TEST BANK for Health Care Information Systems: A Practical Approach for Health Care Management 4th E

Chapter 1: The National Health Information Technology Landscape 1. When did the Institute of Medicine first publish its report calling for the

widespread adoption and use of computer-based patient records? a. 1981 b. 1991 c. 2001 d. 2011 Answer: p. 4 2. HIPAA, signed into law in 1996, was designed primarily to:

a. Make health insurance more affordable b. Simplify administrative processes c.Protect the security and confidentiality of personal health information d. All of the above Answer: p. 5 3. Which of the following is an example of an error of omission?

a. Prescribing a medication that has a potentially fatal interaction with another medication a patient is taking b. Failing to prescribe a medication from which the patient would likely have benefited c.Illegible prescriptions d. All of the above Answer: p. 6 4. Which of the following initiatives led to the rapid advancement and

adoption of e-prescribing in health care? a. HIPAA b. The HITECH Act c.The Medicare Modernization Act of 2003 d. None of the above Answer: p. 7 5. Which entity was charged with providing leadership for the

development and nationwide implementation of an interoperable health information technology infrastructure? a. ONC b. CMS c.IOM d. None of the above Answer:

p. 8 6. Which of the following is NOT a component of the HITECH Act?

a. Establishing Medicare and Medicaid EHR Incentive Programs b. Establishing value-based incentive programs c. Funding regional extensions centers to support providers in adopting and becoming meaningful users of EHRs d. Funding for workforce training programs to support the education of HIT professionals Answer: p. 8-10 7. Which of the following is NOT one of the “triple aims” for the US health care

delivery system? a. Improve the patient experience of care b. Improve the health of populations c.Improve communication between providers d. Reduce per capita cost of health care Answer: p. 12 is best defined as the ability of a system to exchange electronic health information with and use electronic health information from other systems without special effort on the part of the user. a. Coordination of Care b. Meaningful Use c.Integration d. Interoperabi lity Answer: p.

14 8.

9. Which of the following statements best describes the Commonwell Health

Alliance? a. A consortium of HIT vendors and other organizations committed to achieving interoperability b. A not-for-profit organization focused on developing technical standards for HIE c.A government organization focused on legal and policy barriers associated with interoperability d. A social media platform for patients to learn about their health condition and connect with other patients Answer: p. 15 10. Which of the following is the biggest barrier to health information exchange?

a. Technology b. Incentive programs

c.Health information blocking d. None of the above Answer: p. 16

Health Care Information Systems Chapter 2: Health Care Data 1. Health care data and health care information are synonymous and can be

used interchangeably. True False Answer: p. 22-23 2. Which of the following describes protected heath information?

a. Oral or recorded in any form or medium b. Created or received by a health care provider, health plan, public health authority, employer, life insurer, school/university, or health care clearinghouse c.Related to past, present, or future physical or mental health or condition of an individual d. All of the above Answer: p. 24 3. Which organization is the major accrediting agency for health care

organizations in the US? a. The Joint Commission b. NCQA c. CMS d. AHIMA Answer: p.

24 4. Electronic medical records (EMRs) are a digital version of the paper charts

within one practice whereas electronic health records (EHRs) have all those capabilities but are equipped to communicate and share information with other providers.

Tru e Fals e Answer: p. 25 5. Which of the following best defines continuum of care?

a. Services provided for a specific condition for a specific period of time b. Tracks patients over time through a comprehensive array of health services c.Improves health outcomes within defined communities d. None of the above Answer: p. 25-26

6. Which of the following is the primary purpose for creating and

maintaining patient records? a. Patient care b. Communication c. Legal documentation d. Billing and reimbursement Answer: p. 26 7. If the state in which you work does not specify retention requirements for patient

records, you should a. Maintain the records per the Joint Commission’s guidelines b. Maintain the records for as long as the state’s statute of limitations or other regulations require c.Maintain the records for 10 years d. Maintain the records indefinitely Answer: p. 28 8. Which of the following is a characteristic of personal health records (PHRs)?

a. Is a legal document of care b. Is maintained by a health provider c. Is maintained by the patient d. Does not contain as much health care information as an EHR Answer: p. 28-29 9. In which component of the patient record would you find the SOAP note?

a. Problem list b. Physicians orders c.Medication record d.

Progress notes Answer: p. 30 10. In which component of the patient record would you find detailed information

about tissue removed during a surgical procedure? a. Operative report b.

Pathology report c. Laboratory report d. Discharge summary Answer: p. 32

11. The third-party payer receives which standard billing form for health care

provider services such as those provided by a physician’s office? a. UB-04 b. CMS-1450 c.UB-82 d. CMS-1500 Answer: p. 35 12. The American Hospital Association publishes and updates

CPT codes annually. True False Answer: p.

37 13. Which agency is responsible for publishing and annually updating the

ICD-10-CM classification system in the US? a. National Center of Health Statistics (NCHS) b. World Health Organization (WHO) c.Diagnosis Related Group (DRG) d. American Medical Association (AMA) Answer: p.

14. Which entity is responsible for investigating fraud involving government health insurance programs? a. The Joint Commission b. Centers for Medicare and Medicaid Services (CMS) c. Office of Inspector General (OIG) d. American Medical Association (AMA) Answer: p.

42 15. Which of the following is NOT a basic element of health care data analysis?

a. Data must be stored in a retrievable manner. b. Data must be verified and cleaned. c. An analytical tool must be applied to the data. d. Data must be reported in a usable manner. Answer: p. 42 16. A database refers to only large structured, accessible data sets that are

stored electronically. True False

Answer: p.

17. Which of the following is NOT considered one of the “three Vs” of big data?

a. Validity b. Volume c.Variety d. Velocity Answer: p.

43 18. Which of the following is NOT a discharge statistics?

a. Autopsy rates b. Bed occupancy rates c.Consultation rates d. Death rates Answer: p.45 19. Which of the following is one of the five areas of analysis that is crucial

for holding providers accountable for the care delivered to patients? a. Population management b. Disease management c. Cost modeling d.

All of the above Answer: p. 48 20. Which of the following areas of big data analysis is characterized by best

practice care protocols over multiple care settings, enhancing the coordination of care, and monitoring and improving adherence to best practice care protocols? a. Population management b.

Disease management c. Point of care health gap

d. None of the above Answer: p. 48 21. The criteria against which quality is measured change depending on the

product, service, or use. True False Answer: p.

