Domain 3 Data analytics and informatics
212. A coding service had 400 discharged accounts to code in March. The service coded 200 within 3 days, 100 within 5 days, 50 within 8 days, and 50 within 10 days. The average turnaround time for coding in March was: a. 3 days b. 5 days c. 6.5 days d. 9 days
212. b The average turnaround time was calculated by dividing the total response days attributed to the volume of routine requests that were responded to within the reporting period by the volume of routine requests responded to. The calculation is: (200 × 3) + (100 × 5) + (50 × 8) + (50 × 10)/400 = 5 days (Oachs 2020, 778).
213. An organization's productivity standards should reflect its: a. Goals b. Vision c. Procedures d. Affinity groupings
213. a Productivity standards should be aligned with the organization's mission and goals of the organization (Oachs 2020, 772).
214. The fact that a patient entered data into an EHR via a portal is: a. Administrative metadata b. Captured in a data model c. E-discovery d. Software programming
214. a The provenance (or source) of data is considered a form of administrative metadata. The other choices relate to metadata, but are not illustrative of any given form of metadata (Amatayakul 2020, 437-438).
215. Hospitals often use master patient indexes to do which of the following? a. Analyze population-based data b. Determine survival rates c. Evaluate physicians d. Determine whether a patient has been seen in the facility before
215. d Master patient indexes (MPI) contain important patient health information enabling facilities to retrieve patient health data quickly. The MPI allows a hospital to determine whether a patient has been seen in the facility before (Sharp and Madlock-Brown 2020, 177).
216. The root cause of poor quality of data in the EHR can be determined by: a. Benchmarking against best practices b. Determining patient mortality rates c. Measuring patient care outcomes d. Observing how an EHR is used
216. d Observing how an EHR is used, such as whether comment fields are frequently used when structured data should have been used or first choice in a list is selected over a choice that is more specific, is the best way to determine root cause of poor quality of data. Other choices may be indicators of poor quality but also include other factors as well (Amatayakul 2020, 439).
217. Which statistical inference measures both the strength of a relationship between two variables and the functional relationship between them? a. Correlation b. T-test c. Simple linear regression d. Standard deviation
217. c Simple linear regression (SLR) is another type of statistical inference that not only measures the strength of the relationship between two variables, but also estimates a functional relationship between them. SLR may be used when one of the two variables of interest is dependent on the other (White 2020b, 517).
218. Which of the following is a task performed during system customization? a. Adjusting decision support rules b. Data conversion c. Testing d. Workflow and process improvement
218. a System customization enables an organization to make adjustments to how software is used and displayed. Adjusting decision support rules (such as turning them off, or narrowing the specifications for a given rule) are made possible by vendor-supplied tools that do not impact the underlying software (Amatayakul 2020, 427).
219. An example of EHR data stewardship that would be required of the average healthcare professional is: a. Contributing to the design and development of data requirements for an EHR b. Ensuring that structured data is entered when such a choice is available in an EHR c. Maintaining EHR data in an appropriately configured information system d. Not sharing EHR data with others who have a need to know
219. b Stewardship refers to taking care of something you own or have been entrusted with. Given the choices here, EHR data stewardship is exemplified by ensuring proper data entry; contributing to design and maintaining data in an information system are beyond the requirements of the average healthcare professional and not sharing data appropriately is actually not good data stewardship (Amatayakul 2020, 438-439).
220. HIE ________ is concerned with the establishment of a shared set of behaviors and standards that enable health information exchange among a HIE's participants. a. Governance b. Trust community c. Workflows d. Interoperability standards
220 a Agreeing on standards and how they are to be implemented for successful mapping between systems is an important part of governance (Lee-Eichenwald 2020, 387).
221. In order to effectively transmit healthcare data between a provider and a payer, both parties must adhere to which electronic data interchange standards? a. DICOM b. IEEE 1073 c. LOINC d. X12N
221. d X12N refers to standards adopted for electronic data interchange. In order for transmission of healthcare data between a provider and payer, both parties must adhere to these standards (Sayles and Kavanaugh-Burke 2018, 211).
