HSCI 310
What is the primary goal of nanomedicine?
The use of nanotechnology for the prevention, diagnosis, and treatment of disease
Nanoparticles appear to have a very bright and meaningful future in the world; however, what is one potential issue with nanoparticles?
There are cytotoxicity and ethical concerns regarding the use of nanoparticles.
Which statement is true of Meaningful Use?
They are a set of criteria created by the ONC to determine eligibility for financial incentives for health information technology adoption and use
The Future of Nursing report listed all of the following opportunities to transform nursing practice through technology EXCEPT:
fast-tracking nurse education to grow the ranks of nurse practitioners.
Well-defined health IT policies are necessary to ensure that: (Select all that apply.)
confidentiality of protected health information is safeguarded., data capture is being automated., clinical decision support is adopted.
A nurse is asked by the nursing manager to review electronic comments left by patients on the unit's Facebook page. The nurse examines the comments for common themes. This is an example of:
content analysis.
Which of these best describes participatory medicine?
cooperative care model
The HITECH portion of ARRA was meant to do all of the following EXCEPT:
coordinate healthcare delivery standards with international healthcare bodies.
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.
One trend that is influencing healthcare reform is:
disruptive technology
Standard terminologies can be used to do all of the following, except:
decrease system-wide susceptibility to malware and hacking.
Informatics opportunities for reportable conditions include: (Select all that apply.)
enabling the use of computable logic to define where and how reports should be sent., automation of information extraction from electronic health records., improving standardization of message structure and content for reporting., creating public health information systems to receive case reports.
Social media policies should contain: (select all that apply)
guidance on acceptable behavior, methods for handling unacceptable behavior, a statement to promote ethical behavior
Health informatics is both a ____________as well as a_______________.
profession; discipline
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.
A commonly used model for healthcare system change is the systems life cycle (SLC). This model describes stages or phases of an informatics project and it guides system implementation from initial feasibility through a more completed stage of maintenance and evaluation of the products. The Staggers and Nelson Systems Life Cycle Model (SLCM) includes:
Analyze, plan, develop/purchase, test, implement/go-live/maintenance and evolve, and evaluate and return to analyze.
As organizations mature over time in their use of data science, they progress from what to what?
Exploratory data analyses; prescriptive analytics
Using Tall Man Lettering in similar drugs' labels helps solve which iatrogenesis error?
Look-alike names
Why have most clinical decision support (CDS) systems not shown to significantly impact patient outcomes in clinical trials, despite the fact that a majority of systems have been shown to significantly improve care processes?
Many CDS system evaluation trials are underpowered to detect changes in care outcomes.
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. (Select all that apply.)
Methods selected and few targeted outcomes, Research with statistical evaluation of models
National efforts to improve the user experience are under way in the United States. One organization involved with this effort is the:
National Institute of Standards and Technology.
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.
Which incentive has the strongest potential to spur the nationwide adoption of advanced CDS?
Shift of healthcare payment from a fee-for-service model to approaches rewarding the delivery of better quality and outcomes at lower cost
You are asked to justify the creation of the first public health informatics (PHI) program in your jurisdiction by emphasizing its actual benefits. One such benefit is that:
current PHI can enhance public health surveillance such as identifying clusters of diseases.
The MARS mHealth app rating scale measures: (select all that apply)
engagement, information, aesthetics
An important component of the informatics infrastructure is:
establishment and adoption of standards to support semantic interoperability.
You are part of a knowledge management team that is interested in improving the user experience for your organization. The team members know you have taken a course in informatics and ask your advice about how to get started with usability in the organization. You recommend:
examining the support call lists and system change requests.
A business continuity plan for your organization would include: (Select all that apply.)
expected time to recovery based on the requirement for service and available resources., which systems can be excluded from initial recovery.
Public health systems have implemented vocabulary and messaging standards, are used to make public health decisions in a clinical setting, and provide data for public health policy. One of the best examples of a public health system that does all of these is:
immunization information systems.
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.
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.
Task analysis may involve: (Select all that apply.)
speaking to application users about their experiences., quietly and unobtrusively watching as a user interacts with an application., conducting ethnographic studies.
What are the main types of personal health records (PHRs)?
tethered, untethered, stand-alone, and networked
Healthcare providers should friend patients only if:
they understand their social media policy at work
Who is most likely to seek health information from social network sites?
those living with chronic conditions
To automatically track the quality of care, standardized quality measures are needed in order to: (Select all that apply.)
use consistent metrics., benchmark., standardize data collection.
Which statement concerning educational programs in health informatics is correct?
Health informatics programs range from certificate programs offered at the community college level to post-doctoral programs offered at major research institutions.
