SIS) ANS: D
Some examples of specialty department niche systems include perioperative or surgical services, maternity care, neonatal intensive care, and the emergency department. The LIS is an ancillary system. CPOE and CDSS are basic components of the EHR. DIF: Cognitive Level: Apply 5. A university hospital wants to implement a closed-loop medication management system.
Current systems include registration, computerized provider order entry, electronic medication administration record, laboratory, radiology, and pharmacy. Which system is needed to complete the loop? a. Clinical documentation b. Clinical decision support system c. Barcoding system d. Electronic prescribing ANS: C
A closed-loop medication management system would connect the pharmacy system to the CPOE, eMAR, and barcoding systems. DIF: Cognitive Level: Apply 6. As the United States moves toward the implementation of an interoperable EHR, which
statement about the future ―ownership‖ of the patient record is appropriate? a. The electronic medical record will be the property of the service institution. b. Provider access to the electronic record would not require consumer consent. c. Ownership may be driven by who has control and access to the data. d. Consumers will control and own the record.
ANS: C
Traditional medical records have always been the property of the service institution, but this may not be true in the future. Consumer consent is required for health professionals to retrieve or share patient records to ensure personal information is not accessed inappropriately. Ultimately, ownership may be driven by who has control and access to the data. DIF: Cognitive Level: Analyze 7. As EHR adoption expands to include data from multiple healthcare entities, more
opportunities for error exist. Which process can affect data integrity? a. System failure b. Data analysis c. Data downloading d. Data mining ANS: A
Data integrity refers to the accuracy and consistency of stored and transmitted data that can be compromised when information is entered incorrectly, deliberately altered, or the system protections are not working correctly or suddenly fail. DIF: Cognitive Level: Analyze MULTIPLE RESPONSE 1. Which issues are considered impediments to a fully functional electronic health record
(EHR) system? (Select all that apply.) a. Cost b. Standardization c. Care coordination d. Organizational culture e. Privacy and confidentiality f. Education ANS: A, B, D, E
Despite the many advances in technology, there are still many issues to resolve associated with implementation costs, ownership, data integrity, privacy and confidentiality, organizational culture, human factors, and development of an infrastructure to support a nationwide EHR. Care coordination is considered an advantage, and education is not a major issue. DIF: Cognitive Level: Understand 2. The eight-stage EMR model requires which of the following to have been implemented by
the end of Stage 3? (Select all that apply.) a. A basic CDS system b. A PACS available outside Radiology c. Closed-loop medication administration d. A full radiology-picture archiving and communication system e. Major ancillary systems including Laboratory, Radiology, and Pharmacy
ANS: A, B, E
Having major ancillary systems is a requirement for Stage 1. Implementation of a basic CDS system is part of Stage 2, and having a picture archiving and communication system (PACS) outside of Radiology is part of Stage 3. A fully functional radiology-picture archiving system and closed-looped medication administration both come into play during Stage 6. DIF: Cognitive Level: Remember 3. The university hospital is getting ready to implement computerized provider order entry
and some decision support capabilities to include drug-drug and drug-allergy alerts. Which actions should the implementation team take to increase user acceptance of the system? (Select all that apply.) a. Involve users early in the design, testing, and implementation of the system b. Conduct a quantitative research study to provide deeper insight into CPOE issues c. Design the new system to support communication and workflow d. Educate clinicians on how to use the system features e. Plan for continuous safety monitoring ANS: A, C, D, E
Qualitative measures such as early involvement, ensuring design supports communication and workflow, clinician education, and continuous safety monitoring provide deeper insight into the benefits and issues surrounding computerized provider order entry and some decision support capabilities. Quantitative research is helpful but would not provide the deeper content of the issues. DIF: Cognitive Level: Apply 4. The general attitude of consumers toward health information technology is positive.
Which items are perceived EHR benefits for the consumer? (Select all that apply.) a. Collaborative interaction between patients and providers b. Security and privacy of personal information c. Timely access to personal health information d. Online access to educational materials e. Customized care through reminders ANS: A, C, D, E
From a consumer perspective, an EHR system should provide the ability to customize care through appointment reminders, health risk assessments, and timely access to personal health information. The availability of online educational resources will improve understanding of treatment choices and offer more control over personal health outcomes. Consumers also benefit from EHR technology when there is collaborative interaction between patients and physicians. Although the EHR has the potential to address these items, security and privacy of personal information are perceived as major concerns and, therefore are not a benefit to the consumer. DIF: Cognitive Level: Apply
Chapter 08: Administrative Applications in Healthcare Hardy: Hardy: Health Informatics, 3rd Edition
MULTIPLE CHOICE 1. A financial information system (FIS) includes: a. accounts receivable management, accounts payable management, and fiscal
reporting management. b. clinical systems management, accounts receivable management, and fiscal reporting management. c. accounts payable management, accounts receivable management, and clinical systems management. d. fiscal reporting management, accounts payable management, and clinical systems management. ANS: A
FISs are not involved with the clinical management of care. Accounts receivable management, accounts payable management, and fiscal reporting management are financial management processes and included in an FIS. DIF: Cognitive Level: Remember 2. Financial reporting is a vital part of decision making in healthcare organizations. Which
report would be used to show a snapshot of the bottom line? a. Balance sheet or statement of financial position b. Cash flow statements c. Assets, liabilities, and equity d. Income statement or statement of operations ANS: D
Income statements reflect the following formula: revenue – expenses = profit. This is often referred to as the bottom line. The balance sheet, on the other hand, reflects an organization’s assets, liability, and equity. DIF: Cognitive Level: Understand 3. Return on investment (ROI) in financial information systems (FISs) is challenging
because: a. patient accounting is considered an intangible asset. b. FIS systems are very complex. c. FISs often lose money due to complexity. d. staff requires substantial training, which is very costly. ANS: A
Decision makers may have a more challenging time realizing the return on investment or understanding the importance of the investment in FISs, since information technology software applications, such as patient accounting or revenue, are considered intangible assets. DIF: Cognitive Level: Apply 4. The supply item master is: a. an electronic history of all transactions. b. an electronic pricing list of all supplies and services.
c. a list of all items available to order in the organization. d. a list of vendors who supply items to the organization. ANS: C
The supply item master is the master list of supplies available to order in the organization. DIF: Cognitive Level: Remember 5. Materials management in the healthcare environment involves all of the following
EXCEPT: a. inventory control of supplies and equipment. b. logistics management and pipelines. c. the operational management of items used in the delivery of patient care. d. the storage of pharmaceuticals. ANS: B
Materials management is a subset within supply chain management that focuses on the storage, inventory and quality control, and operational management of supplies, pharmaceuticals, equipment, and other items used in the delivery of patient care or managing the patient care system. Logistics involves the flow of goods and services from the point of origin to the point of consumption and thus falls outside the realm of materials management. DIF: Cognitive Level: Understand 6. A vendor master file is: a. a list of federally approved pharmaceutical companies. b. a list of suppliers used by the organization. c. a list of criteria for supplier compliance. d. a list of EHR vendors. ANS: B
The terms vendor and supplier are synonymous, so a vendor master file is a list of suppliers used by the organization. DIF: Cognitive Level: Remember 7. Open shift management: a. refers to a theory of peer-based leadership in which no single person is in charge. b. forecasts openings in the schedule using predictive models. c. refers to a form of scheduling expediency in which staff qualifications are not
considered when making scheduling assignments. d. is a form of web-based self-scheduling. ANS: D
Open shift management uses web-based technologies to allow employee self-scheduling. Other terms used include shift bidding systems. These systems allow employees to sign up for open shifts over the internet. DIF: Cognitive Level: Remember MULTIPLE RESPONSE
1. When using the online billing and payment tool, which functions directly benefit the
patient? (Select all that apply.) a. Self-management of open accounts b. Ability to pay outstanding balances c. Gives providers a dashboard to view critical clinical and financial information d. Secure communication on a 24/7 basis with the business office e. Ability to update address or demographic changes f. Automate the provider’s day as much as possible ANS: A, B, D, E
Self-management of open accounts, ability to pay outstanding balances, secure communication on a 24/7 basis with the business office, and ability to update address or demographic changes are components of the online billing and payment system that benefit patients. These functions benefit patients because patients can access the system to perform the listed functions at their convenience. Though they may indirectly benefit the patient, automating the provider’s day and providing the provider with a dashboard view are direct benefits for the provider. DIF: Cognitive Level: Understand 2. The supply chain in healthcare includes: (Select all that apply.) a. transportation of supplies. b. storage of supplies. c. management of supplies. d. prediction of supplies used. e. marketing of new pharmaceuticals or procedures. ANS: A, B, C
The healthcare supply chain includes the following processes: transportation of supplies, storage of supplies, and management of supplies. It does not include a prediction of the supplies used and is not part of a facility’s marketing efforts. DIF: Cognitive Level: Understand 3. Supply charge capture is a process that: (Select all that apply.) a. helps make sure patients are charged for supplies used in the patient’s care. b. helps to manage and inventory supplies. c. accounts for pharmaceutical supplies based on federal requirements. d. closely links the supply chain to the revenue management system. e. makes use of point-of-use technology to capture charges when supplies are used. ANS: A, D, E
Often in healthcare settings supplies are used without being recorded or charged, causing the loss of millions of dollars in revenue each year. Supply charge capture, or supply cost capture, is a philosophy that promotes point-of-use technology and record keeping to ensure the use of supplies doesn’t fall through the cracks. DIF: Cognitive Level: Apply
Chapter 09: Community Health Systems Hardy: Hardy: Health Informatics, 3rd Edition
MULTIPLE CHOICE 1. Which payer is the largest for home health services? a. Private insurance b. Patients and families in the form of self-pay c. Medicare d. Medicaid ANS: C
As the largest payer, Medicare, through its Conditions of Participation, represents the standard for the services provided by home health agencies and the payment for these services by many commercial insurance payers and state Medicaid programs. DIF: Cognitive Level: Understand 2. What are the two important purposes of the OASIS dataset? a. Determine payment and measure quality and outcomes b. Determine payment and standardize data c. Determine the time of visits and measure quality and outcomes d. Determine efficiency and measure quality and outcomes ANS: A
OASIS, or the Outcome and Information Set, is a standardized dataset with two important purposes: it is the basis for determining payment for each 60-day episode of care, and it measures the quality and outcomes of services delivered by home health agency clinicians. DIF: Cognitive Level: Understand 3. When did formalized home health and community-based systems originate in the United
States? a. 1776 b. 1800s c. 1965 d. 2001 ANS: B
Early home health services originated in the United States in the 1800s and were based on the district nursing model developed in England. Often, initial programs evolved into visiting nurse associations. Home health services increased and changed considerably after Medicare was enacted in 1965. DIF: Cognitive Level: Remember 4. What technology has been described as the next frontier for home health and related
community-based systems? a. EHR b. CDS c. EMR d. BCMA
ANS: B
Clinical decision support (CDS) systems may be the next frontier for home health and related community-based systems. CDS systems are applications that analyze data and help providers make clinical decisions. DIF: Cognitive Level: Remember MULTIPLE RESPONSE 1. Which of the following tools will the standardized hospice dataset probably contain?
(Select all that apply.) a. Pain assessment b. Social aspect of care c. End of life care d. Survey of missed nursing care ANS: A, B, C
The dataset will include composite measures set by hospice and palliative care process measures. Hospice order sets must include two measures: patient related and structural. Pain assessment and end of life care are patient centered. Social aspect of care is a structural domain within a data set. DIF: Cognitive Level: Understand 2. What are the key tenants of the Quadruple Aim for Health Care? (Select all that apply.) a. Better care for individuals b. Better health for populations c. Better working conditions for nurses d. Reduction of per capita costs ANS: A, B, D
The Triple Aim for Health Care is a broad philosophy designed to address the most abstract level of healthcare services in the United States. It includes better care for individuals, better health for populations, and reduction of per capita costs. DIF: Cognitive Level: Understand 3. What are the primary goals for using EHRs in home health and related community-based
systems? (Select all that apply.) a. To provide an effective and efficient method for tracking cost and related billing b. To capture clinicians’ documentation that supported interaction with patients at the point-of-care c. To support clinical decision making and quality of care by presenting best practices and evidence-based practice options d. To improve communication e. To teach patients how to use technology ANS: A, B, C, D
Agency providers are embracing technology as an effective tool to manage all aspects of care. Patients do not participate in the development of EHRs.
DIF: Cognitive Level: Remember 4. The Omaha System consists of components that capture: (Select all that apply.) a. evaluation data. b. cost data. c. assessment data. d. service delivery/activity data. ANS: A, C, D
The Omaha System is a standardized terminology designed to operationalize the nursing or problem-solving process. It consists of the Problem Classification Scheme (assessment), Intervention Scheme (service delivery/activities), and Problem Rating Scale for Outcomes (evaluation). When nurses and other clinicians use the Omaha System, they can describe, quantify, and communicate details about their practice. DIF: Cognitive Level: Remember 5. What are the core values of nurses who work in home health and community-based
systems? (Select all that apply.) a. Embrace interprofessional collaboration b. Involve patients and families in care and decision making c. Schedule home visits and travel to begin and end each work day on time d. Provide patient-centered care ANS: A, B, D
The core values are essential so that nurses help patients and their families increase their knowledge, gain skills, and become independent with their care. Nurses must be very flexible; they need to modify their schedules frequently. DIF: Cognitive Level: Remember 6. Why is it important for software used by nurses who work for home health and related
community-based systems to be based on a standardized terminology? (Select all that apply.) a. To support evidence-based practice b. To generate reports needed to monitor care, improve the quality of services, and track costs c. To improve patient understanding of their medical records d. To improve communication among care providers at multiple locations e. To describe and quantify practice for clinicians, managers, administrators, and third-party reviewers ANS: A, B, D, E
Software needs to be based on a standardized terminology for many reasons. A reasonable level of standardization involving practice, documentation, and information management helps home health nurses and other related community-based system clinicians provide better quality care and share details about that care with those within and outside of their organizations. DIF: Cognitive Level: Understand
Chapter 10: Public Health Informatics
Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE 1. All of the following are core functions of public health except: a. assessment. b. policy development. c. treatment. d. assurance. ANS: C
Public health is focused on prevention and the health of populations before they are injured or ill; clinical care, not public health, involves treating individuals. DIF: Cognitive Level: Understand 2. Public health differs from clinical practice in important ways. Which statement reflects the
differences? a. Public health is focused on the prevention and health of populations before they are ill. b. Public health is focused on one individual at a time to ensure the best possible outcome. c. The health of a community is measured using sophisticated technologies like MRIs. d. Public health is focused on one family at a time to ensure the best possible outcome. ANS: A
Public health is concerned with the health of populations and communities rather than the individual, and therefore its focus is on the health and prevention of illness of populations. DIF: Cognitive Level: Analyze 3. You are asked to justify the creation of the first public health informatics (PHI) program in
your jurisdiction by emphasizing its actual benefits. One such benefit is that: a. current PHI can enhance public health surveillance such as identifying clusters of diseases. b. privacy and security issues are avoided because public health informatics data are de-identified at the community level. c. interoperability already exists for public health IT. d. standards already exist for PHI. ANS: A
Although all four options are relevant issues in PHI, only the fact that PHI can identify and target clusters of diseases for treatment and action is an actual benefit to the community of adding this new program. DIF: Cognitive Level: Analyze
4. Public health systems have implemented vocabulary and messaging standards, are used to
make public health decisions in a clinical setting and provide data for public health policy. One of the best examples of a public health system that does all of these is: a. the linkage of local electronic health records in the 50 states to public health reporting databases. b. immunization information systems. c. geographical informatics systems for reporting environmental issues. d. direct lab reporting of conditions and diseases such as lead poisoning. ANS: B
Immunization information systems exemplify public health systems that implement vocabulary and messaging standards, that are used to make public health decisions in a clinical setting, and that provide data for public health policy. The others lack one or more of the stated elements. DIF: Cognitive Level: Understand 5. Which event shifted the focus from public health surveillance of medical issues such as the
flu and food poisoning to using medical intelligence for situational awareness? a. Ebola outbreak b. COVID-19 pandemic c. H1N1 Influenza pandemic d. SARS ANS: A
Global monitoring is important to notify, track, and provide valuable information to the public through data. The Ebola outbreak of 2015 resulted in improved monitoring within the CDC and the WHO. The outbreak displayed a need to improve sharing information globally to decrease public outbreaks. DIF: Cognitive Level: Remember 6. To reduce future pandemics, what must occur within the healthcare systems? a. Increase staff b. Update surveillance systems c. Improve global communication d. Develop global HIE ANS: B
An outdated public health surveillance system decreases the ability to communicate globally and share data that could have a large impact on the public’s health. This was on display during the COVID-19 pandemic when healthcare systems failed to provide disease surveillance, proper reporting, and monitoring the progression of the disease. DIF: Cognitive Level: Apply MULTIPLE RESPONSE 1. Public health benefits using the health information exchange by: (Select all that apply.) a. Timely and complete reports b. Reported preventive health
c. Monitoring only specific location d. Providing public health alerting e. Laboratory reporting ANS: A, B, D, E
Public health agencies receive a large amount of valuable patient data that can benefit the public by using predictors, faster transmission of records, analysis of gaps in preventable health, and more. DIF: Cognitive Level: Apply 2. An example of an ecological threat is: (Select all that apply.) a. Irritated airway b. Increased estrogen c. Contaminants in drinking water d. Cancer ANS: A, B, C, D
The ecological system has a great impact on the human body. Increased pollution can cause irritation of the airway triggering asthma. Pesticides and herbicides can contaminate the drinking water supply in water sheds, increasing estrogen and cancer-causing radicals in animals and humans. DIF: Cognitive Level: Apply 3. Informatics opportunities for reportable conditions include: (Select all that apply.) a. enabling the use of computable logic to define where and how reports should be b. c. d. e.
