Health Informatics - Midterm
What is a type of network that allows the networks of separate organizations to communicate with one another?
Extranet
A ________ is a primary key in one table, but a variable (not unique) in another.
FK (foreign key)
What is the first system the patient encounters in health system; gather demographic info (name, address, DOB, HCN, next of kin) and additional info (adm/dis date, patient location, disposition). Interfaces with other systems to reduce duplication of data entry and clients being asked for same info repeatedly.
ADT (admission, discharge, transfer)
What is a relatively recent variation of SDLC that breaks the method into smaller chunks and develops each chunk completely before moving onto the next; more flexible and iterative than traditional method, but may not be suited to complex projects?
Agile SDLC
____________ services may have many separate systems or a few separate. Contains ADT, OR system, and financial module and: - Core applications like ADT systems. - Departmental systems like radiology, lab, pharmacy. - business and financial - communications and networking applications to send messages through depts. - document systems for patient data, ex, transcription and point-of-care bedside nursing terminals. - alert functions for test results. - surveillance systems.
HIS (Hospital Information Systems)
What is a not-for-profit, ANSI-acredited standards developing organization (founded in 1987) that provides comprehensive standards for the exchange, integration, sharing, and retrieving of electronic health info that supports patient care? Data content and document standards for the exchange of clinical info. This standard provides the means for exchanging health data without requiring extensive interface programming and maintenance, enabling semantic interoperability.
HL7 (Health Level Seven)
An _____ is the integration of several elements of a business process to achieve a specific outcome; the system receives and process input and provides output. Consists of data, people, work processes, and a combination of hardware, software, communication technology (computer networks) and IT. Performs 5 specific activities: Input, processing, output, storage, and controlling.
IS (information system)
Who is an international standards development organization that owns and administers the development, publication, and maintenance of the SNOMED CT standards and related artefacts and technologies?
International Health Terminology Standards Development Organization (IHTSDO)
Who is a non govt, international treaty-based organization with a technical committee focused on health information standards-based models of EHR architecture and terminology, privacy and security standards, messaging and communication development?
International Organization for Standardization (ISO)
A common type of protocol is the _________ which is assigned when someone uses the Internet, and this protocol has rules for how data is stored in packets and made identifiable and then how it is transmitted and stored.
Internet protocol (IP)
Testing the new IS is part of what phase: A. Design. B. Planning and analysis. C. Implementation. D. Maintenance.
C
Who developed a pan-Canadian interoperable Electronic Health Record Solution (EHRS) architecture for health care information systems' needs that establishes a common basis of understanding between healthcare professionals, providers, and third parties, vendors, govt, developers, and IS beneficiaries; informs and guides the interoperable, nationwide approach to meet the business needs of all participants in the healthcare system.
Canada Health Infoway
Database security involves the use of _________ features to comply with the security requirements of an organization. Rob and Coronel list minimum recommended safety safeguards: - changing passwords and paths. - applying patches. - securing installation folders with access rights. - ensuring only required services are running. - audit logs. - session logging. - encryption.
DBMS
What allows the addition and subtraction of data into the system and supports the extracting of data for reporting purposes? It is a collection of programs that manages the database structure and controls access to the data stored in the database, i.e. Microsoft Access. Software that supports a database; intermediary between user and database. - personal DBMS - Access (inexpensive but not enough storage for healthcare facility) - server-based - Oracle, SQL Server, Sybase, Informix (fast, can be used by multiple end-users)
DBMS (database management system)
What is the international standard for medical imaging and related information, and one of the most widely used data exchange protocols in health care? Defines the formats for medical images that can be exchanged with the data and quality necessary to support clinical use. Fundamental goal is to promote medical image interoperability regardless of the medical device. Has multiple layer support according to the ISO/Open Systems Interconnection (OSI) network model for medical images.
DICOM (Digital Imaging and Communications in Medicine DICOM)
_________________ hierarchy: - data - to convert to meaningful form, must be processed manually or electronically. - information is data that is organized, making it useful or valuable. - knowledge is the body of information and facts about a specific subject; can be derived from information once information is organized, analyzed, and synthesized; is generally personal, subjective, and inherently local. - wisdom is the trait of utilizing knowledge and experience with common sense and insight.
DIKW (data, information, knowledge, wisdom)
CIHI's __________ includes 3 components: 1. data quality work cycle - 3-component approach that involves planning, implementing, and assessing activities. 2. assessment of data quality - made up of 5 dimensions: accuracy, timeliness, comparability, usability, and relevance. 3. documentation of data quality - document quality for both internal and external users.
Data Quality Framework
What provides metadata about data? It is a descriptive list of names (also called representations or displays), definitions, and attributes of data elements collected in an information system or database. In essence, it is the _______ to understand the content of a database in terms of data elements and their associated permissible values. It documents the data elements, structures, etc. within any database. Does not store electronic health record data, stores metadata A good ____ defines each data field according to the following info: - name of field - type of data field - length of data field - edits placed on data field - values allowed to be placed in data field - clear definition of each value.
