Health Informatics Comprehensive Review

Healthcare systems can best use social media in healthcare by:

linking patients within a network, developing collaborative content, and disseminating content. communicating vital information during crises or disasters. sharing bookmarks with others and promoting facility activities.

Patient care workflow and relevant patient information or summaries of prominent aspects of a patient's record are:

major types of clinical decision support.

Forces drive the integration of informatics in the curriculum for health professionals. What is a learning health system?

A system aligning science, informatics, incentives, and culture for continuous improvement and innovation

Which simulation equipment/trainer has the lowest fidelity?

A task trainer

The discipline of biomedical and health informatics has evolved from the work and papers disseminated by which organization?

American Medical Informatics Association

Telemedicine practice guidelines for healthcare professionals' practice is identified by the:

American Telemedicine Association.

The definition of healthcare informatics is defined by several organizations. Which of these statements would best define healthcare informatics in the understanding of clinicians such as nurses and other professional caregivers?

An interdisciplinary professional specialty and scientific discipline that integrates the health sciences, computer science, and information science as well as other analytic sciences with the goal of managing and communicating data, information, knowledge, and wisdom in providing care for individuals, families, groups, and communities.

Which phase of the systems development life cycle involves reviewing and updating the inventory of information systems, functionality, forms, regulations, interviews, and process flow maps?

Analyze

Several individuals should be involved in the negotiation process for the healthcare organization. This person understands the intellectual property rights and contracts and has experience with software license agreements and would play a role on the negotiation team.

Attorney

When analyzing distance education and the different mindset of digital learners who grew up with technology and students schooled in more traditional methods, the focus is:

learners and learning styles.

The Agency for Healthcare Research and Quality suggested which strategies for disseminating advanced clinical decision support on a national level?

CDS developed once and used by many

A strategy for successful management of the implementation of a healthcare information system is to have baseline metrics. This project management activity aligns with which of the following project management implementation steps?

Defining success factors

Which statement best describes the characteristics of the request for proposal (RFP)?

Describes vendor experience, vendor staff strength, market and industry understanding, differential advantages such as usability or available functionality, and cost

What affects the adoption and function of current personal health records?

Desire for functions such as prescription refill, messaging, results, and plan that PHRs offer

The ACE Star Model of Knowledge Transformation is a model of five points to integrate evidence-based practice into informatics solutions. Which activities represent the five points of the star?

Discovery research, evidence summary, translation to guidelines, practice integration, and evaluation of process and outcome

The Centers for Disease Control and Prevention provides a six-step framework for program evaluation of a locally developed project. Select steps for program evaluation.

Engage stakeholders to contribute to goals and metrics. Assess usefulness, feasibility, ethics, and accuracy. Justify conclusions by comparing to standards and expert review.

What are some factors that can impact the fidelity of a simulation experience?

Environment Degree of openness and trust Emotions, beliefs, and self-awareness of participants Participant and instructor motivation and goals Culture of the group

Which region in the world has become a world leader in the use of national and regional health networks and electronic health records (EHRs)?

Europe

Which is a longer-term benefit of the use of available simulation resources?

Higher quality of care

Which system includes personnel administration, staffing and scheduling, training and career development, compensation, benefits, and pension administration and performance evaluation and employee health and safety?

Human resources information system

The categories of prescriptive and predictive analytics are used to analyze data. Which method involves machine and statistical learning?

Knowledge discovery and data mining methods

Using Tall Man Lettering in similar drugs' labels helps solve which iatrogenesis error?

Look-alike names

The use of opinion leaders and real-time feedback about patient outcomes are examples of which type of intervention?

Offer mechanisms to diffuse and adopt new knowledge and include innovation

Identify three major national initiatives driving adoption and Meaningful Use of health information technology in the United States.

Office of the National Coordinator work to achieve interoperability to support functional learning health systems Office of the National Coordinator work with private and public entities to achieve patient-centeredness Institute of Medicine focus on systematic redesign of clinical processes with health IT

How is an institution's vision and strategic plan used as a guide in selecting a new or upgraded healthcare information system?

