RHIT Exam - Domain 3

In a frequency distribution, the lowest value is 5, and the highest value is 20. What is the range? a. 5 to 20 b. 15 c. 7.5 d. 20 to 5

b. 15 The range is the simplest measure of spread. It is the difference between the smallest and largest values in a frequency distribution

Suppose that 6 males and 14 females are in a class of 20 students with the data reported as 3/1. What term could be used to describe the comparison? a. Average b. Percentage c. Proportion d. Rate

c. Proportion A proportion is a particular type of ratio in which x is a portion of the whole (x + y)

Community Hospital had a total of 3,000 inpatient service days for the month of September. What was the average daily census for the hospital during September? a. 10 patients b. 96.77 patients c. 97 patients d. 100 patients

d. 100 patients The average daily census is the average number of inpatients treated during a given period of time. There are 30 days in September, so 3,000 / 30 = 100

In which type of distribution are the mean, median, and mode equal? a. Bimodal distribution b. Simple distribution c. Nonnormal distribution d. Normal distribution

d. Normal distribution The normal distribution is where data follows a symmetrical curve. The normal distribution is actually a theoretical family of distributions that may have any mean or any standard deviation. In a normal distribution, the mean, median, and mode are equal

If you want to display the parts of a whole in graphic form, what graphic technique would you use? a. Table b. Histogram c. Line graph d. Pie chart

d. Pie chart

Which of the following uniquely identifies each record in a database table? a. Data definition b. Data element c. Foreign key d. Primary key

d. Primary key

Data elements collected on large populations of individuals and stored in databases are referred to as: a. Statistics b. Information c. Aggregate data d. Standard

c. Aggregate data

In the community clinic Dr. Simpson, an interventional cardiologist, saw 270 patients last quarter. Of those, he performed stent procedures on 182 patients and angioplasty procedures on 88 patients. What is the proportion of Dr. Simpson's patients who have had stent procedures? a. 0.67 b. 0.45 c. 0.33 d. Unable to determine

a. 0.67 A proportion is a type of ratio in which x is a portion of the whole (x + y). In a proportion, the numerator is always included in the denominator. 182 / 270 = 0.67

If an employee produces 2,080 hours of work in the course of one year, how many employees will be required for the coding area if the coding time on average for one record is 30 minutes and there are 12,500 records that must be coded each year? a. 3 b. 6 c. 36 d. 69

a. 3 The number of records per FTE is 2 (number of records per hour) × 2,080 = 4,160. Therefore, three employees per year are required: 12,500 / 4,160 = 3.0

Given the numbers 47, 20, 11, 33, 30, 30, 35, and 50, what is the mode? a. 30 b. 32 c. 32.5 d. 35

a. 30 The most frequent observation is 30

A family practitioner in your local physician's clinic saw 150 adults in one week for their annual physical examinations. Sixty-seven received the flu vaccine and three patients received the pneumococcal pneumonia vaccine. What is the rate of the flu vaccine administration for this physician? a. 44.7% b. 67.0% c. 20.0% d. 447%

a. 44.7% A rate is a ratio in which there is a distinct relationship between the numerator and denominator and the denominator often implies a large base population. (67/150) × 100 = 44.66 = 44.7%

Suppose that five patients stayed in the hospital for a total of 27 days. Which term would be used to describe the result of the calculation 27 divided by 5? a. Average length of stay b. Total length of stay c. Patient length of stay d. Average patient census

a. Average length of stay The average length of stay (ALOS) is calculated from the total length of stay (LOS). The total LOS divided by the number of patients discharged is the ALOS

On October 1st, a hurricane hit a small coastal community, which has a community hospital licensed for 50 beds. Hospital staff set up 10 additional beds around the facility and used three labor room beds and two treatment room beds in order to help take care of patients. Which of the following would be the denominator used to determine the percentage of occupancy for October 1st? a. 50 b. 60 c. 63 d. 65

a. 50 A bed count, also called an inpatient bed count, is the number of available hospital inpatient beds, both occupied and vacant, on any given day. Temporary beds are not included in the bed count for percentage of occupancy

To use a data element for aggregation and reporting, that data element must be: a. Abstracted or indexed b. Searched c. Subject to case finding d. Registered

a. Abstracted or indexed Abstracting is the process of extracting elements of data from a source document and entering them into an automated system. The purpose of this endeavor is to make those data elements available for later use. After a data element is captured in electronic form, it can be aggregated into a group of data elements to provide information needed by the user

What number is assigned to a case when it is first entered in a cancer registry? a. Accession number b. Patient number c. Health record number d. Medical record number

a. Accession number

The Medical Staff Executive Committee has requested a report that identifies all medical staff members who have been suspended in the past six months due to delinquent health records. This is an example of what type of report? a. Ad hoc or demand b. Annual report c. Exception d. Periodic scheduled

a. Ad hoc or demand

Secondary data is used for multiple reasons including: a. Assisting researchers in determining effectiveness of treatments b. Assisting physicians and other healthcare providers in providing patient care c. Billing for services provided to the patient d. Coding diagnoses and procedures treated

a. Assisting researchers in determining effectiveness of treatments Secondary data is used in research. Data taken from health records and entered into diseaseoriented databases can help researchers determine the effectiveness of alternate treatment methods. They also can quickly demonstrate survival rates at different stages of diseases