sent. automating patient education from electronic health records. automating information extraction from electronic health records. improving standardization of message structure and content for reporting. creating public health information systems to receive case reports.
ANS: A, C, D, E
Informatics opportunities for reportable conditions include the use of computable logic to define where and how reports should be sent, automation of information extraction from the electronic health record, creating public health information systems to receive case reports, and standardization of message structure and content for reporting. DIF: Cognitive Level: Remember
Chapter 11: Evidence-Based Informatics Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE 1. Knowledge is the point of convergence across the areas of: a. evidence-based practice, quality assurance, and informatics. b. evidence-based practice, improvement, and informatics. c. evidence-based practice, quality assurance, and improvement. d. improvement, quality assurance, and informatics.
ANS: B
Knowledge is the point of convergence across the areas of evidence-based practice, informatics, and improvement. None of the other answers includes all these aspects. DIF: Cognitive Level: Remember 2. Which two hurdles does the STAR Model address in employing evidence-based practice? a. The volume and form of knowledge b. The quality and form of knowledge c. The volume and outcomes of knowledge d. The adequacy and form of knowledge ANS: A
The STAR Model addresses two major hurdles in employing evidence-based practice (EBP). These two hurdles are the volume of current professional knowledge and the form of knowledge that healthcare professionals attempt to apply in practice. DIF: Cognitive Level: Remember 3. What is the form of knowledge gained in discovery research? a. Results from single research studies b. Results from meta-synthesis c. Results from systematic review d. Results from meta-analysis ANS: A
Discovery research represents knowledge produced in the form of single research studies. The other three choices represent synthesis of multiple studies. DIF: Cognitive Level: Remember 4. Which type of review is considered the most rigorous? a. Literature reviews b. Systematic reviews c. Integrative reviews d. Single study reviews ANS: B
Evidence summaries include evidence synthesis, systematic reviews, integrative reviews, and reviews of the literature, with systematic reviews being the most rigorous approach to evidence summary. DIF: Cognitive Level: Remember 5. A facility calls in experts to review evidence developed in research and develop guidelines
for clinical practice. Which stage of EBP is represented? a. Evidence summary b. Evaluation of process and outcomes c. Practice integration d. Translation to guidelines ANS: D
In the third stage of EBP, translation, experts are called on to consider the evidence summary, fill in gaps with consensus expert opinion, and merge research knowledge with expertise to produce clinical practice guidelines (CPGs). DIF: Cognitive Level: Understand 6. A(n) ________ is considered the gold standard research design for answering questions
about the efficacy of treatments. a. RCT b. PBE c. TeamSTEPP d. NQMC ANS: A
An experimental design, often called a ―randomized controlled trial (RCT),‖ has emerged as the gold standard research design for answering questions about the efficacy of treatments. DIF: Cognitive Level: Remember 7. Which program displays teamwork communication and skills among healthcare
professionals to enhance patient care? a. Healthcare Research and Quality Reports b. National Healthcare Quality Report c. Team Strategies and Tools to Enhance Performance and Patient Safety d. Star Model of Knowledge Transformation ANS: C
A variety of models and programs have successfully integrated into EBP and improving patient safety and care. The national Team STEPPS has been the most prominent. In 1995, Team STEPPS rolled out across military healthcare and was based on engineering and solving urgent problems and working with a collaborative team approach. DIF: Cognitive Level: Remember 8. When performing a PBE study, researchers use which type of sample size and sources? a. Large sample, similar sources b. Small sample, diverse sources c. Large sample, diverse sources d. Small sample, similar sources ANS: C
When performing PBEs, researchers use a detailed standardization of a sample but with specific parameters. DIF: Cognitive Level: Apply MULTIPLE RESPONSE 1. The goal of the intersection of informatics and evidence-based practice is to transform
healthcare to be: (Select all that apply.)
a. b. c. d.
reliable. safe. effective. efficient.
ANS: A, B, C
The field of informatics and the concept of evidence-based practice (EBP) intersect at the crucial junction of knowledge for clinical decisions with the goal of transforming healthcare to be reliable, safe, and effective. While efficiency is always a goal in healthcare, it is not a primary goal of EBP. DIF: Cognitive Level: Remember 2. Which of the following are evidence summaries? (Select all that apply.) a. literature reviews. b. systematic reviews. c. single-study reviews. d. integrative reviews. e. focus-group reports. ANS: A, B, D
Evidence summaries include evidence synthesis, systematic reviews, integrative reviews, and reviews of the literature. DIF: Cognitive Level: Remember 3. Using the STAR Model, which of the following points indicate knowledge transformation
has occurred? (Select all that apply.) a. Discovery research b. Evidence summary c. Translation to guidelines d. Practice integration e. Testing the hypothesis f. Evaluation of process and outcomes ANS: A, B, C, D, F
The knowledge transformation process in the STAR Model occurs at five points, which can be conceptualized as a five-point star. These five points include discovery research, evidence summary, translation to guidelines, practice integration, and evaluation of process and outcomes. Testing the hypothesis is not a specific point in the STAR Model. DIF: Cognitive Level: Remember 4. Standardized terminology is requisite for: (Select all that apply.) a. naming evidence. b. classifying evidence. c. tagging evidence. d. locating evidence. e. simplifying evidence. ANS: A, B, C, D
Standardized terminology is requisite for naming, classifying, tagging, and locating evidence to use it in practice. DIF: Cognitive Level: Remember 5. For PBE research to be valid, what needs to occur? (Select all that apply.) a. Supervision from advance researchers b. Quality control checks c. Secure data entry software d. Accurate terminology ANS: B, C
Detailed documentation is necessary for PBE to be entered into a standard secure electronic documentation system. Additionally, PBE research needs quality control measures and checks to verify the authenticity of the data. DIF: Cognitive Level: Understand 6. The purpose of an EBP model is to identify which potential need? (Select all that apply.) a. Problem b. Answer c. Topic d. Reply e. Question ANS: A, C, E
A systematic approach to answering EBP models requires identifying a question that needs to be solved, the topic to solve, and/or the problem in healthcare. DIF: Cognitive Level: Remember
Chapter 12: Clinical Decision Support Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE 1. Why have most clinical decision support (CDS) systems not shown to significantly impact
patient outcomes in clinical trials, despite the fact that a majority of systems have been shown to significantly improve care processes? a. CDS systems have not been evaluated in clinical trials. b. Very few studies have assessed the impact of CDS systems on patient outcomes. c. Many CDS system evaluation trials are underpowered to detect changes in care outcomes. d. CDS systems have been implemented and evaluated in too many diverse institutions. ANS: C
The sample sizes of many CDS system evaluation studies were too small or conducted with too short of a time period to detect changes in care outcomes. DIF: Cognitive Level: Analyze
2. Which group would have a financial incentive to implement CDS? a. A community hospital b. An inner-city clinic c. A national insurer d. Depends on CDS and healthcare payment model ANS: D
Whether a particular stakeholder group has a financial incentive to implement CDS depends on the specific CDS under consideration and the governing healthcare payment model in place. DIF: Cognitive Level: Apply 3. A healthcare system has implemented a functionality where patients who are overdue or
almost due for a mammogram are sent letters notifying them to schedule a mammogram based on available data and current clinical care guidelines. Which type of CDS system is this? a. This is not a CDS. b. A personal health record system c. A reminder system d. An alerting system ANS: C
This is a classic example of a reminder system. Patients are also potential targets of CDS interventions. DIF: Cognitive Level: Apply 4. Which statement is not part of the Ten Commandments of CDS? a. Speed is everything. b. Fit into the user’s workflow. c. Alerting is the most effective approach to CDS. d. Ask for additional information only when you really need it. ANS: C
The Ten Commandments of CDS include speed is everything, fit into the user’s workflow, and ask for additional information only when you really need it. Alerting may not be the most effective approach to CDS as it may cause alert fatigue, so it is not one of the Ten Commandments of CDS. DIF: Cognitive Level: Remember 5. Which incentive has the strongest potential to spur the nationwide adoption of advanced
CDS? a. Freely available CDS knowledge in a machine-executable form b. Significant government funding for research efforts to share CDS c. Shift of healthcare payment from a fee-for-service model to approaches rewarding the delivery of better quality and outcomes at lower cost d. Meaningful Use Stage 1 requirements related to CDS ANS: C
All of these are important elements encouraging nationwide adoption of advanced CDS. However, as discussed in the chapter, the shift of healthcare payment from a fee-for-service model to approaches rewarding the delivery of better quality and outcomes at lower cost appears to have the strongest potential for change. DIF: Cognitive Level: Apply MULTIPLE RESPONSE 1. Which tools are examples of CDS? (Select all that apply.) a. An order set b. A reminder c. A phone call d. An infobutton e. An expert system ANS: A, B, D, E
Despite CDS often being limited to alerts and reminders, an order set, a reminder, an infobutton, and expert systems are also examples that represent CDS types. A phone call is not a type of CDS. DIF: Cognitive Level: Apply 2. Why is CDS important for healthcare institutions? (Select all that apply.) a. It can reduce the need for registered nurses. b. It can help reduce medical errors. c. It is a required element of Meaningful Use regulations. d. It can help improve care value. e. It can slow the growth in use of facilities to manageable levels. ANS: B, C, D
CDS is important on multiple levels. CDS has been found to reduce medical errors, is required as part of Meaningful Use, and has the potential to improve the value of care. CDS have not been found to reduce the need for registered nurses, nor have they been tested for impact on facility use. DIF: Cognitive Level: Apply 3. Why are expert diagnostic decision support systems not integrated into clinical settings?
(Select all that apply.) a. They have not been shown to be comparable to the performance of human experts. b. Clinicians generally must go out of their routine workflows to use the systems, and these systems generally require time-consuming data entry. c. There are limited financial incentives to use such systems. d. The systems have been found to be detrimental to patient care. e. The software has been shown to be insecure. ANS: B, C
There has been a lot of attention and promise on diagnostic decision support systems, including trials showing how they could outperform clinician experts. However, as discussed in other sections of the chapter, systems that are misaligned with the clinician’s workflow and limited financial incentives are reasons for limited use of diagnostic CDS systems. Diagnostic CDS can be comparable to human experts when used appropriately. Also, these systems have not been found to be detrimental to patient care, nor have out-of-the-ordinary security concerns been shown. DIF: Cognitive Level: Analyze 4. Which of the following are challenges or barriers to CDS adoption? (Select all that apply.) a. Lack of evidence of CDS effectiveness b. Misaligned financial incentives c. Inadequate EHR adoption d. Lack of widely adopted standards for CDS e. Concerns over ―cookbook medicine‖ ANS: B, C, D, E
All of the choices except lack of evidence of CDS effectiveness are challenges or barriers to CDS adoption. There is evidence to suggest that CDSs are effective. Misaligned financial incentives, inadequate EHR adoption, a lack of widely adopted standards for CDS, and a concern over CDS as ―cookbook medicine‖ are challenges and barriers to adoption. DIF: Cognitive Level: Remember 5. Which of the following practices are included in the CDS Five Rights? (Select all that
apply.) a. Providing the right information b. Providing to the right person c. Providing at the right point in the workflow d. Providing the right reference information e. Using the right intervention format ANS: A, B, C, E
The CDS Five Rights include providing the right information to the right person at the right point in the workflow, using the right intervention format. Providing applicable reference information has been suggested by others to be a potential best practice for CDS. However, it is not one of the CDS Five Rights. DIF: Cognitive Level: Remember
Chapter 13: The Evolving ePatient Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE 1. An ePatient is best described as one who: a. seeks health information from various sources and uses the information for
decision making with health providers. b. manages health decisions, uses the internet, and uses biosensors.
c. collaborates with the health provider, has a chronic illness, and writes blogs. d. makes all decisions, prepares for doctor visits, and gathers data points. ANS: A
Someone who seeks health information from various sources and uses the information for decision making with health providers is inclusive of all types of ePatients. Not all ePatients use biosensors, nor do they all write blogs. ePatients collaborate with their provider to arrive at a decision. DIF: Cognitive Level: Understand 2. Which of these best describes participatory medicine? a. Integrated care model b. Authoritative care model c. Community care model d. Cooperative care model ANS: D
Participatory medicine is described as a cooperative model of healthcare that encourages and expects active involvement by all connected parties, including patients, caregivers, and healthcare professionals, as integral to the full continuum of care. Integrated care focuses on coordinating care between the healthcare disciplines. Authoritative care is paternalistic and does not include the patient in the decision-making process. Community care focuses on coordinating care across resources found in the community where the patient resides. DIF: Cognitive Level: Understand 3. A quantified selfer is best described as one who: a. graphs data. b. tracks personal metrics. c. records lab values. d. uses a sleep diary. ANS: B
A quantified selfer may or may not use the tactics of graphing data, recording lab values, and using a sleep diary; however, all of these fall under the umbrella of tracking personal metrics, which best describes what it means to be a quantified selfer. DIF: Cognitive Level: Remember 4. The maxim ―Doctors know best‖: a. is one of the tenets of participatory medicine. b. is a hallmark of integrated care. c. is the tagline for Health 2.0 websites such as WebMD. d. is the paradigm for a paternalistic care model. ANS: D
―Doctors know best‖ is the paradigm for the paternalistic care model. Participatory medicine includes the patient as a partner in goal setting and decision making. Integrated care has to do with interdisciplinary care. Health 2.0, by its nature, assumes more of a patient-centered and nonpaternalistic approach.