Organization and IT department strategic planning is iterative in nature and requires discerning future goals, directions, and multiple variables.

Standardized datasets used in electronic health records (EHRs) and information systems in home care practice sites include:

Outcome and Assessment Information Set (OASIS).

What are some strategies developed by health practitioners to successfully communicate with policy-makers about informatics?

Patient advocacy Acquire knowledge and communication skills Leverage networks for unified message Demonstrate leadership to connect evidence

What is the difference between personal privacy and information privacy?

Personal privacy involves access to one's person, and information privacy involves access to health data about one's person.

Which phase of the systems development life cycle involves project management and organizing a team?

Plan

What is the greatest challenge associated with the use of social media in healthcare?

Privacy and confidentiality

Identify the three levels of theory relevant to program evaluation.

Program theory Implementation models Scientific theory

After the request for information (RFI) and the request for proposal (RFP), the vendor and the organization complete steps for evaluation. What is the vendor step?

Provide presentations and demonstrations aimed at showing how the system can meet or exceed the requirements.

Which key public health application for infectious and chronic diseases makes comparing information within public health systems challenging because of varying policies among states, cities, and counties?

Public health reporting

Which statement best describes the impact of health informatics on the advantages and disadvantages of nanotechnology?

Reliable information about the safety of nanomaterials lags behind their fabrication.

The process of negotiating an agreement for software involves multiple drafts with compromises and adding essentials into the agreement. Vendors provide the standard form for agreement and iterations of drafts proceed multiple times. What are critical steps for the negotiating team to avoid delays and include the HCO requirements in the agreement?

Require editable drafts of the agreement where changes can be tracked and documents compared.

A quality supply chain system supports the operation and management of clinical systems by integrating which three components with the clinical systems?

Supply item master file, charge description master file, and the transaction history file

What is a critical regulatory issue associated with the use of social media in healthcare education and services?

Support net neutrality

Which type of telehealth uses interactive telecommunications technology and/or patient monitoring technologies to connect a provider and patient for direct care?

Synchronous telehealth

Which best describes the user-centered design with usability goals for effectiveness, efficiency, and satisfaction?

Systematic measures of interactions between user and products with iterative design

Monitoring the data and health information processes are a subset of standards for this accreditation organization in the United States which requires sharing outline accreditation measures to meet the Medicare Conditions for Participation.

The Joint Commission (TJC)

Identify the component of the framework for patient safety and quality research design (PSQRD) used to evaluate quality and patient safety for administering medications safely.

Throughput targeted by intervention

Why is health information technology governance necessary?

To prioritize and align health IT resources with the institution's competing demands and priorities

Best practices for clinical decision support design that improves practitioner performance and patient outcomes consist of which four function categories?

Triggers, input data, interventions, and action steps

Which type of personal health record does not link to healthcare providers and does not let users e-mail their doctor, request medication refills, or schedule appointments but does offer maximum control over content?

Untethered PHR

What led to the development and adoption of electronic personal health records?

Use of personal computers, internet, and EHRs

Of four different usability tests, which will interact with users to determine if 80% of the users can retrieve the correct lab results within 10 seconds of interacting with the system and if users can complete admission orders for a patient with no errors?

Validation test

OpenSimulator is an example of which type of educational software?

Virtual world

Which organization plays a key role in development of global health informatics?

World Health Organization (WHO)

An organization's emergency preparedness and disaster planning groups will have a component of IT downtime as part of a disaster drill. A best practice assessment tool for evaluating a downtime event is:

a configuration management database.

Differences between formative and summative evaluation include:

assessments.

The four operational and organizational factors that enhance or hinder telehealth are:

bandwidth, education, leadership, and technology.

The barriers to the wide adoption of clinical decision support include:

culture of quality improvement.

One of the biggest challenges to establish effective health IT governance is:

deciding where to begin.

The primary goal of home health agency providers in using technology to work with accountable care organizations is to:

facilitate communication and collaboration.

Schools, occupational health, public health, parish nursing, and nurse-managed health centers are examples of:

home healthcare.

