Health Informatics

What are the principles of human-centered design? Select all that apply.

-Iteration of design solutions based on meaning and tasks performed -Active involvement and understanding of users

Name three challenges that limit the integration of social determinants of health data.

-There is limited knowledge of what works best in regards to collecting and using their data in an evidence-based manner. -There is a lack of standardization when it comes to collecting data leading to many inconsistencies that limit when analyzing and decisions are to be made. -It has not been an easy process to integrate social determinants of health data into the electronic health record. Therefore, another alternative has to be created in a custom manner.

What is the range of acceptable probability for data risk?

0.33 to 0.05

What year was the first book on mortality data published in London?

1662

How do personal health records help patients?

A place to consolidate health information, communicate with caregivers, and easily upload information from electronic health records or laboratory sources.

What are the key motivators of PHR adoption? Select all that apply.

Ability to learn new behaviors Elders receiving more care in mulitple locations Perceptions that PHR makes access to care easier Those who preferred to work together with their healthcare provider as a team Those with Internet access and confidence in using the Internet Likelihood of receiving incentives Usefulness of technology rather than ease of use Compatible with current healthcare needs

Which national organization convened members the multiple informatics communities in 2011 to develop recommendations to guide the field of population health informatics?

American Medical Informatics Association

A basic level of competency is an effective use of information. List the seven (7) skills that a professional could demonstrate under this competency level.

Analytics assessment skills, Policy development and program planning, Communication skills, Community dimensions of practice, Basic public health sciences, financial planning and management, and leadership and systems thinking.

_____________________________ allows the sharing of information and does not require explicit consent.

Anonymization

Match the public health informatics competency expertise levels with their skill level.

Aware: able to identify a concept or skill Knowledgeable: Able to apply and describe the skill Proficient: able to synthesize, critique, or teach the skills

There is a wide variety of processing and analysis tools for big data. Select the tools below that allow analytics systems to be designed well.

Batch processing tools like Hadoop. Stream processing tools like S4. Interactive analysis tools like Tableau or JMP.

Big data has five (5) characteristics and is classified into five (5) main categories. Explain the characteristics and categories.

Big data has five characteristics: volume/velocity, variety, veracity, and value. Volume means the rare that data is accumulated, variety is the high-volume data that is in motion through all specialties, veracity is data assurance that analytics and outcomes are credible and error-free, and value is the augmentation of new sources of data that have not been structured. Big data can be classified into five main categories: data sources, content format, data stores, data staging, and data processing. Data sources involve the different areas one can obtain data from (i.e. social media, internet, etc.) Content format is divided into three different types: structured, semi-structured, and unstructured- essentially the format in the data is presented. Datastores include a repository that stores and manages collections of databases, files, and emails. Data staging is the intermediate area where data is stored for processing. Lastly, data processing is where data is manipulated to create information that is meaningful.

All of the following explain CVM except for

CVM used to estimate WTP for technology is done with a triangulated choice model.

Explain the difference between correlation and causality.

Correlation is the relationship between two variables while causality means that one variable causes the other variable.

Match the themes with the Population Health Informatics adoption processes.

Data Governance: assures data sharing agreements are in place Data Quality: completeness, accuracy, timeliness, reliability, or validity of data Population Metrics: accurate and reproducible measures assure effectiveness Interoperability Standards: Frameworks for the development of new solutions assures consistency and alignment Tools and infrastructure: The development of a robust technology depends on this Ethics and Security: Often Limits the expansion of health informatics solutions

What are the three priority characteristics of population health surveillance?

Data collection is ongoing, systematic, and disseminated to key stakeholders.

Match the examples of population health informatics with its context level.

Data: a list of diagnoses for a patient Information: a table of most frequent diagnoses for a given population Knowledge: a utilization risk score derived from the root of the total costs and frequent diagnoses of a population

What kind of EHR system stores data using a third-party software and servers, where there is minimal control of the physical location of the data?

Dedicated host system

_______________________________ reduces the risk that identifying information cannot be reidentified through altering or removing identifiers.

Deidentification

What mHealth apps are classified by basic mobile phones and smart devices?

Device-level apps

Which stage in the knowledge management process involves analytics and other predictive statistics?

Extract knowledge by modeling and data mining

The 20th century saw an exponential increase in the volume of health datasets, growing digital data, and limited cognitive capacity.

False

User interface and support are not important to the adoption and use of PHRs.

False

What are the major barriers to adoption of certified electronic health records?

Finding a system that meets providers' needs Lack of productivity during transition Uncertainty about return of investment of the system Privacy and security

What mHealth apps are classified as automated sensing systems that connect to mobile devices to process data?

Functional-level apps

Which act provided incentives for providers to implement certified electronic medical records (EMRs)?