DIF: Cognitive Level: Remember 5. The culture of the patient-clinician partnership always includes: a. requirements found in the Patient Protection and Affordable Care Act. b. guided discovery. c. involvement of technology specialists and social media activists. d. ePatients and clinicians working in collaboration toward shared goals. ANS: D
The culture of the patient-clinician partnership always includes ePatients and clinicians working in collaboration toward shared goals. The Patient Protection and Affordable Care Act does not require patient-clinician partnerships. Guided discovery may be used in a patient-clinician partnership, but not always. Technology specialists and social media activists are not part of the patient-clinician partnership. DIF: Cognitive Level: Understand 6. The goal of __________________ has been to increase the transparency of medical
documentation, by touting the benefits of such transparency. a. HIPAA b. the Hospital Consumer Assessment of Healthcare Providers and Systems c. the Society for Participatory Medicine d. the OpenNotes Project ANS: D
Many healthcare providers have been reluctant to make their medical documentation and notes available, for fear of extra work, an inability to record candid thoughts, and perceived negative impact on their business. The OpenNotes Project, begun in 2010, has fought to counter this reluctance by highlighting the many benefits of transparency. DIF: Cognitive Level: Remember 7. What defines the ―Google generation‖? a. A person who was born after about 1989 b. A person who desires immediate access to information and is internet savvy c. A person who uses simplified search engines rather than site-specific searches d. A person who is an ePatient ANS: B
A person who desires immediate access to information and is internet savvy is characteristic of an individual belonging to the Google generation. The other choices are not characteristic of being part of the Google generation. DIF: Cognitive Level: Remember 8. In 2013 a Health Online survey found that how many U.S. adults have gone online to find
health information? a. Two thirds b. Half c. One fourth d. One third
ANS: D
An article published in 2013 noted that nearly one third of U.S adults had searched the internet to diagnosis their medical condition. DIF: Cognitive Level: Remember 9. The use of patient portals is reported to be around: a. 10%-20% b. 15%-25% c. 15%–30% d. 20%–30% ANS: C
Patient portals are an ehealth mechanism that allows patients to access records, schedule appointments, make payments, receive education, and communicate with clinicians. In 2020, the U.S. Government Accountability Office reported that only 15%–30% of patients use this online feature. DIF: Cognitive Level: Remember MULTIPLE RESPONSE 1. Digital Health includes: (Select all that apply.) a. At-home test kits b. Telehealth medicine c. Professional video conferencing d. Google research e. Remote patient monitoring ANS: A, B, C, E
During the COVID-19 pandemic, digital health and technology were heavily utilized by providers to provide patient care. DIF: Cognitive Level: Remember
Chapter 14: Digital Health: Managing Health and Wellness Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE 1. In the most recent study by the IMS Institute for Healthcare Informatics, approximately
what percent of the healthcare apps tested included an ability to link the mobile device to a sensor or other healthcare device? a. 10% b. 30% c. None, 0% d. 50% ANS: A
The IMS Institute for Healthcare Informatics study examined 26,864 healthcare apps for iOS and Android systems in 2015 and found that about 10% included such capacity; most of the others only provided information and little to no interactivity. DIF: Cognitive Level: Remember 2. According to the text, which example of the use of mHealth can be facilitated by SMS, the
simplest core mobile phone function? a. Point-of-care diagnostics b. Treatment algorithms c. Connecting patients to providers d. Maintaining healthcare facility electronic records ANS: C
SMS, a core mobile technology, can be used in many mHealth application domains, such as smoking cessation programs, real-time reporting, health surveys, and connecting patients to providers. The other choices all require greater functionality than simple text messaging. DIF: Cognitive Level: Remember 3. Point-of-care decision support tools contained within a mobile device all rely on: a. accurate algorithms and protocols. b. the presence of WiFi. c. some level of real-time link to a healthcare facility. d. user credentials. ANS: A
Point-of-care decision support tools can be used in a wide variety of settings. Some may or may not need WiFi, or a real-time link. But all will need to be programmed with accurate algorithms and protocols in order to function effectively. User credentials is not a correct answer, as many such tools are designed for use by end consumers and not healthcare workers. DIF: Cognitive Level: Remember 4. Which is not a major driving force fueling the mHealth movement? a. An aging society b. Cost savings and earning potential c. Consumer/patient engagement movement d. Technology functionality ANS: A
mHealth’s expansion is being fueled by ever-improving tech functionality, the consumer/patient engagement movement, and the business side of cost savings and earning potential. An aging society, while perhaps needing more healthcare, is not a major part of the expansion. DIF: Cognitive Level: Remember 5. Which is most available throughout Africa? a. Grid-based electricity
b. Piped clean water c. Mobile phone service d. Sewerage service ANS: C
Mobile phone coverage is very widespread throughout Africa, with most countries at least 80% covered by phone service. In contrast, other infrastructure such as electricity, clean water, and sewerage are lagging behind. Mobile coverage’s reach helps explain why it has become such a crucial technology for healthcare workers on the continent. DIF: Cognitive Level: Remember 6. Which statement is true? a. In the U.S., blacks and Hispanics are three times as likely as whites to rely on their
cellphone for access to the internet. b. By 2014, 90% of Americans had smartphones. c. Only 37% of people worldwide have access to a cellphone. d. As of June 2015, a majority of all U.S. adults no longer had a land-line telephone. ANS: A
In the U.S., 13% of Hispanics and 12% of African Americans rely on their cellphone for connection to the internet, three times as many as the 4% of whites who do. By 2014, 90% of Americans had cellphones, but not all were smartphones. Of people worldwide, 37% have a smartphone, but a much larger percent has at least a basic cellphone. And as of June 2015, 44.1% of all U.S. adults no longer had land-line telephones. DIF: Cognitive Level: Analyze 7. The FDA has announced that it will require premarket approval for mHealth apps that: a. monitor and track blood pressure. b. act as ECG machines. c. transfer data to healthcare providers. d. generate health advice from patient-specific information. ANS: B
A portable ECG machine is considered high-risk by the FDA and will require premarket approval. All of the other selections are considered lower risk, and the FDA will only exercise ―regulatory discretion‖ over them. DIF: Cognitive Level: Remember 8. Current research shows the lowest quality, or most limited, evidence for the usefulness of
mHealth in: a. supporting smoking cessation. b. adherence to childhood immunization schedules. c. managing asthma outcomes. d. adherence to retroviral therapy. ANS: C
The evidence for mHealth continues to grow, and there is now high-quality, or at least moderate-quality, evidence for the effectiveness of mHealth in supporting smoking cessation and adhering to immunization and other medicinal schedules. Evidence is currently low for its usefulness in managing asthma. DIF: Cognitive Level: Understand 9. All of the following are among the three biggest mHealth challenges identified by experts
in the U.S. except: a. people misinterpreting their own data. b. making poor health decisions. c. data privacy risks and legal risks. d. interoperability. ANS: D
Interoperability is a noted challenge with mHealth apps and software, but it is not among the top three concerns of U.S. experts. DIF: Cognitive Level: Understand MULTIPLE RESPONSE 1. The MARS mHealth app rating scale measures: (Select all that apply.) a. price. b. engagement. c. information. d. aesthetics. e. YPD (years-of-productive-life) added. ANS: B, C, D
The Institute for Healthcare Informatics MARS scale rates mHealth apps on engagement, functionality, aesthetics, information, and subjective quality. Price is not a direct consideration (though willingness to pay does contribute indirectly to subjective quality), and YPD is not something that MARS measures. DIF: Cognitive Level: Understand
Chapter 15: Personal Health Records Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE 1. What are the main types of PHRs? a. Tethered, untethered, stand-alone, and networked b. Integrated, tethered, untethered, and stand-apart c. Tethered, de-tethered, stand-apart, and stand-together d. USB-based, web-based, and patient portals ANS: A
The main types of PHRs are tethered, untethered, stand-alone, and networked. The other choices are terms that are associated with PHRs but are not general types.
DIF: Cognitive Level: Remember 2. The Kaiser Permanente PHR mobile app lets users do all of the following EXCEPT: a. schedule and cancel appointments. b. participate in telemedicine. c. refill a prescription. d. access lab results. ANS: B
KP’s mobile app allows users to refill prescriptions, schedule or cancel an appointment, e-mail their physicians, and even access lab results. However, the app does not yet allow for the actual performance of telemedicine. DIF: Cognitive Level: Remember 3. Secure PHR messaging refers to the capacity to: a. send messages between healthcare providers within a single EHR. b. send messages between healthcare providers across healthcare systems. c. send messages from patients to providers via a tethered PHR. d. send messages from patients to providers via a stand-alone PHR. ANS: C
Secure PHR messaging refers to the capacity to send messages from patients to providers via a tethered PHR. DIF: Cognitive Level: Remember 4. The most commonly used functions of personal health records are: a. viewing test results and medication refills. b. reading patient education materials and renewing medication prescriptions. c. entering data (such as self-measured glucose and blood pressure) and medical
condition review. d. online appointment scheduling and reading clinical notes. ANS: A
The most commonly used functions of PHRs are viewing test results and medication refills. The other choices are PHR functions that are less commonly used. DIF: Cognitive Level: Remember 5. The Office of the National Coordinator for Health Information Technology (ONC) is best
described as: a. a federal entity charged with increasing public awareness of the value of health information technology. b. the principal federal entity charged with promoting nationwide sales of advanced health information technology. c. the principal federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information. d. a federal agency that regulates the contents and functions of health information technologies, including PHRs.
ANS: C
The ONC is described as the principal federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information. DIF: Cognitive Level: Remember 6. Which statement is true regarding the continuity of care record (CCR)? a. By describing the exact format of the information to be exchanged, it allows for
syntactically interoperable records. b. It is an HTML-based extract of the health record that automatically encrypts and
decrypts data that is sent and received using WPA2. c. It is a tab-delimited extract of the health record that can be viewed on simple
spreadsheet software. d. It was the first effort, in 1989, by a set of healthcare facilities in the United States
to create a digital language in order to share medical records and histories. ANS: A
The continuity of care record is an extract of the health record that prescribes the exact format of the information to be exchanged, allowing for syntactically interoperable records. DIF: Cognitive Level: Understand 7. The ―digital divide‖ refers to: a. higher adoption and use of information technologies among individuals from
ethnic minorities, of lower socioeconomic status, and of older age. b. the gap between the current security of PHRs and the security needed for PHRs to
become more prevalent. c. lower adoption and use of information technologies among individuals from ethnic
minorities, of lower socioeconomic status, and of older age. d. the difference between rates of overall cellphone ownership and ―smartphone‖
ownership. ANS: C
The digital divide refers to lower adoption and use of information technologies among individuals from ethnic minorities, of lower socioeconomic status, and of older age. DIF: Cognitive Level: Remember 8. Which statement is true of Meaningful Use? a. Healthcare facilities needed to meet Stage 3 requirements by October 2015 to
maintain accreditation. b. They are a set of criteria created by the ONC to determine eligibility for financial
incentives for health information technology adoption and use. c. Meaningful Use criteria were created by Congress to delineate the appropriate uses
of health data for research purposes. d. The term refers to the ratio of actual usefulness that patients experience with
medical devices prescribed for them compared to their theoretical usefulness. ANS: B
Meaningful Use refers to criteria created by the ONC to determine eligibility for financial incentives for health information technology adoption and use. DIF: Cognitive Level: Understand 9. Which statement is true of PHRs? a. They have been used in paper form for many years, and electronic versions offer
the same functionality. b. They were a new idea when proposed in the 1990s and are a now a
well-established technology. c. Approximately 35% of the US population currently has one. d. They have been used in paper form for many years, but electronic versions offer new functionality. ANS: D
PHRs have been used in paper form for many years, but electronic versions offer new functionality. DIF: Cognitive Level: Understand MULTIPLE RESPONSE 1. The Health Information Portability and Accountability Act (HIPAA) requires that: (Select
all that apply.) a. individuals be granted access to their healthcare records upon request. b. healthcare providers keep an audit trail of access to an individual’s record. c. Congress update the privacy and security measures required for health records annually. d. healthcare providers must be able to electronically exchange health records by 2016. e. healthcare providers must be able to electronically exchange lab data by 2016. ANS: A, B
HIPAA requires that healthcare providers grant individuals access to their healthcare records on request and that they keep an audit trail of such access to an individual’s record. DIF: Cognitive Level: Understand
Chapter 16: Social Media Tools for Health Informatics Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE 1. A case manager wants to communicate with her clients on a regular basis by sending short
messages that encourage health promotion tips. The tool best suited for this task is: a. Facebook. b. e-mail. c. microblogging. d. Second Life. ANS: C
Clients may benefit from short, directed messages; thus microblogging (a form of short messages) is the most appropriate. The other choices (Facebook, e-mail, and Second Life) are not appropriate for sending short messages. DIF: Cognitive Level: Apply 2. Who is most likely to seek health information from social network sites? a. Individuals about to undergo surgery b. Those seeking reviews and information about prescription drugs c. Those living with chronic conditions d. Individuals learning about friends’ diseases or medical conditions ANS: C
The text states that caregivers and those with chronic conditions are the groups of people most likely to seek health information from social network sites. DIF: Cognitive Level: Remember 3. Which group is allowed to share personal health information on social media sites? a. Providers who monitor the social media site b. Healthcare providers on the site c. Patients/consumers d. Hospital registration clerks ANS: C
Healthcare providers are not allowed to share this information, but patients/consumers are not restricted. DIF: Cognitive Level: Remember 4. Which is an example of apomediation? a. Healthcare providers tell patients not to use Facebook for healthcare advice. b. Healthcare providers direct patients to high-quality information on the web. c. Healthcare providers state that only their web portal should be used by patients. d. Healthcare providers direct patients to websites in which they have a financial
interest. ANS: B
Apomediation means standing by patients and guiding or directing them to quality information, rather than standing between patients and the web. DIF: Cognitive Level: Understand 5. Healthcare providers should friend patients only if: a. they have been their patients for at least 5 years. b. the patients ask them to be a friend. c. the patients have a chronic disease. d. they understand their social media policy at work. ANS: D
There is no law prohibiting friending patients. Professional guidelines and social media policies should outline the instances when friending is possible.