Data dictionary
Duties of a __________ include maintaining the database on an ongoing basis, being the lead on developing and designing databases, controlling user access and security, interfacing with vendors for technical support, ensuring that organization complies with licensing agreement. Routine maintenance tasks: - physical backup of database. - recovery (restoration) - updating - downtime so that minimal productivity is lost.
Database Administrator (DBA)
The ____________ (DBLC) has 6 phases: - database initial study. - database design - implementation and loading. - testing and evaluation - operation - maintenance and evolution
Database Life Cycle
A _________ session is made up of a group of end users, system analysts, and technical development professionals who are brought together to analyze the strengths and weaknesses of the current IS and to propose functionalities for the new system?
JAD (joint application development)
What is the principal international standard for medical laboratory observations and reporting?
Logical Observation Identifiers Names & Codes (LOINC) (Regenstrief Institute)
What standard provides a coherent normative basis for naming lab tests using agreed upon nomenclature? Codes can be mapped to existing local lab vocabularies and can be embedded in HL7 messages?
Logical Observation Identifiers Names and Coders (LOINC)
What systems allows for the collection, storage, aggregation, and reporting of patient health and medical info. Supports scheduling, clinical decision-making, coding, clinical research; billing and audits; can be hybrid or fully EHR.
Medical Record Systems
Who facilitates interoperability of medical imaging equipment (e.g. for traditional X-rays) with their Digital Imaging and Communications in Medicine (DICOM) Standard?
National Electrical Manufacturer's Association (NEMA)
What is the primary storage circuit which holds data temporarily. Data may be retrieved when needed, but it goes out of memory when processing is complete.
RAM (random-access memory)
What is software created by the manufacturer required to ensure the computer functions correctly. Cannot be changed by user.
ROM (read-only memory)
What is developed to obtain a project or service, often through bidding process, details requirements of service and clearly identifies the risk and benefits. - informs suppliers that an organization is looking to procure. - inform suppliers that the selection process is competitive. - allow for widespread distribution and response - ensure suppliers respond factually to the requirement lists. - follow a structure evaluation and selection process so organization can demonstrate impartiality. * Used by healthcare facilities when they don't have the time, money, or expertise to go through IS development process. * Smaller request compared to large Request for Information
Request for Proposal (RFP)
The key to engage stakeholders is ___________, which are integral to the identification of work plan priorities and to the continued sharing and advancement of pan-Canadian and international standards; bring clinical and technical experts together to share implementation experiences and advance development of standards supporting messaging, data, and terminology. Focus on: - laboratory. - DI. - pharmacy - public health. - individual health delivery - secondary or health system use. - terminology. - nonnlincal registries. - privacy and security - architecture and infrastructure.
Standards Collaborative working groups (SCWGs).
What is a private or government agency involved in the development of healthcare information standards at a national or international level? In Canada, Canada Health Infoway's Standards Collaborative and CIHI are participating members. All ______ involve stakeholder involvement.
Standards Development Organization (SDO)
What organizations do not develop base health information standards like SDOs but are vital in the finalization and integration of standards' requirements for use in the implementation of standards-based EHR solutions?
Standards Maintenance and Coordination Organizations (SMOs and SCOs)
What traces the history of an information system and provides the big picture within which the database design and application development can be mapped and evaluated. It is a logical and systematic project planning tool for an IS. Contains 5 phases: - planning. - analysis - detailed systems design - implementation - maintenance
Systems Development Life Cycle (SDLC)
Testing of the new IS system should be conducted using actual patient data, not sample data the vendor has provided or the organization has created for training purposes. T/F
T
What delivers health care and professional education using IT; uses live, two-way video conferencing for remote patients or calling a phone number for health info?
Telehealth
What is a connection which utilizes a pre-existing public communication like a personal internet connection to conduct private communications. Encrypting is used.
VPN (Virtual Private Network)
What is a system of Internet servers that supports specially formatted documents?
