Healthcare Exam 3
The IOM recommendations, the U.S. Public Health Services, and the American Public Health Association advocate for which of the following?
A consistent and unified approach to public health
A major trend in employer-sponsored health insurance coverage is
Adoption of high-deductible health insurance plans
Reasons why improvements in healthcare quality have been slow to occur despite well-documented research on the scope and seriousness of quality problems include
All of these are correct
The systematic review of studies in the peer-reviewed biomedical literature found moderately strong evidence confirming three previously reported factors associated with successful CDSS implementation. The evidence found that all of the following describe successful CDSS implementation, EXCEPT:
Allows time for addition clinical data entry
Using preparedness and emergency management terms, which of the following best describes an incident?
An occurrence or event, natural or manufactured, that requires a response to protect life or property
Attempts at healthcare system reform of the basic problems of cost, quality, and access have consistently demonstrated which of the following results?
Changes in any one of the three basic problems produces unintended consequences with one or more of the other two
The Centers of Disease Control and Prevention originally started in 1946 as the Communicable Disease Center, with the primary mission to:
Combat a malaria epidemic in the southern states
Which of the following is an advantage of a commercially produced off-the-shelf electronic health record system?
Commercially produced systems allowed hospitals to implement comprehensive electronic health records without designing and building custom systems, which can result in prohibitive costs
Enhancing healthcare treatment decisions by providing information to consumers, providers, and payers to improve health outcomes by developing and disseminating evidence on the effectiveness, benefits, and harms of different treatment options best describe which research practice?
Comparative effectiveness research
"Meaningful use" of electronic health records is best described as
Criteria defined by the Office of the National Coordinator in collaboration with the Centers for Medicare and Medicaid services that require meeting time-limited objectives in order to quality for incentive payments under the HITECH Act
Which agency or office is the principal coordinating entity for emergencies in the nation?
Department of Homeland Security
Which of the following best describes a study that uses patient records, interview surveys, various databases of existing medical data, and other information sources to identify those factors and conditions that determine the distribution of health and disease among specific populations?
Descriptive studies
In evaluating the quality of health care, explicit standards differ from implicit standards in that
Explicit standards are developed and agreed upon in advance of the assessment to minimize variation and bais
A paradox of the U.S. healthcare system may be described as
Extraordinary technologies accomplishments that are offset by limited access to services, high costs, and variations in quality
Disasters are rarely relevant to the public health and acute care systems.
False
In the realm of health policy development, local health departments are poorly positioned to provide input to government officials, elected policymakers, and advocacy groups about community needs and priorities.
False
Public health and the management of public health services and organizations are best understood from an individual perspective.
False
T/F: Financial support for local health departments' operations is principally from private, philanthropic organizations
False
T/F: Patient satisfaction is a well-defined concept which can be accurately calculated to indicate health care quality
False
T/F: The Patient-Centered Outcomes Research Institute acknowledges that patient satisfaction is not a significant factor for quality care
False
T/F: health policy reforms have created incentives that have shifted delivery from community-based facilities to acute care because they are generally cheaper and more accessible for patients
False
The North Atlantic Treaty Organization is the lead international agency charged with planning, preventing, and managing outbreaks deemed public health emergencies of international concern.
False
Which of the following allows for fast and accurate identification of patients named "John Smith" because the mater patient index (MPI) maintains sufficient identifying information to ensure selection of the correct patient among all institutions in the exchange?
Federated health information exchange (HIE) architecture
Which regulation had a chilling effect on healthcare institutions' willingness to share data with other institutions due to liability for patient privacy and security of patient data
Health Insurance Portability and Accountability Act
The federal government's principal agency concerned with health protection, promotion, and provision of services to vulnerable populations is the Department of
Health and Human Services.
Most electronic health records (EHRs) are not designed to share patient health information between systems and institutions. A solution for overcoming this limitation in current EHR design has been the development of:
Health information exchanges (HIEs)
Which of the following best describes an emerging research field that seeks to understand and improve how societies organize themselves in achieving collective health goals and how different actors interact in the policy and implementation processes to contribute to policy outcomes?
Health policy and systems research
As early as 1966, Avedis Donabedian at the University of Michigan characterized health care as divided into three components. The research paradigm of their assumed linkages guides the quality-of-care investigators. Which of the following is NOT one of the components?
Inputs
All of the following describe a personal health record (PHR) expect:
Is usually provided for free as part of electronic health information (EHR) systems
Which of the following best describes why it is important for public health agencies and organizations to seek diversification of the profession?
It facilitates the interdisciplinary approaches to community problem identification and problem-solving, which are hallmarks of modern public health practice
As a professional health-oriented discipline, public health is unique in what way?