The study of how people design, implement, and evaluate interactive computer systems in the context of users' tasks and work is:

human-computer interaction.

The best health IT governance approach should include evaluation of impact by:

iterative assessment to evaluate unintended consequences and alignment with institutional strategic direction.

When compared to the "Best of Breed" approach in selecting healthcare information system architecture, the integrated system:

provides applications that are excellent for some areas and less optimal for other areas.

Several mechanisms exist to provide the healthcare industry and business associates the direction for implementing and maintaining HIT infrastructure appropriately. The execution of rules about using health information systems and exchanges is directed by:

regulations developed by administrative agencies.

A downtime risk assessment will be developed based on:

root cause and degree of impact.

The STEEEP recommendations and redesign principles reflected in health professional education programs to improve the quality of care are best described as:

safe, timely, effective, efficient, equitable, and patient-centered.

Components of formal management that align directly with the knowledge of project management process groups, activities, and steps and that are essential to successful delivery include:

scope management, time management, project integration, communication, and procurement steps.

Cloud computing is critical to the future of public health informatics because it:

shares databases for transforming and managing data. locates a suite of application services to a remote site to share resources with a variety of users. configures and standardizes any customization efforts for all to use.

The clinician specific benefit from use of an EHR is:

simultaneous access to patient records.

The role of health practitioners in the International Organization for Standardization of health informatics initiatives involves developing and testing:

standards for integration of a reference terminology model.

Stakeholders such as patients perceive that the most important issue impacting EHR adoption is:

trusting providers to protect the privacy of their personal information.

Application-level and enterprise-level business intelligence can be differentiated by:

use of an independent software solution or a component software solution of an EHR.

An emerging approach to knowledge building includes measuring the effectiveness of EBP guidelines. This approach requires steps to obtain clinical data through the application of PBE research design techniques. These techniques include:

using collected electronic data with cohort samples of patients with identified characteristics to detect subtle patterns within comprehensive standardized data about practice interventions and treatments.

The characteristics of big data include:

volume, variety, value, veracity, and velocity.

Communication strategies for planned and unplanned downtime in your organization should provide clinicians and support staff enough information, but not too much. A good strategy is a template message explaining:

what is down, when it began, how long, why, what changed, who is impacted, what to expect, and what procedures to follow.

When you document lessons learned and create ongoing support models for operations and maintenance, the project management procedures signify this process group?

Closure processes

Information age students are calling for learner-driven education environments. What is a recommended better pedagogic approach to integrate informatics competencies in the curriculum?

Access to learning tools as an adapted version of a clinical information system used in acute and ambulatory care facilities, knowledge bases, and scholarly exchange networks

Which definition most accurately describes data integrity?

Accuracy and completeness of health information

When health practitioners attest to their Meaningful Use of a certified EHR, their practice is demonstrating which Stage 2 requirements?

Adopt EHR functionality to support continuous quality improvement, patient safety, and sharing structured data/information within the health information exchange networks

Several reasons are provided for implementing or upgrading an electronic information system. Which initiative encourages more timely updates of treatment plans based on best practices?

Agency for Healthcare Research and Quality's Translating Research into Practice

The Office of Inspector General and the U.S. Department of Health and Human Services have the authority to accept safe harbors that protect against criminal and civil prosecution for Stark and Anti-Kickback violations in certain situations. To qualify for safe harbor protection, identify the criteria that does not meet safe harbor requirements under the Anti-Kickback statute.

Agreement specifies some services, full-time intervals, price, and written signed agreements in effect for 6 months

Which is a benefit of advancing technology on healthcare education?

Allows more flexibility in the time and location

When the negotiation process is completed, who is responsible for signing the agreement?

Chief executive officer (CEO), chief financial officer (CFO), chief information officer (CIO)

Two studies have reported that if fully using electronic health records (EHRs) within American hospitals, the volume of preventable fatal hospital-based events each year could be reduced by 78,800 to 132,000. What were the critical considerations to achieve such a significant improvement to patient safety?