World Wide Web
What refers to the degree to which info in or derived from the database or registry reflects the reality it was designed to measure?
accuracy
System _________ and product review include a number of steps, some of which should be completed prior to contact finalization: - discuss and finalize system customization. - clarification of resource allotment from vendor. - review agreement on project elements - verification of integration and interfacing procedures and IT contacts within organization who will work with vendor. - supply of documentation for system, including user and system admin manuals. - availability of test and production environments. - discussion and finalization of support and maintenance protocols during and after implementation. - training procedures and timelines. - determination of system upgrade processes and any cost that may be involved in these.
acquisition
What systems are designed to manage the admin, HR, financial, and legal info of an organization; can be stand-alone or modules within central system of organization.
administrative systems
In what phase of the Systems Development Life Cycle (SDLC) is a detailed analysis of the current state of affairs and the need for a new system undertaken; assessment of user needs, analysis of workflow, efficiency of existing system; user proficiency and satisfaction, timeliness of data; assesses readiness of change?
analysis
What is the characteristic of an entity?
attribute
System evaluation can be aided by ________ used to complete a quantitative assessment of the software for usability, maintenance, and sustainability; criteria-based, objective, systematic, and critical analysis of the software
audits
End-user requirements are identified in the _____ phase of the SDLC: A. Design. B. Analysis. C. Implementation. D. Maintenance.
b
Healthcare Human Factors Group at University Health Network developed guidance for use of terminologies such as: a. pCLOD in user interfaces. b. SNOMED CT in user interfaces. c. none of the above. d. all of the above.
b
Which HL7 working group provides guidance related to terminology (e.g. TermInfo and CTS 2)? a. HL7 CDA. b. HL7 Vocabulary. c. HL7 Structured Documents. d. HL7 EHR-S Functional Model
b
During the evaluation portion of IS development, vendors may have _______ software available for internal demonstrations and previews to customers; this is referred to also as a preview, a prototype, or technical preview. Users test the _____ version and are able to point out errors and problems with the system.
beta
What captures the reasons for initiating a project; prepared by dept requesting upgrade with valid reasons why human and financial resources should be allocated to project; after reviewing the _______ the management should thoroughly understand why new system is required and make an educated decision about approval?
business case
What is a brief, precise, an unambiguous description of policy, procedure, or principle within a specific organization?
business rule
The Logical Observation Identifiers Names and Codes (LOINC) is a standard used for which branch of healthcare? Select one: a. Diagnostic Imaging b. Rehabilitation c. Laboratory d. Mental Health
c
What is InfoCentral? a. Health Canada's wiki. b. CIHI's wiki. c. Canada Health Infoways' SC wiki. d. IHE's wiki.
c
What is the concept of relationship between tables referred to as?
cardinality
What is the name for an individual who is in a senior leadership position in the area of responsibility that the new system will serve? Often in healthcare a physician; should be enthusiastic supporter of project as well as influential and well-respected.
champion
Health data has several _______ that are different than other data: - data sparesness - only small subset of possible attributes, ex small number of ICD-10 codes for each person. - very large number of dimensions - diagnostic, intervention, lab coding systems all contains thousands of codes. - rapidly expanding set of attributes - new discoveries every day - de-identified data - source data versus derived data - associate some data with explanatory metadata - requirement for near real-time data.
characteristics
What kind of architecture refers to a central server or host computer which provides services to many remote processors, or clients? (clients = computer that access shared resources; servers = computers that share resources)
client/server architecture
What is the name for computers that are used to access shared resources in a network?
clients
What refers to the extent to which databases are consistent over time and use standard conventions, making them similar to other databases?
comparability
What term refers to the physical construction of hardware components and their relationship to one another?
computer architecture
The three steps of data modelling are: 1. _________ model: Mapping out of business requirements in easy to understand terms. Can be illustrated using a context-level data flow diagram; simple diagram, with no field or table info. 2. ___________ model: basic concept of tables and the relationship between them. At this stage a more detailed diagram is drawn (Diagram 0). 3. __________ model: Process of mapping out tables, relationships, and keys using ERD. Choice of database software is made; must also take into account hardware requirements for storing data.
conceptual, logical, physical
What is a restriction or rule that is placed on data?
constraint
The modified ACHI Framework for Classifying Standards defines data ____ standards as standards that allow for data and metadata to be reliable and comparable no matter when or where the data are collected.
content
Data __________ is the moving of computer data from 1 format to another to address changing standards for data and file handling. May occur when old system is upgraded; can be as simple as a field to field move (1 system to another with similar set up) or it can involve combining multiple fields into one or the use of different data standards and field structures. Data quality checks and audit need to occur after this to ensure no errors occurred during the process.
conversion
Canada Health Infoway Standards approved and in use, have the following status: a. Canadian Strategy Selection (CSS) b. Canadian Draft for Use (CDFU) c. Canadian Approved Standards (CAS) d. none of the above
d
Standards are made adaptable and reusable to address business requirements, not otherwise addressed in generic national or international versions of a standard. This approach is known as: a. constraint - where particular code sets are specified for use. b. extension - where new requirements are added. c. neither a nor b. d. both a and b.
d
Terminology management tools are able to support: a. browsing. b. authoring and editing. c. mapping. d. all of the above
d
The methods used to identify requirements for a proposed IS is (are): A. Conducting site visits. B. Conducting a JAD. C. Developing a prototype. D. All of the above.