DIF: Cognitive Level: Remember 6. In the future, social media in healthcare is likely to be: a. nothing at all. It has gone too far already. b. minimally used only by ―geeks.‖ c. widely used and deeply integrated. d. static, as people return to in-person and lower-technology means of
communication. ANS: C
Social media’s reach continues to expand, even to areas and demographics traditionally underserved. Social media is already deeply integrated into the ―tapestry‖ of healthcare and is likely to continue to be increasingly so. DIF: Cognitive Level: Understand 7. SERMO for MDs and ANA’s NurseSpace are two examples of what kind of social media
structure? a. Advocacy Group-Consumer b. Consumer-Consumer c. Provider-Consumer d. Provider-Provider ANS: D
SERMO and NurseSpace exemplify social media resources meant to connect providers with other providers in order to exchange experiences and clinical information. DIF: Cognitive Level: Remember 8. Social media is unsecure and can be a high risk for security breach issues. When you
accept a friend on social media, that could be an extension of other friends. The friend extension could have malicious codes attached that affect your settings. This type of social media virus is known as: a. Phishing b. Ransom wear c. Malicious friending d. Malware ANS: C
Accepting a person on social media through another person can cause malicious codes to be attached and change the settings of the user. DIF: Cognitive Level: Remember MULTIPLE RESPONSE 1. Social media tools include: (Select all that apply.) a. social networks and microblogging. b. wikis and blogs. c. desktop computers.
d. video and picture sharing. e. medical reference websites. ANS: A, B, D
Social media is focused on not only connecting and collaborating with others but also sharing user-generated material of all types. While a desktop computer may assist a person to discover social media tools, it is not a social media tool in and of itself. Medical reference websites are static and noninteractive in nature, not tools of social media. DIF: Cognitive Level: Remember 2. A Remote Access Trojan (RAT) is a malware program that operates in the background and
can do the following: (Select all that apply.) a. Steal passwords b. Gain private information c. Take on owner identity d. Locate hardware ANS: A, B, C
A RAT malware program is a back door entrance through an app onto an owner’s computer, handheld device, or laptop. The program runs undetected but collects information and can infect the device. DIF: Cognitive Level: Understand 3. Social media policies should contain: (Select all that apply.) a. guidance on acceptable behavior. b. methods for handling unacceptable behavior. c. a prohibition on using social media within the office environment. d. penalties for misuse. e. a statement to promote ethical behavior. ANS: A, B, E
Social media polices should contain guidance on acceptable behavior, methods for handling unacceptable behavior, and a statement that promotes ethical behavior. Imposing penalties for misuse should be discussed on a case-by-case basis. And in general social media does not need to be prohibited within the office environment, as long as its proper use is understood. DIF: Cognitive Level: Remember
Chapter 17: Project Management Principles Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE 1. Which of the following activities would be considered project management? a. Overseeing a team of eight that’s working for the next 3 months to create a new
billing form b. Directing the IT department in its day-to-day tasks c. Upgrading the network cabling for all 35 computers and servers in a clinic
d. A scheduled quarterly meeting of a hospital’s board of directors to discuss
oversight of the hospital’s departments, revenues, challenges, and opportunities ANS: A
Project management is the oversight of a temporary endeavor or project to create a unique deliverable. The key points are being in charge, and the fact that the endeavor has a specific goal and a definite beginning and end. Of the above, only overseeing a team working on creating a billable form would be considered project management. DIF: Cognitive Level: Apply 2. Which of the following typically is considered most all-encompassing? a. Project management b. Process management c. Program management d. Portfolio management ANS: D
As portfolio management involves creating and managing numerous projects and/or programs, it is the most all-encompassing of the above. DIF: Cognitive Level: Apply 3. Which of the following is true of project process groups? a. Closing activities are optional, and planning activities consume the most resources. b. Defining a project through planning is key, and initiating activities usually take the
most time. c. Initiating activities are often undervalued, while execution activities generally take
the most time and resources. d. Planning activities look at the ―best case,‖ while initiating activities focus on
―worst case.‖ ANS: C
The chapter lists four basic activities in a project—initiating, planning, execution, and closing. Initiation is the most important, yet it is often the least valued. Planning is where projects are formally defined but are often rushed for ―quicker, better, faster.‖ Execution activities typically take the most time and resources. And closing activities are key in order to draw a line and effectively end the project and transition to maintenance/operational phases. DIF: Cognitive Level: Analyze 4. Documentation for support is considered a deliverable at which stage of the project
management process? a. Initiating b. Planning c. Execution d. Closing ANS: C
The closing of a project marks the official handoff of the deliverable, and transition to ongoing operational and maintenance phases. This is the time when support documentation is typically handed over to the operational teams. DIF: Cognitive Level: Understand 5. Your task is to study and examine precisely what the project you are involved with is
trying to accomplish, in order to set definable goals and boundaries. What aspect of the project are you working on? a. Project integration b. Scope management c. Quality management d. Procurement management ANS: B
Scope is the ―area‖ that a given project entails. Defining scope means defining the boundaries of what the project is meant to accomplish. Scope management means overseeing a project to ensure that it stays within its scope. DIF: Cognitive Level: Analyze 6. Studying a project’s potential opportunities is part of what area of management? a. Scope b. Cost c. Integration d. Risk ANS: D
Risk management deals not only with the threats a project faces, but also with its opportunities. Scenarios that help or hinder a project must be considered, and risks must be identified. Every opportunity also has its commensurate risks and trade-offs, which are aspects of the project that the risk manager analyzes. DIF: Cognitive Level: Understand 7. The overarching purpose of portfolio management is what? a. Managing the cost of a project b. Determining the best mix of resources for scheduling and implementing numerous
projects c. Cohesively coordinating interrelated projects d. Reaching strategic goals within a planned timeline ANS: B
Portfolio management involves overseeing numerous, often unrelated, projects and programs. It involves trade-offs of ―unlimited wants‖ and ―limited resources‖ and can best be described as determining how to apply the resources one has in the most advantageous way, across varied projects and programs. DIF: Cognitive Level: Understand MULTIPLE RESPONSE
1. PMI knowledge components include which of the following? (Select all that apply.) a. Project integration b. Program alignment c. TCP/IP networks d. Procurement management e. Time management ANS: A, D, E
PMI knowledge components include project integration and the management of scope, time, human resources, cost, quality, communication, risk, and procurement. DIF: Cognitive Level: Apply 2. A portfolio manager does what? (Select all that apply.) a. Organizes various projects to focus on, for example, patients, quality outcomes,
and financial goals b. Oversees implementation of related systems c. Looks out for scope creep d. Helps determine which projects should be given priority in terms of resource
allocation and availability e. Is responsible for centralized management of processes, methods, and structures in order to ensure successful flow of multiple disparate projects ANS: A, D, E
A portfolio manager looks at ―big-picture‖ items, organizing a number of different and disparate or unrelated projects in order to align them with the organization’s overall strategic goals. A portfolio manager does not usually oversee only related systems; that would be the work of a program manager. A portfolio manager also does not intimately oversee project scope creep, which is the responsibility of the individual project managers within the larger portfolio. DIF: Cognitive Level: Understand 3. Which of the following are designed specifically to track project tasks and timelines and
their interrelationships? (Select all that apply.) a. Magic Quadrant b. Gantt chart c. PERT chart d. MS Access e. MS Word ANS: B, C
Gantt charts and PERT charts are two popular methods for tracking a project, including scheduling the various tasks and timelines and noting interrelationships and dependencies. Magic Quadrant does no such thing, and MS Access is a database. MS Word can be used in helping to prepare timeline charts but is not designed specifically for that purpose. DIF: Cognitive Level: Remember
Chapter 18: Strategic Planning & Information System Selection Hardy: Hardy: Health Informatics, 3rd Edition
MULTIPLE CHOICE 1. When planning for a new project it is imperative for the implementation to run smoothly.
This can only be done with the help of which key individuals? a. Physicians b. Leadership c. Stakeholders d. Patient care leaders ANS: C
The complex nature of implementing any project require the support of all stakeholders. This support will allow a positive push for all. Without the stakeholders championing the project, the project manager may feel pushback from the organization during implementation. DIF: Cognitive Level: Apply 2. Which is included in an RFP but not an RFI? a. Desired system components and functionality b. Financial considerations c. Description of the hospital or health system d. Goals of the organization ANS: B
Pricing and financial considerations are part of an RFP but not part of an RFI. DIF: Cognitive Level: Analyze 3. At which stage of defining requirements are tools for analyzing strengths, weaknesses,
opportunities, and threats useful? a. Review inventory of information systems b. Collect samples of system reports c. Interview and observe staff d. Identify regulatory and accreditation requirements ANS: C
The SWOT analysis is useful when preparing to interview current staff and stakeholders, to help learn what questions to ask in order to get the clearest picture of the current systems in place and the needs for the future. DIF: Cognitive Level: Analyze 4. When evaluating responses to an RFP, which consideration would be least useful as part of
typical system evaluation criteria? a. Cost b. Vendor experience c. Vendor’s future development plans d. Vendor’s market and industry understanding ANS: C
Vendors will likely want to tout their future plans. However, when evaluating the responses to an RFP, it is important to know what can be delivered, configured, and implemented at the actual time of need, rather than what may be possible in the months and years to come. DIF: Cognitive Level: Analyze MULTIPLE RESPONSE 1. What should be considered when identifying and selecting a healthcare information
system? (Select all that apply.) a. The organization’s strategic vision b. Organizational strategic alignment c. The information technology department’s goals and objectives d. Operating system(s) in use e. Vendor strategic planning ANS: A, B, C
Having an organizational strategic vision and strategic alignment and clear information technology goals and objectives is essential before trying to identify and select a healthcare information system. The operating system and vendor strategic planning are not part of an organization’s goals and mission. DIF: Cognitive Level: Analyze 2. Which methods will provide information useful in requirements identification? (Select all
that apply.) a. The Delphi method b. Inventorying current documents and forms c. Interviews d. Direct observation e. Regression analysis ANS: B, C, D
Methods useful in providing information for requirements identification include inventorying current documents and forms used by the organization, conducting interviews with stakeholders, and direct observation to collect data. A variety of data collection methods is necessary to define system requirements. DIF: Cognitive Level: Analyze 3. When reviewing various EHR systems, which six items should be evaluated? (Select all
that apply.) a. Current framework is sufficient b. Charting a patient encounter c. Secure network d. Importing data e. Workflow processes f. Downtime policies g. End users
ANS: A, B, D, E, F, G
It is important to review characteristics of various EHR systems and consider the result when researching vendors. Key characteristics to consider for the end process include: training, data, underlying models, Infrastructure, policies, and patient experience. DIF: Cognitive Level: Understand 4. When evaluating the security of an EHR system, project managers need to consider these
items: (Select all that apply.) a. Who will access the system b. How will authentication be performed c. Who will monitor the system d. What encryption will be used e. What training is provided to users ANS: A, B, D, E
Consideration should be given to onsite and offsite system access. Onsite, most facilities are secured within their network through a VPN. Strong passwords, reporting phishing emails, and utilizing organizational technology will reduce security risk. Outside of a secure network, two-factor authentication provides a layer of security to the user. DIF: Cognitive Level: Remember 5. When considering a new EHR system, a team should be assembled to evaluate the various
vendors. The team should consist of users such as: (Select all that apply.) a. Environmental Services b. Physicians c. Patients d. Pharmacist e. Therapist f. Chief Executive Office g. Nutritionist h. Security ANS: B, C, D, E, G
Assembling a team with direct users of the EHR will allow a variety of workflows to be evaluated. This detailed evaluation will provide various functionalities and potential stumbling blocks. DIF: Cognitive Level: Remember
Chapter 19: Contract Negotiations and Software Licensing Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE 1. Which of the following is true? a. A patent is a kind of copyright. b. Copyright protects the ―invention‖ of an inventor. c. Patent protection applies to inventions. d. Patent applies to original works.
ANS: C
Copyright and patent are two different concepts. Copyright applies to the authors of original works. Patent protects the invention of an inventor. DIF: Cognitive Level: Understand 2. When commercial software is distributed, typically: a. the source code is withheld. b. the right of ownership to the source code transfers to the buyer. c. object code, executables, and source code are bundled and shipped together. d. the software becomes ―open source.‖ ANS: A
Generally, commercial software companies release and distribute the executable or object code for their software but hold back the actual source code as a trade secret. DIF: Cognitive Level: Apply 3. Using SaaS: a. software is sold directly to consumers and becomes their property. b. software is sold to consumers, who then have a license to use it. c. software applications are held by a vendor and made available to customers over a
network. d. software resides on no media. ANS: C
SaaS stands for ―Software as a Service‖ and is a system in which the vendor holds the application and makes it available to customers over a network, usually the internet. DIF: Cognitive Level: Analyze 4. When negotiating an agreement between a vendor and the HCO, which entity should write
the second draft of the agreement? Which should write the third? a. Vendor; vendor b. HCO; HCO c. HCO; vendor d. Vendor; HCO ANS: D
The vendor agreement’s first draft is generally created by the vendor. By having the vendor also create the second draft, the HCO allows the agreement to move closer to the HCO’s positions and desires before the HCO starts putting its own language in. Generally the HCO should write the third draft, as draft-writing is a mutual process with shared control. DIF: Cognitive Level: Understand 5. In a license agreement, the questions of who the users are, whether software can be
distributed, and the number of copies that can be run all fall under the category of: a. scope. b. definition of terms.
c. specifications. d. service level agreements. ANS: A
Scope is a wide umbrella term in license agreements. It can be subdivided into ―Who are the users?‖ ―rights,‖ ―restrictions and license metrics‖ (in other words, whether or not the software can be distributed), ―number of copies,‖ and ―environments and instances.‖ DIF: Cognitive Level: Understand 6. In a software license, a ―response‖ to a user problem: a. is another word for a ―solution.‖ b. may, completely legally, never be forthcoming. c. is typically guaranteed to be 24 hours or sooner. d. is independent of problem severity. ANS: B
An HCO should be extremely careful about the wording of the license with regard to vendor response to a user problem. ―Response‖ does not mean ―solution‖—it means simply response. The time allowed for a response can vary widely. And the nature of the response can vary depending on the problem’s severity. If the HCO is not diligent, it is fully possible for a license to be written so that a vendor does not legally need to respond to a number of problems that arise. DIF: Cognitive Level: Analyze 7. A fee of 18% of the license fee per year for vendor maintenance and support would be
considered: a. high. b. quite typical. c. barely acceptable. d. low. ANS: B
The annual fee for maintenance and support by a vendor is most usually 15 to 22%, with a wider range of 12 to 24% being fairly typical. DIF: Cognitive Level: Understand MULTIPLE RESPONSE 1. On the vendor’s side, which of the following revenue recognition issues may drive or
affect key provisions of the agreement? (Select all that apply.) a. Insufficient user uptake upon implementation b. Conditions on payment c. Delivery of software not existing at the time the agreement is signed d. Payment milestones e. Possible refunds ANS: B, C, D, E
User uptake does not generally affect the vendor’s pay—it is more an issue on the HCO’s side with ensuring that its users actually make proper use of the software being purchased. DIF: Cognitive Level: Apply 2. Which kinds of code can a computer read? (Select all that apply.) a. Source code b. Executable code c. High-level code d. C++ e. Interpretive code ANS: B, E
Executable and interpretive code are two examples of code that has been turned into usable form by a computer. Source code (sometimes called high-level code) is written in a human-readable terminology that has to be translated into a form a computer can read. C++ is such high-level code. DIF: Cognitive Level: Understand 3. From a legal perspective, which of the following serve as contractually binding statements
made by a vendor? (Select all that apply.) a. RFP material incorporated into the license agreement b. Statements by salespersons c. Marketing materials d. The license agreement e. A written memorandum of understanding that precedes the license agreement ANS: A, D
Thanks to the ―Entire Agreement‖ clause that vendors and their attorneys will insist on including in the agreement, only material that is explicitly written into the agreement will be legally binding. The HCO should not consider any statement, verbal or written, that doesn’t appear explicitly in the license agreement as legally binding. DIF: Cognitive Level: Analyze
Chapter 20: Implementing and Upgrading an Information System Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE 1. A large medical practice that specializes in cancer care is weighing the advantages and
disadvantages of implementing the most recent version of a commercial EHR or building its own homegrown system for its office. The staff selects a commercial EHR from a major vendor. Which factor best supports this decision? a. A commercial product can be easily customized to accommodate the unique needs of the hospital. b. A homegrown system cannot be certified through and alternative program. c. The commercial version is considered more robust in function. d. A homegrown system is typically interfaced with the organization’s ADT system and downstream systems.
