Health Care Information Systems (Exam 1)

Information System

Stuff and People working Together Arrangements of data (information), processes, people, and information technology that interact to collect, process, store, and provide outputs of information needed to support an organization.

Which standards development method occurs when a group of interested people or organizations agree on a certain specification without any formal adoption process? a. De facto b. Ad hoc c. Government mandate d. Consensus

b. Ad hoc

____________ gives a health care organization the authority to participate in the federal Medicare and Medicaid programs. a. Licensure b. Certification c. Accreditation d. Authorization

b. Certification

Assuming that a strategic IT plan already exists, the first step in a system acquisition process is which of the following? a. Screen the marketplace and review vendor profiles b. Establish a project steering committee and appoint a project manager c. Determine system goals d. Define project objectives and scope of analysis creen the marketplace and review vendor profiles

b. Establish a project steering committee and appoint a project manager

Health Insurance Portability and Accountability Act (HIPAA)

- 1996: Signed by President Bill Clinton *- Makes health insurance more affordable and accessible - Simplifies administrative processes* - Protects security and confidentiality of personal health information

What did the Health Information Technology for Economic and Clinical Health (HITECH) Act do?

-Established Medicare and Medicaid HER incentive programs -Funded regional extension centers to support meaningful use adoption -Funded workforce training programs to support health information technology professionals

What are Interoperability Standards

-Health Level Seven International (HL7): focused on technical standards for health information exchange -HL7 Fast Healthcare Interoperability Resources (FHIR): standards introduced in 2012 and are under development •Sequoia Project: focused on legal and policy barriers associated with nationwide interoperability •Commonwell Health Alliance: a consortium of HIT vendors and organizations who are committed to achieving interoperability

What are the two parts that make up MACRA?

-Value-based payment methods -Alternative payment methods

What are some alternate payment methods?

1) Accountable Care Organizations (ACOs) 2) Bundled Payments 3) Patient-Centered Medical Homes

What are the two primary types of Health Information Systems?

1) Administrative 2) Clinical

EHR Benefits

1.Quality, outcomes, and safety - Adherence to evidence-based care - Enhanced surveillance and monitoring - Decreased medication errors 2. Efficiency, improved revenues, and cost reduction 3. Provider and patient satisfaction

Outline how we got to where we are with HIT

1990's: The Call for HIT -IOM -HIPAA 2000 -2010: The Arrival of HIT -HITECH Act 2010 -Present: Health Care Reform and the Growth of HIT -ACA -MACRA -21stCentury Cures Act -Tax Cut and Jobs Act -Value-based & alternative payment programs Interoperability

Institute of Medicine (IOM)

1991: Published a report on the problems with paper-based medical records and called for computer-based patient records (CPR)

Institute of Medicine

1991: Published a report on the problems with paper-based medical records and called for computer-based patient records (CPR)

Health Insurance Portability and Accountability Act (HIPAA)

1996: Signed by President Bill Clinton -Makes health insurance more affordable and accessible -Simplifies administrative processes -Protects security and confidentiality of personal health information

Creation of the ONC

2004 -2005 Fed Government Pushes for EHR adoption with ONC Done through Executive Order by George W. Bush after the UK begun there's in 2003. Creation of Office of the National Coordinator for Health IT Federal ONC HIT budget $42M No money and no real authority

21st Century Cures Act

2016 - Designed to help accelerate medical product development and bring new innovations and advances to patients who need them faster and more efficiently authorized 4.8 Billion to fund large projects Amends HITECH act. Defines Interoperability - enables exchange of electronic health information without special effort on part of the user. To be certified EHR must be able to transmit and receive data from registries certified by ONC.

Define Commonwell Health Alliance:

A consortium of HIT vendors and organizations who are committed to achieving interoperability

Information Blocking

A practice by some electronic health record providers and developers that actively blocks transfer of electronic information between institutions with different electronic systems.

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

A. ONC (Office of the National Coordinator)

Information System (IS):

Arrangements of data (information), processes, people, and information technology that interact to collect, process, store, and provide outputs of information needed to support an organization.

Define MACRA

Medicare Access and CHIP Reauthorization Act

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

Biggest advancement of HIT gave loaaaadddddss of money $30B Dolla Dolla Bill Yall - Established Medicare and Medicaid HER incentive programs - Funded regional extension centers to support meaningful use adoption - Funded workforce training programs to support health information technology professionals

Behavioral Factors to change

Create an appropriate environment User expectations vary Clear and effective communication is key Do not underestimate user resistance Understand the culture BEFORE you make the investment

Medicare Modernization Act

Created in 2003; Allowed for rapid Advancement and adoption of e-prescribing in health care due to mandates

Define 21stCentury Cures Act (Cures Act):

Designed to help accelerate medical product development and bring new innovations and advances to patients who need them faster and more efficiently

T/F Technology is a barrier to interoperability

False

Define the Sequoia Project:

Focused on legal and policy barriers associated with nationwide interoperability

What are the two subcommittees of ONC?

HIT Policy and HIT Standards

What was part of the American Recovery and Reinvestment Act and provided billions of dollars of funding for Health IT growth in 2009?