d
The need for standards originates from the diversity of: a. Information systems. b. Business needs. c. health care settings. d. all of the above
d
What is a euphemism for conducting business via Internet tools, especially the WWW and e-mail? Uses both the web (business-to-customer B2C, i.e. websites on disease prevention, customer booking portals) and electronic data interchange (EDI) (business-to-business (B2B, i.e. EHR, transcription) as means of conducting business.
e-commerce
What is one of the most important aspects of system implementation because consistent training will ensure that the users understand the system and will be entering data accurately and consistently? It also helps to protect the confidentiality and security of the system.
education
An _________ database supports many users (more than 50) while a workgroup database supports less than 50 users.
enterprise
What is a large IS that manages data for an entire healthcare business, allows organization to perform activities such as: - HR management - financial - customer relationship management - supply chain planning - sales and logistics
enterprise-wide system (or enterprise resource planning system)
What is a noun, the subject of data to be stored?
entity
The ___________ diagram (ERD) uses graphical representations to depict database components.
entity relationship
What is a knowledge system built from a set of rules applied to specific problems?
expert system
What are systems shared among different health systems that exist to report info required by regulatory agencies or as part of an info exchange for regional comparison, ex provincial pharmaceutical information systems?
external (cooperative)
What type of database is a text file consisting of 1 table that is delimited by a comma or tab. It has a row and column structure with 1 record per row. Limitations: - no way to join data in multiple tables if desired. - same data may be stored in multiple tables, leading to data integrity issues if not all tables are updated at the same time.
flat file
What is an attribute whose values match the PK values in another table.
foreign key (FK)
________ refers to the physical equipment that makes up the info system; applies to all physical electronic devices, including input, output, and storage devices, includes central processing unit (CPU), hard disk, RAM, ROM, DVD, video, sound, and network cards.
hardware
In what kind of database is one data item substitute for another in a kind of parent-child relationship; the parent can have more than 1 child, but child data element is limited to 1 parent. Limitations - inflexible.
hierarchical
What system focuses on integrating and meeting the needs of all or most departments in the hospital, ex. ADT which is used by all clinical depts.
hospital
________ computers process both the continuous (analog) and discrete (digital, i.e. personal computer) data; used in scientific fields and hospitals and are used to watch the patient's health condition in the ICU.
hybrid
An ________ plan is put in place during stage 4 of SLDC. According to Fenton and Liebermann at minimum the plan should consist of the following items. (A GANTT chart is a useful tool for this process): - major tasks identified - major milestones set. - estimated duration of task. - dependencies. - resources and budget. - person responsible for each task and milestone. - target dates for milestones. - measures for evaluating success. * 3 tasks are critical: testing the new system, training end users, and converting to the new system.
implementation
During ________ the system and organization are customized as needed and then readied for live use. Training requirements and documentation changes that are accompanied by flow charts and revised policies and procedures will contribute to a smooth transition.
implementation
In what phase of the Systems Development Life Cycle (SDLC) is the vendor selected and contract finalized and signed off; a project plan and schedule is developed; Implementation Committee is formed, consisting of members of the Steering and Proposal Committees; at least one high level Champion is desirable. Broken down into sub-phases: - workflow and process analysis - install components - train staff - "train the trainer method". One or more key users are trained as super users and train colleagues. - convert data and test - communicate progress. - plan for go-live date. - support and evaluation - problems could involve going over budget, unforeseen delays, last-minute changes by key stakeholders. assign group to look after issues quickly so staff do not develop negative attitudes towards system. - Go-Live - Can be handled in different ways: rolled out in stages known as pilots (small portion rolled out first and tested); parallel run (most costly but safest); Riskiest method is to switch over new system entirely on Go-Live date (can work if adequate back-ups and testing in place)
implementation
Robertson emphasizes that ___________ management is not about technology; rather, it encompasses people, process, technology, and content. Key challenges for _____ management include: - technology - people -process - content
information
The CIHI and the International Organization for Standardization (ISO)/Technical Committee (TC) 215 Health Informatics modified the Advisory Committee on Health Infrastructure Framework for Standards Classification in 2002, resulting in 4 classes: - organization and people standards. - process standards. - ____________ standards - data structure, content, messaging, information and data management. - technology standards
information
What is the art and science of organizing and labeling websites, intranets, online communities, and software to support usability?
information architecture
During the assessment, evaluation, selecting process of a new ___________, the project team should understand: - functionality - what functions must new system be able to perform to meet needs? - conformance - are there international, national, provincial, or organizational standards that must be met? - certification - certified by external reviewing organizations or standard-setting bodies. Steps involved (similar to SDLC): - define needs. - identity potential vendor systems. - develop RFP. - evaluate RFP responses. - schedule software demonstrations. - make a decision. - define scope of work (SOW) and create and agree on a contract. - move forward with project planning and implementation.