ANS: C
Commercial electronic health systems are more expensive than homegrown systems but are also considered among the ―Best of Breed‖ products. A homegrown system can be certified through a Certification Commission for Healthcare Information Technology (CCHIT) program called EACH. Homegrown systems are usually fully integrated using a common database and are not interfaced with other dissimilar applications. DIF: Cognitive Level: Apply 2. A large medical center that specializes in high-risk pregnancies is implementing an entire
suite of clinical applications such as CPOE, barcode medication administration (BCMA), nursing documentation, data acquisition system to collect clinical data from cardiac and fetal monitors and ventilators, laboratory system, radiology system, PACS, and cardiology. It has a large, highly skilled, experienced IT team. The project team decided to go with a Big Bang go-live versus an incremental or phased approach. Which factor best supports this decision? a. The Big Bang approach decreases the possibility of errors. b. The incremental approach is best for hospitals with large IT departments. c. The Big Bang approach minimizes overall productivity loss. d. The incremental approach normally has lower implementation costs. ANS: A
Big Bang decreases the possibility of errors because physicians do not have to use different workflows in different departments or units. Users also have high levels of support in the initial days. Big Bang will have a major negative impact on productivity initially with a gradual return to baseline. The incremental approach is best suited for organizations with small IT departments and minimal support personnel. It also typically will increase the overall costs of the project. DIF: Cognitive Level: Apply 3. An unintended consequence associated with the use of an electronic health system occurs
when: a. a physician places a medication order with an inappropriate drug dose for a pediatric patient in a CPOE system. b. a physician enters orders on a patient who was incorrectly selected from a drop-down list of the physician’s personal patient list. c. a nurse enters a telephone order from the attending physician into the electronic health system and fails to read back the order. d. a nurse enters PRN pain medication orders on a patient and fails to record the indications for each pain medication. ANS: B
The physician entering orders on a patient who was incorrectly selected from a drop-down list of the physician’s personal patient list would be an example of an unintended consequence. The other responses are examples of behaviors that are not unique to orders placed in an EHR and can occur in a paper system as well. DIF: Cognitive Level: Apply
4. Which activity or intervention should be avoided when implementing an EHR system? a. Public and unwavering support for the project by the organization’s leadership b. Building a large number of aliases for orders and alerts for select clinical scenarios c. Input from representatives from different disciplines over the course of the project d. Default clinical information and responses to order prompts on orders and fill in as
much as possible on order sets ANS: B
Physicians will count clicks and do not want to be stopped during order entry unless it is necessary. An overuse of alerts will cause alert fatigue. DIF: Cognitive Level: Analyze 5. Which activity or intervention is the least helpful to the success of an EHR
implementation? a. Schedule the go-live date for a Monday when everyone is fresh for the new workweek. b. Anticipate user resistance and plan extensively for it. c. Prepare for continual EHR maintenance and oversight. d. Provide a hotline phone number for communication and troubleshooting. ANS: A
It is best to avoid Monday or Friday as the go-live date, because the healthcare clinic may be at its busiest and vendor support personnel may be less available. DIF: Cognitive Level: Apply 6. A system that incorporates evidence-based content and clinical decision support includes: a. building multiple aliases. b. using Tall Man lettering for select medications. c. enforcing the use of only CMS-approved abbreviations. d. providing real-time updates to the order item master. ANS: B
Using Tall Man lettering for select medication is the only example of clinical decision support. Building multiple aliases, enforcing CMS-approved abbreviations, and providing real-time updates to the order item master are examples of building specific safety protocols into the EHR system. DIF: Cognitive Level: Apply 7. Which factor commonly interferes with the goal of successfully completing an EHR
implementation that is on time and within budget? a. Scope creep b. Big Bang go-live c. An integrated EHR system d. Delayed transition to ICD-10 codes ANS: A
A Big Bang go-live, an integrated EHR system, and delayed transition to ICD-10 codes do not impact the success of completing an EHR implementation that is on time and within budget. The only factor that impacts the success of completing an EHR implementation that is on time and within budget is scope creep. DIF: Cognitive Level: Remember 8. Anything that obstructs a network’s ability to exchange or access information in an
electronic health record is known as: a. Tall man lettering b. Big bang c. Information blocking d. Information influence ANS: C
Information blocking as identified in The Cures Act, section 4004, that allows patients the ability to securely access their electronic health record. DIF: Cognitive Level: Remember 9. A term for in-person education and support to the end user during a go-live is known as; a. Training modalities b. Video -based learning c. Migration d. At the Elbow support ANS: D
Go-live activities involve many moving parts. ―At the elbow‖ support refers to a superuser or trainer to support the end user in person, side by side to any staff that may have difficulties with a new system. This support is typically given for the first few days during go-live. DIF: Cognitive Level: Remember 10. A go-live plan is specifically broken down into task and phases by the? a. Stakeholders b. Project manager c. Vendor d. IT department ANS: B
A project manager will break down a go-live plan into critical tasks and a specific schedule for the timing of the migration of systems to be implemented as smoothly as possible. DIF: Cognitive Level: Understand MULTIPLE RESPONSE 1. Which kinds of testing are crucial when implementing a new information system solution?
(Select all that apply.)
a. b. c. d. e.
User testing Hardware testing Software testing Functional testing Stress testing
ANS: B, C, D
Testing the hardware and software extensively are key to a successful implementation. Functional testing, determining whether the system functions as designed and works effectively, is also critical. Stress testing is not a separate kind of testing regimen, and the end users themselves are not tested within the testing regimen, but rather educated about the new system and then supported intensively when the system first goes live. DIF: Cognitive Level: Remember 2. What are some of the challenges that occur with the integration of technology in health
care? (Select all that apply.) a. Voice dictation b. Patient portals c. Remote patient monitoring d. Telehealth e. Remote chart reviews ANS: A, B, C, E
During the global pandemic, healthcare systems moved at record speed to adapt to patient needs. Telehealth was a platform that was being delivered securely but voice assistants, patient portals, and remote monitoring provided a cyber security headache. DIF: Cognitive Level: Understand
Chapter 21: Downtime and Disaster Recovery for Health Information Systems Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE 1. Which examples are natural disasters that could affect IT systems? a. Bomb, flood b. Earthquake, bomb, terrorist attack c. Flood, earthquake, hurricane d. Terrorist attack, hurricane, flood ANS: C
Floods, earthquakes, and hurricanes are natural disasters. Bombs and terrorist attacks are man-made disasters. DIF: Cognitive Level: Analyze 2. Which is an example of healthcare IT physical infrastructure? a. PACS b. Biomedical devices c. Enterprise data warehouse
d. Anesthesia system ANS: B
PACS, data warehouses, and anesthesia systems are all IT infrastructure; only biomedical devices are part of an IT system’s physical infrastructure. DIF: Cognitive Level: Analyze 3. Which system is an example of a core clinical application? a. Scheduling system b. Electronic health record c. Claim scrubber d. Physiologic monitoring system ANS: B
The electronic health record is a core clinical application because it is used for every patient in every care situation. The scheduling system and claim scrubbers are revenue cycle applications. The physiologic monitoring system is an ancillary or specialty area system. DIF: Cognitive Level: Apply 4. Which system is an example of an ancillary service application? a. Keyless entry system b. PBX switchboard c. E-mail d. Radiology information system ANS: D
The radiology information system is an ancillary service application used for ancillary clinical patient care. PBX switchboard, e-mail, and keyless entry systems are business applications supporting the business operation but are not used for patient care. DIF: Cognitive Level: Apply 5. If the planned single system downtime is less than 1 hour in the middle of a Sunday night,
which downtime level should be assigned? a. Level 1 b. Level 2 c. Level 3 d. Level 4 ANS: A
A single system planned downtime at the least busy clinical time creates the lowest level of downtime risk, or level 1. Levels 2, 3, and 4 are all higher risk in this scenario. DIF: Cognitive Level: Analyze 6. If an unplanned total network outage occurs with all systems affected during the week at
1300 hours and there is no estimated time to recovery announced, which downtime level should be assigned? a. Level 1
b. Level 2 c. Level 3 d. Level 4 ANS: D
Unplanned outage of all systems and the network at the busiest time for the business and patient care is the highest risk outage for an organization, or level 4. Levels 1, 2, and 3 are all lower risk than level 4 in this scenario. DIF: Cognitive Level: Analyze 7. Which redundant EHR application is critical to avoid disrupting nurses’ care of patients
during downtime? a. The billing system b. The registration system c. CPOE and the MAR (medication administration record) d. The SAN (storage area network) ANS: C
CPOE and the MAR are crucial to nurses’ care of patients. The billing system, registration system, and SAN support other operational functions. DIF: Cognitive Level: Analyze 8. What is the primary reason to back up data entered into electronic health records? a. In the event of a system failure, the EHR system can be recovered with accurate
data. b. The work of physicians will be disrupted in the clinics if the system fails and there
is no backup. c. Administrators cannot continue to bill patients if the EHR fails and no backup
exists. d. The interface engine will not be able to function if the EHR fails and no backup is
available. ANS: A
The key reason is that if a system fails and data is lost or data integrity is in question, available backups allow the system to be recovered with accurate and complete data. The work of physicians, billing, and the interface engine all depend on a complete and accurate recovered system but are single functions rather than the overarching, key reason to do complete backups. DIF: Cognitive Level: Analyze MULTIPLE RESPONSE 1. Which examples of essential information technology physical hardware infrastructure
could cause a downtime if they fail? (Select all that apply.) a. Network cabling b. Network switches or hubs c. Financial applications d. Interface engine
e. Server ANS: A, B, E
Network cables and switches, as well as computer servers, are actual hardware components of infrastructure. They are physical pieces of IT equipment. Financial applications and the interface engine are software. DIF: Cognitive Level: Apply 2. What are the integral components of a downtime communication plan? (Select all that
apply.) a. Who needs to know the details. b. Who has passed the annual charting review exam. c. What details are needed. d. What systems and workflows are impacted. e. Who is going to communicate the information. ANS: A, C, D, E
Who needs to know which details, which systems and workflows are impacted, and who is going to communicate the information are critical components of a downtime communication plan. Which personnel have passed the annual charting exam would be communicated at a unit-based level to the employees and the unit management. DIF: Cognitive Level: Analyze
Chapter 22: Improving the User Experience for Health Information Technology Hardy: Health Informatics: An Interprofessional Approach, 3rd Edition MULTIPLE CHOICE 1. Your organization acknowledges that providers want to improve their user experience with
health information technology (IT) products. You want to raise awareness of the potential benefits to the organization. You could draw on stated benefits such as: a. improved productivity, patient safety, and decreased customer support costs. b. improved cognitive support, increased maintenance costs, and patient safety. c. decreased user errors, decreased customer support costs, and increased administrative overhead. d. decreased maintenance costs and increased training. ANS: A
Improved productivity, patient safety, and decreased customer support costs will help you raise awareness of the potential benefits to your organization. DIF: Cognitive Level: Remember 2. Which of these best describes an example of usability? a. The IT department is surveying your unit to determine the placement of new
computer workstations. b. A researcher is conducting a study of how nurses interact with electronic
documentation to organize care handoffs. c. The leadership in your institution is asking for your help to determine oncology
patient flow across regional institutions. d. The administration has asked you to take responsibility for orientation of new hires
and the retraining of selected current employees on use of the automated medication administration system because there have been a consistent number of user errors. ANS: B
An example of usability would be when a researcher is conducting a study of how nurses interact with electronic documentation to organize care handoffs. The other items describe ergonomics, non-HIT workflow, and education/training. DIF: Cognitive Level: Analyze 3. National efforts to improve the user experience are under way in the United States. One
organization involved with this effort is the: a. Office of Technology and Disasters. b. American Nurses Association. c. National Institute of Standards and Technology. d. National League for Nursing. ANS: C
An organization involved in national efforts to improve the user experience is the National Institute of Standards and Technology. The Office of Technology and Disasters, American Nurses Association, and National League for Nursing are not involved with the user experience. DIF: Cognitive Level: Remember 4. You are asked to perform a heuristic evaluation of the new orders management module of
your inpatient system. You discover that the flow of the orders is different than the way providers are taught in school. This is an example of: a. consistency and standards. b. match between system and world. c. informative feedback. d. ergonomics. ANS: B
Match addresses the way health practitioners think and the design of systems. DIF: Cognitive Level: Apply 5. You want to make sure you consider crucial components as you design your first usability
study. One of these components is to consider users and their characteristics. Other components are: a. a developmental timeline, tasks, information, product, and context. b. tasks, information, projected errors, context, and interactions. c. information, a developmental timeline, context, and group interactions. d. information, testing, errors, and context. ANS: A
Crucial components as you design your first usability study include a developmental timeline, tasks, information, product, and context. The HHCI describes elements to consider. DIF: Cognitive Level: Remember 6. Your team is working on a mobile health (mHealth) device for diabetics to track their
glucose levels, insulin, and preventive care appointments. They have just created the very first prototype, based on their understanding of the requirements. You want to assess, fairly informally, whether the application includes the appropriate content for users (consumers). You plan to ask patients from an ambulatory clinic to participate. The kind of test you would plan is a(n): a. validation test. b. formative test. c. comparison test. d. assessment test. ANS: B
The type of test that is appropriate is a formative test, a fairly informal test done early in the life cycle to assess the effectiveness of emerging design concepts. DIF: Cognitive Level: Apply 7. You are part of a knowledge management team that is interested in improving the user
experience for your organization. The team members know you have taken a course in informatics and ask your advice about how to get started with usability in the organization. You recommend: a. talking to the CEO about her ideas. b. examining the support call lists and system change requests. c. working with only physicians, since they have been the most vocal about issues with the EHR. d. hiring a consultant. ANS: B
The first step is to understand the key users’ issues, and support call lists and change requests would give that information. DIF: Cognitive Level: Apply 8. Nielsen coined the term ―Discount Usability Testing‖ to indicate the design of tests that
conserve resources, including funding and time. One example is a reduced number of users who need to participate. He indicates that as few as how many users can find 80% of design issues? a. 3 b. 5 c. 10 d. 15 ANS: B
Nielsen’s work in the early 1990s noted that as few as 5 users can find as many as 80% of design issues.