It uses an interdisciplinary approach and methods with emphasis on preventive strategies, links with government and politics, and dynamic adaptations to new problems
Regional health information organizations (RHIOs) do all of the following except:
Maintain a universal business model established by Medicare to fund their community-based services
The most significant incentive in the Health Information Technology for Economic and Clinical Health Act created which of the following?
Medicare and Medicaid Electronic Health Record Incentive Program
Which of the following is an initiative that resulted from the collective thought of researchers that enhanced collaboration was needed to address vulnerabilities related to the human-environment interface and related to zoonoses potentially impacting humans?
OneHealth
Which of the following describes how public health leaders can affect health and health equity in their communities?
Partnering across multiple sectors and leveraging data and resources to address social, environmental, and economic conditions
The development of training programs for the community, public awareness, logistical support, communications, early warning, and ongoing monitoring refers to:
Preparedness
The National Health Security is an active strategic approach to planning for health security preparedness in the country. All of the following describe the objectives of the National Health Security, execpt:
Provide authority to State governors during an emergency
Which of the following incorporates actions necessary to maintain and/or return the community to normal after the disaster?
Recovery
Which of the following best describes health systems research?
Research provides evidence that, when applied, can make healthcare affordable, safe, effective, equitable, accessible, and patient-centered.
Which of the following best describes the role of the USPHS and the Surgeon General?
Serve to help frame and promote the national health agenda
Challenges that threaten the health and well-being of individuals and communities require public health professionals to possess which of the following skills?
Strong management knowledge, skills, and abilities in public health
Which of the following best describes a provision of the ACA that requires disclosures to the Center of Medicare and Medicaid Services about any payments or other transfers of value made to physicians or teaching hospitals, which may help to bring these ethical breaches under control?
Sunshine Act
Which of the following is a meta-analysis of several high-quality randomized, controlled clinical trails?
Systematic review
System thinking considers that actions or changes in one aspect of a health system are likely to affect outcomes in another. Which of the following best describes why systems thinking is necessary to navigate the complexity of health systems?
Systems thinking allows for a better understanding of the effects of different interventions, policies, and behaviors on system-wide effects, positive and negative, planned and unintended consequences
The accrediting body for public health education programs is:
The Council on Education for Public Health.
Which organization is key in driving quality improvement and patient safety?
The Joint Commission
Evidence-based medicine is best described in terms of:
The conscientious explicit, and judicious use of current best evidence in making decisions about the care of individual patients
Which of the following describes a historical barrier to board implementation of HIT?
The gap between those who bear the costs of the technology and those who receive its benefits
Which of the following describes a historical barrier to broad implementation of HIT?
The gap between those who bear the costs of. the technology and those who receive its benefits
In preparedness and emergency management, which of the following best describes a hazard?
The probability of the occurrence of a disaster caused by a natural phenomenon, by a failure of manufactured sources of energy, or by uncontrolled human activity
Why did the Institute of Medicine report, The Future of Public Health, serve as an important infection point for public health in the United States?
The report was as a call to action for public health to consider what its role was in the face of several pressing health challenges
Why did the Institute of Medicine report, The Future of Public Health, serve as an important inflection point for public health in the United States?
The report was as a call to action for public health to consider what its role was in the face of several pressing health challenges.
A workforce that prioritizes diversity, equity, and inclusion will be positioned to understand better and serve its population while simultaneously improving organizational performance.
True
It was not until the 1990s that commercially produced EHR systems were mass marketed and sold to healthcare institutions in high volume.
True
Local boards of health are legally constituted entities charged with protecting and promoting the health of their communities.
True
One intent of reformed systems of reimbursement and accountability for population health is to allow practitioners to emphasize wellness and prevention over intervention.
True
One of the ten core health department functions is to mobilize community partnerships and action to identify and solve health problems.
True
State health departments' syndromic surveillance systems monitor data such as school absenteeism, workplace absenteeism, emergency call systems, and volume of emergency department visits to detect unusual patterns which may signal evolving public health issues.
True
T/F: A high-performing and responsive health system reflects its population
True
T/F: A workforce that prioritizes diversity, equality, and inclusion will be positioned to understand better and serve its population while simultaneously improving organizational performance
True
T/F: As part of the policy development and administration process, many federal health agencies provide information and technical assistance to state and local agencies and nongovernmental organizations
True
T/F: Before COVID-19, rural communities experienced great difficulty with the recruitment and retention of providers
True
T/F: Emergency preparedness actives for the healthcare industry require attention to public health, personal health, and the civil structures of society
True
T/F: Healthcare technology reduces practice variation and ensures healthcare providers provide a consistent standard of care based on the best scientific evidence for the patients and populations they serve
True
T/F: Healthy People provides science-based, 10-year national objectives for improving people's health nationwide
True
T/F: In 2020, the COVID-19 pandemic caused a tremendous financial strain for hospitals and especially rural hospitals, with a record of 20 rural hospitals closing in one year
True
T/F: One intent of reformed systems of reimbursement and accountability for a population health is to allow practitioners to emphasize wellness and prevention over intervention.