222. The surgery department is evaluating its postoperative infection rate of 6 percent. The chief of surgery asks the quality improvement coordinator to find the postoperation infection rates of 10 similar hospitals in the same geographic region to see how the rates compare. This process is called: a. Benchmarking b. Critical pathway analysis c. Internal comparisons d. Universal precautions
222. a Benchmarking is the systematic comparison of the products, services, and outcomes of an organization with those of a similar organization. Benchmarking comparisons also can be made using regional and national standards or some combination (Shaw and Carter 2019, 42).
223. The statement "Coding of inpatient records must be completed at a 98 percent accuracy rate" is an example of a: a. Goal b. Vision statement c. Qualitative standard d. Quantitative standard
223. c Qualitative standards specify the level of service quality expected from a function, such as accuracy rate. For example, assignment of diagnostic and procedure codes for inpatient records is at least 98 percent accurate (Oachs 2020, 772).
224. To ensure quality of data, the cancer committee reviews the abstracting done by the cancer registry personnel. This type of reliability check is called: a. Precision b. Recheck c. Interrater d. Construct
224. c Reliability is frequently checked by having more than one person abstract data for the same case. The results are then compared to identify any discrepancies. This is called an interrater reliability method of checking. Several different people may be used to do the checking. In the cancer registry, physician members of the cancer committee are called on to check the reliability of the data (Houser 2020, 571).
225. A clinic that is expanding its service offerings and needs an individual to help design a new database will be searching for a: a. Data administrator b. Database administrator c. Data governance manager d. Data technologist
225. a A data administrator focuses on understanding interrelationships among data in order to prepare a logical design for a database. A database administrator is an information technology specialist in database implementation and maintenance. Data governance managers are, typically, users of databases. Data technologist is not a commonly used job title, but it may be one who manages metadata (Amatayakul 2020, 414).
226. A researcher mined the Medicare Provider Analysis Review (MEDPAR) file. The analysis revealed trends in lengths of stay for rural hospitals. What type of investigation was the researcher conducting? a. Content analysis b. Effect size review c. Psychometric assay d. Secondary analysis
226. d Secondary analysis is the analysis of the original work of others. In secondary analysis, researchers reanalyze original data by combining data sets to answer new questions or by using more sophisticated statistical techniques. The work of others created the MEDPAR file (Houser 2020, 563).
227. A data model is used to: a. Define every data element in an information system b. Describe how data are used in creating information c. Display information to users in a meaningful way d. List the attributes of data
227. b A data model is an important part of describing how data will be processed. It has other uses as well, but the model itself does not define the data, show how it is displayed, or list attributes. Most of these functions are performed by a data dictionary (Amatayakul 2020, 437).
228. A way to assess the quality of data in the EHR is to: a. Audit structured data entries b. Compare data in the EHR to dictated documents c. Determine an acceptable error rate d. Review data against established norms
228. a Auditing structured data can reveal a number of potential data quality issues, such as when all choices for a structured field are the same, when a structured field is often empty. Comparing data in the EHR to dictated documents is an extremely time-consuming process and would only be used after auditing structured data; there are virtually no established norms for quality specific to a given data element, and determining an acceptable error rate is not an assessment of quality (Amatayakul 2020, 439).
229. A healthcare facility has decided to adopt a tool that helps with multidisciplinary care planning. What tool meets these criteria? a. Clinical pathways b. Clinical practice guidelines c. Clinical provider order entry d. Electronic health record
229. a Clinical pathways are a tool designed to coordinate multidisciplinary care planning for specific diagnoses and treatments (Sayles and Kavanaugh-Burke 2018, 6).
230. Which of the following statements justifies the use of a dashboard? a. It facilitates budget development. b. It manages information system projects. c. It utilizes statistical techniques. d. It monitors key measures.
230. d Dashboards are reports of process measures to help leaders follow progress to assist with strategic planning. The dashboard provides the status on key measures (Sayles and Kavanaugh-Burke 2018, 8).