49 22. Which professional organization has developed and published a data quality

management tool that defines a specific set of characteristics of health care data that should always be present? a. The Joint Commission b. NCQ A c.

AHIM A d. CMS Answer: p.

50 23. Using an abbreviation that has two different meanings is an example of a lack of: a. Data comprehensiveness b. Data

definition c.

Data consistency d. Data precision Answer: p.

51 24. Errors attributed to a flaw or discrepancy in adherence to standard operating

procedures or systems are known as: a. Systematic errors b. Random errors c.Preventable errors d. Programming errors Answer: p.

54 25. Which of the following would help reduce errors during data collection and

processing? a. Standardize data entry fields b. Institution real-time quality checking c. Building human capacity d. All of the above Answer: p. 55

Chapter 3: Health Care Information Systems 1. Which type of information system is used to manage personnel, finances,

materials, supplies, or equipment? a. Administrative information system b. Ancillary information system c.Clinical information system d. Revenue cycle system Answer: p.

67 2. Which of the following is NOT a feature of a patient portal?

a. Patients can access test results. b. Patients can request a refill on prescriptions. c.Patients can contact their physician during off hours in emergency situations. d. Patients can view their account and pay their bill online. Answer: p. 68 3. In the 1960s and 70s, health care executives invested primarily in

administrative and financial systems.

Tru e Fals e Answer: p. 69 4. Minicomputers were smaller, more powerful, and more affordable than

mainframe computers, and they interfaced well with other clinical and administrative systems in the organization.

Tru e Fals e Answer: p. 70 5. In which decade did Medicare shift from a cost-based reimbursement

system to a prospective payment system based on diagnosis related groups? a.

1970s b.

1980s c.

1990s

d. 2000s Answer: p. 70 6. The 1990s technological advances

included: a. Widespread use of the Internet and email b. Local area networks c. Development of microcomputers d. All of the above Answer: p. 71 7. Which law made incentive money available for eligible professionals and hospitals to adopt and become “meaningful users” of EHR? a. HIPAA, 1996 b. Medicare Modernization Act, 2003 c. HITECH Act, 2009 d. None of the above Answer: p. 73 8. Which of the following accurately reflects EHR system use?

a. As of 2015, only 50% of physicians in community health centers had adopted an EHR. b. As of 2015, EHR adoption among specialty hospitals was much higher than general medicine hospitals. c.As of 2015, the Veterans Administration (VA) transitioned to an EHR system. d. As of 2015, nearly 84% of US nonfederal acute care hospitals had adopted basic EHR systems. Answer: p. 74 9. Which of the following is NOT considered a function of a “basic” EHR system?

a. Clinical decision support b. Results management c.Order entry management d. Health information data Answer p. 74 / 76 10. What are the major benefits of EHR systems? a. Quality, outcomes, and safety b. Efficiency, improved revenues, and cost reduction c. Provider and patient

satisfaction d. All of the

above Answer: p. 77-79 11. Which of the following is NOT a person-generated health data (PHGD)

technology? a. Fitbits b. Food diary apps c. Pace makers d. None of the above Answer: p. 82 12. Despite the proliferation in the adoption and use of EHR systems, health

care providers and organizations still face which three critical issues? a. Interoperability, consistency, and training b. Interoperability, usability, and health IT safety c.Interoperability, standardization, and satisfaction d. Interoperability, inefficiency, and quality Answer: p. 83 13. Which of the following is NOT a barrier to interoperability? a. Differing laws across states b. Alignment of payment incentives c. Health information

blocking d. Advances in technology Answer: p.

87

14. Which entity formed a tasked force to study, identity, and make

recommendations regarding system usability? a. AMIA b. CMS c.AHIMA d. NCQA Answer: p.

89 15. Which of the following is a health IT safety concern as identified by Meeks and

colleagues? a. Lack of best practices b. Cyber attacks c.System-to-system interfacing

d. All of the above Answer: p.

91-92

Chapter 4: Information Systems to Support Population Health Management 1. The population health efforts most health systems and ACOs are undertaking

are aimed at providing better preventive and medical care for the entire population in a specific geographic area.

Tru e Fals e Answer: p. 102 2. Value-based care is a solution to which of the following problems?

a. Rising health costs b. Duplication of services c.Clinical inefficiency d.

All of the above Answer: p. 102 3. Shared savings programs are best defined as

a. Making a single payment for hospital and physician services instead of separate payments b. Rewarding providers with financial and nonfinancial incentives based on performance on select measures c.Rewarding providers by paying a bonus that is explicitly connected to the amount by which they reduce the total cost of care d. Paying the provider organization a single payment for all services associated with a hospitalization or other episode of acute care Answer: p. 103 4. Which of the following is NOT an outcome achieved by patient-centered medical

homes? a. Mitigating health disparities b. Reducing hospital and emergency department visits c. Increasing Medicare spending d. All of the above are outcomes Answer: p. 104 5. Which of the following is the biggest barrier of

the ACO model? a. Building the infrastructure for effective data sharing b. Improving patient outcomes c. Controlling costs

d. None of the

above Answer: p. 105 6. Population health management requires a shift in industry perspectives and

health care practices. Which of the following is NOT characteristic of PHM? a. Collaborative teams of providers b. Offering care at centralized facilities c.Keeping groups of people healthy d. Customizing health care for each patient Answer: p. 107 is the ability to identify a patient or cohort at risk for a negative health event or preventable health care utilization. a. Segmentation b. Identificat ion c.

Stratificatio n d.

Interventio n Answer: p. 109 7.

8. Which is NOT a goal of care management?

a. Manage the most complex patients through the health care system b. Manage the overall health of a select population c.Consider patient preferences and overall situation d. All of the above are goals Answer: p. 110 9. Which of the following is best used to determine which patient records exist for

a member and where the source data is located? a. EHR b. Record locator service c.Master patient indices d. Practice management system Answer: p. 113 10. As reimbursement becomes more complex, which of the following systems

must evolve to support payments based on quality and performance? a. Revenue cycle system b. Care management system

c.Workflow and rules engine d. Registries and scorecards Answer: p.

