Chapter 18 EHR

Enterprise content management (ECM) system

Has workflow functionalities and other tools to manage documents in a logical manner; it goes beyond a scanning solution that only makes images of documents for retrieval or archival purposes

Which recognition system is able to recognize handwriting?

ICR

File formats

Include those used in word-processing software (e.g., .DOC or .DOCX), as PDF files (.PDF), as .JPG or other image structures, and other formats

Hybrid records are those including:

Paper and electronic content

A collision of data can occur with which form of recognition technology?

RFID

Real-time location system (RTLS)

RTLS includes a wireless (radiofrequency, infrared, or ultrasound) tag that emits signals enabling content or people wearing the tag to be tracked.

Unlike paper or scanned documents, when structured information affords:

Representation of information that support electronic decision making

An example of a use of workflow management is:

Routing charts to various staff members for coding

A service that provides document scanning only when needed is:

Scan on demand

ECM enables which of the following changes to occur in an HIM department?

Shift release of information to point of service

Enterprise content, collaboration, and communication management (EC3M) system

Systems that aid in the management of electronic content as well as the sharing and transmission of such content, especially among members of a team who may need to dynamically interact with documents as they are being created

Workflow technology

Technology that automatically routes electronic documents into electronic in-baskets of its department staff for disposition decisions

Clinical messaging

The function of electronically delivering data and automating the workflow around the management of clinical data

Workflow management

The planning, organizing, directing, and controlling of the workflow

Enterprise content, collaboration, and communication (EC3M) systems:

Use groupware to manage project documentation

Front-end speech (FES) recognition

Uses of speech recognition technology that rely on limited vocabularies and away from a point of care

In which ECM technology is content such as PACS images, video recordings, and photographs managed?

Vendor Neutral Archive (VNA)

Which of the following is an example of positive patient identification?

Verification of patient ID

Information as a service

When discussion databases, instant messaging etc. are part of a cloud-based offering of EC3M, they are often referred to as

Optical mark recognition

the oldest form of optical recognition and requires pre-printed forms to contain locations for marking specific, limited information that is then read by a scanning system and content incorporated into an EDM, ECM, or any other system capable of receiving such information

Intelligent word recognition

the recognition of unconstrained handwritten words. Thus, instead of reading character-by-character, IWR is able to recognize entire words or phrases. It matches these words or phrases to a user-defined dictionary to reduce character-based system errors

Radio frequency identification (RFID)

two-dimensional bar code

Enterprise master person index (EMPI)

used to consolidate EDM/ECM systems by integrating master person indexes (MPIs) from entities in the consolidating organization

Groupware

An Internet technology that consolidates documents from different information systems within an organization to help people collaborate on specific tasks

Code 39 bar code standard

An alphanumeric, self-checking, variable-length code that has been standardized by the Health Industry Bar Code Council (HIBCC); also called linear bar code

Vendor neutral archive (VNA)

An integrated platform on which multiple different EDM and ECM systems can exchange content

When an organization pushes the scanning function out to the end user, what type of system is it

Distributed

Which of the following is false concerning ECM implementation?

Due to reduction in space needs, physical concerns are minimal

ECM systems

Enable positive patient identification as a result of storing patient photographs

What is the focus of the enterprise content management?

Enterprise Content Management focuses on managing unstructured information in ways to lend structure, improve interoperability, and gain intelligence from that information.

Two-dimensional bar code

A barcode in which data are encoded in both the height and the width of the barcode symbol; the amount of data that can be contained in a two-dimensional barcode symbol is significantly greater than that stored in a one-dimensional symbol

Knowledge management system

A management strategy that promotes an integrated and collaborative approach to the process of information asset creation, capture, organization, access, and use

QR codes

A matrix form of bar code that can be read by a smart phone app, which will take the holder of the phone to a specific URL

Optical character recognition

A method of encoding text from analog paper into bit-mapped images and translating the images into a form that is computer readable

Positive patient identification

A method of matching a patient to their information, such as requiring the use of government-issued photo identification

Adaptive case managment

A process improvement technique most suitable for knowledge workers where processes performed are often not predictable and systems must be able to adapt to such situations

Electronic document management (EDM) system

A storage solution based on digital scanning technology in which source documents are scanned to create digital images of the documents that can be stored electronically on optical disks

Workflow management system

A system that stores workflow definitions as a collection of tasks, resources, and conditional logic

Workflow engine

A system that takes care of the management of workflow, including task assignment generation, resource allocation, activity performance, case preparation and modification, launching of applications, and the recording of logistical information (Andrew and Bruegel 2005)

Electronic signature authentication

A system that utilizes a user ID and password to indicate review and approval of the content of a document

Hybrid record

A system with functional components that (1) include both paper and electronic documents and (2) use both manual and electronic processes

Which of the following is true about how enterprise content management manages content?

A variety of services, such as document imaging, forms management and data modeling, are managed

Code 128 bar code standard

A very high density code that encodes all alphanumeric and special characters, enabling bar codes to include upper- and lowercase and larger numbers

In a physician office, ECM is an important means to:

support continuity of care by making previous information available

A standard guide for electronic signature authentication is offered by:

ASTM International

In the typical provider setting, how much patient information exists outside of the EHR?

About 25 percent

Which of the following is true about the content managed by enterprise content management?

Both structured and unstructured content can be managed

The C-CDA is required for use in:

CEHRT

In addition to bar codes on medical record documents, what other forms of recognition characteristics enhance the accuracy of forms indexing features?

COLD

1st gap in a physician office EHR environment where a document imaging system can be of value

Clinical messaging is a service that provides a secure, electronic infrastructure to automate the delivery of health data to site where patient care decisions are made. Such messaging systems are considered in the context of e-mail-like systems, which are not linked to the EHR or to an ECM.

A two-dimensional code that enables comprehensive information to be read by a bar code reader is

Code 128

Which bar code can encode complex information?

Code 128

According to FDA rule, drugs and biologicals are required to have:

Code 39

Document imaging system

Computer systems that capture, store, and reprint images of documents

Which of the following is a set of document templates?

Consolidated Clinical Document Architecture (C-CDA)

A CDA document:

Contains an optional XML component

Which of the following forms of identification system is similar in technology to speech recognition

Intelligent character recognition

Give an example of workflow management in enterprise content management?

It is used as a workflow tool and to manage "stray" documents and integrate other content from other sources.

Speech recognition

Most speech recognition systems are used in a transcription environment, where transcribers can listen and correct inaccuracies (AHIMA 2003b), or in uses that rely on limited vocabularies and away from a point of care, often referred to as front-end speech (FES).

Which of the following is a required element in the CDA?

One narrative section in human readable form

Intelligent character recognition

an advanced form of OCR in which the system "learns" (through various forms of artificial intelligence, such as artificial neural networks) to recognize a specific person's handwriting and, over time, increases its accuracy

2nd gap in a physician office EHR environment where a document imaging system can be of value

chart conversion may be accomplished by including abstraction, scanning of documents, or simply pulling previous records for a period of time. The transition to EHR should include a review of technology that scans the documents and supports workflow and content management.

POISED

preparing to see patients by reviewing the record in advance; orienting the patient to the physician's use of the computer; gathering information while the patient is talking; sharing information with the patient by turning the computer screen to them; educating patients using graphical representations of information from the system; and debriefing with the patient to ensure understanding (Hirsch 2015a) 683