DIF: Cognitive Level: Remember MULTIPLE RESPONSE 1. Task analysis may involve: (Select all that apply.) a. speaking to application users about their experiences. b. learning task-specific software. c. quietly and unobtrusively watching as a user interacts with an application. d. conducting ethnographic studies. e. hardware stress tests. ANS: A, C, D
Task analysis looks at the human side of an application—the cognitive tasks and processes that people perform in their day-to-day work. Therefore it encompasses things like interviews, shadowing, and ethnography but has nothing to do with learning software or testing hardware. DIF: Cognitive Level: Apply 2. Measuring user interaction, or user interaction satisfaction, is made easier by the use of
which of the following popular usability questionnaires? (Select all that apply.) a. SUS b. eMAR c. QUIS d. SEIPS e. Purdue Usability Testing Questionnaire ANS: A, C, E
eMAR is the electronic medication administration record; SEIPS is the Systems Engineering Initiative for Patient Safety. The other three are all popular usability questionnaires. DIF: Cognitive Level: Apply
Chapter 23: Data Science and Analytics in Healthcare Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE 1. Which measure is most important for evaluating the performance of classifiers, models
that predict class membership? a. Root mean squared error (RMSE) b. Area under the receiver operating characteristic (ROC) curve c. Percentage of correctly classified cases d. Hosmer-Lemeshow statistic ANS: B
The area under the receiver operating characteristic (ROC) curve is the most important overall measure of classifier performance.
DIF: Cognitive Level: Remember 2. Which specialized method is used in knowledge discovery and data mining? a. Stratified sampling b. Conceptual analytic methods c. Selection of the optimal subset of variables/features for use in modeling d. Machine learning ANS: C
Knowledge discovery and data mining (CRISP-DM) makes use of specialized analytic methods, characteristically machine learning, to identify patterns in a semi-automated fashion. DIF: Cognitive Level: Remember 3. The process of knowledge discovery and data mining is best characterized as: a. machine learning, use of statistical methods, and large amounts of data. b. a process wherein patients are selected for clinical trials. c. ―fishing‖ for information in data. d. cleaning data for further analysis using other methods. ANS: A
Knowledge discovery and data mining (CRISP-DM) is a process in which machine learning and statistical methods are applied to analyze large amounts of data. DIF: Cognitive Level: Remember 4. As organizations mature over time in their use of data science, they progress from what to
what? a. Retrospective analysis; exploratory data analyses b. Real-time analytics; retrospective analytics c. Exploratory data analyses; prescriptive analytics d. Data mining; knowledge discovery ANS: C
In its initial forays, an organization typically begins by looking back at the data it’s collected, through retrospective (or exploratory data) analyses. It then gradually moves up the scale of difficulty toward prescriptive analytics. DIF: Cognitive Level: Understand 5. A health analytics professional must be skilled in all of the following except: a. computer hacking. b. healthcare operations. c. management and economics. d. statistical understanding. ANS: C
A health analytics professional must have wide skills, from knowledge of healthcare operations, to understanding computer hacking and programming enough to be able to manipulate data, to understanding mathematics and statistics. He or she, however, does not generally need management or economics training.
DIF: Cognitive Level: Understand 6. Assigning individual records or rows in a dataset for specific purposes (eg, model
development, model validation) is a process known as: a. partitioning. b. sampling. c. data mining. d. Bayesian networking. ANS: A
Partitioning refers to the assignment of individual records or rows in a dataset for a specific purpose: model development (training, incremental testing of models during development) or model validation (data held out from the development process for the purpose of unbiased performance estimation). DIF: Cognitive Level: Apply MULTIPLE RESPONSE 1. Which methods are examples of data mining? (Select all that apply.) a. Decision trees b. Stratified random sampling c. Bayesian networks d. Artificial neural networks e. Factor analysis ANS: A, C, D
Decision trees, Bayesian networks, and artificial neural networks are methods commonly used in data mining. DIF: Cognitive Level: Remember 2. Which of the following are examples of analytics tools? (Select all that apply.) a. Graphics programs like Photoshop and 3DS Max b. Spreadsheets like MS Excel c. Database management systems like SQL Server d. Statistical analysis programs like Rapidminer e. Programming languages like R or Python ANS: B, D, E
Spreadsheets, statistical analysis programs, and some programming languages can all be analytics tools. Graphics programs may help visualize analysis, and a DBMS may help organize data so it can be found easily, but neither falls under the category of tools. DIF: Cognitive Level: Understand 3. In a set of consistently coded clinical data, the data should be analyzed using descriptive
statistics and visualization with respect to the following: (Select all that apply.) a. Distribution b. Arcing
c. Sparsity d. Identifiers e. Outliers ANS: A, C, D, E
All of the choices are generally useful properties that can help in data analysis, except for ―arcing,‖ which is not a term used in the text. DIF: Cognitive Level: Remember 4. Which of the following data characteristics are important in understanding big data in
healthcare? (Select all that apply.) a. Variety b. Vagrancy c. Venality d. Velocity e. Volume ANS: A, D, E
The ―five V’s‖ of data characteristics include volume (quantity of data), velocity (speed at which data are gathered), variety (the number of different data sources), veracity (accuracy and completeness), and value. DIF: Cognitive Level: Remember
Chapter 24: Safety and Quality Initiatives in Health Informatics Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE 1. An important component of the informatics infrastructure is: a. establishment and adoption of standards to support semantic interoperability. b. defined standard value sets, groupings, aligners, and attributes. c. organizations enabled to set individual standards for quality measurement and
reporting. d. variation in the types of data used to populate the quality metrics. ANS: A
Establishment and adoption of standards at multiple levels are important components of the informatics infrastructure. The standard quality metrics must define standard value sets, taxonomies, concept codes, attributes, and data structures. Organizations must adopt the same standards for quality measurements and reporting. Standard clinical content needs to be adopted and used in the electronic systems, and the content should be represented by standard data terminologies. DIF: Cognitive Level: Remember 2. When evaluating quality and patient safety, which approach defines the framework for
Patient Safety and Quality Research Design (PSQRD)? a. Outcomes are driven mainly by Meaningful Use directives. b. Consideration of current managerial processes has no effect on patient outcomes.
c. Patient safety is best achieved by minimizing changes to existing processes. d. Quality and safety are based on organizational structure, management and clinical
processes, and their linkages to patient outcomes. ANS: D
According to Donabedian, quality is based on organizational structure, processes, and their linkages to patient outcomes. Consideration of current managerial processes in place has a latent effect on patient outcomes. The framework for PSQRD builds upon Donabedian’s structure-process-outcome model to support evaluation of an intervention from the preimplementation testing phase through implementation and evaluation. In the case of a health information technology (IT) intervention, the expanded framework supports understanding where the health IT intervention is most likely to have an effect, within the organizational causal chain of quality and safety events. The PSQRD framework provides a means to categorize interventions according to areas of the causal chain targeted. DIF: Cognitive Level: Remember 3. Why is the PSQRD a useful framework for research and practice? a. It explains why using computer applications is the best way to support better
patient outcomes. b. It supports implementation, performance improvement, and rigorous research
methodologies. c. It ensures successful implementation of a clinical process change. d. It increases communication among clinical staff. ANS: B
While the PSQRD framework may improve communication and implementation, a critical strength of this framework is its systems approach and comprehensive strategy for ongoing monitoring and evaluation. The PSQRD framework provides a means to introduce health IT interventions in a systematic way, and it serves as a reminder to incorporate measures of success across the causal chain. This approach supports implementation, performance improvement, and research projects with an appreciation for the effects and the limitations of health IT and other intervention components. DIF: Cognitive Level: Remember 4. A nurse forgets to walk a patient during the nurse’s shift. This is an example of an error of: a. commission. b. omission. c. condition. d. remission. ANS: B
Forgetting to do something that is required for a patient would be considered an error of omission. Doing the wrong thing would be considered an error of commission. Condition and remission are not considered error types. DIF: Cognitive Level: Apply 5. A nurse gives a patient the wrong drug. This is an example of an error of: a. commission.
b. omission. c. condition. d. remission. ANS: A
Doing the wrong thing would be considered an error of commission. Forgetting to do something that is required for a patient would be considered an error of omission. Condition and remission are not considered error types. DIF: Cognitive Level: Apply 6. A hospital has an integrated clinical decision support system embedded in the EHR.
According to Donabedian’s model, this would be considered: a. structure. b. process. c. outcome. d. effectiveness. ANS: A
The setting and its attributes (eg, the physical structure of buildings, staffing rations, the equipment available within an organization, and the budget to support care provision) are all part of structure. The EHR with an embedded CDS system is part of the structure of an organization. DIF: Cognitive Level: Apply 7. A nurse uses a CDS system to make an informed clinical decision regarding a drug dosage
ordered for a patient. According to Donabedian’s model, this would be considered: a. structure. b. process. c. outcome. d. effectiveness. ANS: B
The managerial and clinical processes in place to support the provision of care are all included under the process component. The use of a CDS system is considered process. DIF: Cognitive Level: Apply 8. A unit has been experiencing a high rate of patient falls for the past 3 months. According
to Donabedian’s model, patient falls would be considered: a. structure. b. process. c. outcome. d. effectiveness. ANS: C
The end results of the structures and processes are considered outcomes. These may include clinical outcomes. The measurement of patient falls is considered an outcome. DIF: Cognitive Level: Apply
MULTIPLE RESPONSE 1. To automatically track the quality of care, standardized quality measures are needed in
order to: (Select all that apply.) a. use consistent metrics. b. benchmark. c. standardize data collection. d. ensure clinical efficiency. e. have intuition. ANS: A, B, C
To automatically track the quality of care, standardized quality measures are needed to ensure that all organizations are using consistent metrics for benchmarking and that organizations are using the same types of data to populate the quality metrics. DIF: Cognitive Level: Understand 2. Which items are included in the IOM six aims for improvement? (Select all that apply.) a. Safe b. Patient-centered c. Innovative d. Effective e. Unintrusive ANS: A, B, D
The six aims for improvement are safe, effective, patient-centered, timely, efficient, and equitable. Innovation and level of intrusion are not among the six aims for improvement. DIF: Cognitive Level: Remember
Chapter 25: Informatics in the Curriculum Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE 1. Advocating for users’ needs and acting as a liaison among the users, the IT staff, and the
vendor are competencies for a(n): a. generalist. b. data scientist. c. consultant. d. implementation support specialist. ANS: C
Learning how to advocate for users’ needs and act as a liaison among the users, the IT staff, and the vendor are specialist traits, not generalist; they are competencies for consultants whose role is to analyze and recommend solutions for HIT implementation problems. DIF: Cognitive Level: Remember
2. Which organization spearheaded the development of informatics competencies across the
nursing curriculum? a. TIGER b. AMIA 10x10 c. HRSA d. HIMSS ANS: A
The Technology and Informatics Guiding Education (TIGER) initiative, launched in 2005 along with Quality and Safety Education in Nursing, helped pave the way for developing informatics competencies across the nursing curriculum. DIF: Cognitive Level: Remember 3. The Health Information Technology for Economic and Clinical Health (HITECH) Act has
influenced healthcare delivery because it is: a. a training program for informatics specialists. b. an organization that develops informatics competencies. c. an academic electronic health records software. d. federal legislation that promotes the use of electronic health records. ANS: D
HITECH has influenced healthcare delivery because it is federal legislation that promotes the use of electronic health records. HITECH has not specifically addressed informatics training or education. DIF: Cognitive Level: Remember 4. The Quality and Safety Education in Nursing (QSEN) project developed competencies
based on work completed by: a. HRSA. b. TIGER. c. IOM. d. AMIA 10x10. ANS: C
The QSEN project developed competencies based on work completed by the Institute of Medicine (IOM). HRSA, TIGER, and AMIA 10x10 may address informatics competencies, but they did not provide the foundation for the QSEN project. DIF: Cognitive Level: Analyze 5. The practice workflow and information management redesign specialist role requires what
kind of education and training? a. Community-college based b. Ph.D.-level focus c. University-based d. In-service training and certification ANS: C
A practice workflow and information management redesign specialist assists in reorganizing the work of a healthcare provider to take full advantage of meeting the Meaningful Use criteria. This role requires university-based education and training. DIF: Cognitive Level: Remember 6. Evaluating data from all relevant sources, including technology, to inform the delivery of
care is a competency for a(n): a. generalist. b. advanced practice nurse. c. specialist. d. implementation project manager. ANS: A
Evaluating data from all relevant sources, including technology, to inform the delivery of care is a fundamental building-block competency for a generalist. The generalist receives undergraduate training for this role. DIF: Cognitive Level: Remember 7. Cognitive psychology claims that learning involves memory, motivation, thinking,
reflection, and abstraction. Which question is instrumental in teaching critical thinking? a. What? b. How? c. Why? d. Who? ANS: B
―Knowing how‖ involves memory, motivation, thinking, reflection, and abstraction. These skills are useful in teaching critical thinking. ―Knowing what‖ represents behaviorism, and ―knowing why‖ represents constructivism. ―Knowing who‖ is not part of the learning theories discussed. DIF: Cognitive Level: Remember 8. Educating students about informatics includes working with EHRs and: a. evidence-based practice (EBP). b. interprofessional teams. c. patient safety. d. communication tools. ANS: D
Informatics primarily involves working with information and communicating information to others. Therefore communication tools are a necessary component of an informatics education. While the EBP, interprofessional teams, and patient safety can be enhanced by the use of informatics, they are not informatics knowledge, skills, or attitudes. Informatics is about information and communicating it to others. DIF: Cognitive Level: Analyze 9. Incorporating usability principles into software configuration and implementation is a
competency of:
a. b. c. d.
the generalist. the advanced practice nurse (APN). the nursing informatics specialist (INS). the implementation support specialist.