The hospital-acquired infection rate for our hospital is 0.2%, whereas the rate at a similar hospital across town is 0.3%. This is an example of a: a. Benchmark b. Check sheet c. Data abstract d. Run chart

a. Benchmark A benchmark is a systematic comparison of one organization's measurement characteristics to those of another similar organization. When an organization compares its current performance to its own internal historical data, or uses data from similar external organizations, it helps establish an organization benchmark

A PI Team is concerned with the time it is taking for patients to get through the registration process. To better understand the causes or reasons for the delay in this process the PI Team would like to gather observational data. What data collection tool would be appropriate for this team to develop for their observation data? a. Check sheet b. Ordinal data tool c. Balance sheet d. Nominal data tool

a. Check sheet A check sheet is used to gather data based on sample observations in order to detect patterns. When preparing to collect data, a team should consider the four W questions: Who will collect the data? What data will be collected? Where will the data be collected? When will the data be collected?

A record is considered a primary data source when it: a. Contains data about a patient and has been documented by the professionals who provided care to the patient b. Contains data abstracted from a patient record c. Includes data stored in a computer system d. Contains data that are entered into a disease-oriented database

a. Contains data about a patient and has been documented by the professionals who provided care to the patient The health record is considered a primary data source because it contains data about a patient that has been documented by the professionals who provided care or services to that patient. Data taken from the primary health record and entered into registries and databases are considered a secondary data source

The process of extracting and analyzing large volumes of data from a database for the purpose of identifying hidden and sometimes subtle relationships or patterns and using those relationships to predict behaviors is called: a. Data mining b. Data warehouse c. Data searching d. Big data

a. Data mining Data mining is the process of extracting and analyzing large volumes of data from a database for the purpose of identifying hidden and sometimes subtle relationships or patterns and using those relationships to predict behaviors

Which of the following is a technique for graphically depicting the structure of a computer database? a. Data model b. Data flow diagram c. Foreign key d. Primary key

a. Data model Data models provide a contextual framework and graphical representation that aid in the definition of data elements

Your administrator has asked you to generate a report that gives the number of hypertension patients last year. This is an example of ________. a. Descriptive analytics b. Predictive analytics c. Prescriptive analytics d. Real-time analysis

a. Descriptive analytics Data analytics is the science of examining raw data with the purpose of drawing conclusions about that information. Analytics can be descriptive, predictive, or prescriptive. Descriptive analytics is just the summarization of data

In this experimental study, blood pressure is taken before and after an experimental medication is used as the intervention in a sample of participants that were previously unable to control their blood pressure with other medications. In this example, the independent variable is the __________ and the dependent variable is the__________. a. Experimental medication; blood pressure b. Blood pressure; experimental medication c. Blood pressure; heart disease d. Experimental medication; heart disease

a. Experimental medication; blood pressure The independent variable in this example is the intervention used (medication) and the dependent variable is the disease that is being assessed (blood pressure)

To be reliable, statistical data must: a. Have some consistency b. Be applicable to what is being measured c. Be collected from one source only d. Have multiple meanings

a. Have some consistency The data used in the statistics must be valid and reliable. Validity answers the question of whether one measured what one intended to measure, and reliability means that there is some consistency of results

Case finding is a method used to: a. Identify patients who have been seen or treated in a facility for a particular disease or condition for inclusion in a registry b. Define which cases are to be included in a registry c. Identify trends and changes in the incidence of disease d. Identify facility-based trends

a. Identify patients who have been seen or treated in a facility for a particular disease or condition for inclusion in a registry Case finding is a method used to identify the patients who have been seen or treated in the facility for the particular disease or condition of interest to the registry. After cases have been identified, extensive information is abstracted from the patients' paper-based health records into the registry database or extracted from other databases and automatically entered into the registry database

Which unit of measure is used to indicate the services received by one inpatient in a 24-hour period? a. Inpatient service day b. Volume of services c. Average occupancy charges d. Length of services provided

a. Inpatient service day

Why is the MEDPAR file limited in terms of being used for research purposes? a. It only contains Medicare patients. b. It only provides demographic data about patients. c. It uses diagnoses and procedure codes. d. It breaks charges down by specific types of service.

a. It only contains Medicare patients.

Which of the following is the first step in analyzing data? a. Knowing your objectives or purpose of the data analysis b. Starting with basic types of data analysis and work up to more sophisticated analysis c. Utilizing a statistician to analyze the data d. Presenting your findings to administration

a. Knowing your objectives or purpose of the data analysis The first step in analyzing data is to know your objective or the purpose of the data analysis

Certificates, such as those for births and fetal-deaths, are reported by hospitals to the individual state registrars and maintained permanently. State vital statistics registrars then compile the data and report them to which of the following: a. National Center for Health Statistics b. Agency for Healthcare Research and Quality c. Health Services Research d. National Statistics Research

a. National Center for Health Statistics Healthcare facilities are interested in births and deaths, fetal deaths, and induced terminations of pregnancy; facilities generally are responsible for completing certificates for births, fetal deaths, abortions, and occasionally, deaths. All states have laws that require this data. The certificates are reported to the individual state registrars and maintained permanently. State vital statistics registrars compile the data and report them to the NCHS