Clinicians can document treatment completely within the EHR Health informaticians fully involved in the design, selection, and implementation Healthcare providers who maximize their use of EHRs to care for patients

Of four different usability tests, which has the objective of determining which application, design, or product is more effective, efficient, and/or satisfying and can be completed anytime in the systems life cycle?

Comparison test

When evaluating course management systems, which criteria are important for students?

Compatibility with operating systems, mobile devices, firewalls and antivirus programs, and usability

What guides development of the ideal personal health record (PHR)?

Comprehensive longitudinal record and data ownership, control, and privacy

The specialty of health informatics was developed from nurses, physicians, and others who have innovated changes in healthcare practices. This specialty finds solutions from using which three areas of science?

Computers, information, and health sciences

The interprofessional team of learners interpret information and the world according to their personal reality and learn by observing, processing and interpreting information, and then customizing the information into personal knowledge for immediate application. Which pedagogical theory answers the question "why?"?

Constructivism

What statement is true regarding distributed education and distributive learning?

Distributive learning can happen in any setting including technology learning resources with interactive hands-on learning by doing.

Identify which domain of mHealth applications this example supports. A program provides pregnant women with stage-appropriate information through text messages about pregnancy, birth, and care of an infant.

Domain for client education and behavior change

Which are major trends and their implications for future developments in healthcare, health informatics, and informatics research?

EHR optimized with decision support, improving the user experience for health IT, big data and data visualization, and nanotechnology and nanoinformatics

Identify the advantage of adopting standardized terminologies in practice for the patient's daily care.

Effective data retrieval and exchange

Which characteristics of informatics interventions are measured during program evaluation?

Effectiveness in decision support or identifying patients Reach of targeted people

Which EHR application provides a color-coded list display of details for scheduled, unscheduled, pending, past due, and completed types of medications and fluids?

Electronic Medication Administration Record (eMAR)

The project manager role uses a variety of skills to take on the responsibility to manage a project from initiation to closure. Which of the following responsibilities is not the role of project manager?

Evaluate changes in the scope of the project and support stakeholders who add to the project.

EHRs are designed to make documentation easier but can lead to fraud and abuse claims by the Federal government that may include hefty fines and jail time if violations are proven. Which are examples of physical safeguards to prevent fraud and abuse claims?

Facility access controls, workstation use, and workstation security

Several United States (US) governmental processes and structures help regulate health information technology. Which federal agency regulates development of new health IT devices and is responsible for enforcement of competition in the healthcare market?

Federal Trade Commission (FTC)

Which of the statements best describes current federal and state laws regulating privacy and security practices and procedures?

Federal and state laws increased privacy protections for genetic information by prohibiting most health plans from using or disclosing it for underwriting purposes.

Which statements describe the field of nanotechnology?

Field requiring collaboration across engineering, physics, chemistry, biology, and materials Controlling and altering matter at the atomic or molecular level Creating materials, devices, and other structures at the nanoscale (1-1000 nm)

General ledger, payroll, patient accounting, claims processing, claims denial management, contracts management, and fixed asset management are basic applications for which system(s)?

Financial information systems

Which statement is true regarding the techniques used to analyze and distinguish forecasters from futurists when planning for future directions and trends?

Forecasters focus on incremental changes from existing trends, while futurists focus on systemic transformational change.

Six components continue to serve as the foundation to change the healthcare delivery system since 2004. Select the statements that set forth the fundamental policies.

Guide medical decisions at the time and place of care and deliver appropriate evidence-based medical care Promote wider availability of accurate and complete information on costs, quality, and outcomes Implement effective infrastructure for secure and authorized exchange of protected health information to coordinate care

Which components make up the comprehensive educational information system?

Hardware Overlapping and integrated functionality Data produced by all information systems

What legislation was critical to encourage providers to adopt EHRs, achieve meaningful use with the EHRs, and exchange meaningful health information?

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

To communicate and exchange clinical data collected across settings, which organization has modeled frameworks for data exchange with standardized terminologies?