231. The performance standard "Complete five birth certificates per hour" is an example of a: a. Quality standard b. Quantity standard c. Joint Commission standard d. Compliance standard
231. b Quantity standards (also called productivity standards) and quality standards (also known as service standards) are generally used by managers to monitor individual employee performance and the performance of a functional unit or the department as a whole. To properly communicate performance standards, managers need to make the distinction between quantitative and qualitative standards and identify examples of each for the HIS functions. In the scenario, completing five birth certificates per hour is identifying the quantity of work rather than how well the work is being performed so it is a quantity standard (Oachs 2020, 773).
232. This type of chart is used to focus attention on any variation in a process and helps the team to determine whether that variation is normal or a result of special circumstances. a. Pareto chart b. Pie chart c. Control chart d. Line chart
232. c Control charts can be used to measure key processes over time. Using a control chart focuses attention on any variation in a process (Shaw and Carter 2019, 88-89).
233. The decision has been made to perform data mining to determine where the skilled nursing facility is profitable and where there is a loss. Identify a data mining technique that could be used. a. Association rule learning b. Normalization c. Computer-aided software engineering d. Data modeling
233. a Association rule learning is a type of data mining identifies interesting relationships between two concepts in the database. For example, it may identify that patients who are treated with drug A have a better outcome than patients who are treated with drug B (Sayles and Kavanaugh-Burke 2018, 38).
234. Tina is the EMPI coordinator for Smithtown Healthcare, a large medical center with many satellite clinics. Because so many patients visit the clinics, sometimes new health record numbers are mistakenly assigned to them (even though they may already have a number) when they register for a particular service. As the EMPI coordinator, Tina performs all of the following tasks as part of her regular job duties except: a. Unmerging overlays b. Merging duplicate records c. Confirming the health record contains all patient visits d. Verifying insurance status
234. d The challenge for facilities is to maintain a correct and current MPI so that each patient has a unique identifier number. Duplication and overlays and overlap are major problems. Healthcare facilities have hired HIM professionals as EMPI coordinators to clean and maintain EMPI systems to ensure that the correct information on the correct patient is available to the provider and others who need it. Verifying insurance status would not be part of the job duties of an EMPI coordinator (Reynolds and Morey 2020, 132).
235. What type of interoperability addresses the medical words, phrases, and terms used in healthcare and their definitions so that there is clear and consistent usage among all EHR systems? a. Process b. Technical c. Semantic d. Syntactic
235. c This process involves the use of standardized terminologies, such as SNOMED-CT, to provide clarity, consistency, and appropriate meaning in HIE (Sayles and Kavanaugh-Burke 2018, 183).
236. What component of an EHR provides communication between clinical and administrative staff members, offers access to various results reporting from lab and radiology, and even communicates with patients? a. Clinical messaging b. Clinical decision support c. Document management system d. Registration—admission, discharge, transfer
236. a Clinical messaging is the function of electronically delivering data and automating the workflow around the management of clinical data. Clinical messages can use e-mail, portals, virtual private networks, and other means to provide the secure means of communication needed for patient information. These messages are shared in such a way as to protect the privacy of the patient (Sayles and Kavanaugh-Burke 2018, 154).
237. The HIM director is performing a staffing analysis to determine the number of employees needed to prep, scan, index, and carry out quality control on scanned medical records. Given a turnaround time of 24 hours and an average number of 48,000 images to be captured and considering the benchmarks listed here, what is the least number of employees the department needs, with each employee working an eight-hour shift? a. 25 employees b. 36 employees c. 36.1 employees d. 37 employees
237. a The staffing level is determined by dividing the number of images by the expected productivity. An FTE is the total number of workers, including part-time, in an area as the equivalent of full-time positions. Divide 48,000 by maximum standard work per hour for each function then add up the calculated hours for each function and divide by 8 (White 2020a, 157).
238. Keith is the supervisor of the MPI and chart deficiency review staff in the HIM department, which also includes being the liaison for the billing department and the R-ADT staff. He frequently meets with Michael, the R-ADT supervisor, to discuss methods to combat healthcare fraud and to verify that the patients are who they say they are and that they have the appropriate documentation for verification. This process is called: a. Consent management b. Identity management c. Identity matching d. Patient identification
238. c Identity matching (also known as patient matching) is the process in which the facility identifies the right person within the database to exchange information between healthcare organizations. The process examines different demographic elements from different health information technology systems to determine if they refer to the same patient (Sayles and Kavanaugh-Burke 2018, 195).