ANS: D
Incorporating usability principles into software configuration and implementation is a competency of the implementation support specialist. This is not a competency of the generalist, APN, or INS. DIF: Cognitive Level: Remember 10. Existing resources that promote meeting the challenge of teaching informatics in the health
professional curriculum are: a. a sufficient number of trained faculty. b. readily available technical infrastructure. c. collaborative practice and simulation. d. simulation and academic electronic health records (AEHRs) software. ANS: C
Today’s learner is driven by immersion in their environment and hands on. New tools and approaches are now incorporated into education for a better learning experience. DIF: Cognitive Level: Analyze
Chapter 26: Distance Education - A New Frontier Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE 1. Which two instrumental movements pushed correspondence courses forward? a. The Society to Encourage Studies at Home and Chautauqua College of Liberal
Arts b. The invention of the television and cable services c. The development of web 2.0 tools and the internet d. Fiber-optic cables and 2-way video communications ANS: A
Phase one of distributive education historical developments was pushed forward by the establishment of the Society to Encourage Studies at Home and the Chautauqua College of Liberal Arts. The invention of the television and cable services, the development of web 2.0 tools and the internet, fiber-optic cables, and 2-way video communications relate to other events that further promoted distance education. DIF: Cognitive Level: Remember 2. Distributive education is: a. education that takes place in different settings and at different times. b. the use of electronic devices to deliver the instruction and by which the learners
acquire their knowledge. c. customized, learner-centered education that uses technology to provide learner
experiences where the learner is engaged in the learning activities that may or may not be at a distance. d. a version of distance education that requires the use of the internet or an intranet to deliver the educational materials. ANS: C
Distributive education is customized, learner-centered education that uses technology to provide learner experiences where the learner is engaged in the learning activities that may or may not be at a distance. The definition incorporates the main components of technology, engagement, customization, interaction, and individualization. The remaining choices are not complete enough or describe other terms like distance education, elearning, or online learning. DIF: Cognitive Level: Understand 3. What is the main difference between a portal approach and a proprietary course
management system (CMS) approach in distance education? a. Portal-based systems can only be accessed by faculty of an institution, and proprietary CMS systems can be accessed by students and faculty. b. Portal-based systems can be accessed by students and faculty of an institution, and proprietary CMS systems can only be accessed by faculty. c. Portal-based systems are products purchased or licensed by a vendor, and proprietary CMS systems are developed and customized by the learning institution. d. Portal-based systems are developed and customized by the learning institution, and proprietary CMS systems are products purchased or licensed by a vendor. ANS: D
Portal-based systems are developed and customized by the learning institution, and proprietary CMS systems are products purchased or licensed by a vendor. Both systems allow access to students and faculty alike. DIF: Cognitive Level: Understand 4. From a faculty perspective, the two critical criteria for a CMS/LMS are: a. ease of use and tool set. b. installed base and integration. c. cost and scalability. d. ease of use and installed base. ANS: A
While all of these criteria are important, for faculty a CMS/LMS’s ease of use and tool set (the included features) are the most critical in the above list. Ease of use, tool set, stability, and support are the things that would impact a faculty member’s decision the most. The installed base and integration, cost and scalability, and ease of use and installed base are generally more important to the technology staff and administration. DIF: Cognitive Level: Understand 5. Two examples of campus portal systems are: a. Moodle and Blackboard. b. Ellucian and Jenzabar.
c. Desire2Learn and Blackboard. d. Sakai and Ellucian. ANS: B
Ellucian and Jenzabar are portal systems. Blackboard and Desire2Learn are CMS, and Moodle and Sakai are open source examples. DIF: Cognitive Level: Remember 6. For a successful distributive education program, the institution: a. must always offer students the option for distributed learning even if there is no
faculty buy-in. b. should move forward with an initiative to offer distributive learning in order to
stay competitive even when resources may not be in place. c. must match the goals and objectives for a distributive education initiative to the mission and goals of the institution. d. should offer distributive education as a way of making money and lowering operating costs. ANS: C
Without matching goals and objectives of distributive education to the mission and goals of the institution, resources will not line up correctly, which is a recipe for failure. A successful program requires commitment from faculty and appropriate institutional resources and will cost money; it may or may not make money for the institution. DIF: Cognitive Level: Remember 7. In a distributed learning environment, faculty members should: a. take their face-to-face lectures and turn them into a podcast. b. teach the course the same way as the face-to-face course, as all sections of the
course need to be the same. c. use the same activities as the on-campus courses; there is no need to adjust them. d. develop learning activities that engage the learner with relevant real-world
activities. ANS: D
In distributive education the instructor needs to empower the learners to take charge of their learning, to be engaged, and to have a comprehensive learning experience. Podcasts of lectures do not engage the learner and using the same learning activities does not take advantage of the tools available to engage and empower the learner. DIF: Cognitive Level: Remember 8. To ensure student success and engagement, faculty members should: a. make evaluative comments in the discussion forum as to the quality of each
student’s post so they can improve. b. administer multiple-choice tests to measure students’ progress in learning the
concepts. c. provide timely feedback to students using a grading rubric through the grading
center. d. use their discretion as to the amount and frequency of their feedback to the
students. ANS: C
Providing students with information that their learning will be evaluated through a rubric and when this will occur should keep the students engaged and successful. The Family Educational Rights and Privacy Act (FERPA) frowns on other students having access to evaluative comments of classmates. Multiple-choice questions do not necessarily keep the student engaged. Students should know what is required, when, and how soon they will receive feedback on their progress. DIF: Cognitive Level: Apply 9. Critical to a successful distributive education program are the student support services.
The first thing one should do is: a. make sure the library has online access to its holdings through online lending, full text literature databases, and online access to the research librarian. b. arrange for tutoring services especially in the distribution courses such as probability and statistics, college algebra, English, and sciences. c. arrange for the bookstore to provide delivery services for required textbooks. d. survey the students for what support services they expect from the school. ANS: D
Faculty must determine or assess the needs of the students for support services before deciding what to provide; the other answers all relate to specific support services one might provide. DIF: Cognitive Level: Apply MULTIPLE RESPONSE 1. The Higher Education Opportunity Act of 2008 stipulates which of the following? (Select
all that apply.) a. Faculty must select and submit textbook requirements to the campus bookstore before posting the next semester’s schedule and registration. b. Institutions must verify that the enrolled student is actually the person completing the course. c. Colleges and universities must give students access to their educational records. d. Institutions must post a net price calculator as well as security and copyright policies on their websites. e. Schools must pay attention to the change in terminology from distance learning to distance education. ANS: A, B, D, E
All of these are encompassed by HEOA except for student access to their educational records, which is a provision of FERPA. DIF: Cognitive Level: Remember
Chapter 27: Legal Issues, Federal Regulations, and Accreditation Hardy: Hardy: Health Informatics, 3rd Edition
MULTIPLE CHOICE 1. Powers granted to both the federal and state governments are known as what? a. Conditional powers b. Concentric powers c. Concurrent powers d. Conflicting powers ANS: C
Concurrent powers are given to both the federal and state governments at the same time, such as the ability to regulate the privacy of PHI. DIF: Cognitive Level: Remember 2. By what legal code or precedent are powers not granted to the federal government
reserved by the states? a. HIPAA b. HITECH c. The 10th Amendment to the U.S. Constitution d. The Stark Law ANS: C
The 10th Amendment to the U.S. Constitution, known as the reserved powers clause, reads as follows: ―The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.‖ DIF: Cognitive Level: Remember 3. Which is true of guidance documents? a. They are official agency publications. b. They are identical to regulations and rulemaking. c. They are legally binding. d. They come from the U.S. Congress. ANS: A
Guidance documents may resemble rulemaking, but they are non-legally binding documents produced by agencies, in order to help subjects understand and comply with specific regulations. DIF: Cognitive Level: Understand 4. Which of the following is true regarding administrative enforcement? a. There is an additional route of appeal if a decision is issued in an administrative
proceeding as opposed to a federal court proceeding. b. There are fewer routes of appeal if a decision is issued in an administrative proceeding as opposed to a federal court proceeding. c. Administrative settlement agreements include the finding of liability against an entity. d. An administrative proceeding is more formal than a court proceeding. ANS: A
Administrative proceedings and court proceedings are functionally equivalent. The same remedies are available to both the federal court judge and the administrative law judge. However, the administrative system offers an additional route of appeal regarding decisions, when compared to the court system. DIF: Cognitive Level: Apply 5. E-mailing fraudulent claims from an office in Houston, Texas, to a Medicare facility in
Washington, D.C., for medical care not actually performed would constitute what? a. A civil but not criminal infringement b. Wire fraud as well as a violation of the False Claims Act c. Only wire fraud d. Unbundling ANS: B
Such interstate e-mailing of fraudulent information would be wire fraud as well as a breach of the False Claims Act. Such a breach could be a civil as well as criminal case. Unbundling involves fraudulently increasing revenue by separately billing for individual parts of a typically bundled service, which isn’t what is happening in the question. DIF: Cognitive Level: Apply 6. A vendor provided all advanced practice registered nurses with free mobile devices to
stimulate referrals. Which regulation is being violated? a. The Anti-Kickback Statute b. The Stimulus Act c. The HITECH Act d. HIPAA ANS: A
The Anti-Kickback Statute makes it a criminal offense to knowingly and willfully offer, pay, solicit, or receive any remuneration to induce or reward referrals of items or services reimbursable by a federal healthcare program. Where remuneration is paid purposefully to induce or reward referrals of items or services payable by a federal healthcare program, the Anti-Kickback Statute is violated. DIF: Cognitive Level: Apply 7. Which of the following would be regulated by the FDA? a. A health information website b. An app that functions as a medical device c. A FitBit d. Google Glasses ANS: B
Only mHealth applications that are considered medical devices, such as electrocardiograms, can be regulated by the FDA. DIF: Cognitive Level: Remember MULTIPLE RESPONSE
1. Which agencies can accredit hospitals for participation in Medicare and Medicaid
programs? (Select all that apply.) a. The Joint Commission b. Det Norske Veritas c. Safe Harbors d. Federal Trade Commission e. National Coordinator for Health Information ANS: A, B
The Joint Commission (TJC) and Det Norske Veritas (DNV) are the only two agencies that the Center for Medicare and Medicaid Services has authorized to accredit hospitals. DIF: Cognitive Level: Understand 2. The Stark Law considers which of the following Designated Health Services? (Select all
that apply.) a. Physical therapy services b. Housecleaning and janitorial services c. Home health services d. Prosthetic devices and supplies e. Medical language translation services ANS: A, C, D
The Stark Law governs physician self-referral for Medicare and Medicaid patients. Its ―Designated Health Services‖ cover a variety of topics, including physical therapy, home health, and prosthetic devices. It does not involve language translation or any kind of housekeeping services that convalescing patients may need. DIF: Cognitive Level: Remember 3. Which of the following would the FDA consider a Class II medical device? (Select all that
apply.) a. A device of medium safety risk b. A callus remover c. A powered wheelchair d. Items needing premarket approval e. A titanium implant ANS: A, C
Class II devices are considered medium risk by the FDA and require general controls as well as special controls. A powered wheelchair falls in this category. A callus remover would be a Class I low-risk device, whereas an implant meant to be surgically placed inside a patient would be considered a Class III high-risk device. DIF: Cognitive Level: Understand
Chapter 28: Privacy and Security Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE
1. Which definition most accurately describes privacy? a. The means to ensure health record privacy and confidentiality b. Accuracy and completeness of health information c. The rights of individuals to control access to their person or information about
themselves d. An act that has the potential to cause harm to an informational asset ANS: C
Privacy is the rights of individuals to control access to their person or information about themselves. Security is defined as the means to ensure health record privacy and confidentiality. Data integrity is defined as the accuracy and completeness of health information. A threat is an act that has the potential to cause harm to an informational asset. DIF: Cognitive Level: Remember 2. A healthcare provider forgets to update a patient’s medications. Which fair information
principle is being violated? a. Correction b. Openness and transparency c. Data quality and integrity d. Safeguards ANS: C
By not keeping a patient’s records current and up-to-date, the healthcare provider is violating the fair information principle of data quality and integrity. Correction involves allowing individuals to dispute the accuracy of their information, openness and transparency involve keeping patients informed on policies regarding PHI, and safeguards are actions implemented to protect sensitive data. DIF: Cognitive Level: Apply 3. If a breach of protected health information has been discovered, to which agency does the
breach need to be disclosed? a. The Joint Commission b. U.S. Department of Health and Human Services c. U.S. Code of Federal Regulations d. Office of Civil Rights ANS: B
If an organization breaches protected health information, it should be reported immediately to the U.S. Department of Health and Human Services. DIF: Cognitive Level: Understand 4. An organization reviews its data security policies and procedures to ensure the security for
its patients protected health information (PHI). Which analysis is this organization undergoing? a. Breach notification b. Right to access
c. Risk assessment d. Denial of service ANS: C
A risk assessment provides organizations with a roadmap to prepare for cyber threats and potential vulnerability. By ensuring that electronic PHI is protected, the organization is implementing HIPAA Right to Access Rule. DIF: Cognitive Level: Remember 5. A nurse received an email that an update to the software system was needed to be able to
chart. The signature line was signed by the IT department but the sender’s address was from outside of the organization. This type of cyber threat is known as: a. Ransomware b. Keylogging c. Malware d. Spear phishing ANS: D
Emails sent to a member of an organization with the use of a fraudulent page to encourage the user to click on something to install is known as phishing. After clicking on the link, malware can be loaded into the computer. DIF: Cognitive Level: Apply 6. An organization that loses the ability to access its computers for patient care information is
known as what type of cyber attack? a. Ransomware b. Keylogging c. Malware d. Spear phishing ANS: A
Ransomware infects and disables computers, rendering the organization unable to retrieve patient data for patient care. DIF: Cognitive Level: Apply 7. As healthcare delivery and technology continue to expand, who can assist in the
development of safeguards while working with legislation? a. Chief Medical Officer b. State Representatives c. Health Informaticists d. College Professors ANS: C
Health informaticists strive to improve and develop methods, processes, and the collection of patient data. This experience provides talking points and experience to assist in developing regulations that will provide safe and secure measures for protected health information. DIF: Cognitive Level: Understand
MULTIPLE RESPONSE 1. Biometric identifiers are now commonly used in many settings. Which identifiers are
considered biometric? (Select all that apply.) a. Facial scan b. Voice typing c. Chip scan d. Eye scan ANS: A, B, D
State laws now include an individual’s biometric information privacy. Biometric identifiers allow users to access technology devices through physical or biological characteristics such as fingerprints, face and voice recognition, and iris scans. DIF: Cognitive Level: Understand 2. A patient’s informed consent must include: (Select all that apply.) a. Capacity to make a decision on their own behalf. b. Sufficient information to understand the decision being made. c. Information of possible consequences of the decision. d. Wording that the consent is given voluntarily. ANS: A, B, C, D
Informed consent is the right of the patient to have control of the healthcare they are receiving. Patients should be given all information and have all questions answered before signing a consent form for a procedure or treatment. DIF: Cognitive Level: Remember 3. Examples of access to patient health information records referred to as a designated record
set include: (Select all that apply.) a. CPT codes b. Radiology report c. Lab report d. Demographics e. Hospital bill ANS: A, B, C, E
A designated record set that is maintained by a physician consists of medical records, billing records, health insurance claims, and any record that the provider utilizes in the decision-making process. DIF: Cognitive Level: Apply
Chapter 30: Health Policy and Health Informatics Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE 1. The EHR incentive Meaningful Use criteria are adapted from work done by:
a. b. c. d.
the National Quality Forum. the HITECH Act. The Joint Commission. the Institute of Medicine.
ANS: B
The EHR incentive program’s Stage 1 criteria for meeting Meaningful Use are divided into five initiatives adapted through legislation policy of the HITECH Act. DIF: Cognitive Level: Remember 2. Which office of the Department of Health and Human Services is charged with overseeing
nationwide efforts to implement and use health IT and electronic exchange of health information? a. MARCA b. The Institute of Medicine (IOM) c. The Office of the National Coordinator (ONC) d. The American Medical Informatics Association (AMIA) ANS: C
The ONC is the only governmental agency reporting to the DHHS. Its role is to coordinate implementation of health IT and electronic information exchange. DIF: Cognitive Level: Remember 3. James received a new job and was required to turn in his notice to his current employer.
What should James review to understand his obligation to his employer to resign from his position? a. Procedure b. Policy c. Codes d. Instruction manual ANS: B
A policy provides guidance on what to do or what is expected from an employee. Procedures will provide the steps on how to do something. A code has an underlying meaning. An instruction manual is irrelevant to the question. DIF: Cognitive Level: Understand 4. Which agency focuses on how to improve the value in healthcare in the U.S.? a. Agency for Healthcare Research and Quality b. Institute of Medicine c. Department of Health and Human Services d. Joint Public Health Informatics ANS: A
The Agency for Healthcare Research and Quality (AHRQ) is a government sponsored agency that investigates the evidence to make healthcare safer and improve quality. AHRQ works with academic institutions, hospitals, physicians, and a variety of healthcare systems to research the best measures.