True
T/F: Public health and private medicine remain interdependent in endeavors such as disease surveillance, vital statistics reporting, and participation in community health education campaigns
True
T/F: The National Institutes of Health provides leadership and direction to programs designed to improve the Nation's health by conducting and supporting research
True
T/F: The nation faces many threats to population health related to all types of disaster events
True
T/F: The percentage of office-based physicians with any EHR/EMR systems in the United States as of 2017 illustrates the current state of adoption for the outpatient setting. This report indicated that all states, except New York and the District of Columbia, have some level of EHR adoption
True
T/F: Under the Administration of Strategic Preparedness and Response Healthcare Readiness cooperative agreement, the Hospital Preparedness Program was created
True
The Federal Emergency Management Agency established the National Incident Command System as a comprehensive national approach for managing incidents across entities.
True
The World Health Organization acts as the coordinator for disease reporting and surveillance at the global level.
True
Virtually none of the commercially available EHR systems available in today's market or the custom-designed systems at large academic institutions can easily exchange patients' health information with care providers outside of their institutions.
True
A system that combines the intuitive strengths of humans with the limitless data retention and recall speed of computers to create a hybrid system that is intuitive with a tireless data-processing capability to optimize the physician's performance describes:
a computerized clinical decision support system
Information blocking is
a conscious effort on the part of some EHR vendors to make their EHR systems difficult to interface with other vendor's EHR systems, and thus require their customers to buy more of their software.
The initiative called Public Health 3.0 describes:
a model and path forward for the field of public health to redefine and reinvent public health for the future.
All of the following describe actions of mitigation, except:
address unintended consequences.
The federated model of health information exchange (HIE)
allows contributing institutions to maintain control over data for which they are responsible under HIPAA
The major difference between public health ethics and medical ethics is that while medical ethics have an individual and clinical focus, public health ethics
are concerned with institutions' interactions with communities.
As a core function of public health, assessment is best defined as
collecting and analyzing data to define population health status and quantify existing or emerging health problems.
The federated model of health information exchange architecture is best described as a model in which
data resides only within each institution's system and the health information exchange database houses only a master patient index with unique patient identifiers.
The COVID-19 pandemic highlighted the need to strengthen activities among acute care, public health, and:
disaster preparedness.
Empirical standards for assessing the quality of healthcare practices (also known as "performance report cards") rely upon
distributions, averages, ranges, and other data of variability measures and information collected from similar health services providers to compare practices to a norm.
"Public Health" embodies many definitions, but is most broadly defined as
efforts to cope with health problems arising from people living in groups.
A goal of comparative effectiveness research is to
enhance healthcare treatment by developing and disseminating evidence on the effectiveness, benefits, and harms of different treatment options.
The single most important factor in accelerating health information technology adoption since 2008 has been
financial incentive programs that reward "meaningful use" of the use of e-prescriptions
Clinical research
focuses primarily on the various steps in the process of medical care: the early detection, diagnosis, and treatment of disease or injury; the maintenance of optimal physical, mental, and social functioning; the limitation and rehabilitation of disability; and the palliative care of those who are irreversibly ill.
The Agency for Healthcare Policy and Research was established in 1989 to prioritize:
funding two research projects: patient outcome research teams and literature synthesis projects or meta-analyses.
The Agency for Healthcare Research and Quality (AHRQ) is a federal agency charged with
improving outcomes and quality of healthcare services, reducing costs, improving patient safety, and fostering effective services.
All of the following describe a personal health record (PHR) except:
is usually provided for free as part of electronic health information (EHR) systems.
The National Health Security Strategy is an active strategic approach to planning for health security preparedness in the country. All of the following describe the objectives of the National Health Security Strategy, except:
provide authority to State governors during an emergency.
In 2016, Council on Education for Public Health updated the accreditation criteria for public health schools and programs, revising core competencies to reflect:
renewed emphasis on management and leadership as important elements of public health education and practice.
At the core of health systems research is:
systems thinking
Three organization elements essential for successful health information systems implementation are
technology, policies and procedures, and culture.
The World Health Organization describes quality as:
the degree to which health services for individuals and populations increase the likelihood of desired health outcomes
The United States has never planned comprehensively or strategically for the development and deployment of its healthcare workforce and, as a result:
the preparation of each generation of health workers is just as fragmented and confusing as the healthcare system they will one day join.
Population-based strategies to improve health include efforts to control epidemics, to ensure safe drinking water and food, to reduce vaccine-preventable diseases, to improve maternal and child health, and:
to conduct surveillance of health problems.
The centralized model of health information exchange
works by having all participating institutions send copies of their healthcare data to one centralized repository on a regular basis so one regionally comprehensive record can be maintained for each patient