Health Level Seven International (HL7)

Which of the following helped define health informatics?

Health informatics books and journals Professional organizations and their conferences University-level education and certification programs

When managing the interrelationships among the stakeholders to further develop EHR systems, health information technology (HIT) professionals need to facilitate life-cycle change. Select the foundational health informatics knowledge HIT professionals need to consider?

Healthcare providers advocate for their involvement in selecting systems that directly and indirectly impact patient care.

Which groups are included in the Campaign for Action?

Healthcare providers, consumer advocates, policy-makers, and business, academic, and philanthropic leaders

Which usability study compares products against accepted usability guidelines to reveal major and minor usability issues?

Heuristic evaluation

In Meaningful Use stage 2, eligible providers have demonstrated their abilities to exchange information for which of these public health purposes?

Immunization Registry Reporting and Syndromic Surveillance Reporting Specialized Registry Reporting and Disease Surveillance System Reporting

Which best describe the benefits for healthcare from using social media tools?

Improve provider to provider, patient to provider, provider to patient communication Finding others with similar conditions and treatments Study content on sites, collect data for research

Which computerized application(s) can faculty members use to project materials from a computer, document camera, or the internet and to create, edit, write, save, and distribute notes and figures?

Interactive whiteboard

The World Health Organization has identified many health informatics initiatives. Which initiative has been and continues to be a concern for information sharing across countries and states and requires collaborative work?

Interoperability issues and meaningful documentation

Which components are associated with community-based healthcare?

Interprofessional collaboration Patients who are knowledgeable about their own healthcare Work with patients and their families over time

Social, political, and other factors influence the implementation of public informatics solutions. which of the following has been the largest challenge to enhancing future public health infrastructure?

Lack of resources

Contract negotiations involve understanding the implications of contract provisions commonly included in an agreement (contract) for software purchased by a healthcare organization (HCO). This agreement protects healthcare organizations when including obligations, warranties, and assurance that the software and its functionality, performance, and compatibiliity achieve intent. What protects the vendor's intellectual property within the software?

License

Which system involves the documentation of chemistry, hematology, and microbiology results and physiological parameters for vital signs and obstetric measurements and represents standardized healthcare terminologies relevant to patient-to-patient care for all clinical disciplines?

Logical Observation Identifier Names and Codes (LOINC)

Identify the component of the framework for patient safety and quality research design used to evaluate quality and patient safety for the nursing process intervention to diagnose a pressure ulcer.

Management or clinical process

Which foundational science contributes systematic and logical approaches, processes, and procedures for understanding phenomenon and solving problems to the study of informatics?

Mathematics

Which Meaningful stage requires that more than 50% of all patients of the eligible provider, emergency department, or inpatient hospital or critical access hospital who request an electronic copy receive their clinical summary(ies) within three business days?

Meaningful Use stages 1, 2, and 3

The Medicare Access & CHIP Reauthorization Act (MACRA) proposes four categories of measurement (quality, resource use, clinical improvement, EHR use) that will be used to determine scores for payment. Which programs supports this initiative?

Merit-Based Incentive Payment System (MIPS)

The highly advanced decision support feature integrated within an electronic information system would support which activity?

Message from logic rule based on patient variables: diagnosis, patient location, documentation

Choose the best two responses to describe evaluation research.

Methods selected and few targeted outcomes Research with statistical evaluation of models

Which of these statements best describes the unique features of mHealth when compared to health IT applications?

Mobile configuration, wireless, consumer-grade hardware, short messaging service

Which federal entity began training physicians and other health researchers in the use of computer technology for medical education and healthcare processes?

National Library of Medicine

What are some institutional challenges in technology-enhanced education?

Not enough faculty educated to teach informatics Insufficient infrastructure to support the integration of health IT tools in the curriculum Incorporating evidence-based practice Becoming patient-centered

Which items were mentioned in the Institute of Medicine's Future of Nursing report?

Nurses should be involved in shaping health IT. Lack of integration of EHRs is a barrier.