information system
Defining variables in each table and the primary key fields for each table is the first step for ensuring data __________ in relational databases?
integrity
________ provide a way of ensuring that data that are entered or updated in a database by authorized users do not result in loss of data quality; could be either specification of uniqueness (only allowing M or F in gender field) for values of a column or validation of values of a column (only range of specified values for temperature field).
integrity constraints
What systems serve more than 1 department, and information may be input and used by various departments. For example, a laboratory system that is used by the lab but also other various clinical departments who need access to lab reports.
interdepartmental
What is a shared boundary across which 2 components of a computer system exchange information? Provide a method of moving data from system to system. May be referred to as middleware. In three-tier architecture, there is an ________ engine acting as a tool to exchange info between applications.
interface
What type of IS system is usually composed of an electronic library or central repository of best practices; integrates clinical database, EHR, and embeds drug info into physician order-entry process?
knowledge management system (KMS)
What is the first generation of programming languages, consists of ones and zeros?
machine
What term refers to one central physical computer connected to various local terminals and supportive hardware (printers, etc) which process large amounts of information on their behalf?
mainframe architecture
What phase of the Systems Development Life Cycle (SDLC) consists of the ongoing activities necessary to keep the new system running at an optimal level; tech support available 24/7; staff in place to support system backup, upgrades from vendor, equipment maintenance and replacement; ongoing user training as system is updated; planning for disaster recovery; continuous evaluation (starting after 6 months) to ensure system meets need of organization, if not cycle repeats. - evaluation includes objective and subjective (opinions) criteria; doesn't serve the system being evaluated but the next one to be implemented.
maintenance
The modified ACHI Framework for Classifying Standards defines information and data __________ standards as processes used to collect, process, analyze, and disseminate health info and data. Example is CIHI Data Quality Framework, a tool to promote and monitor data quality for data submission to CIHI.
management
Managers of nursing, PT, HIM often used computer systems called _________ to manage budgets, create work schedules, perform employee evaluations. Three categories: - management information system - middle managers, specialized to support particular area of business; includes transaction data input, summary reports; input data on dictated reports, coded reports, incomplete reports; output data include production schedules and productivity analysis. - decision support system - alerts to physician about patient care; reminders of clinical practice guidelines; link to websites like National Library of Medicine. - executive information system - seniors executives, provides easy access to both internal and external information; dashboards.
management information systems (MISs)
What type of cardinality (relationship between tables) would be used for table A with account number & bill type & bill date and table B with account number & bill type & bill date & payment amount? Many entity occurrences are associated with many entity occurrences of another entity, i.e. a person takes many medications, and each one of those medications is taken by many people.
many-to-many
Data conversion may require data ________, which is the process of defining where a field should go if there is no corresponding field in the receiving system. It is a process in which 2 distinct data models are created and a link between them is defined.
mapping
What is defined as data that gives info about other data? Tells the user what they need to know about that particular field in a standardized fashion.
metadata
What is a series of activities conducted to identify gaps between current and desired organizational, group, or individual performances. following this analysis, activities are developed to address the gaps?
needs assessment
In what kind of database is every item related to many others in a cobweb fashion; limitations - complicated
network
What is defined as a system of computers, peripherals, terminal and databases connected by communication lines? includes Ethernet (via cable) and Wi-Fi. Where at least 1 process in 1 device is able to send and receive data to and from at least 1 process residing in a remote device, then the 2 devices are said to be a ______.
network
In setting up a relational database, data redundancy is avoided by the process of _________, which takes on 3 forms: 1. Eliminate repeating groups in tables. Create 2nd table for each set of related data. ID the primary key in table 2. Create separate tables for values that apply to multiple records. Relate these tables with a foreign key. 3. Eliminate fields that do not depend on the key.
normalization
What kind of database is designed to handle objects rather than text or numbers, ex. database that holds MRI scans, 2 types of info are stored: object and method (description of how to use data).
object-oriented
What type of cardinality (relationship between tables) would be used for table A with account number & patient name and table B with account number, diagnosis code sequence, ICD-10-CM diagnosis code? One entity occurrence is associated with many entity occurrences of the other entity, i.e. a person sees 1 doctor, who sees many patients.
one-to-many
What type of cardinality (relationship between tables) would be used for table A with patient ID & Discharge status code and table B with Discharge status code & definition? Each entity occurrence is associated with only 1 entity occurrence, i.e. one bed per patient and each patient occupies only one bed.
one-to-one
When ISs are used to process data created and used by business operations, they are referred to as ___________ systems, whose role is to efficiently process business tractions, support communication and collaboration among business units, ex. R-ADT (registration-ADT) or transaction-processing system (TPS) (patient admissions, employee time cards, supply purchases) or enterprise collaboration systems (e-mail, appt scheduling, videoconferencing).
operation support
An ___________ database's primary function is to support day-to-day operations.