____________facilitates sharing of health information and exchange of data in accordance with the HITECH Act of 2009.
Health information organization
A healthcare system has implemented a functionality where patients who are overdue or almost due for a mammogram are sent letters notifying them to schedule a mammogram based on available data and current clinical care guidelines. Which type of CDS system is this?
A reminder system
Which of these best describes an example of usability?
A researcher is conducting a study of how nurses interact with electronic documentation to organize care handoffs.
Which example constitutes an internal security event?
A system administrator installed a new server without any security measures.
A nurse gives a patient the wrong drug. This is an example of an error of:
commission.
What was the first professional association to express interest in accreditation for health informatics-related educational programs?
AHIMA
An organization implements a policy on installing software service packs on all its computers. This is an example of which type of control?
Administrative
Which of the following would be regulated by the FDA?
An app that functions as a medical device
Which description best defines the electronic health record (EHR)?
An electronic record of patient health information created by encounters across multiple settings
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
Which system is recommended as a method to address patient safety and reduce errors that occur during the actual administration of medicines?
Barcode medication administration (BCMA)
A university hospital wants to implement a closed-loop medication management system. Current systems include registration, computerized provider order entry, electronic medication administration record, laboratory, radiology, and pharmacy. Which system is needed to complete the loop?
Barcoding system
Nurses, pharmacists, physicians, therapists, and patients learn new informatics applications from using organizing structures and outlines that are based on previous practice knowledge. Which technology-related literacies guide this learning process?
Basic, computer, information, digital, and health literacies
ICD-9 and ICD-10 are examples of which category of terminology?
Billing code
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
What are two major theories that help us analyze and explain the occurrences or instances of certain phenomena with health informatics? (Select all that apply.)
Chaos theory, Information theory
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)
All data instances within patient clinical records are collected and stored in what component of the electronic health record?
Clinical data repository
Which issues are considered impediments to a fully functional electronic health record (EHR) system? (Select all that apply.)
Cost, Standardization, Organizational culture, Privacy and confidentiality
Which is true of both HITECH and MACRA?
HITECH offers incentives to both physicians and hospitals while MACRA is focused on physicians.
Which international organization develops and maintains standards for data exchange?
Health Level 7 (HL7)
A healthcare provider forgets to update a patient's medications. Which fair information principle is being violated?
Data quality and integrity
Which methods are examples of data mining? (Select all that apply.)
Decision trees, Bayesian networks, Artificial neural networks
What are the advantages of telehealth for patients? (Select all that apply.)
Decreased travel time or distance and removal of travel barriers, Immediate access to care, Early detection of disease processes or health issues, Ownership of healthcare and feelings of empowerment
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 government organization manages the largest telehealth program in the United States as of this writing?
Department of Veterans Affairs
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
Which one of these characteristics of informatics interventions are measured during program evaluation?
Effectiveness in decision support or identifying patients
The eHealth network is a voluntary network of representatives from where?
Europe
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.
Why is it difficult to establish effective health IT governance?
Fundamentally, effective governance means that some stakeholders' informatics needs will need to be de-prioritized
The trend in healthcare IT is shifting from what to what?
IT infrastructure being developed in-house to data warehouses developed by vendors and in-house resources
Financial reporting is a vital part of decision making in healthcare organizations. Which report would be used to show a snapshot of the bottom line?
Income statement or statement of operations
Stage 3 of Meaningful Use includes which of the following? (Select all that apply.)
Instituting computerized provider order entry, Providing education resources identified by CERHT to patients, Using computerized provider order entry for a majority of medication orders
Why is CDS important for healthcare institutions? (Select all that apply.)
It can help reduce medical errors., It is a required element of Meaningful Use regulations., It can help improve care value.
Why is health IT governance needed? (Select all that apply.)
It ensures the alignment of informatics resources with institutional priorities., It effectively prioritizes the use of informatics resources., It optimizes the return on investment on informatics investments.
Which languages does the nursing profession consider national and international "data standards" that they wish to cross-map their own terminologies to? (Select all that apply.)
LOINC, SNOMED CT
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 compatibility achieve intent. What protects the vendor's intellectual property within the software?
License
What are some examples of indirect costs to organizations that have security breaches? (Select all that apply.)
Lost productivity, Damaged public trust, Remediation costs
Which payer is the largest for home health services?
Medicare
Which issue is a deterrent to global interoperability?
Multiple terminologies used in describing and documenting healthcare
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.
Which phase of the systems development life cycle involves project management and organizing a team?
Plan
An innovative prospective research design that uses data gathered from current practice to identify what care processes work in the real world is known as __________________.
Practice based evidence
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
When evaluating quality and patient safety, which approach defines the framework for Patient Safety and Quality Research Design (PSQRD)?
Quality and safety are based on organizational structure, management and clinical processes, and their linkages to patient outcomes.
Which terminology serves as a resource to represent domain knowledge of interest and thus facilitates data collection, processing, and aggregation using computer processing?