Which of the following types of data does not have a natural order? a. Nominal b. Ordinal c. Ratio d. Interval

a. Nominal Qualitative data are divided into the nominal scale and ordinal scale. Nominal data observations are organized into categories in which there is no recognition of order, and ordinal data are types of data where the values are in ordered categories and the order of the numbers is meaningful, but not the numbers themselves

A health data analyst has been asked to abstract patient demographic information into an electronic database. Which of the following would the analyst include in the database? a. Patient date of birth b. Name of attending physician c. Patient room number d. Admitting diagnosis

a. Patient date of birth

Which of the following best represents the definition of the term data? a. Patient's laboratory value is 50. b. Patient's SGOT is higher than 50 and outside of normal limits. c. Patient's resting heartbeat is 70, which is within normal range. d. Patient's laboratory value is consistent with liver disease.

a. Patient's laboratory value is 50. Although sometimes used interchangeably, the terms data and information do not mean the same thing. Data represent the basic facts about people, processes, measurements, conditions, and so on. They can be collected in the form of dates, numerical measurements and statistics, textual descriptions, checklists, images, and symbols. After data have been collected and analyzed, they are converted into a form that can be used for a specific purpose. This useful form is called information. In other words, data represent facts and information represents meaning

The HIM Logistics Manager, Tim, is working with the IT Workflow Analyst, Kristen, to develop entity-relationship diagrams and dataflow diagrams to evaluate HIM procedures prior to the implementation of the new EHR. What type of metadata is being created during this process? a. Structural b. Descriptive c. Administrative d. Modeling

a. Structural 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

This type of analytics allows users to prescribe a number of different possible actions: a. Descriptive analytics b. Predictive analytics c. Prescriptive analytics d. Real-time analysis

c. Prescriptive analytics

Which events must occur in order to maintain patient identity data integrity? a. The data must be accurately queried b. The data must be accurately analyzed c. The data must be accurately normalized d. The data must be accurately coded

a. The data must be accurately queried Maintenance of data integrity is a key aspect of data quality management. When it comes to patient identity and HIE, integrity is of prime importance to linking the patient to the correct information. Three events must occur in order to maintain patient identity data integrity. The data must be accurately collected, entered, and queried

An employee views a patient's electronic health record. It is a trigger event if: a. The employee and patient have the same last name b. The patient was admitted through the emergency department c. The patient is over 89 years old d. A dietitian views a patient's nutrition care plan

a. The employee and patient have the same last name

Within the context of the inpatient prospective payment system, how is the case-mix index calculated? a. The sum of all relative weights divided by the total number of discharges b. The total number of inpatient service days divided by the total number of discharges c. The sum of all MDCs divided by the total number of discharges d. The total number of inpatient beds divided by the total number of discharges

a. The sum of all relative weights divided by the total number of discharges

Recently, a local professional athlete was admitted to your facility for a procedure. During this patient's hospital stay, access logs may need to be checked daily in order to determine: a. Whether access by employees is appropriate b. If the patient is satisfied with their stay c. If it is necessary to order prescriptions for the patient d. Whether the care to the patient meets quality standards

a. Whether access by employees is appropriate

Community Hospital had 250 patients in the hospital at midnight on May 1. The hospital admitted 30 patients on May 2. The hospital discharged 40 patients, including deaths, on May 2. Two patients were both admitted and discharged on May 2. What was the total number of inpatient service days for May 2? a. 240 b. 242 c. 280 d. 320

b. 242 A unit of measure that reflects the services received by one inpatient during a 24-hour period is called an inpatient service day. The number of inpatient service days for a 24-hour period is equal to the daily inpatient census—that is, one service day for each patient treated. The calculation is: [(250 + 30) − 40] + 2 = 242

In May, 270 women were admitted to the obstetrics service. Of these, 263 women delivered; 33 deliveries were by C-section. What is the denominator for calculating the C-section rate? a. 33 b. 263 c. 270 d. 296

b. 263 The denominator (the number of times an event could have occurred) in this case would be 263 as 263 women delivered

Given the numbers 47, 20, 11, 33, 30, 30, 35, and 50, what is the median? a. 30 b. 31.5 c. 32 d. 35

b. 31.5

The HIM professional reported to the quality improvement committee at Community Hospital that there were 58 patients with influenza discharged from the hospital in January. Of those 58 patients, 3 patients died. What is the case fatality rate for influenza for January? a. 1.60% b. 5.17% c. 0.10% d. 94.8%

b. 5.17% The case fatality rate is the total number of deaths due to a specific illness during a given time period divided by the total number of cases during the same period. (3 ×100) / 58 = 300 / 58 = 5.17%

Community Hospital discharged 9 patients on April 1. The length of stay for each of the patients was as follows: for patient A, 1 day; for patient B, 5 days; for patient C, 3 days; for patient D, 3 days; for patient E, 8 days; for patient F, 8 days; for patient G, 8 days; for patient H, 9 days; for patient I, 9 days. What was the average length of stay for these nine patients? a. 5 days b. 6 days c. 8 days d. 9 days

b. 6 days The average length of stay is the mean length of stay of hospital inpatients discharged during a given period of time. Add the total days for each patient (for a total of 54 days) and divide by 9 patients = 6 days

Review of disease indexes, pathology reports, and radiation therapy reports are parts of which function in the cancer registry? a. Case definition b. Case finding c. Follow-up d. Reporting

b. Case finding

What term is used for the number of inpatients present at any one time in a healthcare facility? a. Average daily census b. Census c. Inpatient service day d. Length of stay

b. Census

The number of inpatients present in a healthcare facility at any given time is called a ________. a. Survey b. Census c. Sample d. Enumeration

b. Census Healthcare facilities have a census, which is the count of patients present at a specific time and in a particular place

Which of the following is made up of claims data from Medicare claims submitted by acute-care hospitals and skilled nursing facilities? a. NPDB b. MEDPAR c. HIPDB d. UHDDS

b. MEDPAR The Medicare Provider Analysis and Review (MEDPAR) file is made up of acute care hospital and SNF claims data for all Medicare claims.