Health Information Technology for Economic and Clinical Health (HITECH)

What was the name of the federal law passed in 2009 that significantly increased health information technology adoption nationwide?

Health Information Technology for Economic and Clinical Health (HITECH) Act

What are two primary uses of Geographic Visualization (GeoVis) tools to improve public health practice?

Health assessments and policy development

Name the five primary functions or services that health professionals have become increasingly reliant upon.

Health professionals have become increasingly reliant of information and community technology. With this, they are able to: Assess the health of the community, Ensure preventative services are being provided based on the health of the community, Provide treatment and follow-ups as needed, Ensure that the services being providing are working in benefit of the community, and identify resources that could with with health initiatives within the community.

What type of evaluation method is based in a process to detect inconsistencies or errors within the prototype so modifications can be done before a system is fully deployed?

Heuristic Evaluation

What mechanism of telehealth delivery promotes patient-physician consultations?

Interactive monitoring

What mHealth apps are classified to diagnose, treat, monitor, support, prevent and educate?

Intervention-level apps

What are the three structural barriers to the adoption of technology?

Lack of availability of necessary technology. The technology is not always accessible. Technology is not always used.

Match the user-friendly attributes below.

Learnability: the capacity of a system to support comprehension. Speed of Performance: duration of task completion Error Handling: Ability to recover from errors Retention: ability of users to recall prior tasks with ease Satisfaction: acceptance in using the system

Which professional setting has been very slow and lacking to develop informatics infrastructure and systems?

Local health departments

Telehealth was projected to increase 10-fold between 2012 and 2018. What is this largely attributed to?

Mobile apps

Which PHR was developed by Epic and is one of the most widely used PHRs by health systems?

MyChart

Which continent has the highest Internet penetration rate at 88% (2017)?

North America

What are the six (6) core informatics competencies according to the Accreditation Council for Graduate Medical Education, and what was the 2016 average national salary for an informatics professional in the US?

Patient Care Medical Knowledge Practice based learning and improvement Interpersonal skills and communication Professionalism Systems based practice

______________________________ consists of sensitive details such as health history.

Personal Health Information

What is the primary purpose of using informatics for population health improvement?

Population health focuses on the health status and outcomes of a defined group.

What provided new resources to 57 state, local, and territorial health departments to implement electronic lab reporting (ELR) beginning in 2010?

Prevention and Public Health Fund (Affordable Care Act)

_______________________________ is a globally recognized framework based on seven foundational principles and emphasizes respect for user privacy as a default requirement.

Privacy by Design (PbD)

Match the dominant types of health information exchange (HIE) to their network/structure descriptions.

Private HIE: HIE within the membership affiliate group only Government HIE: HIE facilitated within state boundaries and support a network of networks community-based hie: hie among providers and organizations with no financial relationship to each other vendor-facilitied hie: hie that is a hybrid system with service lawyers on top of an EHR infrastructure

Community health workers (CHWs) connect between health systems and communities in low resource settings, and serve many functions. How can the use of mHealth improve their service?

Process improvement and technology development

Which level of informatics practitioner should be able to disseminate information on the relevance of standards, contribute to standards development efforts, and support orderly migration to a standards-based framework?

Public Health Informatician

Which level of informatics practitioner should be able to identify interoperability concerns, determine what is needed for information systems development, and assess clinical data for use in public health projects?

Public Health Informatician

What mechanism of telehealth delivery has the patient conduct various measurements from their home?

Self-monitoring

Which level of informatics practitioner should be able to evaluate agency resources, manage risk-related issues in information systems, and develop operational policies?

Senior Public Health Informatician

Which level of informatics practitioner should be able to significantly contribute to strategic decision-making, direct health informatics planning, and make recommendations on project decisions?

Senior Public Health Informatician

Population health informatics systems involve what functions of data? (select all that apply) (PARTIAL)

Storage, Creation, Processing

What mechanism of telehealth delivery focuses on patient monitoring through data gathering and storage?

Store-and-forward approach

A key challenge of EHR-based surveillance is enriching datasets with data relevant to social determinants of health (i.e., education, income, occupation, ethnicity, housing and transportation status, etc.).

T

Fair information practices (FIPs) are universally recognized principles for managing personal data.

T

HL7 is the most widely recognized and adopted syntactic standard in health informatics.

T

Overcoming barriers to prepare a competent workforce will require training in health informatics, data literacy, and systems science methods in order to enhance population health

T

Personal health record (PHR) attributes can vary from system to system and be subjective or objective.

T

Population health informatics is a blend of public health, computer science, medicine, and information processing.

T

The contingent valuation method focuses on the initial risk of life and the expected reduction of risk due to the adoption of technology, controlling for all socioeconomic factors.

T

There is some concern that if explicit consent for sharing data for secondary analyses is sought at the outset, the responses themselves could be biased.