HITECH ACT

What does HITECH Act stand for?

Health Information Technology for Economic and Clinical Health Act

Categories of IT investments by Objective Type

Infrastructure Enables other investments or applications to be implemented and deliver desired capabilities (e.g., data communication networks, workstations, clinical data repositories) Mandated May be necessary in order to comply with initiatives of accrediting bodies Cost Reduction IT systems to reduce cost, e.g. automation of processes to reduce staff Specific New Products and Services Involves consumer utilization, competitor response, and impact on related businesses Quality Improvement E.g., reduce waiting times, improve the ability of physicians to locate information, improve treatment outcomes, reduce errors in treatment Major Strategic Initiative Intended to significantly change the competitive position of the organization or redefine the core nature of the enterprise (MHS Gensis)

Is technology a barrier to interoperability?

NO!!!

Define Accountable Care Organizations (ACO)

Networks of providers that share responsibility for coordinating care and meeting health care quality and cost metrics for a defined patient population (Medicare Example)

Define ONC

Office of the National Coordinator for Health Information Technology (ONC)

Office of the National Coordinator for Health Information Technology (ONC)

Office of the National Coordinator for Health Information Technology (ONC)

What information is protected by HIPAA?

Oral or recorded in any form or medium THAT IS Created or received by a health care provider, health plan, public health authority, employer, life insurer, school/university, or health care clearinghouse THAT ISRelated to past, present, or future physical or mental health or condition of an individual.

Define PPACA (2010)

Patient Protection and Affordable Care Act

Main Purpose of Patient Records

Patient care - Main Purpose! • Communication • Legal documentation • Billing and reimbursement • Research and quality management • Population health • Public health

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

Planning and analysis, design, implementation, support and evaluation

Office of the National Coordinator for Health Information Technology (ONC)

Provides leadership for the development and nationwide implementation of an interoperable health information technology infrastructure

Medicare Modernization Act (2003)

Rapid Advancement and adoption of e-prescribing in health care due to mandates

Who does the director of ONC report to

Reports directly to Secretary of HHS

Information Technology

Stuff Term that describes the combination of computer technology (hardware or software) with data and telecommunications technology (data, image, and voice networks).

Define Information Technology (IT):

Term that describes the combination of computer technology (hardware or software) with data and telecommunications technology (data, image, and voice networks).

Which of the following is NOT a feature of a patient portal? a. Patients can contact their physician during off hours in emergency situations b. Patients can access test results c. Patients can request a refill on prescriptions d. Patients can view their account and pay their bill online

a. Patients can contact their physician during off hours in emergency situations

Explain what the HITECH Act.

The HITECH Act was legislatively mandated to provide leadership and oversight

The project steering committee should compile a final report. All of the following elements should be included except: a. Project repository b. Final recommendation and ranking c. System goals and criteria d. Cost-benefit analysis

a. Project repository

Which of the following is NOT considered one of the "three Vs" of big data? a. Validity b. Variety c. Velocity d. Volume

a. Validity

Interoperability

a. enables the secure exchange of electronic health information b. allows for complete access, exchange, and use of all e-health info

T/F CPOE is part of the electronic health record

True

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

a. Office of the Inspector General (OIG)

Which of the 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

a. A simplified, unifying corporate technology platform

Tableau can connect to what kind of data format? a. All of these b. Microsoft Excel____ c. JSON File d. Oracle Server

a. All of these

What are the major stated benefits of EHR systems? a. All of these b. Quality, outcomes, and safety c. Provider and patient satisfaction d. Efficiency, improved revenues, and cost reduction

a. All of these

Which of the following would help reduce errors during data collection and processing? a. All of these b. Institution real-time quality checking c. Building human capacity d. Standardize data entry fields

a. All of these

__________ 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. Interoperability b. Integration c. Coordination of Care d. Meaning Use

a. Interoperability

Despite the proliferation in the adoption and use of EHR systems, health care providers and organizations still face which three critical issues? a. Interoperability, usability, and health IT safety b. Interoperability, consistency, and training c. Interoperability, inefficiency, and quality d. Interoperability, standardization, and satisfaction

a. Interoperability, usability, and health IT safety

Which of the following statements best fit with Machine Intelligence? a. Machine intelligence is a prediction technology b. The cost of goods and services that rely on prediction are increasing c. All of these statements fit with Machine Intelligence d. The cost of prediction is increasing

a. Machine intelligence is a prediction technology

Which of the following is NOT a component of the HITECH Act? a. Funding for workforce training programs to support the education of HIT professionals b. Establishing value-based incentive programs c. Funding regional extensions centers to support providers in adopting and becoming meaningful users of EHRs. d. Establishing Medicare and Medicaid EHR Incentive Programs

b. Establishing value-based incentive programs

Which law made incentive money available for eligible professionals and hospitals to adopt and become "meaningful users" of EHR? a. HIPAA, 1996 b. Health Information Technology for Economic and Clinical Health (HITECH) Act, 2009 c. Medicare Modernization Act, 2003 d. None of these

b. Health Information Technology for Economic and Clinical Health (HITECH) Act, 2009