115 11. Which of the following best describes the capability of a workflow and rules

engine? a. Analyzing clinical and administrative data to identify areas for improving the quality of care and reducing the cost of care b. Automating routine care management tasks c.Monitoring process performance and alerting staff members to missed steps, sequence issues, or delays d. Exchanging clinical and administration information among different health care entities and between providers and patients Answer: p. 115-116 is best described as having the ability to exchange information electronically with others in order to have a comprehensive view of the patient’s health and care. a. Predictive analytics b. Telemedicine c.Business intelligence d. Health information exchange Answer: p. 117 12.

13. Which of the following is NOT considered a patient

engagement tool? a. Scorecards b. Patient portals c. Social media d. All of the above are patient engagement tools Answer: p. 119 14. Which of the following was NOT identified by KLAS as a best practice in

adopting patient portals? a. Talk to physicians b.

Develop in house c. Educate patients d. Educate staff as if they were patients Answer: p. 122-123 15. Social media benefits health care in which of the following ways?

a. Creates a sense of community b. Delivers new clinical research insights c. Aids in measuring patient

satisfaction d. All of the above Answer: p. 124-126 is defined as exchanging medical information via electronic communications to improve a patient’s clinical health status. a. Predictive analytics b.

Telemedicine c. Business intelligence d. Health information exchange Answer: p. 126

16.

17. Which of the following services is offered through telehealth? a. Clinician-to-clinician consultations b. Critical care c. Cybersurger

y d. All of the above Answer: p.

128 18. The need for telemedicine is driven by which of the

following factors? a. Increased demand for access and convenience b. Increased number of licensed health care professionals c. Decreased occurrences of chronic diseases d. All of the above Answer: p.

128 19. Which of the following is NOT a barrier to wide-spread telemedicine? a. Confidentiality and liability b. Data standards c. Lack of universal

reimbursement d. Parity laws Answer: p. 128 20. A master care plan is best described as

a. A longitudinal, cross-venue health care plan and its described outcomes b. A specific plan developed according to the patient’s preferences and health condition c.A long-term care plan to maintain health integrated with short-term plans for transient conditions d. A medical care plan that records a patient’s problems and medications Answer: p. 129 21. Life-threatening trauma and diseases of mysterious origin are often

described in a predefined patient plan.

Tru e Fals e Answer: p. 130 22. Risk is the likelihood that the plan will not be followed or will not result

in desired outcomes. True False Answer: p. 130 23. Which of the following is not characteristic of a “plan-centric application”?

a. A library of plans b. Costfocused c. Algorithms d. Team-based Answer: p.

130-131 24. Value-based payment is based on conformance to chronic

disease protocols. True False Answer: p. 132 25. A shift from applications focused on developing the patient’s plan for health to

applications focused on documenting the patient’s record is the key component in successfully achieving population health management.

Tru e Fals e Answer: p. 132 & 133

Chapter 5: System Acquisition is defined as the process that occurs from the time the decision is made to select a new system until the time a contract has been negotiated and signed. a. System acquisition b. System implementation c.System selection d. System development Answer: p. 142 1.

2. The four phases of the system development life cycle in sequential order are

a. Design, planning and analysis, implementation, support and evaluation b. Support and evaluation, implementation, design, planning and analysis c.Planning and analysis, implementation, design, support and evaluation d. Planning and analysis, design, implementation, support and evaluation Answer: p. 144 3. All alternatives are considered, a cost-benefit analysis is done, a system is

selected, and vendor negotiations are finalized in which phase of the system development life cycle? a. Planning and analysis b. Design c. Implementation d. Support and evaluation Answer: p. 145 4. Assuming that a strategic IT plan already exists, the first step in a system

acquisition process is which of the following? a. Determine system goals b. Define project objectives and scope of analysis c.Establish a project steering committee and appoint a project manager d. Screen the marketplace and review vendor profiles Answer: p. 147 5. The ideal project steering committee consists of how

many members? a. 3-4 b. 5-6 c. 10-12 d. 20-25 Answer: p. 150

6. Which of the following organizations provides market analysis reports and

listings of vendors that provide EHR systems? a. HIMSS b. AMIA c.KLAS d. None of the above Answer: p. 153 7. Which of the following is NOT a mechanism used by a steering committee

when determining system requirements? a. RFP b. Focus-group sessions or small-group interviews c.Written or electronic surveys d. Representatives gather input from users in specific areas Answer: p. 154 8. All of the following are examples of technical infrastructure except:

a. Hardware requirements b. Disaster recovery c.Security d. Software upgrades Answer: p. 154155 9. An RFP might be used when the health care organization is considering only a

small group of vendors or products or when it is still in the exploratory phase.

Tru e Fals e Answer: p. 157 10. Which of the following statements cloud-based services is false? a. Cloud-based options require less upfront capital expenses for the organization. b. Cloud-based options require fewer IT staff members and resources

from the organization. c. Cloud-based options require the organization to maintain the system. d. Cloud-based options allow for scalability and access to analytic capabilities. Answer: p. 158

11. Which of the following is NOT a drawback to cloud-

based services? a. Slow deployment due to customizations b. Technical support technicians do not have an intimate knowledge of the organization’s operations c. Data ownership, security, and privacy concerns d. All of the above are drawbacks Answer: p. 159 12. Which of the following is a reason to conduct vendor demonstrations?

a. Validate how much the vendor can deliver of what has been proposed b. Evaluate the look and feel of the system from the programmer’s point of view c.Conduct system usability testing d. All of the above Answer: p.

162 13. Which of the following are methods for evaluating a vendor’s product and

reputation? a. Site visits to other facilities b. Vendor user group conferences c. Market reports d. All of the above Answer: p.

162-163 14. The project steering committee should compile a final report. All of the

following elements should be included except: a. System goals and criteria b. Cost-benefit analysis c. Final recommendation and ranking d. Project repository Answer: p. 164-165 15. What is the final step of the system acquisition process where

expectations are outlined and performance requirements are determined with the vendor? a. Contract negotiations b. Contract summary c.Vendor analysis d. Vendor

agreement Answer: p. 165 16. Which of the following is NOT the responsibility of the project manager? a. Establish clear roles and responsibilities for individual committee members b. Set target dates c. Establish methods for communicating progress

and problems d. Make the final decision Answer: p. 166 17. Which of the following is NOT a pitfall in the acquisition process? a. Not defining criteria and methods for selecting the vendor b. Assigning too little weight to the RFP process c. Turning negotiations into a

blood sport d. All of the above are pitfalls Answer: p. 167-168 consists of concepts, strategies, and principles that guide an organization’s technology choices and the manner in which the organization integrates and manages these choices. a. IT integration b. IT infrastructure c. IT architecture d. IT platforms Answer: p.