A quality goal for the hospital is that 98 percent of the heart attack patients receive aspirin within 24 hours of arrival at the hospital. In conducting an audit of heart attack patients, the data showed that 94 percent of the patients received aspirin within 24 hours of arriving at the hospital. Given this data, which of the following actions would be best? a. Alert the Joint Commission that the hospital has not met its quality goal b. Determine whether there was a medical or other reason why patients were not given aspirin c. Institute an in-service training program for clinical staff on the importance of administering aspirin within 24 hours d. Determine which physicians did not order aspirin

b. Determine whether there was a medical or other reason why patients were not given aspirin

Large population-based studies are used to identify the care processes or interventions that achieve the best healthcare outcomes in different types of medical practice. This research concept is called? a. Clinical pathway b. Evidence-based medicine c. Patient-centered care d. Morbidity indicators

b. Evidence-based medicine Evidence-based medicine attempts to identify the care processes or interventions that achieve the best outcomes in different types of medical practice. Researchers perform large population-based studies. Such studies are difficult to do without a well-developed information infrastructure to provide data for analysis

A statewide data base is used by your performance improvement department each month to compare other facilities' readmission rates to your facility's rates. This is an example of ________. a. Internal data b. External data c. Ratio data d. Nominal data

b. External data. External data sources refers to data collected outside an organization. For example, a census, reports from the Centers for Medicare and Medicaid Services (CMS) or the Centers for Disease Control (CDC), economic databases, journals, even social media have links to outside data

Which autopsy rate compares the number of autopsies performed on hospital inpatients to the total number of inpatient deaths for the same period of time? a. Net b. Gross c. Hospital d. Average

b. Gross A gross autopsy rate is the proportion or percentage of deaths that are followed by the performance of autopsy

The type of statistics that makes a best guess about a larger group of data by drawing conclusions from a smaller group of data is called: a. Descriptive statistics b. Inferential statistics c. Generalized statistics d. Mathematical statistics

b. Inferential statistics Inferential statistics help make inferences or guesses about a larger group of data by drawing conclusions from a small group of data

Why is the MEDPAR file limited in terms of being used for research purposes? a. It only provides demographic data about patients b. It only contains Medicare patients c. It uses ICD-10-CM diagnoses and procedure codes d. It breaks charges down by specific type of service

b. It only contains Medicare patients

Which term is used to describe the number of calendar days that a patient is hospitalized? a. Average length of stay b. Length of stay c. Occupancy rate d. Level of service

b. Length of stay Length of stay (LOS) is calculated for each patient after he or she is discharged from the hospital. It is the number of calendar days from the day of patient admission to the day of discharge. When the patient is admitted and discharged in the same month, the LOS is determined by subtracting the date of admission from the date of discharge

Sometimes data do not follow a normal distribution and are pulled toward the tails of the curve. When this occurs, it is referred to as having a skewed distribution. Because the mean is sensitive to extreme values or outliers, it gravitates in the direction of the extreme values thus making a long tail when a distribution is skewed. When the tail is pulled toward the right side, it is called a __________. a. Negatively skewed distribution b. Positively skewed distribution c. Bimodal distribution d. Normal distribution

b. Positively skewed distribution When the tail is pulled toward the right side, it is called a positively skewed distribution; when the tail is pulled toward the left side of the curve it is called a negatively skewed distribution

The business office at Community Hospital is looking at software that can help them with decreasing their fraud and abuse cases. The software claims to be able to flag those patients that would most likely be involved in fraud by examining many databases at the same time and finding those patients with demographic discrepancies. This is an example of ________. a. Descriptive analytics b. Predictive analytics c. Inferential statistics d. Descriptive statistics

b. Predictive analytics Predictive analytics is a branch of data mining concerned with the prediction of future probabilities and trends, also called forecasting

A managed care organization is using a system that examines the past healthcare behaviors of their patients to determine their future costs for their healthcare. This is an example of ________. a. Descriptive analytics b. Predictive modeling c. Prescriptive analytics d. Real-time analysis

b. Predictive modeling Predictive modeling is a process used in predictive analysis to identify patterns that can be used to determine the odds of a particular outcome based on the observed data. That is, statistics from the past are reviewed to determine what is likely to happen in the future. Predictive modeling is used by many companies that want to predict future trends

Health departments use the health record to monitor outbreaks of diseases. In this situation what type of use of the health record does this represent? a. Educational b. Public health and research c. Medical review organization d. Patient care

b. Public health and research Public health and research uses data in the health record for many reasons including monitoring disease outbreaks