operational
What is the most critical resource in healthcare?
patient data
What is the name for the different pieces of hardware connected to central processing units (CPUs) to make them more functional and user-friendly, i.e. - input (scanners, barcodes, keyboards, sensors), - processing - memory - output (computer screen, printer, etc) - storage (flash drive, hard drive, CDs; internal or external) - communications (modems, Wi-Fi)
peripherals
__________ software are software applications designed for individual use on personal computers to improve efficiency and productivity of work: - database systems, i.e. Access - spreadsheets - presentation - project management, ie. GANTT or PERT charts - groupware. i.e. Lotus Notes
personal productivity
How data flow through a network through a configuration of cables, computers, and other devices is referred to as a ________. Four types commonly used: - bus topology - computer connected to a common backbone (older topology). - star - central hub. - ring - connected to network in a closed loop or ring. mesh - combines bus, star, and ring, i.e. Internet
physical topology
In what phase of the Systems Development Life Cycle (SDLC) is the business problem defined as well as goals and scope of project, alternative solutions, required resources and benefits?
planning
What is an attribute that is a unique identifier of each row/record in the table, i.e. ID number.
primary key (PK)
What are charts that are graphical in nature and provide a symbolic representation of the processing activities performed on the work piece?
process flowchart
In the DIKW hierarchy, _______ is the critical action necessary for conversion of data into wisdom and is required to advance from 1 level of the hierarchy to another.
processing
What provide rules and conventions for communication between devices on a network? Help to encrypt and secure sensitive information that is being communicated between users. Network _____ enable computers on the network to communicate with each other, provides common language (i.e. HTTP (hypertext transfer protocol) for webpage browsers; SMTP (simple main transfer protocol) for emails.
protocol
What is a state of preparedness of persons, systems, or organizations to meet a situation and carry out a planned sequence of actions. _______ is based on thoroughness of the planning, adequacy, and training of the personnel and supply and reserve of support services or systems? The _______ of an organization to the meet the challenges of system implementation must be systematically assessed and identified risks mitigated. The human factor is the key to this; keeping stakeholders in the loop throughout the project is vital as well as education and timely responses to users difficulties.
readiness
A metadata____________ is an authoritative source of reference information about the representation, meaning, and format of data collected and managed by an enterprise. It does not contain the data itself but the information that is necessary to clearly describe, inventory, analyze, and classify data.
registry
What is the most common type of database and one that you will be exposed to most often. First developed in 1970s. Data with a common purpose, concept, or source are arranged into tables. Each row is an record or entity, each column is a field or attribute. Key concept is that there is a relationship between the tables and they are joined by a unique identifier that is present in both tables. - type of database that stores data in predefined tables made up of rows and columns.
relational
What is a verb that describes association between entities?
relationship
What refers to the degree to which a database or registry meets the current and potential future needs of users?
relevance
_________ is the level of interoperability where every piece of info communicated electronically is fully interpreted y the receiver in the same manner in which it was sent.
semantic interoperability
The three basic pieces of system _____ are the operating system, language translator, and utility program.
software
what is defined as a collection of computer programs and operating info stored on a computer. There are two types: - Operating system - set of instructions that direct actual computer operating functions, Windows, MAC OS. DOS (disk operating system) - application - support end user to perform required tasks, ex. Microsoft Office
software
A example of a data _________ standard is the Reference Information Model (RIM) used in HL7 V3, which is an abstract-oriented model that shapes the design and development of HL7 V3 messages through a methodological approach that provides the necessary metadata information and structure required.
structure
What is the term used to describe voice and data communications within an organization? Provides the technology infrastructure that enables people to talk to each other using a telephone, access a database, and send e-mail
telecommunications
What refers to the currency of the data at the time of release, determined by measuring the gap between the end of the reference period to which the data pertain and the date on which the data becomes available to users?
timeliness
What is the name for IS systems developed by IS vendors and installed on hospitals' computers; facility purchased a complete system of hardware and software that was installed by vendor and ready to implement?
turnkey
What is the name of a graphical technique available to assist systems analysts; it is an object-oriented modelling language that assists in the documentation of a software project by specifying, visualizing, modifying, constructing, and commenting the artifacts of a system under development?
unified modelling language (UML)
What refers to the ease with which a database or registry's data may be understood and accessed?
usability
What diagram is an important part of the documentation process that documents the functions of a system from the user's point of view; similar to a story that describes the functions of the system; used with sequence diagram
use case
What kind of architecture allows info to be processed and stored on the internet rather than in the physical location on-site. Needs particularly strong security and integrity of data.
web based architecture
What is a process that is undertaken when a new system is implemented in order to ensure that the system fits the current business processes; also assists in changing processes to work with new system. Several stakeholders need to be involved, including: - front-line workers. - experts with vision on how work should be done. - IT staff with understanding of current flow. - team lead, project manager or facilitator. Basic steps are: - review and assessment of current state. - definition of future state or goal. - development of strategy; how processes will change and system needs to be customized. - identification of benefits. - development of identification plan which includes education. - ensuring there is a plan in place for evaluation of the new processes.
workflow analysis
IS experts estimate that at least _____ percent of the technical staff's time should be devoted to maintenance activities.