170 18.

19. Which of the following statements is true? a. In creating an architecture, an organization will implement platforms and

be guided by its IT infrastructure. b. In creating an infrastructure, an organization will implement platforms and be guided by its IT architecture. c. In creating an infrastructure, an organization will implement architecture and be guided by its IT platform. d. In creating a platform, an organization will implement infrastructure and be guided by its IT architecture.

Answer: p. 171

20. A best of breed architecture is most accurately

described as a. Sharing data between applications b. Sharing data by having all applications use one database c. Sharing data by having integrated access to data d. None of the above Answer:

Chapter 6: System Implementation and Support 1. A(n)

is someone who is well respected in the organization, sees the new system as necessary to the organization’s achievement of its strategic goals, and is passionate about implementing it. a. Project manager b. IT manager c.System champion d. Business sponsor Answer: p. 182 is the individual who holds overall accountability for the project and represents the area of the organization that is the major recipient of the project. a. Project manager b. IT manager c.System champion d.

Business sponsor Answer: p. 185 2.

3. There can be more than one individual serving as a business

sponsor of a project. True False Answer: p. 186 4. The order of activities in system implementation projects is determined by the

implementation team according to the organization’s needs and resources.

Tru e Fals e Answer: p. 188 5. In which phase does the IT staff play the biggest role?

a. Workflow and process analysis b. System

installation c. Staff training d. Data conversion Answer: p.

193 6. Which of the following is the primary problem with the train the

trainer approach? a. The trainer may leave the organization. b. The training process depends on the vendor. c. The trainer may be ineffective. d. Training takes time away from the trainer’s primary duties.

Answer: p. 195 7. Data should be cleaned before being converted. Which of the following does NOT characterize clean data? a. Accurate b. Comple te c.

Consisten t d. Current Answer: p.

196 8. Email communication should be the primary method of communicating the

progress of the system implementation.

Tru e Fals e Answer: p. 197 9. Which of the following should be considered when determining the go-live date?

a. On a day when the patient census is low b. After staff have been trained c.When IT staff are available to monitor and assess system problems d. All of the above are considerations Answer: p. 198 means that leadership takes every opportunity to present the vision throughout the organization. a. Language and vision b.

10.

Connection c. Trust d.

Communicati on Answer: p.

200 11. Which of the following was NOT discussed in the text as a strategy that

may lead to greater organizational acceptance of a new system? a. Create an appropriate environment b. Allocate sufficient resources c.Do not underestimate user resistance d. All of the above strategies were discussed Answer: p. 202 12. If the company has adequately prepared and trained staff for the new

systems, users can expect problem-free system operation from the start.

Tru e Fals e Answer: p. 203 & 210 13. During the implementation process, it is important to maintain current

workflow so that staff is not overwhelmed with changes.

Tru e Fals e Answer: p. 204 14. The criterion used to evaluate the system’s value or success depends on the

individual’s expectations and point of view. While not all criterion are the same, they all have equal importance to the organization in achieving its strategic goals.

Tru e Fals e Answer: p. 203 15. All of the following are ways to get user buy-in except:

a. Communicate the vision (p. 200) b. Seek input during the planning process (p. 191)

c.Offer incentives (p. 205) d. Communicate a target date for users to efficiently use the new system Answer: p. 191, 200, 205 16. If users are ever to fully realize the system’s value, they must have access to

technical support, preferably by— a. Providing local, in-house support b. Contracting with a local computer firm c.Partnering with a neighboring organization d. Training an employee to assume the support role Answer: p. 206 17. It is reasonable to expect that the hardware, software, and network will likely

need to be replaced within how many years as advance are made in technology, the organization’s goals and needs change, and the health care environment changes? a. 5 – 7 years b. 3 – 10 years c. 10 – 15 years d. 12 – 20 years Answer: p.

207 18. Companies should employ all of the following types of training except:

a. Training before and after go-live b. Group training c.One-on-one training d. All of the above should be utilized Answer: p. 207 19. Which of the following was NOT identified by Ash and colleagues as an

unintended consequence of implementing a CPOE. a. More work/new work b. New kinds of errors c. Patient dissatisfaction d. Dependence on the system Answer: p. 209

20. After a system is implemented, an organization can optimize use in all of the

following ways except: a. Providing additional training b. Adding new features or functionality c.Retrieving data from the former system d. All of the above are optimizations Answer: p.

210

Chapter 7: Assessing and Achieving Value in Health Care Information Systems 1. Which of the following is NOT characteristic of IT-enabled value?

a. IT value is both tangible and intangible. b. IT value is not variable across organizations. c.A single IT investment can have a diverse value proposition. d. Different IT investments have different objectives, value propositions, and value assessment techniques.

Answer: p. 216 2. Which of the following is an example of intangible value?

a. Increase in revenue b. Quicker admissions process c. Improved collaboration d. Reduction in turnover Answer: p.

217 3. Of the four classes of investment identified by Ross and Beath, which

involves upgrading core IT infrastructure and applications, reducing the costs, or improving the quality of IT services? a. Transformat ion b.

Renewal c. Process improvement d.

Experiment s Answer: p.

222 4. What did the authors describe as a cornerstone in

examining IT value? a. IT project proposal b. Formal financial analysis c. Strategic plan discussions d. Industry research publications Answer: p.

225 5. Which common financial measure is calculated by subtracting the initial

investment from the future cash flows that result from the investment? a. Return on interest b. Internal rate of

return c. Net present value d. Discount rate Answer: p. 226 6. A projection with great certainty that people will use the system in specific

ways is an example of which common proposal problem? a. Fractions of effort b. Underestimating the effort c.Shaky extrapolations d. Reliance on complex behavior Answer: p. 232 7. An unplanned, sudden deterioration in the organization’s fiscal performance that may slow a project is an example of which common proposal problem? a. Fairy-tale savings b. Unwarranted optimism c.Shaky extrapolations d. Failure to account for postimplementation costs Answer: p. 233 8. Which of the following was NOT discussed by the authors as a step to ensuring

the delivery of value? a. Require proposals b. Increase accountability c.Manage outcomes d. Invest more resources Answer: p. 235-242 9. In the process of increasing accountability for investments, who should defend the

IT investment? a. IT staff members b. Project sponsors c.

Business owners d. CEO Answer: p.

