RHIT Practice Questions: Domain 3 (Data Analytics and Use)

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? $3.36 per record $4.49 per record $5.43 per record $5.51 per record

$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 (Horton 2016a, 174-175).

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? - $3.36 per record - $4.49 per record - $5.43 per record - $5.51 per record

$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 (Horton 2016a, 174-175).

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? - 0.67 - 0.45 - 0.33 - Unable to determine

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 (Horton 2016a, 23).

[See table p. 107 #244] At Community Hospital, each full-time employee is required to work 2,080 hours annually. The table below shows the amount of time that five employees were absent from work over the past year. What is the total sick leave rate for this group of employees for the year? Employee A : 6 Employee B: 16 Employee C: 8 Employee D: 32 Employee E: 40 - 0.29% - 0.98% - 1.29% - 1.54%

0.98% 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. Add each employee's sick leave hours together to get a total of 102. Multiplying 2,080 (full time equivalent) by 5 (number of employees) equals 10,400. Take the total sick leave hours (102) and multiply by 100, then divide it by the total hours for the 5 full time employees (10,400). Calculations: (6 + 16 + 8 + 32 + 40) = 102 hours total sick leave time; (2,080 × 5) = 10,400 total hours for the 5 coders; (102 × 100) / 10,400 = 10,200 / 10,400 = 0.98% total sick leave rate (Horton 2016a, 23).

Mr. Jones was admitted to the hospital on March 21 and discharged on April 1. What was the length of stay for Mr. Jones?

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 (Horton 2016b, 390).

In a frequency distribution, the lowest value is 5, and the highest value is 20. What is the range?

15 The range is the simplest measure of spread. It is the difference between the smallest and largest values in a frequency distribution (Watzlaf 2016, 360).

What is the mean for the following frequency distribution: 10, 15, 20, 25, 25?

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 (Watzlaf 2016, 359).

[See p. 121 #295] The Information Services Department has requested information about the electronic signature system being used in your facility. They would like to know the locations where physicians are accessing the system. Review the information in the table below. What is the percentage of physicians not using the electronic signature system? - 2.2% - 2.45% - 18.81% - 99.99%

2.2% The ratio of a part to the whole is often expressed as a percentage. Percentages are a useful way to make fair comparisons. The percentage of physicians not using the system is 2.2%. (11 physicians not using the system × 100) / 500 = 1,100 / 500 = 2.2% (Horton 2016a, 18).

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? - 0.02% - 5% - 20% - 200%

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% (Horton 2016b, 395-396).

[See p. 113 #263] Using the information in the table below, calculate the C-section rate at University Hospital for the semiannual period. - 15.03% - 19.24% - 20.04% -. 25.06%

20.04% C-section rate: (101 × 100) / 504 = 10,100 / 504 = 20.039 = 20.04% (Horton 2016a, 155). C section rate = (c sections / delivered) x 100

[See p. 120 #292] The coding department at Community Physician's Clinic developed the following report for the denials committee at the clinic. The billing report shows the following information. How many hours will it take to reconcile these denials if each denial takes 1.5 hours to review and resubmit the bill? - 11.46 hours - 264 hours - 3450 hours - Unable to determine

264 hours A table is an orderly arrangement of values that groups data into rows and columns. Almost any type of quantitative information can be grouped into tables. Columns allow you to read data up and down, and rows allow you to read data across. The columns and rows should be labeled. In order to determine the amount of time it will take to reconcile all of the denials the number of denials is multiplied by the amount of time it takes to complete each denial (1.5 hours). 1.5 hours × 176 denials = 264 hours (Horton 2016a, 249-250).

Given the numbers 47, 20, 11, 33, 30, 30, 35, and 50, what is the mode?

30 The mode is the simplest measure of central tendency. It is used to indicate the most frequent observation in a frequency distribution. The most frequent observation is 30 (Watzlaf 2016, 359).

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? - 44.7% - 67.0% - 20.0% - 447%

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% (Horton 2016a, 23).

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:

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% (Horton 2016b, 392-393).

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, 3 died. What is the case fatality rate for influenza for January? - 1.60% - 5.17% - 0.10% - 94.8%

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% (Horton 2016a, 93). (Formula: # of times something happened divided by # of times something could have happened)

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? - 50 - 60 - 63 - 65

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 (Horton 2016a, 54).

[See p. 117 #282] Analyze the following report of physician deficiency rates and determine which physician has the lowest deficiency rate for H&Ps completed within 24 hours of admission. - 102 - 237 - 391 - 637

637 A table is an orderly arrangement of values that groups data into rows and columns. Almost any type of quantitative information can be grouped into tables. Columns allow you to read data up and down, and rows allow you to read data across. The columns and rows should be labeled. In this table, the physician with the lowest rate of deficiency is number 637 (Horton 2016a, 249-250).

[See p. 119 #290] Using the information in the table below, calculate the vaginal delivery rate at University Hospital for the semiannual period. - 20.04% - 59.97% - 84.13% - 79.96%

79.96% Vaginal delivery rate: (403 × 100) / 504 = 40,300 / 504 = 79.96% (Horton 2016a, 155-157).

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?

8 days 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 (Watzlaf 2016, 359).