239. How are employee performance standards used? a. To communicate performance expectations b. To assign daily work c. To describe the elements of a job d. To prepare a job advertisement
239. a Standards that are measurable and relevant to an employee's overall performance are helpful in setting clear expectations. They also are useful in providing constructive feedback (LeBlanc 2020, 701).
240. What is the term for health records maintained by patients or their families? a. Electronic health records b. Mixed-media records c. Personal health records d. Longitudinal health records
240. c Personal health records electronically populate elements or subsets of protected health information (PHI) from provider organization databases into the electronic records of authorized patients, their families, other providers, and sometimes health payers and employers. A range of people and groups maintain the records, including the patients, their families, and other providers (Reynolds and Morey 2020, 117).
241. What sets the acceptable level of quantity and quality for each function of a job? a. Performance standards b. Position descriptions c. Job procedures d. Job evaluation
241. a Performance standards are often developed for the key functions of the job and set the quantity and quality for each job function (LeBlanc 2020, 700).
242. The following table shows the LOS for a sample of 11 discharged patients. Using the data listed, calculate the range. a. 29 b. 1 c. 5 d. 28
242. d The range is the simplest measure of spread. It is the difference between the smallest and largest values in a frequency distribution: Range = xmax - xmin For this scenario, the range is 1 to 29 (29 - 1) or 28 (White 2020a, 182).
243. Which application uses statistical techniques to determine the likelihood of certain events occurring together? a. Predictive modeling b. Standard deviation c. T-test d. Serial numbering
243. a Predictive modeling applies statistical techniques to determine the likelihood of certain events occurring together (White 2016a, 7-8).
244. The following question was typed into the system: How many patients were discharged on November 12, 2020? This is an example of what type of query? a. Data manipulation language b. Structured query language c. Query by example d. Natural language query
244. d Natural language queries use common words to tell the database which data are needed (Sayles and Kavanaugh-Burke 2018, 29).
245. The generic formula for calculating rate of occurrence is used to calculate hospital-acquired infections in an intensive care unit in a given month. If the number of hospital-acquired infections is the numerator, the denominator would be the: a. Number of patients who died of infection b. Number of deaths in the ICU c. Number of discharges (including deaths) of ICU patients d. Total number of hospital discharges
245. c Hospital-acquired (nosocomial) infection rates may be calculated for the entire hospital or for a specific unit in the hospital. They also may be calculated for the specific types of infections. Ideally, the hospital should strive for an infection rate of 0.0 percent. The formula for calculating the hospital-acquired, or nosocomial, infection rate is: Total number of hospital-acquired infections for a given period/Total number of discharges, including deaths, for the same period × 100 (Edgerton 2020, 490).
246. A hospital allows the use of the copy functionality in its EHR system for documentation purposes. The hospital has established explicit policies that define when the copy function may be used. Which of the following would be the best approach for conducting a retrospective analysis to determine if hospital copy policies are being followed? a. Randomly audit EHR documentation for patients readmitted within 30 days. b. Survey practitioners to determine if they are following hospital policy. c. Institute an in-service program for all hospital personnel. d. Observe the documentation practices of all clinical personnel.
246. a Auditing a random selection of EHR documentation would be the best approach for avoiding selection bias and in determining how the copy function is being used (Houser 2020, 562).
247. This type of data display tool is used to illustrate frequency distributions of continuous variables, such as age or length of stay (LOS). a. Bar graph b. Histogram c. Pie chart d. Scatter diagram
247. b A histogram is used to display a frequency distribution. It is different from a bar graph in that a bar graph is used to display data that fall into groups or categories (nominal or ordinal data) when the categories are noncontinuous or discrete (Marc 2020, 538).
248. How long should the master patient index be maintained? a. For at least 5 years b. For at least 10 years c. For at least 25 years d. Permanently
248. d The master patient index (MPI) is a permanent database including every patient ever admitted to or treated by the facility. Even though patient health records may be destroyed after legal retention periods have been met, the information contained in the MPI must be kept permanently (Reynolds and Morey 2020, 132).