236 10. In the process of increasing accountability for investments, during which

step should the project sponsors and business owners be defined and develop

and understanding of the accountability they now have for the successful completion of the project? a. Step one b.

Step two c. Step three d. Step four Answer: p.

236 11. Why should IT projects be reviewed in a forum that routinely reviews similar

requests? a. Routine review allows forum members to understand good and bad proposals. b. Routine review allows forum members to compare and contrast proposals. c. Routine review allows forum members to take a portfolio view of potential investments. d. All of the above.

Answer: p. 236 12. Of the four types of IT investments in a portfolio identified by Weill and

Aral, which includes applications that support core operations process? a.

Infrastructur e b.

Transactiona l c. Informational d. Strategic Answer: p.

238 13. Once the implementation is over and the change settles in, value will have been achieved. True False Answer: p. 240 14. It is appropriate for the organization to hold parties to celebrate their

achievements (e.g., implementation of a new system).

Tru e Fals e Answer: p. 240 15. Implementation is the end point of the

IT initiative. True False Answer: p. 241 16. Which of the following is NOT a strategy to shorten the deliverables cycle?

a. “Big bang” implementation b. Staged rollouts c.Pilots d. All of the above are strategies to shorten the deliverables cycle Answer: p. 241 17. All of the following are examples of factors outside of the organization’s control

that may dilute the IT investment except: a. Immature technology b.

Inadequate resources c. Shortage of qualified staff members d. Customer reactions Answer: p. 243 18. “Making an effort to materially improve the process that the system is designed

to support” describes which observation of realizing value? a. IT value requires innovation in business practices. b. Economic value comes from incremental innovations rather than “big bang” initiatives. c.Strategic value comes from the cumulative effect of sustained initiatives to innovate business practices. d. Sustainable value requires that the leaders understand that change is an aspect of organization life rather than something to be endured every couple of years.

Answer: p. 244-245 is the extent to which the company has invested in technologyenable initiatives to change how the company operates. a. Digital maturity b. Transformation maturity c. Digital intensity d. Transformation intensity 19.

Answer: p. 246 20. CapGemini’s study of digital maturity found that transformation intensity was

more important that digital intensity.

Tru e Fals e Answer: p. 247

Chapter 8: Organizing Information Technology Services 1. Which of the following was NOT identified in the text as one of the four

core functions of an IT department? a. Operations and technical support b. Applications management c.IT administration d.

Project proposals Answer: p. 253 2. Data center management is a subgroup of which of the four core functions

of an IT department? a. Operations and technical support b. Applications management c. IT administration d. Project proposals Answer: p. 254 3. Who is the most senior IT executive that managers the IT department and is

seen as the executive who can successfully lead the organization in its efforts to apply IT to advance its strategies. a. Chief technology officer (CTO) b. Chief information security officer (CISO) c. Chief information officer (CIO) d. Chief medical information officer (CMIO) Answer: p. 258 4. Which organization has identified seven key attributes/competencies of CIOs and

offers intensive “boot camp” training sessions for professional development of CIOs? a. AMI A b.

CHIM E c. CMS d. HIMSS Answer: p.

258 5. The CIO should always report to the CEO of the

organization. True

False Answer: p. 260 6. Which IT leadership role is a relatively new position and emerged as a result of

the growing interest in adopting clinical information systems and leveraging those systems to improve care? a. Chief technology officer (CTO) b. Chief information security officer (CISO) c.Chief information officer (CIO) d. Chief medical information officer (CMIO) 7. Which IT staff member works with programmers and vendor staff members to test new systems and system upgrades, recommend solutions, and determine whether program requirements have been met? a. Project leader b.

Systems analyst c. Database administrator d. Network administrator Answer: p. 263 8. Applications programmers write programs to handle specific user tasks, such

as a program to track inventory within an organization.

Tru e Fals e Answer: p. 263 9. Which IT staff member plans, designs, coordinates, and coordinates system

security measures? a. Project leader b. Systems analyst c.Programmer d. Database administrator Answer: p. 263 10. Which of the following workgroup members of an analytics group acts as a

liaison between the technical and clinical teams and helps the technical team understand and interpret clinical data as s/he seeks to build algorithms that mimic clinical workflow? a. Data architect

b. Application

administrator c.

Knowledgeable manager d. Outcomes analyst Answer: p. 265 11. Decentralized decision making occurs when an organization has a highly

structured hierarchy in which decisions are made by a few senior leaders.

Tru e Fals e Answer: p. 267 12. Which of the following is a benefit of a decentralized decision

making structure? a. Innovative use of information systems b. Efficient administration of resources c. Effective planning of shared systems d. Better staffing Answer: p.

268-269 13. Most IT services in a health care organization are either fully

centralized or decentralized. True False Answer: p. 269 14. Although a person might report to someone else according to the

organizational chart, s/he should report to the project manager during a specific project.

Tru e Fals e Answer: p. 271 15. Which of the following is NOT a reason identified in the text that an

organization might outsource IT functions? a. Some organizations do not have enough staff members with the skills, time, or resources to provide sufficient IT service.

b. Some organizations want to free up IT staff members time for sabbaticals or internships with other departments. c.Some organizations can better control costs through IT contracts with defined project scope and timeline. d. All of the above are reasons to outsource IT Answer: p. 272 is a desirable approach in assessing IT services that brings a level of objectivity to the assessment process. a. Auditing b. Benchmark ing c.

Consulting d.

Reviewing Answer: p.

275 16.

17. According to the textbook, all of the following are areas that should be

assessed when evaluating IT effectiveness except: a. Governance b. Budget c. Service levels d.

Vendors Answer: p. 275-277 18. Spending a low percentage of the operating budget on IT means that

underinvestment is occurring and the IT budget should be increased.

Tru e Fals e Answer: p. 276 19. Which of the following is NOT a common metric regarding infrastructure? a. Reliable b. Resili

ent c.

Realistic d. Response time Answer: p. 277-278

20. Of the eight core IT processes that must be managed for an effective IT

department, which competency involves development of IT staff skills and retention of IT talent? a. Human capital management b. Relationship management c.Platform management d. Value management Answer: p. 280

Chapter 9: Privacy and Security is an individual’s constitutional right to be left alone and to limit access to his or her health care information. a.

Privacy b. Security c. Confidentiality d. Protectio n Answer: p. 288 1.

relies on trust that information shared with a health care provider during the course of treatment will be used only for its intended purpose and not disclosed otherwise. a. Privacy b. Security c.Confidentiality d. Protectio n Answer: p. 288 2.