The 2014-2018 HHS Strategic Plan identified current Health and Human Services programs which have implications for health informatics. The following programs are part of this plan:

Prevent and manage the impacts of infectious diseases and chronic diseases and conditions, including the top causes of disease, disability, and death Eliminate disparities in health, including healthcare access and quality Provide healthcare coverage through Medicare, Medicaid, the Children's Health Insurance Program, and the Health Insurance Marketplace

A process of initiation or preplanning, formal planning, creation and implementation of a plan, and measurement of progress and performance from start to finish.

Project management

Implications for mHealth research encourage the use of guides that have been endorsed by major donor organizations and outline best practices for technology-enabled programs. Identify the strategies that best support mHealth research. (Select all that apply)

Reuse and improve existing tools and platforms rather than build new ones Sustainability in mHealth projects Mitigate overlap and waste of implementing mHealth projects

A nurse working in a healthcare facility forgets to lock her computer after accessing a patient's personal health information, allowing an unauthorized user access to the file. Which fair information principle is being violated in this case?

Safeguards

In what ways are practice management systems (PMSs) different than integrated healthcare systems?

Scale of provider services Healthcare Common Procedure Coding System (HCPCS)

The International Council of Nurses identified a role of health practitioners in using which health informatics initiative?

Telenursing

Standards to develop evidence-based simulation educational experiences include the INACSL Standards for best teaching strategy. Select the set of standards offering the best educational experiences.

Terminology, professional integrity, participant objectives, facilitation methods and simulation facilitator, interprofessional education, simulation design, debriefing process, evaluation of expected outcomes

Information technology and clinical staff members have roles in system downtime planning. What two roles are specific to the IT staff in addressing system downtime planning?

Test the new functionality and discover any dependencies. Establish methods to communicate to senior leadership, staff, and the community.

A Shared Nationwide Interoperability Roadmap has been distributed by the Office of National Coordinators and is part of the HHS 2014-2018 initiatives. Select the statement that best describes interoperability.

The ability of health information systems to work together within and across organizational boundaries to effect delivery of healthcare for individuals and communities by sharing data between EHRs

Data and information within the EHR systems provide opportunities to generate knowledge. Healthcare providers must have an understanding of health informatics. Which of the following statements best describes their role in knowledge generation?

The clinician supports the use of standardized languages to document patient care to allow others such as patients and other clinicians to search the terms to understand the assessments, diagnoses, treatment procedures, therapy, or intervention.

Driving forces that are behind the mHealth movement include:

access, cost savings, better functionality, research, connected globally, and public engagement.

Select the activities that are part of the informatics specialist role in KDDM and PBE in healthcare environments?

analyzes complex nonlinear relationships Design data capture for clinical records and research records. Adapt and calibrate models for different settings and populations.

Identify two reasons why knowledge discovery and data mining (KDDM) is a preferred method. (Select all that apply)

analyzes very large repositories of clinical data from large data warehouse with standard and local sets of variables analyzes complex nonlinear relationships

Shared control of the agreement document is necessary in preparing response drafts that are redlined to show changes to the prior draft. Due diligence is part of the process of negotiating an agreement for software, which means the negotiating team has responsibility for the following:

ask who has recently discontinued use of the vendor's software and why. check with other users and visit user sites.

Three core public health functions and workflows supported by information technology include:

assessment, policy development, and assurance.

The essential components and attributes of an EHR include:

automate, track, and document decision support processes and rationale. communication and connectivity processes. active and inactive problem lists link to order entry and results management. longitudinal record link with dentistry and optometry records.

Applying futurology methodology of envisioning a desired endpoint and working back to determine what activities and policies to achieve a possible, probable, and preferred future describes:

backcasting.

Organizing concepts or expressions according to their similarities rather than semantic resemblances is known as:

classification.

Benefits of the health information exchange infrastructure for public health include the ability to:

communicate with selected provider and patient populations through secure messaging to receive lab reports and sending alerts on potential outbreaks.

Three clinical practice considerations for telehealth-delivered care for health professionals are:

competency of physicians and nurses. confidentiality and privacy. equal to face-to-face care.