249. Due to an influenza epidemic in Smithtown, the hospital is almost at full capacity. Which information system would be used to efficiently manage resources such as personnel, beds, and appointments of surgeries and CT scans, to coordinate equipment and staff as needed? a. Registration—admission, discharge, transfer b. Financial c. Scheduling d. Administrative
249. c Scheduling systems are used to control the use of resources throughout the healthcare facility. These resources can include staff, equipment, rooms, and more. Scheduling systems may be centralized or independent (Sayles and Kavanaugh-Burke 2020, 118).
250. An EHR system is programmed by the vendor not to release certain patient data because it is considered proprietary to the vendor and a healthcare organization. The vendor is protecting its own business interests above that of the patient. This is an example of: a. Continuity of care record b. Graphic user interface c. HIPAA security breach d. Health information blocking
250. d Health information blocking occurs when persons or entities knowingly and unreasonably interfere with the exchange or use of electronic health information. Blocking stems from healthcare providers or HIT vendors protecting their own proprietary and business interests above the interests of the patient and healthcare improvement. These efforts actively impede the progress sought by the concept of EHRs and health information exchange (Sayles and Kavanaugh-Burke 2018, 150).
251. What trend can be summarized from the line plot shown in the chart? a. The length of stay has increased for hospital A and decreased for hospital B since the first quarter. b. The length of stay for both hospitals decreased during the third quarter. c. The length of stay has decreased for hospital A and increased for hospital B since the first quarter. d. The length of stay for both hospitals increased during the third quarter.
251. c A line plot is used for two main purposes: (1) to present trends or patterns in the number of occurrences between groups or (2) to present trends or patterns in the mean of a variable between groups. Typically, the change of a variable over time is compared. In this case, the trend that can be summarized by this line plot is that the LOS for Hospital B has increased and for Hospital a has decreased since the 1st quarter (Marc 2020, 537).
252. Identify the true statement regarding training. a. A variety of methods should be used to accommodate different learning styles. b. Training should be limited to the information system only. c. Training should be performed a minimum of six months prior to implementation of the information system. d. In order to facilitate training, all employees should receive the exact same training regardless of their position.
252. a People learn best in different ways, such as auditorily and visually. To accommodate these differences, a variety of methods should be used in training (Sayles and Kavanaugh-Burke 2018, 76).
253. An HIM professional was conducting an audit to evaluate the timeframes for the administration of painkillers in surgical patients, and the medication administration record would be reviewed. The medication administration record would be found within which clinical software? a. Nursing b. Laboratory c. Radiology d. Pharmacy
253. a Nursing documentation traditionally includes medication administration record. These records are maintained by nursing staff for all patients and include medication given, time, form of administration, and dose and strength (Reynolds and Morey 2020, 114).
254. What type of data mining technique would be used to group diagnoses? a. Association rule learning b. Anomaly detection c. Regression analysis d. Classification analysis
254. d Classification analysis is a method of identifying important information about the data in the database by grouping data much like grouping diagnoses and procedures Sayles and Kavanaugh-Burke 2018, 38).
255. What term is used for a centralized database that captures, sorts, and processes patient data and then sends it back to the user? a. Clinical data repository b. Data exchange standard c. Central processor d. Digital system
255. a A clinical data repository is a centralized database that captures, sorts, and processes patient data and then sends it back to the user (Amatayakul 2017, 24).
256. Dr. Jones comes into the HIM department and requests that the HIM director provide a list of all of his patients from the previous year in which the principal diagnosis of myocardial infarction was indicated. Which index would the HIM director query from to provide Dr. Jones with this information? a. Disease index b. Master patient index c. Operative index d. Physician index
256. a A disease index is a listing in diagnosis code number order for patients discharged from the facility during a particular time period. Each patient's diagnoses are converted from a verbal description to a numerical code, usually using a coding system such as the International Classification of Diseases (ICD) (Sharp and Madlock-Brown 2020, 178).
257. What elements would you change in the following graph to make the visualization more effective? a. Present the data in a vertical orientation b. Use a dot plot c. Remove the color d. Present the data as a line plot
257. d For data that is presenting changes over time, the preferred presentation method is a line plot (Marc 2020, 537).