3. Which of the following is NOT one of the key sources regarding legal protection

of an individual’s health information? a. HIPAA b. State privacy laws c.The Joint Commission d. Federal Trade Commission Act Answer: p. 289 4. Which law was written specifically to protect patient confidentiality only in

federally operated health care facilities, such as Veterans Administration hospitals, Indian Health service facilities, and military health care organizations? a. HIPAA b. Privacy Act of 1974 c.Freedom of Information Act d. Federal Trade Commission Act Answer: p. 290 5. Which HIPAA rule was added as part of the HITECT Act in 2009?

a. Privacy Rule b. Security Rule c.Breach Notification Rule d. None of the above Answer: p. 291 6. Which of the following elements is NOT required on a valid release of

information form? a. Name of person/entity receiving information b. Marital status c.Patient’s signature and date d. All of the above are required Answer: p. 293 7. Which of the following is a standard of the HIPAA Security Administrative

Safeguards? a. Device and media controls b. Facility access controls c.Workstation security d.

Workforce security Answer: p. 296 8. Which standard related to the HIPAA Security Physical safeguards requires the

CE to implement policies and procedures for the movement of hardware and electronic media that contain ePHI into and out of the facility and within a facility? a. Device and media controls b. Facility access controls c.Workstation security d. Workforce security Answer: p.298 9. Which of the following is NOT a specification of the access control

standard related to the HIPAA Security Technical Safeguards? a. Unique user identification b. Emergency access procedure c.Automatic log-off d. Data storage Answer: p. 299

10. If a breach of unsecured protected health information occurs, all of the

following should be notified except: a. Individuals affected b. Major media outlets c.Office for Civil Rights d. Office of the National Coordinator for Health IT Answer: p. 301 is a general term for software that is written to “infect” and subsequently harm a computer system. a.

Spyware b.

Malware c. Ransomware d. Virus Answer: p.

305 11.

12.

are a type of virus specifically designed to look like a safe program.

a. Spyware b. Ransomware c.Trojans d. Worms Answer: p.

305 13. According to the text, what is the primary challenge of developing an effective

security program in a health care organization? a. Balancing the need for security and the cost of security b. Preventing unintentional health care information breaches c.Maintaining information security while allowing controlled access to information d. Developing a comprehensive security program that is easy for the staff to understand and follow Answer: p. 307 14. All of the following are components that should be addressed in an

organization’s security action plan except: a. Administrative safeguards b. Organizational standards c.Policies and procedures d. All of the above are components Answer: p. 309

15. According to the text, what is the cause of 41% of all data breaches?

a. Technology malfunctions b.

Cybercrime c. Improper use of the heath information system d. None of the above Answer: p. 312 protect systems that utilize the Internet from intrusions and threats from outside sources. a. Antivirus software b. Backu ps c.

Firewall s d. Patches Answer: p.

314 16.

17. Which of the following is NOT characteristic of a strong password? a. At least eight characters in length b. A combination of letters, numbers, and

special characters c. Includes personal information d. All of the above are characteristic of strong passwords Answer: p. 316 18. Which of the following is an action taken to limit network access?

a. Keep machines in locked rooms. b. Manage keys to facilities. c.Restrict removal of devices from secure areas. d. Set up wireless routers to operate only in encrypted mode. Answer: p. 317 19. Which of the following is NOT a component of the NIST

cybersecurity framework? a. Framework Analysis b. Framework Core c. Framework Implementation Tiers d. Framework Profile Answer: p. 319 20. Which of the following is NOT one of the five concurrent and continuous

functions the Framework Core? a. Analyze b. Detect c.Respond d. Recover Answer: p.

319

Chapter 10: Performance Standards and Measures is the process that gives a facility legal approval to operate. a. Licensure b. Certification c. Accreditation d. Authorizat ion Answer: p. 325 1.

gives a health care organization the authority to participate in the federal Medicare and Medicaid programs. a. Licensure b.

Certificatio n c. Accreditation d.

Authorizatio n Answer: p.

325 2.

3. Who oversees the licensure of health care facilities?

a. Accrediting organizations b. Federal government c.

State government d. CMS Answer: p.

325 4. Which of the following is NOT an accrediting agency?

a. The Joint Commission b. NC QA c.

CMS d. All of the above are accrediting agencies Answer: p. 326-327 5. Excluding laboratories, how often must a health care organization undergo an

on-site survey in order to maintain accreditation with The Joint Commission? a. Every year b.

Every 3 years c. Every 5 years d. Every 7 years Answer: p.

330 6. Which of the following organizations is the leading accrediting body for health

plans? a. The Joint Commission b. NQF c.CIH Q d.

NCQ A Answer: p. 332 7. Which of the following is NOT one of the six aims for establishing quality health

care as outlined by Crossing the Quality Chasm? a. Effective b. Effici ent c.

Ethical d.

Equitable Answer: p.

335 8. Which of the following is NOT one of the four major categories of quality

measures? a. Structure b. Process c.Outcome d. All of the above are categories Answer: p. 335 9. Which is one of the oldest and widely used sets of health care performance

measures in the US with more than 90 percent of health plans in the US collecting and reporting this data? a. ORYX b. PQ RS c.

HEDI S d. CQM Answer: p.

337 10. How often are CQMs (clinical quality

measures) updated? a. Every year b. Every 3 years c. Every 5 years d. Every 7 years Answer: p.

337 11. Which is a nonprofit organization with board members from both private

and public sectors that maintains a large, searchable database of performance measures? a.

AHR Q b.

NQF c. CMS d. HRSA Answer: p.

337 is the process of comparing one or more performance measures against a standard. a. Assessing b. Benchmarking c.Regulating d. Standardiz ing Answer: p. 342 13. Which organization developed a widely used group of patient experience surveys in the public arena under the Consumer Assessment of Healthcare Providers and Systems program? a. AHRQ b. NQF c.CMS d. HRSA Answer: p.

342 12.

14. All of the following are online tools that allow organizations to compare data sets

except: a. Dartmouth Atlas b. Quality Check c.Hospital Compare d. All of the above are online tools for comparing data Answer: p. 343-344 15. Which of the following is defined as a patient safety event that did not reach the

patient? a. Incidents b. Near misses c.Unsafe conditions d. None of the above Answer: p. 345 16. Which of the following is NOT one of the three broad aims of the

National Quality Strategy? a. Innovative care b. Healthy people and communities c. Affordable care d. All of the above

are aims Answer: p.