Who is principle entity responsible for implementation for U.S. health care IT standards for interoperability? a. Health Level Seven International (HL7) b. Office of the National Coordinator for Health IT (ONC) c. American National Standards Institute d. American Society for Testing and Materials

b. Office of the National Coordinator for Health IT (ONC)

Which of the following is NOT a person-generated health data (PHGD) technology? a. Fitbits b. Pace makers c. Food diary apps d. None of these (they are all examples)

b. Pace makers

Which of the following is NOT a mechanism used by a steering committee when determining system requirements? a. Representatives gather input from users in specific areas b. Request for proposals c. Focus-group sessions or small-group interviews d. Written or electronic surveys

b. Request for proposals

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. implementation b. design c. planning and analysis d. support and evaluation

b. design

HIPAA, signed into law in 1996, was designed primarily to: a. Make health insurance more affordable b. Protect the security and confidentiality of personal health information c. All of these d. Simplify administrative processes

c. All of these

Which of the following describes protected health information? a. Related to past, present, or future physical or mental health or condition of an individual b. Created or received by a health care provider, health plan, public health authority, employer, life insurer, school/university, or health care clearinghouse c. All of these d. Oral or recorded in any form or medium

c. All of these

What is the final step of the system acquisition process where expectations are outlined and performance requirements are determined with the vendor? a. Contract summary b. Vendor agreement c. Contract negotiations d. Vendor analysis

c. Contract negotiations

Using an abbreviation that has two different meanings is an example of a lack of: a. Data precision b. Data comprehensiveness c. Data consistency d. Data definition

c. Data consistency

Which federal agency recently released a proposed regulatory framework for Modifications to Artificial Intelligence/Machine Learning based Software as a Medical Device (SaMD) a. Federal Communication Commission (FCC) b. Federal Trade Commission (FTC) c. Food and Drug Administration (FDA) d. Office of the National Coordinator for Health IT (ONC)

c. Food and Drug Administration (FDA)

Which of the following is the largest barrier to health information exchange? a. Technology b. Incentive programs c. Health information blocking d. None of these

c. Health information blocking

What is the universal product identifier for all human drugs? a. None of these b. Logical Observation Identifiers Names and Codes (LOINC) c. National Drug Code (NDC) d. National Library of Medicine's Unified Medical Language (UMLS)

c. National Drug Code (NDC)

Which of the following is NOT a pitfall in the acquisition process? a. Assigning too little weight to the RFP process b. Turning negotiations into a blood sport c. Not defining criteria and methods for selecting the vendor d. All of these are pitfalls

d. All of these are pitfalls

Which of the following is NOT a basic element of health care data analysis? a. Data must be reported in a usable manner b. Data must be stored in a retrievable manner c. An analytical tool must be applied to the data d. Data must be verified and cleaned

d. Data must be verified and clearned

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

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

Which of the following is the primary purpose for creating and maintain patient records? a. Legal documentation b. Billing and reimbursement c. Communication d. Patient Care

d. Patient Care

Which of the following initiatives led to the rapid advancement and adoption of e-prescribing in health care due to mandates? a. The HITECH Act b. None of these c. HIPAA d. The Medicare Modernization Act of 2003

d. The Medicare Modernization Act of 2003

__________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 development b. System implementation c. System selection d. System acquisition

d. system acquisition

Accountable Care Organizations (ACO):

networks of providers that share responsibility for coordinating care and meeting health care quality and cost metrics for a defined patient population

Electronic Health Record

• Total Health of Patient • Care outside the office • Share information between providers • Decision Support and CPOE

Electronic Medical Record

• Track Data over time • Easily identify scheduled preventative measures • Monitor and improve the overall quality of care within the practice

Health Insurance Portability and Accountability Act (HIPAA)

•1996: Signed by President Bill Clinton •Makes health insurance more affordable and accessible •Simplifies administrative processes •Protects security and confidentiality of personal health information

Discuss Health Information Technology for Economic and Clinical Health (HITECH) Stimulate adoption of EHR's

•2009 Fed HIT budget $30B •Provided incentive money to adopt electronic health systems •Meaningful Use program (Now named "Promoting Interoperability") •Rules for receiving this funding were issued in July 2010

Features and Functions of Electronic Health Records

•Electronically collect and store patient data •Supply information to providers •Supply information to researchers •Allow direct input into a computerized provider order entry (CPOE) system •Advise health care practitioners -Clinical Decision Support (CDS)

What are Interoperability Barriers?

•Governance and alignment of agendas among disparate organizations •NOT technology •Health information blocking: occurs when persons or entities knowingly or unreasonably interfere with the exchange or use of electronic health information. This is currently the largest barrier for health information exchange.

What does Computerized Provider Order Entry (CPOE) do?

•Physician places clinical orders into computer (rather than writing on paper) •Orders results post in system for viewing •Numerical results can be trended •Enables real time decision support to guide and direct LIP clinical behavior

Define Electronic Health Record

•Total Health of Patient •Care outside the office •Share information between providers •Decision Support and CPOE

Define Electronic Medical Record

•Track Data over time •Easily identify scheduled preventative measures •Monitor and improve the overall quality of care within the practice