T

Match the types of interoperability with the correct process and representation.

Technical Interoperability: requirements are easily fulfilled Syntactic Interoperability: successful communication of data using a structure that is understood by both systems Semantic interoperability: data must be translated into a standard format

What years did the United States begin a CDC fellowship program and the National Center for Public Health Informatics?

The CDC fellowship program began in 1996. The National Center for Public Health Informatics began in 2005.

A. What caused HL7 to gain popularity in the US? B. Explain what the incentive program promoted the adoption of. C. Provide one example of a population health use case for the incentive program.

The HL7 gained popularity in the United States when the incentive program 'meaningful use' was used to adopt Electronic Health Records. This incentive program promoted the adoption of Electronic Health Records/ One of the population health cases that were used for the incentive program was Quality Reporting Document Architecture (QRDA). This was a document format that helps place a standard structure to report quality measure data in a way that it can organize, analyze, and interpret the data.

What is interoperability?

The ability of two information systems to exchange data and something useful comes is achieved with the data.

What are the four (4) models of cloud computing recognized by the US National Institute of Standards and Technology (NIST)? Explain each model and provide an example for each.

The first model is a public cloud- readily accessible apps and storage feature to the public by pay-per-use from the provider. An example of this is the iCloud software on Apple products. The second model is a private cloud, this is a cloud that is restricted to one sole organization and secures this service. An example of this would be Virginia Beach using a google schools program that was solely dedicated to vbschools. A community cloud is when several organizations or stakeholders have access and pool resources to share one cloud service. An example of this would be within the Sentara field- a field filled with many different branches of hospitals and stakeholders having one sole cloud. A hybrid cloud is when two or more clouds (any of the ones listed above) are placed together. An example of this would be the IBM and Juniper Networks.

What are four factors that have empowered the collection and development of new population-wide data sources?

The increasing implementation of health IT solutions amongst healthcare providers Expanding data variety that is generated by different population's health data systems The widening continuity of data flow among health IT solutions The growing population coverage of health IT solutions

What are data?

The measurement, characteristic, or state of a person, provider, payer, or population.

Describe the role of standards in how to structure or represent information for meaning B. Identify four (4) examples of technical standards. C. Explain what standards development organizations (SDOs) do

The role of standards is to establish technical approaches, formats, or definitions, that prevent different variations on how to structure information to semantic or normalized meaning. B. Four examples of technical standards are SOAP, HTTP, HL7, and Logical Observation Identifiers Names and Codes (LOINC). C. Standards development organizations (SDOs), are representative groups of stakeholders, like nurses, physicians, vendors, etc, who come together to design and come to an agreement on a standard approach to representing.

Discuss two compelling use cases of HIE for population health improvement.

The two compelling use cases of HIE for population health improvement are care coordination alerts and population health dashboards. Care coordination alerts are event notification services and ADT alerts that send messages to primary care physicians, care managers, and/or ACOs after a nonroutine medical encounter was made, for example, a visit to the emergency room. On the other hand, population health dashboards help track different health indicators within populations and subpopulations with the use of dashboards that are created through software applications that contain the different indicators that can be found within different populations.

According to the Centers for Medicare & Medicaid Services, the design of the EHR mainly facilitates information access and helps in streamlining the workflow of healthcare providers, while supporting other healthcare-related activities and decision-making.

True

Hospitals that have invested in EMRs and health information exchanges have seen reductions in emergency department waiting times, drug-drug interactions, and readmissions after 30 days of discharge.

True

The main economic evaluation models require that the costs and benefits of health improvement projects be estimated.

True

_______________________________________________ is the consumption of health services for the satisfaction from good health.

Willingness To Pay (WTP)

_____________________________ refers to an on-demand, self-service emerging technology enabling users to access computing resources anytime from anywhere.

cloud computing

Public health agencies and healthcare organizations record population-level data using _________________ tools and technologies.

cloud-based

Individual groups working in silos is the most productive way to ensure interoperability of population health data.

f

have not been sufficiently recognized despite the knowledge of their impact on health outcomes and longevity.

social determinants of health

In 2011, the Affordable Care Act was passed to address population health and forced collaboration among a variety of stakeholders to strengthen the health care delivery, services, and general well-being.

t

The challenge of linking between electronic health records (EHR) of individuals and their social-service records has both technical and regulatory components.

t

Match the terms with their definition as it pertains to errors and validation of predictive models.

type 1 error: rejecting the null hypothesis when the null hypothesis is actually true type II error: failing to reject the null hypothesis when null hypothesis is actually false underfitting: a model that does not reflect systematic relationships in to data and produced biased predictions Cross-validation: A simulation method of partioning a single dataset into separate training and validation sets to assess a prediction model Tuning: the process of adjusting the complexity of a model to find an appropriate balance between over- and under-fitting