25
Physicians use specialized computer systems called ________ to help them make important decisions about patient care.
decision support systems (DDSs)
What systems are used to serve the specific information needs and functions of a particular department, such as HR or respiratory therapy?
departmental
In what phase of the Systems Development Life Cycle (SDLC) is a project manager identified and a steering committee of stakeholders formed, whose role it is to plan, organize, coordinate, and manage the project so it remains within scope, timeliness, and budget. Broken into sub phases as described by Fenton and Biedermann: - define system goals - must align with vision and mission and external authorities, i.e. Health ministry. - determine system requirements. - screen for potential vendors - develop and distribute Request for Information (RFI) - issue Request for Proposal (RFP) to select vendors (smaller group of vendors as determined by response to RFI). RFP is more formal doc in which vendors are invited to submit bid. A Proposal Committee evaluates RFPs. - evaluate vendors - use of side-by-side matrix . - hold vendor demonstrations - invite top vendors to demonstrate their systems live. - site visit and reference check - Project steering committee members visit site and check references; checking references with customers of vendors. - rank vendors and cost - contract negotiation - review with legal team
design
What systems collect, store, manipulate, and make clinical info (history, meds, OR procedures, labs, radiology) available to caregivers, ex. OR systems, laboratory info system (LIS), radiology info system (RIS), and Pharmacy.
CIS (Clinical Information Systems)
Who defines health informatics as the intersection of clinical, IM/IT, and management practices?
COACH (Canada's Health Informatics Association )
Canada Health Infoway has a contract with ________, an international informatics company focusing on data standardization and interoperability, to support the deployment of SNOMED CT and other terminologies in pan-Canadian standards. CHI is also testing different modules of International Health Terminology Standards Development Organization (IHTSDO) Workbench, including module for translation of SNOMED CT to French
Apelon
___________'s SC standards life cycle is adapted form other standards organizations, has 6 main stages: - assessment - needs analysis, coordination or publication of standard, education of end-users, revision of clinical or admin policies. - development - adoption, adaptation, or development of a standard; uses data modelling tools to define data to be collected or specify terminology content - education and training - especially education on change management; may include published standards or supporting guides to assist with interpretation; education provided by CHI, CHIMA, COACH, etc. - implementation - as projects are implemented, they need support ongoing in the for of meetings, forums, supporting tools like user guides and manuals. - conformance - standards-based framework is essential to ensure conformance; no alterations without formal review as they can disrupt data transmission and cause inability to compare data sets. - maintenance - addresses ongoing sustainability and relevance of health information standards; essential to integrity, involves managing updates, producing incidental corrections, and guides to assist with updates
Canada Health Infoway
What was launched in 2007 and designed by public and private sector stakeholders in the Canadian health information standards community to coordinate the maintenance, education, training and stakeholder engagement for EHR standards; also advance Canadian interests and requirements for health information standards internationally through sustained relationships with principal international SDOs? - works closely jurisdictional (eHealth Ontario's eHealth Standards Program) and cross-jurisdictional projects (pan-Canadian Panorama public health surveillance project, IBM), jurisdictional implementation or advisory groups (JIG, JAG)
Canada Health Infoway's Standards Collaborative
__________ is one of the most common uses of HL7 V3, which essentially provides a standardized XML compatible structure for documents of mixed content such as patient referral letter or DS. Standard focused on organization of data and information for easier communication purposes?
Clinical Document Architecture (CDA)
What is an entity consisting of many diverse and autonomous components or parts (called agents) which are interrelated, interdependent, linked through many (dense) interconnections and behave as a unified whole in learning from experience and in adjusting (not just reacting) to changes in the environment? The healthcare system can be described as this. They are characterized by diffused (distributed) and not centralized control and unlike rigid (mechanistic) systems, they change in response to the feedback received from their environment to survive and thrive in new situations.
Complex Adaptive System (CAS)
What systems are used in complex or multisite organizations where various hospitals, clinics, nursing homes, or other healthcare facilities have info that is linked.
Enterprise-wide
What is a connection between computers and devices within a small physical area, such as home or office; one special form is an intranet (specialized client/serve network that uses Internet technologies to provide info within organization)
LAN (local area network)
Each table in an entity relationship database will have a ________, which is a variable that uniquely identifies a record in the table.