Reference terminology
Which specialized method is used in knowledge discovery and data mining?
Selection of the optimal subset of variables/features for use in modeling
Select the option that best describes the current major challenges for informatics infrastructure.
Storage architectures, lack of implemented standards, and applications match clinical workflow
As EHR adoption expands to include data from multiple healthcare entities, more opportunities for error exist. Which process can affect data integrity?
System failure
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? (Select all that apply.)
Test the new functionality and discover any dependencies., Establish methods to communicate to senior leadership, staff, and the community.
By what legal code or precedent are powers not granted to the federal government reserved by the states?
The 10th Amendment to the U.S. Constitution
A vendor provided all advanced practice registered nurses with free mobile devices to stimulate referrals. Which regulation is being violated?
The Anti-Kickback Statute
What is the office of the Department of Health and Human Services that is charged with overseeing nationwide efforts to implement and use health IT and electronic exchange of health information?
The Office of the National Coordinator (ONC)
What are the primary goals for using EHRs in home health and related community-based systems? (Select all that apply.)
The correct answers are: To provide an effective and efficient method for tracking cost and related billing, To capture clinicians' documentation that supported interaction with patients at the point-of-care, To support clinical decision making and quality of care by presenting best practices and evidence-based practice options, To improve communication
Which technical development created a tension between centralized and decentralized computer management in healthcare?
The development of the personal computer
What is the first factor in deciding on an optimal health IT governance for an institution?
The organizational culture
Why is it important for software used by nurses who work for home health and related community-based systems to be based on a standardized terminology? (Select all that apply.)
To support evidence-based practice, To generate reports needed to monitor care, improve the quality of services, and track costs, To improve communication among care providers at multiple locations, To describe and quantify practice for clinicians, managers, administrators, and third-party reviewers
Which of the following data characteristics are important in understanding big data in healthcare? (Select all that apply.)
Variety, Velocity, Volume
What defines Health 2.0? (select all that apply)
Web based content, Social networks, Health related mobile applications
E-mailing fraudulent claims from an office in Charleston, WV, to a Medicare facility in Washington, D.C., for medical care not actually performed would constitute what?
Wire fraud as well as a violation of the False Claims Act
What defines the "Google Generation"?
a person who desires immediate access to information and is internet savvy
Point of care decision support tools contained within a mobile device all rely on:
accurate algorithms and protocols
Which is not a major driving force fueling the mHealth movement?
an aging society
Differences between formative and summative evaluation include:
assessments
Your organization acknowledges that providers want to improve their user experience with health information technology (IT) products. You want to raise awareness of the potential benefits to the organization. You could draw on stated benefits such as:
improved productivity, patient safety, and decreased customer support costs.
The Health Information Portability and Accountability Act (HIPAA) requires that: (select all that apply)
individuals be granted access to their healthcare records upon request, healthcare providers keep an audit trail of access to an individual's record
All of the following are among the 3 biggest mHealth challenges identified by experts in the US except:
interoperability
The technical hurdle of successfully sharing a patient's data between a hospital in Charleston, WV, and a specialist in Cleveland, OH, requires:
interoperability, which requires standards to be in place.
The NIC system includes:
interventions for illness prevention.
The "digital divide" refers to:
lower adoption and use of information technologies among individuals from ethnic minorities, of lower socioeconomic status, and of older age
Legal and regulatory issues directly impacting telehealth practice for healthcare providers include: (Select all that apply.)
malpractice., licensure., credentialing., reimbursement.
A health analytics professional must be skilled in all of the following except:
management and economics.
Current research shows the lowest quality, or most limited, evidence for the usefulness of mHealth in:
managing asthma outcomes
The visual representation that illustrates what is occurring and how one understands the intervention to solve a problem is called a:
model.
An organization decides to utilize a silver nanoparticle in the production of a product in order to make the product antimicrobial. This is an example of:
nanofabrication.
It is important to monitor and track unintended consequences of health IT implementation because:
not much is known and we need to learn more.
A nurse forgets to walk a patient during the nurse's shift. This is an example of an error of:
omission.
Return on investment (ROI) in financial information systems (FISs) is challenging because:
patient accounting is considered an intangible asset.
Which group is allowed to share personal health information on social media sites?
patients/consumers
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?
purpose, functions, and internal and external structures.
Using social media tools for research purposes helps: (select all that apply)
recruit patients, identify new variables to study, provide insight into the patient's experience, promote data sharing and communication within a disease population
Contemporary organizations need formal structured change control processes that:
reduce variability across processes and provide standardization across projects.
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.
An ePatient is best described as one who:
seeks health information from various sources and uses the information for decision making with health providers
The options for cloud computing are best described as:
software, infrastructure, and platform as a service.
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 most commonly used functions of personal health records are:
viewing test results and medication refills
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.