258. Which of the following would not be done with a master patient index (MPI) system? a. Merging duplicate health record numbers b. Identifying discharge dates c. Printing outpatient general consent forms d. Looking up health record numbers
258. c The master patient index (MPI) is a patient-identifying directory referencing all patients related to an organization and which also serves as a link to the patient record or information, facilitates patient identification, and assists in maintaining a longitudinal patient record from birth to death (Sayles and Kavanaugh-Burke 2018,115-116).
259. In January, Community Hospital had 57 discharges from its medicine unit. Four patients developed urinary tract infections while in the hospital. What is the hospital-acquired infection rate for the medicine unit for January? a. 0.07% b. 2.17% c. 7% d. 217%
259. c The hospital-acquired infection rate is (4 × 100)/57 = 400/57 = 7.0%. Hospital-acquired (nosocomial) infection rates may be calculated for the entire hospital. They also may be calculated for the specific types of infections. Ideally, the hospital should strive for an infection rate of 0.0 percent (Edgerton 2020, 490).
260. The HIM director is on the design team for the CPOE system. During a user interface design session, a sample of the electronic system is demonstrated. Two of the physicians are concerned about the overuse of alerts. What problem could the alert feature pose in the new system? a. Unnecessary alerts can lead to clinicians ignoring other important alerts. b. Alerts make order entry difficult. c. Physicians do not like to be reminded how to treat patients. d. The Joint Commission discourages an alert system.
260. a The use of CPOE can lead to significant improvements in patient safety because of the reminders or alerts built into the system. Although alerts and reminders are useful, too many become frustrating to the physicians because they have to constantly stop their data entry to address the alerts and reminders (Sayles and Kavanaugh-Burke 2018, 155).
261. Prior to the implementation of the new EHR, the HIM manager is working with the IT analyst in order to improve departmental workflows. They are using structural metadata. This type of data can be used to create which of the following? a. Dataflow diagrams b. Data mapping c. Data audit d. Data architecture
261. a Structural metadata is the process of acquiring, storing, manipulating, and displaying data. Data models, such as entity-relationship diagrams (ERD) and dataflow diagrams (DFD) are diagrammatical or graphic tools used to help program the system and to identify areas of inefficiency (Sayles and Kavanaugh-Burke 2018, 249).
262. Dr. Kotter treats highly unusual medical cases requiring many laboratory, radiology, and other diagnostic tests. Hospital administration wants to determine if additional facilities, personnel, and equipment are needed to meet current and future community demands. Which information system would be helpful in this scenario? a. Decision support system b. Registration—admission, discharge, transfer c. Clinical documentation improvement d. Executive information system
262. a The decision support system (DSS) is an information system that gathers data from a variety of sources and assists in providing structure to the data by using various analytical models and visual tools in order to facilitate and improve the ultimate outcome in decision-making tasks associated with the nonroutine and nonrepetitive problems (Sayles and Kavanaugh-Burke 2018, 109).
263. Which component of the EHR is designed to track and report outbreaks of infectious diseases and childhood immunization levels to public health officials? a. Population health b. Continuity of care record c. Results reporting d. Health information exchange
263. a The population health component in an EHR is designed to capture and report healthcare data that are used for public health purposes. It allows the healthcare provider to report infectious diseases, immunizations, cancer, and other reportable conditions to public health officials. This reporting is required at the local, state, and national levels and includes infectious diseases. A population health system also can connect with public health officials to receive alerts regarding health issues (Sayles and Kavanaugh-Burke 2018, 156).
264. Kelly, the CDI specialist, is evaluating the information used by the coding professionals when they need to code various surgeries. She is particularly interested in the time lag between the actual surgical procedure and the determination of the pathology diagnosis. In which information system would the data element "principal procedure" be found? a. Transcription system b. Encoder/grouper c. Data quality indicator d. Tumor registry
264. b The encoder is specialty software used by coders to select the appropriate code for the diagnosis(es) and procedure(s) supported by the health record. A grouper is a computer program that uses specific data elements to assign the diagnostic and procedural codes entered into the encoder into the appropriate Medicare severity diagnosis-related group (MS-DRG) or other diagnosis-related group (DRG) (Sayles and Kavanaugh-Burke 2020, 89-90).