PK (primary key)
What is the name given to the language that is used to manipulate data in relational databases. These commands retrieve and manipulate the data required; may be entered by user; commands are given in queries, and these follow a basic structure: SELECT(attribute1)FROM(table2)WHERE x=y. Common programming language used in reports writers like Crystal Reports. Nonprocedural language that lets user specify what must be done without having to specify how it is done.
SQL (structured query language)
The typical database softwares in healthcare are:
SQL Server, Oracle (server-based DBMS)
What is comprehensive health care terminology, provides formal representation of concepts, terms, and relations between concepts.
SNOMED CT (Systemized NOmenclature of MEDicine Clinical Terms)
What is a connection between computers and devices within a large physical area such as different sites of an organization? World's largest _____ is the Internet, which consists of millions of interconnected LANs.
WAN (wide area network)
A physician ordering a lab test is an example of a: a. business process. b. input. c. output. d. storage
a
Data that do not individually identify patients and that have been organized into meaningful categories for ease of analysis and understanding are best known as ___________. Select one: a. Aggregate Data b. Record-level Data c. Coded Data d. Grouped Data
a
Flexibility is incorporated into the conformance criteria at international and national levels to: a. meet different needs in jurisdictions. b. support different vendors unique systems. c. none of the above. d. all of the above.
a
Standards should not be changed to accommodate local needs outside of a controlled, transparent methodology with formal review and decision process during the following stages: a. development or maintenance. b. implementation or conformance. c. needs analysis/assessment or eduction. d. none of the above.
a
The SDLC is: a. the traditional way to plan and implement an IS. b. Takes at least 3 years to complete. c. Is primarily transition oriented d. Is a never-ending process.
a
The standards-based framework of a system that fulfills health information standards requirements is essential to ensuring _______________. a. Conformance b. Compliance c. Accreditation d. Credentialing
a
Guidelines for Developing a ___________: 1. Design a plan for the development, implementation, and continuing maintenance of the ___________. 2. Develop an enterprise _________ that integrates common data elements used across an enterprise - collect metadata throughout the enterprise. 3. Ensure collaborative involvement and buy-in of all key stakeholders when data requirements are being defined for an information system. 4. Develop an approvals process and documentation trail for all initial data dictionary decisions and for ongoing updates and maintenance. 5. Identify and retain details of data versions across all applications and databases. 6. Design flexibility and growth capabilities into the data dictionary so that it will accommodate architecture changes resulting from clinical or technical advances or regulatory changes. 7. Design room for expansion and constraint of field values over time. 8. Follow established International Organization for Standardization (ISO)/International Electrotechnical Commission (IEC) 11179 guidelines or rules for metadata registry construction to promote interoperability and automated data sharing. 9. Adopt nationally-recognized standards and normalize field definitions across data sets to accommodate multiple end user needs. 10. Beware of differing standards for the same clinical or business concepts. 11. Use geographic codes and geocoding standards. 12. Test the information system to demonstrate conformance to standards as defined in the data dictionary. 13. Provide ongoing education and training for all staff. 14. Assess the extent to which the use of the agreed-upon data elements supply consistency of information sharing and avoid duplication.
data dictionary
The purpose of the ________ is to standardize definitions and ensure consistency of use of data elements. Standardizing data enhances interoperability across systems, improves data validity and reliability, improves communication, provides developers with a common language and road map to promote consistency across applications, saves money, help those responsible for managing data, and their supporting systems, to understand the data.
data dictionary
What are graphical representations of the flow of data through an information system, modelling its process aspects?
data flow diagram
What is a tool used in the modelling stage of database planning? It is a graphical representation of the flow of data through an information system?
data flow diagram (DFD)
What discipline focuses on the proper generation, storage, and retrieval of data?
data management
What is a science of extracting useful information from large data sets or databases; a proactive process that searches for anomalies that have not been identified by end user.
data mining
What is a representation of the data to be stored in a database and the relationships between the tables and data fields? A simple representation, usually graphical, of more complex real-world data structures. The two most important elements in ____________ are the ERD and the data dictionary.
data model
What is the first step in the database design process?
data modelling
What is a central repository of data from various sources? Designed to perform data analysis rather than support routine operations. Principal purpose is to provide data for improved decision support. Does not contain any "live" transactional data. Data is populated by downloads from live systems on a regular basis and linked or integrated to facilitate reporting and analysis. It is often confused with a database, but a data ____ has the characteristics of: - large - historical - dependent on multiple source systems. - cross-organizational analysis. - trends, metrics, and report outputs. - specialized labour * storage device for multiple databases that can be accessed via a single question-and-report interface.
data warehouse
What is a collection of stored data, typically organized into fields, records, and files.
database
What is an organized collection of data, text references, or pictures that are stored in a file in standardized format that can be easily manipulated and retrieved?
database
What is an organization of components that define and regulate the collection, storage, management, and use of data within a database environment? Five components: - hardware - software - people - procedures - data
database system.