Which tool is used to display performance data over time? a. Status process control chart b. Run chart c. Benchmark d. Time ladder

b. Run chart A run chart displays data points over a period of time to provide information about performance. The measured points of a process are plotted on a graph at regular time intervals to help team members see whether there are substantial changes in the numbers over time

The HIM manager at Community Hospital is responsible for reviewing audit trails detailing potential access issues within the EHR. Which one of the following would be a type of activity that the manager would want to review? a. Every access to every data element or document type that occurred within the facility b. Whether the person viewed, created, updated, or deleted information belonging to a patient with the same last name c. Physical location of the redundant servers used for backup d. Whether all patients setup accounts in the patient portal

b. Whether the person viewed, created, updated, or deleted information belonging to a patient with the same last name

The facility privacy officer receives a phone call from a patient who is concerned that her former sister-in-law who is a hospital employee has accessed her health record. The privacy officer requests an audit log of activity within the patient's health record. What part of the audit log must be analyzed to determine if this complaint has merit? a. The patient demographic information b. Which employees viewed, created, updated, or deleted information c. The ownership of the record d. Whether the patient had requested to be omitted from the facility patient directory

b. Which employees viewed, created, updated, or deleted information

The HIM department at Community Hospital has three full time coders. One is considered the lead coder and his salary is $20.35 per hour. One coder is a new graduate who makes $15.50 per hour and the third coder is an experienced employee who earns $18.90 per hour. The lead coder codes four records per hour; the new coder codes three records per hour and their experienced coder codes six records per hour. Using a 7.5-hour productive day, what is the unit cost for the lead coder? a. $3.36 per record b. $4.49 per record c. $5.43 per record d. $5.51 per record

c. $5.43 per record The lead coder's annual salary is $20.35 × 2,080 (hours per year) = $42,328. The lead coder's productivity is 7.5 hours per day × 4 records per hour = 30 records per day. 30 records per day × 5 days per week × 52 weeks per year = 7,800 records per year. Yearly salary of $42,328 / 7,800 records per year = $2.556 = $5.43 per record

Community Hospital discharged nine patients on April 1. The length of stay for each of the patients was as follows: for patient A, 1 day; for patient B, 5 days; for patient C, 3 days; for patient D, 3 days; for patient E, 8 days; for patient F, 8 days; for patient G, 8 days; for patient H, 9 days; patient I, 9 days. What was the median length of stay? a. 5 days b. 6 days c. 8 days d. 9 days

c. 8 days. Correct Answer: C The median is the midpoint of a frequency distribution. It is the point at which 50 percent of observations fall above and 50 percent fall below. Eight is the mid-point of the distribution where 50 percent of the observations fall above and below eight

The HIM manager recently performed an audit of health record documentation in the EHR looking for reports that had been indexed incorrectly. The audit showed that for the 100 records reviewed there was a 4 percent error rate. Given that the national average labor cost of each misindexed report is $200, what is the labor cost for the department for handling these misindexed reports? a. $8,000 b. $500 c. $800 d. $500,000

c. $800 Indexing in the EHR can be checked by conducting a random audit. To conduct a study, a subsection of the EHR reports can be checked for mislabeled reports. Any mislabeled reports that are found are noted, and an accuracy rate can be determined and compared against the established standard. In this scenario, there was a 4 percent error rate for the 100 records in the sample. If the cost of each misfile is $200, this would cost the facility $800

Mr. Jones was admitted to the hospital on March 21 and discharged on April 1. What was the length of stay for Mr. Jones? a. 5 days b. 10 days c. 11 days d. 15 days

c. 11 days Length of stay (LOS) is calculated for each patient after he or she is discharged from the hospital. It is the number of calendar days from the day of patient admission to the day of discharge (31 - 21) + 1 = 11 days

What is the mean for the following frequency distribution: 10, 15, 20, 25, 25? a. 47.5 b. 20 c. 19 d. 95

c. 19 The mean is the arithmetic average of frequency distribution. Put simply, it is the sum of all the values in a frequency distribution divided by the frequency: (10 + 15 + 20 + 25 + 25) / 5 = 19

Community Hospital had 25 inpatient deaths, including newborns, for the month of June. The hospital performed five autopsies for the same period. What was the gross autopsy rate for the hospital for June? a. 0.02% b. 5% c. 20% d. 200%

c. 20%. The gross autopsy rate is the proportion or percentage of deaths that are followed by the performance of autopsy. In this case, (5 / 25) × 100 = 20%

Community Memorial Hospital had 25 inpatient deaths, including newborns, during the month of June. The hospital had a total of 500 discharges for the same period, including deaths of adults, children, and newborns. The hospital's gross death rate for the month of June was: a. 0.05% b. 2% c. 5% d. 20%

c. 5% The gross death rate is the proportion of all hospital discharges that ended in death. It is the basic indicator of mortality in a healthcare facility. The gross death rate is calculated by dividing the total number of deaths occurring in a given time period by the total number of discharges, including deaths, for the same time period: 25/500 = 0.05 × 100 = 5%

Information that has been taken from the health records of injured patients and entered into the trauma registry database has been: a. Aggregated b. Mapped c. Abstracted d. Queried

c. Abstracted After trauma cases have been identified, information is abstracted from the health records of the injured patients and entered into the trauma registry database