346 17. Which of the following is not a “lever” that helps align organizations with the

NQS? a. Payment and incentives b. Incident reporting c. Certification, accreditation, and regulation d. Workforce development Answer: p. 346-347 18. Which initiative encourages individual eligible professionals and group

practices to assess and report the quality of care provided to their patients and risk negative payment adjustments if they do not do so? a. PSO b. NQ S c.

PQR S

d. MIPS Answer: p. 347-348 19. Which

of the following original CMS value-based programs determines whether or not an acute care hospital should be paid a reduced amount based on performance across health-acquired infections and unacceptable adverse events? a. Hospital value-based purchasing b. Hospital readmissions reduction c. Hospitalacquired conditions d. None of the above Answer: p. 348 20. Which new program streamlines three existing quality programs and rewards

eligible professionals for meeting and surpassing established thresholds? a. PSO b. NQS c. PQ RS d.

MIPS Answer: p. 347-348

Chapter 11: Health Care Information System Standards are the sets of rules for what should be included for the needed function and system level. a. Frameworks b. Implementation guides c. Standards d. None of the above Answer: p. 359 1.

2. Which standards development method occurs when a group of interested

people or organizations agrees on a certain specification without any formal adoption process? a. Ad hoc b. De facto c.Government mandate d. Consensu s Answer: p. 360 3. Which standards development method occurs when a vendor of other

commercial enterprise controls such a large segment of the market that its produce becomes the recognized norm? a. Ad hoc b.

De facto c. Government mandate d.

Consensus Answer: p.

360 4. Employing standards developing organizations (SDOs) is

characteristic of which standards development method? a. Ad hoc b. De facto c.Government mandate d.

Consensus Answer: p. 360 5. Which of the following is an example of a “profiling body”?

a. World Wide Web Consortium

b. American National Standards Institute c.Office of the National Coordinator for Health Information Technology d. All of the above are profiling bodies Answer: p.

363 6. Who is responsible for the development, maintenance, and modification of

relevant electronic data interchange standards? a. Standards developing organizations (SDOs) b. Designated standard maintenance organizations (DSMOs) c.International Organization for Standardization (ISO) d. Office of the National Coordinator for Health Information Technology (ONC) Answer: p. 364 7. Who is principle entity responsible for implementation for health care IT standards for interoperability? a. ATSM International b. HL7 International c.AN SI d.

ONC Answer: p. 367 8. Which of the following primary HL7 standards is a document markup standard

for clinical information exchange among providers? a. Clinical Document Architecture b. Continuity of Care Document c.Clinical Context Object Workgroup d. None of the above Answer: p. 368 9. Which of the following terminology standards have NOT been recommended by

NCVHS? a. SNOMED CT b. LOINC c.RxNorm d. All of the above have been recommended Answer: p. 371 10. What is the universal product identifier for all human drugs?

a. Logical Observation Identifiers Names and Codes (LOINC) b. National Drug Code (NDC) c. National Library of Medicine’s Unified Medical Language (UMLS) d. None of the

above Answer: p. 372 11. Which of the following is NOT one of the six parts in the LOINC name

structure? a. Property measured b. Time aspect c.Scale type d. Product category Answer: p. 373 12. The goal of which standard below is to enable disparate health information

systems to communicate with one another in an unambiguous manner. a. SNOMED CT b. LOIN

C c.

RxNor m d. All of the above have been recommended Answer: p. 374 13. Which knowledge sources of the UMLS project contains concepts from

more than one hundred source vocabularies and strives to incorporate and map existing vocabularies into a single system? a. UMLS Metathesaurus b. UMLS Semantic Network c. Specialist Lexicon and Lexical Tools d. None of the above Answer: p. 375 14. Which of the following is NOT considered health care data?

a. Payment advice b. Claims status c.Provider directories d. All of the above are considered health care data Answer: p. 379 15. Which standard set has the potential to accelerate health care IT

interoperability as it goes beyond the function of a traditional messaging system and includes modern web services to exchange clinical information? a. Clinical Document Architecture (CDA) b. Continuity of Care Document (CCD) c.Fast Health Interoperability Resources (FHIR)

d. HL7 Health Record-System Functional Model Answer: p. 384

Chapter 12: IT Alignment and Strategic Planning 1. Which of the following is NOT an objective of the strategic planning process?

a. Ensure that IT plans and activities align with the plans and activities of the organization b. Create a communication tool that can inform the organization of the IT initiatives that will and will not be undertaken c.Establish a political process that helps ensure the plan results have sufficient organizational support d. All of the above are objectives Answer: p. 396-397 is the determination of the basic long-term goals and objectives of an organization, the adoption of the course of action, and the allocation of resources necessary to carry out those actions. a. Alignm ent b.

Strategy c. Formulation d.

Implementatio n Answer: p.

398 2.

involves making decisions about the mission and goals of the organization and the activities and initiatives it will undertake to achieve them. a. Alignment b. Strategy c.Formulation d. Implementat ion Answer: p.

398 3.

involves making decisions about how we structure ourselves, acquire skills, establish organizational capabilities, and alter organizational processes to achieve the goals and carry out the activities we have defined. a. Alignment b. Strategy c.Formulation d. Implementat ion Answer: p.

399 4.

5. Which vector of IT strategy can be highly speculative and may not require

immediate action? a. Organizational strategy b. Continuous improvement of core processes and information management c.Examination of the role of new information technologies d. Assessment of strategic trajectories is the combination of an organization’s decisions about what it will do, how it will do it, and why “the what and how” are of such value that customers will pay them. a. Strategic trajectory b. Business model c.Operation plan d. Framewo rk Answer: p. 403 7. What are the four components of the IT asset? a. Applications, infrastructure, data, IT staff b. Applications, software, data, hardware c. Infrastructure, interfaces, data, IT staff d. Infrastructure, software, hardware, IT staff Answer: p. 405 6. A(n)

are the systems that users interact with: for example, scheduling, billing, and EHR systems. a. Interfaces b. Infrastruct ure c.

Applications d.

Programs Answer: p.

406 8.

9. Strategy discussions surrounding the application asset as a whole focus on

all of these key areas except: a. Application acquisition b. Application implementation c.Application uniformity d. Sourcing Answer: p.