DIF: Cognitive Level: Remember 5. In what year were penalties began for non-compliance of the use of certified EHR
systems? a. 2014 b. 2015 c. 2016 d. 2017 ANS: C
The HITECH began levying penalties for non-compliance of certified EHR systems in 2016. DIF: Cognitive Level: Remember 6. What are the responsibilities of the U.S. Department of Health and Human Services? a. Fund and regulate b. Investigate and respond c. Policy and procedures d. Policy and protection ANS: D
The U.S. Department of Health and Human Services’ two responsibilities contain various roles but ultimately encompass setting policies that ensure effective delivery of care and protection of community health. DIF: Cognitive Level: Apply MULTIPLE RESPONSE 1. Which recommendations did the IOM make to address health IT safety concerns and make
patient care safer? (Select all that apply.) a. HHS should fund a new Health IT Safety Council. b. HHS should establish a mechanism for vendors and patients to report health IT–related deaths, serious injuries, or unsafe conditions. c. Health IT should be moved from private, for-profit organizations into a nationalized central agency with strict oversight. d. Every patient should download and use the federal government’s MyHealthIT mobile app to document healthcare safety concerns. e. ONC should work with the private sector to make comparative user experiences publicly available. ANS: A, B, E
The IOM made a series of recommendations including a new Health IT Safety Council, a way for vendors and patients to report health IT–related problems and making comparative user experiences public. The IOM did not recommend any kind of nationalized IT system, nor is there a federal MyHealthIT app. DIF: Cognitive Level: Apply
2. The IOM report, HIT and Patient Safety: Building Safer Systems for Better Care,
documented that safe use of health IT relies on: (Select all that apply.) a. the interplay of people, process, and technology. b. vendors, users, and government. c. clinicians and patients. d. commercial interests. e. luck. ANS: A, B, C
The safe use of HIT relies on many factors, including clinicians, patients, and sociotechnical issues such as the interplay of people, process, and technology. Vendors, users, government, and the private sector all have roles to play. DIF: Cognitive Level: Remember 3. Well-defined health IT policies are necessary to ensure that: (Select all that apply.) a. confidentiality of protected health information is safeguarded. b. the DHHS receives its monthly report in a timely manner. c. data capture is being automated. d. clinical decision support is adopted. e. the retail value of confidential information can be maintained. ANS: A, C, D
Well-defined policies are necessary to ensure that confidentiality of protected health information is safeguarded, data capture is being automated, and clinical decision support is adopted. Policymakers should leverage these opportunities to transform nursing practice using new and existing technologies intended to support decision making and care delivery. The DHHS does not receive a monthly report, and confidential information is not sold. DIF: Cognitive Level: Apply 4. The future in healthcare technology includes: (Select all that apply.) a. Artificial medical intelligence b. Nanotechnology c. Electronic health records d. VR e. Machine learning ANS: A, B, D, E
The future in healthcare technology has surpassed the electronic health record and now encompasses medical intelligence for predictive modeling, wearable technology that provides real-time vital signs and data, robotics, and more. DIF: Cognitive Level: Understand
Chapter 31: Health Information Technology Governance Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE
1. According to the Informatics Capability Maturity Model, the degree to which IT is
innovatively leveraged to enable leaner processes and seamless information flows represents which dimension? a. Managing information b. Using business intelligence c. Aligning business and informatics d. Using information technology ANS: D
The ownership of health IT governance, as with other aspects of governance, depends on the institution. DIF: Cognitive Level: Remember 2. What is the first factor in deciding on an optimal health IT governance for an institution? a. The EHR system in use b. The organizational culture c. The size of the IT budget d. Whether the organization is a for-profit or non-profit entity ANS: B
Of the listed factors, an organization’s culture is the most important factor that needs to be considered. DIF: Cognitive Level: Analyze 3. Why is it difficult to establish effective health IT governance? a. Fundamentally, effective governance means that some stakeholders’ informatics
needs will need to be de-prioritized. b. There is too much literature available on the topic, making it difficult to choose
which approach to follow. c. So few activities within a healthcare organization involve informatics. d. No stakeholder wants to have a say in how informatics resources are leveraged. ANS: A
The fundamental reason for the difficulty of informatics governance is that there is more effort desired from informatics than resources allow. DIF: Cognitive Level: Apply 4. The trend in healthcare IT is shifting from what to what? a. Data warehouses developed by third-party vendors to infrastructure developed
in-house b. IT infrastructure being developed in-house to data warehouses developed by vendors and in-house resources c. A wide array of decision support tools to more closely defined transaction-based applications d. Litigation avoidance costs to operational productivity costs ANS: B
After many decades in which healthcare organizations developed in-house transaction-based IT applications, the trend has now opened up toward more robust data warehouses developed by vendors as well as in-house resources. DIF: Cognitive Level: Apply 5. The health IT governance Model: a. has been overtaken by a newer generation of assessment tools. b. was developed by a partnership of the CDC and National Institutes of Health. c. is a qualitative model that measures an organization’s capabilities along five
dimensions. d. is intended to be administered by an outside, and thus neutral, agency. ANS: C
The Informatics Capability Maturity Model, developed by the UK’s National Health Service, measures an organization’s capabilities along five dimensions, rating them from 1 to 5, and can be self-administered by an organization. DIF: Cognitive Level: Apply MULTIPLE RESPONSE 1. Why is health IT governance needed? (Select all that apply.) a. It ensures the alignment of informatics resources with institutional priorities. b. It effectively prioritizes the use of informatics resources. c. It optimizes the return on investment on informatics investments. d. It encourages clinician involvement. e. It can prevent malpractice litigation. ANS: A, B, C
Health IT governance is needed as it ensures the alignment of informatics resources with institutional priorities, effectively prioritizes the use of informatics resources, and optimizes the return on investment on informatics investments. All three reasons are core to the need for health IT governance. DIF: Cognitive Level: Apply 2. Which components are necessary for effective health IT governance? (Select all that
apply.) a. Organizational structures for assessing clinical processes b. Organizational structures responsible for clearly defining institutional priorities c. Organizational structures responsible for ensuring that informatics efforts are aligned with institutional priorities and optimally utilized d. Accompanying processes to operationalize the governance e. Proper procedures for punishing transgressions ANS: B, C, D
Effective health IT governance requires organizational structures responsible for clearly defining institutional priorities, organizational structures responsible for ensuring that informatics efforts are aligned with institutional priorities and optimally utilized, and accompanying processes to operationalize the governance. Though the term used is ―governance,‖ the field is concerned with oversight and guidance rather than rulemaking and enforcement. DIF: Cognitive Level: Remember 3. Which factors represent internal and external forces that require effective informatics
governance? (Select all that apply.) a. Increasing demand for decision support and analytics b. Greater expectations for information access and transparency c. Clinician demand d. Meaningful Use and healthcare reform e. An increase in the use of internally produced, transaction-based applications to support back-office functions and the delivery of clinical care ANS: A, B, D
Increasing demand for decision support and analytics, greater expectations for information access and transparency, and Meaningful Use and healthcare reform represent significant issues that increase the demand for informatics resources and subsequently require more effective health IT governance and prioritization. DIF: Cognitive Level: Apply 4. Which groups are relevant stakeholders for health IT governance? (Select all that apply.) a. Specialists refining clinical processes b. Institutions working on payment reform and personalized medicine c. Health services researchers d. Actual healthcare providers e. Senior organizational leadership ANS: A, B, C, D, E
All of these are relevant stakeholders who have a key and generally direct interest in effective health IT governance. DIF: Cognitive Level: Understand 5. Which activities represent dimensions of the health IT governance? (Select all that apply.) a. Clinical documentation b. Managing information c. Using business intelligence d. Aligning business and informatics e. Cost control ANS: B, C, D
Managing information, using business intelligence, and aligning business and informatics are dimensions of the National Health Service’s Informatics Capability Maturity Model. While clinical documentation and cost control are parts of an overall Healthcare IT system, these specific elements are not part of the Maturity Model.
DIF: Cognitive Level: Remember
Chapter 32: Global Health Informatics Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE 1. A digital device that collects, sends, and stores data without the need of human interaction
is known as: a. PaaS b. IaaS c. SaaS d. Internet of things ANS: D
Health data is recorded and connected using the internet resulting in the ability to track and monitor patient information. Items such as wearable sensors, mobile phones, and computing devices. These all provide a patient’s health data to be processed and stored. DIF: Cognitive Level: Remember 2. Global health informatics (GHI) focuses on the use of technology and research to provide
data and resources on a global perspective. In which countries is this type of research most successful? a. Affluent b. Poverty c. Regency d. Laborer ANS: B
GHI commissions the use of appropriate technology for global solutions particularly those in low resource countries. Low income, low resource countries have limited access to health care because of limited financial resources. Because of these challenges, a focus on digital incentives has improved access to quality healthcare services. DIF: Cognitive Level: Understand 3. Medical artificial intelligence can be established by evaluation of large data that then
applies the information to predict and provide treatment decisions. Such treatment interventions have been predicted in the treatment of: a. Smallpox b. Shingles c. Tuberculosis d. Diabetes ANS: C
Artificial intelligence (AI) is a resource that is seen predominately in high-income countries. Research shows that in low income settings tuberculosis and malaria have shown advancement for treatments with the use of AI.
DIF: Cognitive Level: Remember 4. An example of SaaS web-based service model is: a. Google App b. Apache c. Dropbox d. Microsoft Azure ANS: C
There are three types of cloud computing services that allow remote storage of data. These include SaaS, PaaS, and IaaS. SaaS utilizes the internet to deliver all applications and run directly through a web browser that is managed by a third-party vendor. DIF: Cognitive Level: Apply 5. To sustain a global digital health initiative ,human and technical factors must function to
scope with financial and regulatory efforts that include: a. Healthcare ecosystem b. User-centered design c. Technical factors d. Health innovators ANS: A
A healthcare ecosystem provides balanced healthcare support that includes doctors, hospitals, businesses, and clinics providing quality care with a variety of choices for care. Telehealth is one example of a digital healthcare ecosystem that is offered through many major health insurance companies. DIF: Cognitive Level: Understand 6. For global health informatics to move forward, what impact will provide the biggest
change? a. Corporate leadership b. Policies c. Government support d. Staffing ANS: B
Global digital health informatics in challenging because of the prosperities and understanding of needs within the world. Policies and funding will shape the future of how digital informatics will be used. DIF: Cognitive Level: Remember 7. Telemedicine technology barriers may include: a. Low bandwidth b. Low literacy c. Myopia d. Presbycusis ANS: A
Telemedicine can have technical and cultural barriers.
DIF: Cognitive Level: Apply MULTIPLE RESPONSE 1. Examples of digital health categories include (Select all that apply.) a. VR headset b. Smart watch c. Insulin therapy pump d. Robots e. Patient portal ANS: A, B, C, D, E
Digital health includes anything that is mobile, part of health information technology, wearable devices, telehealth, and personal information that is presented digitally. DIF: Cognitive Level: Apply 2. Internet of Things (IoT) architecture has three levels that include (Select all that apply.) a. Sensors b. Cloud computing c. Cable networks d. Technology department ANS: A, B, C
The three basic layers for IoT in healthcare delivery are the processed layer, network layer, and application layer. Examples of processed layer is including how the data will be collected. Network level includes how the data will get to the end user. Application layer includes how the data will be interpreted. DIF: Cognitive Level: Apply 3. Adoption of an electronic health record poses many challenges. What specific tasks are
included (Select all that apply.) a. Effective computer training b. Undeveloped infrastructure c. Insufficient technical support d. Satisfactory funding ANS: B, C
Challenges to implementing an EHR include poor infrastructure, inadequate computer skills and training, inadequate technical support, and limited funding. DIF: Cognitive Level: Understand
Chapter 33: Informatics and the Future of Healthcare Hardy: Hardy: Health Informatics, 3rd Edition MULTIPLE CHOICE
1. Data science includes data analytics. The role of the healthcare data analyst role is to
discover: a. patterns in care b. gaps in the system c. technology problems d. revenue opportunities ANS: A
Collected healthcare data and analyzing big data sets can be challenging regarding understanding and stripping away the data that is meaningless. Meaningful healthcare data must have actionable insight to be useful. DIF: Cognitive Level: Knowledge 2. Which term is analogous to future research? a. Futuristics b. Futurology c. Foresightology d. Rationalists ANS: B
Futurist research includes foresight, prospective studies, and prognostic studies that are rational and systematic to state what is possible, probable, and preferable. DIF: Cognitive Level: Knowledge 3. Strategic planning for health informatics to implement technology applications should take
how long? a. 6 months to 1 year b. 1 to 2 years c. 1 to 3 years d. 5 to 10 years ANS: C
A professional health and informatics specialist should utilize the traditional forecasting and planning method for future implementation for 1 to 3 years to vet the process. Long-range planning can take 5 to 10 years before incorporating. DIF: Cognitive Level: Remember 4. Becky has been asked to review the historical data for patients in the Dallas, Texas area
who have been diagnosed with Varicella in the last six months. This type of analysis is known as? a. Trend b. Predictive c. Visual d. Extrapolation ANS: A
Trend analysis involves looking at historical data to identify trends over time. Some trends Becky may see includes specific zip codes with higher rates, specific months with higher rates, and specific populations with higher rates.
DIF: Cognitive Level: Apply 5. Machine learning strengthens health care by providing research and predictability. In the
future, machine learning may provide: a. Incentives b. Normalization c. Supplementation d. Development ANS: B
Machine learning allows establishing models that can analyze data and deliver results quickly, providing historical and real-time data. Machine learning in health care will allow providers to make better decisions on patient's treatment options, which lead to improved quality patient care. DIF: Cognitive Level: Understand 6. An example of a newer data visualization tool used for large data sets is: a. UpSet plot b. Pie chart c. Bar graph d. Data map ANS: A
UpSet is a new data visualization tool that focuses on large data and displays information in a storylike manner, intersecting numerous data points. Pie charts, bar graphs, and data maps are typically used for small data sets with a confined sampling of data. DIF: Cognitive Level: Apply 7. A society trend that health informaticians are tracking is: a. Aging population b. Chronic diseases c. Healthcare costs d. Healthcare shortage ANS: C
Healthcare trends in society include costs. Costs for health care continue to rise and are predicted to reach $6.2 trillion by 2028. DIF: Cognitive Level: Remember MULTIPLE RESPONSE 1. Which factors lead to the increased cost of healthcare? (Select all that apply.) a. Aging population b. Longer life spans c. Chronic health conditions d. High insurance premiums e. Healthcare provider shortage
ANS: A, B, C, E
It is costing more to care for an increased number of chronically ill patients. This has placed a strain on the healthcare system including healthcare burnout rates. DIF: Cognitive Level: Understand 2. Futurist research focuses on what type of change? (Select all that apply.) a. Existing b. Systemic c. Transformational d. Incremental ANS: B, C
Futurist research focuses on systemic and transformational change and provides an alternative to a preferred future. Forecasters focus on existing trends and incremental changes. DIF: Cognitive Level: Remember