When establishing health information technology (IT) governance, this step assists in understanding five dimensions:

conducting a health IT capability maturity assessment.

The role of evidence-based practice (EBP) in developing informatics-based solutions for managing patient care includes solutions that generate support for clinical decisions through:

designing EBP documentation screens, order sets, Infobuttons, and clinical reminders.

The component of information security that converts data into a form, called a ciphertext, which cannot be easily understood by unauthorized people is an example of:

encryption.

In distance education, when analyzing how quickly faculty members provide comments on submitted work with rubric-based design learning activities for each activity, the focus is on:

evaluation.

An education initiative used to practice roles and responsibilities of participating disciplines is:

evidence-based practice simulation scenarios.

The governance structure for health IT should include:

executives and board of directors. chief medical informatics officer. chief nursing informatics officer. chief information officer.

A business continuity plan for your organization would include:

expected time to recovery based on the requirement for service and available resources. which systems can be excluded from initial recovery. exercises to test the plan.

The historical phase of distance education in which television broadcast course programs were shared across academic institutions to deliver content is best described as:

fourth phase.

Continued professional development through informatics seminars/webinars or conferences:

increases the competency and skills to promote practice changes when technology evolves with decision support systems. accelerates national efforts to increase adoption of health IT for consumer engagement, public health surveillance, and research. includes workshops to learn about new standards of care and digital training to help the interdisciplinary team to learn specific competencies.

Research design involves a balance of internal validity (the validity of the causal inference that the treatment is the "true" cause of the outcome) and external validity (the validity that the causal inference can be generalized to other subjects, forms of the treatment, measures of the outcome, practitioners, and settings). The weaknesses of practice-based evidence observational designs include:

internal validity. causality between treatment and outcomes.

In the national road map led by Osheroff and colleagues, clinical decision support was described as:

interventions to provide knowledge and person-specific information, intelligently filtered or presented at appropriate times, to clinicians, staff, patients, or other individuals to enhance health and healthcare.

The three biggest mHealth challenges associated with implementation include:

patients misinterpret their own data, make poor health decisions, and data privacy and legal risks.

Social media policies addressing information disclosure, professional integrity, and appropriate use should be developed by a team comprising:

physicians, nurses, IT, legal, and community representatives.

Telehealth tools to enable self-care in consumer informatics include:

pill identifiers and drug interaction checkers. symptom checkers, fitness trackers, and personal health records.

Information systems and applications for delivery of healthcare are addressing needs associated with health informatics. Three essentials to explore with each of these systems and applications would include:

purpose, functions, and internal and external structures.

The primary benefits of point-of-care standardized terminologies in home health clinical information systems are:

real-time and one-time external monitoring and documentation. quantitative data for outcomes reporting and disclosing patient outcomes disparities. prerequisite for decision support to improve performance. maintain accurate lists of problems and medications, and reuse of information.

Contemporary organizations need formal structured change control processes that:

reduce variability across processes and provide standardization across projects.

Two national initiatives related to promoting quality data standards in the United States involve an ability to capture data for quality reporting in the context of existing documentation workflows. This is applied in work aimed at:

semantic interoperability for data context and meaning (ONC health IT agenda). exchange of electronic health information for care delivery and quality reporting purposes (CMS Meaningful Use Stage 2).

Quality of care has been defined as the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge by:

the Institute of Medicine.

A computerized teaching tool used to manage educational information and often to deliver education in addition to the traditional classroom environment is:

the learning management system.

Current research regarding the effectiveness of personal health records as an approach to improving healthcare has shown that:

the use of secure messaging in the PHR by individuals with diabetes was associated with better glycemic control. increased use of secure messaging by individuals with diabetes was associated with increased outpatient visits. personal health record use was associated with reduced telephone calls to the clinic and a reduced number of outpatient visits per year.

When very large amounts of data are available, large sets can be sampled for model development and validation. Which statement best describes key elements of model development and validation:

training data, incremental testing of data examples during training, and data held out from the training process for the purpose of unbiased performance estimation.