406

10. Which term refers to broad properties of the organization’s infrastructure such as

reliability, security, and agility? a.

Characteristics b. Capabilities c. Assets d. Qualities Answer: p.

407 11. All of the following are IT staff members who manage and advance

information systems in an organization, day in and day out, except: a. Analysts b. Programmers c. Computer operators d.

Application developers Answer: p. 408 12. According to Weill and Broadbent, what four areas must the

leadership understand and strategically/tactically integrate in order to achieve effective IT alignment? a. Market position, environment, IT strategy, and IT applications b. Strategic context, environment, IT strategy, and IT portfolio c. Strategic context, infrastructure, IT strategy, and IT staff skills d. Organization objectives, infrastructure, IT strategy, IT portfolio Answer: p. 418 13. All of the following are examples of weaknesses that can significantly

diminish the likelihood that IT investments will lead to improved organization performance except: a. Shaky financial state b. Incompetent leadership c.Unclear strategies d. All of the above are weaknesses Answer: p. 419 14. Which of the following is NOT one of the characteristics identified by Earl’s

studies of organizations in the UK with a history of IT excellence? a. IT planning is not a separate process

b. IT strategic thinking precedes every IT project c.IT plans emphasize themes d. All of the above are characteristics Answer: p.

419-420 15. During which phase of the hype cycle, developed by Gartner Inc., does interest

wane as experiments and implementations fail to deliver on the hype of the peak? a. Peak of inflated expectations b. Trough of disillusionment c. Slope of enlightenment d. Plateau of productivity Answer: p. 422

Chapter 13: IT Governance and Management refers to the principles, processes, and organizational structures that govern the IT resources. a. IT effectiveness b. IT governance c. IT alignment d. IT management Answer: p.

428 1.

2. Weill and Ross identified five areas that form foundation of IT governance.

Which of the following is an integrated set of choices that guide the organization in satisfying business needs? a. IT principles b.

IT architecture c. IT infrastructure strategies d. IT investment and prioritization Answer: p.

430 3. Which of the following is NOT characteristic of well-developed governance

mechanisms? a. They are efficient and timely. b. They make authority clear. c. They rarely change. d. They are perceived as objective and fair. Answer: p. 430-431 4. Who is responsible for ensuring that individual and organizational information

systems are reliable, secure, efficient, and supportable? a. IT department b. IT users c.Senior management d. All of the above Answer: p.

432

5. Who is responsible for ensuring the organization has a comprehensive,

thoughtful, and flexible IT strategy? a. IT department b. IT users c.Senior management d. All of the above Answer: p.

433 6. High IT costs because of insufficient economies of scale, significant levels of

redundant activity, and the cost of supporting a high number of heterogeneous systems are problems that arise if too much responsibility is given to which group? a. IT department b.

IT users c. Senior management d. None of the above Answer: p. 434 7. Which of Feld and Stoddard’s principles for effective IT investments requires that

the IT platform be well architected and be defined and developed from the perspective of the overall organization? a. A simplified, unifying corporate technology platform b. A long-term IT renewal plan linked to corporate strategy c. A highly functional, performance-oriented IT organization d. None of the above Answer: p. 435 8. Which core structure of IT government holds the fundamental accountability

for the performance of the organization, including the IT function? a. Chief information officer b. IT liaisons c.Senior leadership forum d. The board Answer: p. 436 9. Which core structure of IT government discusses strategy and makes major

decisions regarding operations, budgets, and initiatives?

a. Chief information officer b. IT liaisons c.Senior leadership forum d. The board Answer: p.

437 10. Which core structure of IT government ensures that the IT department and the

IT strategy receive needed feedback and that function leaders understand the directions and challenges of the IT agenda? a. Chief information officer b. IT liaison c. Senior leadership forum d. The board Answer: p.

438 11. Brown and Sambamurthy identified five mechanisms used by IT groups that

improve coordination and working relationships with the rest of the organization.

Which of the mechanisms identifies individuals who are responsible for linking a particular organization department of function with the IT department. a. Integrators b. Groups c.Informal relationship building d. Human resource practices Answer: p.

439 12. According to the authors, what is one of the most critical management undertakings that makes strategy real through commitment of resources? a. Establishing policies and procedures b. Distributing IT responsibilities c.

Developing budgets d. Seeking accreditation Answer: p. 440 13. Which category of budgeting identifies funds associated with using and

maintaining an asset? a. Capital b. Operating c.Ongoing

d. Maintena nce Answer: p. 441 14. What is the first step in the budget process?

a. IT leadership reviews the strategic IT initiatives with the senior leadership of the organization. b. The organization must decide which new and ongoing initiative that improve current operations will be funded. c.The operations and strategic budget recommendations are reviewed and discussed at an executive committee meeting. d. The IT department submits an operating budget to support the applications and infrastructure that will be in place as of the beginning of the fiscal year.

Answer: p. 443 15. Which of the following is NOT a result of sponsors presenting and defending

their own IT requests? a. Assessment of trade-offs between IT and non-IT investments b. Accountability for investment results c.Improves management comfort in dealing with IT proposals d. Thorough defense as sponsors are most knowledgeable of their request and its details Answer: p. 444-445 16. All of the following are characteristic of a failed IT initiative except:

a. Project does not deliver on promised application features b. Project encounters too many problems and is no longer viable c.Project takes much longer than estimated d. Project is significantly over budget Answer: p. 445 17. Which of the following factors that should be managed by leadership during an

implementation occurs when the odor from prior failures significantly taints the credibility of newly proposed initiatives and weakens organizational acceptance? a. Organizational baggage b. Organizational inertia c.Lack of candor d. Lack of belief in a project Answer: p.

448

18. All of the following are mistakes that may lead to a failed IT project except:

a. Immature technology b. Debates surrounding the project c.Unclear objectives d. Understaffin g Answer: p.

448-451 19. Which of the following is NOT one of the five management behaviors of

successful senior leaders identified by Earl and Feeney? a. They continually pressured the IT department to improve its efficiency and effectiveness and be visionary in its thinking. b. They made sure that IT was closely linked to core management processes. c. They incorporated IT into their vision of the future of the organization. d. They left the exploration of new technologies to the IT staff.

Answer: 457 20. According to the text, any IT-enabled advantage results from engaging in

the following except: a. Acquiring a new system b. Improving processes c. Gathering critical data d. Defining new business models Answer: p. 460