Community Hospital wants to compare its hospital-acquired urinary tract infection (UTI) rate for Medicare patients with the national average. The hospital is using the MEDPAR database for its comparison. The MEDPAR database contains 13,000,000 discharges. Of these individuals, 200,000 were admitted with a principal diagnosis of UTI; another 300,000 were admitted with a principal diagnosis of infectious disease, and 700,000 had a diagnosis of hypertension. Given this information, which of the following would provide the best comparison data for Community Hospital? a. All individuals in the MEDPAR database b. All individuals in the MEDPAR database except those admitted with a principal diagnosis of UTI c. All individuals in the MEDPAR database except those admitted with a principal diagnosis of UTI or infectious disease d. All individuals in the MEDPAR database except those admitted with a diagnosis of hypertension

c. All individuals in the MEDPAR database except those admitted with a principal diagnosis of UTI or infectious disease The Medicare Provider Analysis and Review (MEDPAR) file is made up of acute care hospital and skilled nursing facility (SNF) claims data for all Medicare claims. The MEDPAR file is frequently used for research on topics such as charges for particular types of care and DRGs. The limitation of the MEDPAR data for research purposes is that the file contains only Medicare patients. Community Hospital is excluding MEDPAR data of those patients with a principal diagnosis of UTI or infectious disease because these would not represent a hospital acquired condition (HAC) because the patients were admitted with those diagnoses. Community Hospital is looking for comparative secondary diagnosis data of Medicare patients from the MEDPAR file to compare their HAC rate for UTIs to the national average from the MEDPAR data

Data found on sites such as Hospital Compare use aggregated data to describe the experiences of unique types of patients with one or more aspects of their care. This data collection is called? a. Patient-specific b. Administrative c. Comparative d. Detailed

c. Comparative Comparative data uses aggregate data to describe the experiences of unique types of patients with one or more aspects of their care

For research purposes, an advantage of the Healthcare Cost and Utilization Project (HCUP) is that it: a. Contains only Medicare data b. Is used to determine pay for performance c. Contains data on all payer types d. Contains bibliographic listings from medical journals

c. Contains data on all payer types

What is the official count of inpatients taken at midnight called? a. Average daily census b. Census c. Daily inpatient census d. Inpatient service days

c. Daily inpatient census The result of the official count taken at midnight is the daily inpatient census

One of the pediatricians at Community Physician's Clinic worked with a software vendor to get a display of the patients she currently has in the hospital on her smart phone that lets her know current information such as lab results, vital signs, medications given. This is called a ________. a. Big data b. Descriptive analytics screen c. Dashboard d. Descriptive tablet

c. Dashboard A dashboard is a visual display of the most important information that a physician would need to see about his patients. These can usually be customized by facility or an individual

Which rate is used to compare the number of inpatient deaths to the total number of inpatient deaths and discharges? a. Net hospital death rate b. Fetal/newborn/maternal hospital death rate c. Gross hospital death rate d. Adjusted hospital death rate

c. Gross hospital death rate The gross death rate is the proportion of all hospital discharges that ended in death. It is the basic indicator of mortality in a healthcare facility. The gross death rate is calculated by dividing the total number of deaths occurring in a given time period by the total number of discharges, including deaths, for the same time period

Which rate describes the probability or risk of illness in a population over a period of time? a. Mortality b. Prevalence c. Incidence d. Morbidity

c. Incidence An incidence rate is used to compare the frequency of disease in different populations. Populations are compared using rates instead of raw numbers because rates adjust for differences in population size. The incidence rate is the probability or risk of illness in a population over a period of time

Suppose you want to display the number of deaths due to breast cancer for the years 2005 through 2015. What is the best graphic technique to use? a. Table b. Histogram c. Line graph d. Bar chart

c. Line graph A line graph may be used to display time trends. A line graph is especially useful for plotting a large number of observations. It also allows several sets of data to be presented on one graph

Which of the following reportable diseases usually requires reporting within 24 hours of a suspected diagnosis? a. Chicken pox b. Mumps c. Measles d. Pertussis

c. Measles

The following data fields comprise a database table: patient last name, patient first name, street address, city, state, zip code, patient date of birth. Given this information, which of the following is a true statement about maintaining the data integrity of the database table? a. Patient last name should be used as the primary key for the table. b. Patient date of birth should be used as the primary key for the table. c. None of the data fields are adequate to use as a primary key for the table. d. Patient last and first name should be used as the primary key for the table.

c. None of the data fields are adequate to use as a primary key for the table. A primary key must uniquely identify a record. None of the options provided will uniquely identify a record. Multiple individuals may have the same name and birth dates

What do the wedges or divisions in a pie graph represent? a. Frequency groups b. Various data c. Percentages d. Classes

c. Percentages

A report that lists the ICD-10-CM codes associated with each physician in a healthcare facility can be used to assess the quality of the physician's services before he or she is: a. Scheduled for a coding audit b. Subjected to corrective action c. Recommended for staff reappointment d. Involved in an in-house training program

c. Recommended for staff reappointment The medical staff department is particularly interested in the ICD-10-CM codes associated with each physician. Because diagnostic codes can identify untoward events that occur during hospitalization, the quality of a physician's services can be identified through reports called physician reappointment summaries. These summaries outline the number of cases by diagnosis and procedure type, LOS, and infection and mortality statistics. At reappointment to a facility's medical staff, code-based reports are required. The medical staff department accumulates these reports and works with the elected or appointed medical staff leadership to ensure that a thorough analysis of each physician's activities takes place before he or she is reappointed to the staff