265. In which type of health information exchange architectural model does the entity operate much like an application service provider (ASP) or bank vault? a. Consolidated b. Federated—consistent databases c. Federated—inconsistent databases d. Switch
265. b The federated architectural type has become more prevalent for health information organizations. There are two forms of this architecture. The consistent federated form is very similar to the consolidated architecture in which the data repository is partitioned but centrally managed. The consistent federated form, however, takes this one step further and physically separates the data but still offers centralized management. Essentially, this is much like an application service provider (ASP) or software as a service (SaaS) model of acquiring software (Amatayakul 2017, 417-418).
266. Community Memorial Hospital discharged nine patients on April 1. The length of stay for each patient is shown in the following table. What is the median length of stay for this group of patients? a. 5 days b. 6 days c. 8 days d. 9 days
266. c The median is the midpoint of a frequency distribution and falls in the ordinal scale of measurement. It is the point at which 50 percent of the observations fall above and 50 percent fall below. If an odd number of observations is in the frequency distribution, the median is the middle number. In this data set, 8 is the middle number (White 2020a, 177).
267. Last year, 73,249 people died from diabetes mellitus in the United States. The total number of deaths from all causes was 2,443,387, and the total population was 288,356,713. Calculate the proportionate mortality ratio for diabetes mellitus. a. 0.003 b. 10.94 c. 0.09 d. 3.0
267. d The proportionate mortality ratio (PMR) is a measure of mortality due to a specific cause for a specific time period. In the formula for calculating the PMR, the numerator is the number of deaths due to a specific disease for a specific time period, and the denominator is the number of deaths from all causes for the same time period. The proportionate mortality ratio for diabetes mellitus = 73,249/2,443,387 = 0.03 × 100 = 3.0% (AHIMA 2017, 192; Edgerton 2020, 476).
268. In what condition is it more suitable to present data as a table instead of a graph? a. When the trend and the exact numeric value are important to the interpretation b. When the trend in values is most important c. When it is required to know the exact numeric value of a variable d. When the exact numeric value is not important to an interpretation
268. c A chart offers the advantage of seeing the general trend of data and comparing differences in data between groups or over time. However, the precise numeric values are more easily discerned when reading a table (Marc 2020, 529-530).
269. Which of the following basic services provided by a health information exchange (HIE) entity matches identifying information to an individual? a. Consent management b. Person identification c. Record locator d. Identity management
269. b Because there is no mandated unique patient identifier, ensuring that the HIE organization can identify the right patient as it seeks to exchange information is a process of identity matching (Amatayakul 2017, 419).
270. What type of system would look for contraindications between two medications, such as Warfarin (Coumadin) and ibuprofen, that could increase bleeding? a. Laboratory b. Radiology c. Pharmacy d. Nursing
270. c If a particular medication were prescribed to the patient, the physician may not know that it would contraindicate the use of this certain drug because of the pre-existing allergy; the PIS would alert the physician to this contraindication and suggestion another medication (Sayles and Kavanaugh-Burke 2018, 137).
271. Allowing different health information systems to work together within and across organizational boundaries is referred to as: a. Telehealth b. Interoperability c. Informatics d. Interfaces
271. b Health informatics must consider the development of standards for software to be used in the EHR and the exchange of data. Compatibility and interoperability, allowing different health information systems to work together within and across organizational boundaries in order to advance the effective delivery of healthcare for individuals and communities, are a key focus in health informatics (Biedermann and Dolezel 2017, 22).
272. Providing a process's policy and procedure guide to a user who has never used the information system and then asking the user to perform the process could be used in what type of testing? a. Application b. Documentation c. Volume d. Acceptance
272. b These documents should be followed during the testing process to ensure that the instructions in the documents are accurate (Sayles and Kavanaugh Burke 2018, 75).
211. A computer software program that supports a coder in assigning correct codes is called a(n): a. Encoder b. Grouper c. Automated coder d. Decision support system
a An encoder is used to increase the accuracy and efficiency of the coding process. Encoders promote accuracy as well as consistency in the coding of diagnoses and procedures (Amatayakul 2017, 292).