General Hospital is performing peer reviews of their medical providers for quality outcomes of care. The hospital has more than 500 providers on its medical staff. The process to peer review even 10 cases for each provider is quite extensive. The quality department has concluded that to accomplish this review process, they will review 20 percent of each provider's inpatient admissions to the hospital every other year. In this situation, the quality department has applied to their review process. a. Benchmarking b. Data analysis c. Sampling d. Skewing

c. Sampling Sometimes the organizational characteristic or parameter about which data are being collected occurs too frequently to measure every occurrence. In this case, those collecting the data might want to use sampling techniques. Sampling is the recording of a smaller subset of observations of the characteristic or parameter, making certain, however, that a sufficient number of observations have been made to predict the overall configuration of the data

Hospital A discharges 10,000 patients per year. Hospital B is located in the same town and discharges 5,000 patients per year. At Hospital B's medical staff committee meeting, a physician reports that he is concerned about the quality of care at Hospital B because the hospital has double the number of deaths per year than Hospital A. The HIM director is attending the meeting in a staff position. Which of the following actions should the director take? a. Make no comment since this is a medical staff meeting. b. Agree with the physician that the data suggest a quality issue. c. Suggest that the data be adjusted for possible differences in type and volume of patients treated. d. Suggest that an audit be done immediately to determine the cause of deaths within the hospital.

c. Suggest that the data be adjusted for possible differences in type and volume of patients treated. When doing external benchmarking, the other organizations need not be in the same region of the country, but they should be comparable in terms of patient mix and size. The data from the two hospitals are not comparable because Hospital A discharges more patients than Hospital B. In addition, data on the comparability of severity of illness between the two hospitals is lacking and an informed decision cannot be made

A secondary data source includes ________. a. Vital statistics b. The medical record c. The physician's index d. A videotape of a counseling session

c. The physician's index Secondary data sources are data derived from primary sources and may be collected by someone other than the primary user. Secondary data sources are facility specific. The physician index is an example of a secondary data source

The HIM department at Community Hospital has three full time coders. One is considered the lead coder and his salary is $20.35 per hour. One coder is a new graduate who makes $15.50 per hour and the third coder is an experienced employee who earns $18.90 per hour. The lead coder codes four records per hour; the new coder codes three records per hour and their experienced coder codes six records per hour. Using a 7.5-hour productive day, what is the unit cost for the new graduate coder? a. $3.36 per record b. $4.49 per record c. $5.43 per record d. $5.51 per record

d. $5.51 per record The new graduate coder's salary is $15.50 × 2,080 (hours per year) = $32,240. Productivity is 7.5 hours per day × 3 records per hour = 22.5 records per day. 22.5 records × 5 days per week × 52 weeks per year = 5,850 records per year. $32,240 / 5,850 = $5.51 per record

Community Hospital's HIM department conducted a random sample of 200 inpatient health records to determine the timeliness of the history and physicals completion. Nine records were found to be out of compliance with the 24-hour requirement. Which of the following percentages represents the H&P timeliness rate at Community Hospital? a. 4.5% b. 21.2% c. 66.7% d. 95.5%

d. 95.5% A complete history and physical report represents the attending physician's assessment of the patient's current health status, and accreditation standards require it to be completed within 24 hours of admission. In this case, 191 instances of timely H&Ps out of 200 sampled is 95.5% accuracy. The calculation is (191/200) × 100 = 95.5%

Which of the following is an example of how an internal user utilizes secondary data? a. State infectious disease reporting b. Birth certificates c. Death certificates d. Benchmarking with other facilities

d. Benchmarking with other facilities

Which of the following is an example of how an internal user utilizes secondary data? a. State infectious disease reporting b. Birth certificates c. Death certificates d. Benchmarking with other facilities

d. Benchmarking with other facilities Internal users of secondary data are individuals located within the healthcare facility. Internal users include medical staff and administrative and management staff. Secondary data enable these users to identify patterns and trends that are helpful in patient care, long-term planning, budgeting, and benchmarking with other facilities

After the types of cases to be included in a cancer registry have been determined, what is the next step in data acquisition? a. Case registration b. Case definition c. Case abstracting d. Case finding

d. Case finding

After the types of cases to be included in a trauma registry have been determined, what is the next step in data acquisition? a. Registering b. Defining c. Abstracting d. Case finding

d. Case finding Cancer registries were developed as an organized method to collect these data. Case finding is a method used to identify the patients who have been seen or treated in the facility for the particular disease or condition of interest to the registry. After cases have been identified, extensive information is abstracted from the patients' paper-based health records into the registry database or extracted from other databases and automatically entered into the registry database

A consumer nonprofit organization wants to conduct studies on the quality of care provided to Medicare patients in a specific region. An HIT professional has been hired to manage this project. The nonprofit organization asks the HIT professional about the viability of using billing data as the basis for its analysis. Which of the following would not be a quality consideration in using billing data? a. Accuracy of the data b. Consistency of the data c. Appropriateness of the data elements d. Cost to process the data

d. Cost to process the data Several factors must be addressed when assessing data quality. These include: data accuracy, consistency, comprehensiveness, and timeliness. Cost to process the data does not influence the quality

Which term is used to describe the number of inpatients present at the census-taking time each day plus the number of inpatients who were both admitted and discharged after the census-taking time the previous day? a. Inpatient bed occupancy rate b. Bed count c. Average daily census d. Daily inpatient census

d. Daily inpatient census The result of the official count taken at midnight is the daily inpatient census. This is the number of inpatients present at the official census-taking time each day. Also included in the daily inpatient census are any patients who were admitted and discharged the same day

What is data called that consists of factual details aggregated or summarized from a group of health records the provides no means to identify specific patients? a. Original b. Source c. Protected d. Derived

d. Derived Derived data consist of factual details aggregated or summarized from a group of health records that provide no means of identifying specific patients. These data should have the same level of confidentiality as the legal health record

This type of chart plots all data points as a cell for two given variables of interest and, depending on frequency of observations in each cell, provides color to visualize high or low frequency. a. Barplot b. Scatter plot c. Boxplot d. Heatmap

d. Heatmap A heat map plots all data points as a cell for two given variables or interest, and depending on frequency of observations in each cell, provides color to visualize high or low frequency

One of the questions on the patient satisfaction survey that is sent to the patient after discharge asks for the number of times the nurses checked the patient's vital signs in a day. This is an example of which type of data? a. Qualitative b. Interval c. Nominal d. Quantitative

d. Quantitative Healthcare data are divided into two broad categories of quantitative and qualitative data. Quantitative data are numeric while qualitative data describe observations. Quantitative data can be numerically counted. They deal with measurements

Community Hospital is using a system that will help them detect when intracranial pressure becomes high in patients with a recent CVA that will quickly send an alert to the physician. This is an example of ________. a. Descriptive analytics b. Predictive analytics c. Prescriptive analytics d. Real-time analysis

d. Real-time analysis Unlike retrospective analytical tools, such as predictive modeling, real-time analytics refers to data that can be accessed as they come into a computer system. Real-time analytics, also referred to as streaming analytics, implies instantaneous results; however, the data may not be immediately available, but rather available within a few minutes. The most valuable data in this category are those that are collected and analyzed during the customer interaction, not the review afterward (

A celebrity injured while on vacation was admitted to the local community hospital for treatment of a fracture. On day two of the admission, the hospital was contacted by several media agencies stating that they were aware the patient was at the facility and requesting information about the current medical condition of this high profile celebrity patient. The CEO is concerned that an employee has shared information to the media regarding this patient. The facility privacy officer was tasked with determining if a facility employee leaked this information to the press. How would the privacy officer begin this analysis? a. Create a new policy about high-profile patient privacy b. Start by discussing the situation with the media to resolve their inquiries c. Contact employees in the facility d. Review audit trail information to determine which employees have accessed this patient's information

d. Review audit trail information to determine which employees have accessed this patient's information

Which of the following is used to plot the points for two variables that may be related to each other in some way? a. Force-field analysis b. Pareto chart c. Root cause analysis d. Scatter diagram

d. Scatter diagram Scatter diagrams are used to plot the points for two continuous variables that may be related to each other in some way. For example, one might want to look at whether age and blood pressure are related. One variable, age, would be plotted on the vertical axis of the graph, and the other variable, blood pressure, would be plotted on the horizontal axis

Which of the following is true about a primary key in a database table? a. Usually is not a unique number b. Changes in value c. Is dependent on the data in the table d. Uniquely identifies each row in a table

d. Uniquely identifies each row in a table Primary keys ensure that each row in a table is unique. A primary key must not change in value. Typically, a primary key is a number that is a one-up counter or a randomly generated number in large databases. A number is used because a number processes faster than an alphanumeric character. In large tables, this makes a difference. In the PATIENTS table, the PATIENT_ID is the primary key. It is good programming practice to create a primary key that is independent of the data in a table

Recently, a state senator was admitted to your facility for a serious medical condition. The facility privacy officer has been tasked with reviewing access logs daily to determine which of the following? a. Whether or not the patient is fit to continue public service b. What information should be shared with the media c. That the patient has received adequate care d. Whether all access by hospital employees was appropriate

d. Whether all access by hospital employees was appropriate

As part of your job responsibilities, you are responsible for reviewing audit trails of access to patient information. The following are all types of activities that you would monitor except: a. Every access to every data element or document type b. Whether the person viewed, created, updated, or deleted the information c. Physical location on the network where the access occurred d. Whether the patient setup an account in the patient portal

d. Whether the patient setup an account in the patient portal

The facility privacy officer is visited at the hospital by a recent patient who is concerned that her nosy neighbor, who happens to be a hospital employee, accessed her EHR inappropriately in order to tell other neighbors about the patient's health conditions. In order to determine this occurred, the privacy officer requests an audit log of activity within the patient's health record. What part of the audit log would the privacy officer need to first analyze to determine if this patient complaint is valid? a. The physician documentation from her recent stay regarding the patient's health conditions b. Whether the patient had requested any amendments to her record c. If the record has any deficiencies that would cause the record to be delinquent d. Which employees viewed, created, updated, or deleted information

d. Which employees viewed, created, updated, or deleted information