Information that has been taken from the health records of injured patients and entered into the trauma registry database has been: - Aggregated - Mapped - Abstracted - Queried

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 (Sharp 2016, 178). Question 161 / 1 point

After the types of cases to be included in a trauma registry have been determined, what is the next step in data acquisition?

Abstracting After the cases have been identified, information is abstracted from the health records of the injured patients and entered into the trauma registry database. The data elements collected in the abstracting process vary from registry to registry but usually include: demographic information on the patient; information on the injury; care the patient received before hospitalization (such as care at another transferring hospital or care from an emergency medical technician who provided care at the scene of the accident or in transport from the accident site to the hospital); status of the patient at the time of admission; patient's course in the hospital; and diagnosis and procedure codes (Sharp 2016, 178).

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

Ad hoc or demand As opposed to periodic and exception reports, demand reports, also known as ad hoc reports, are produced as needed, whenever a manager demands or asks for it. Usually, demand reports are produced through report generators or database query languages and are customized by the manager (Johns 2015, 236).

[See table p. 104 #226] The following data were derived from a comparative discharge database for hip and femur procedures: These data can best be described as: - Aggregate - Identifiable - Patient specific - Primary

Aggregate Secondary data are considered aggregate data. Aggregate data include data on groups of people or patients without identifying any particular patient individually. Examples of aggregate data are statistics on average length of stay (ALOS) for patients discharged within a particular diagnosis-related group (DRG) (Sharp 2016, 173).

[See Chart p. 102 #219] City Hospital's HIM department made a decision to discontinue outsourcing its release of information (ROI) function and perform the function in house. Because of HIPAA implementation, the department wanted better control over tracking release of information. Given the graph shown here, how would you evaluate the ROI revenue growth?

Annualized revenue for YR-7 is more than the costs. Line graphs are used to display time trends in data. A line graph is useful for plotting data to make observations. In analyzing the chart, the revenue exceeds the costs (Watzlaf 2016, 351).

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

Data Model Data models provide a contextual framework and graphical representation that aid in the definition of data elements (Amatayakul 2016, 301).

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? - Average length of stay - Total length of stay - Patient length of stay - Average patient census

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 (Horton 2016b, 390).

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

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 (Sharp 2016, 173).

Review of disease indexes, pathology reports, and radiation therapy reports are parts of which function in the cancer registry?

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 (Sharp 2016, 176).

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

Census Even though much of the data collection process has been automated, an ongoing responsibility of the HIM professional is to verify the census data that are collected daily. The census reports patient activity for a 24-hour reporting period. Included in the census report are the number of inpatients admitted and discharged for the previous 24-hour period and the number of intrahospital transfers. An intrahospital transfer is a patient who is moved from one patient care unit (for example, the intensive care unit) to another (for example, the surgical unit). The usual 24-hour reporting period begins at 12:01 a.m. and ends at 12:00 a.m. (midnight). In the census count, adults and children are reported separately from newborns (Horton 2016b, 386).

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

Census Healthcare facilities have a census, which is the count of patients present at a specific time and in a particular place (Horton 2016a, 5).

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? - Patient-specific - Aggregated - Comparative - Detailed

Comparative Comparative data uses aggregate data to describe the experiences of unique types of patients with one or more aspects of their care (Shaw and Carter 2015, 428).

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 ________. - Big data - Descriptive analytics screen - Dashboard - Descriptive tablet

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 (Horton 2016a, 326).

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

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 (Sharp 2016, 172).

[See p. 112 #257] Community Hospital performed a cost-savings analysis between its current paper-based, on-site coding processes and an e-WebCoding telecommuting model. Given the graph here, what does the cost analysis show? - The current system saves more than the e-WebCoding system would. -. The current system reduces DNFB significantly. - Cost comparison reflects a net reduction in overall expenses on a monthly basis for the e-WebCoding system. - There is not enough information to make a determination.

Cost comparison reflects a net reduction in overall expenses on a monthly basis for the e-WebCoding system. The data on the graph show there is a net reduction in overall expenses on a monthly basis for the e-WebCoding system. Learning to use data analysis tools and data aggregation techniques is important for improvement decisions. Making decisions based on actual experience and aggregate data is much better than making decisions based on intuition or gut feelings (Shaw and Carter 2015, 95-97).

What is the official count of inpatients taken at midnight called? - Average daily census - Census - Daily inpatient census - Inpatient service days

Daily Inpatient Census The result of the official count taken at midnight is the daily inpatient census (Horton 2016b, 386).

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? - Inpatient bed occupancy rate - Bed count - Average daily census - Daily inpatient census

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 (Horton 2016b, 386).

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

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 (Horton 2016a, 322).

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

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 (Horton 2016b, 413).

[See p. 110 #253] Community Hospital has compared its admission-type patient-profile data for two consecutive years. From a performance improvement standpoint, which admission types should the hospital examine for possible changes in capacity handling? - Elective - Emergency - Newborn - Urgent

Emergency A pie chart is used to show the relationship of each part to the whole, in other words, how each part contributes to the total product or process. The 360 degrees of the circle, or pie, represent the total, or 100 percent. The pie is divided into "slices" proportionate to each component's percentage of the whole. Review of the pie chart shows that the emergency department has had significant patient growth over the five-year period. By using this patient profile data for performance improvement, the hospital should examine capacity changes for this department (Shaw and Carter 2015, 91).

[See Table p. 103 #225] At Community Hospital, each full-time employee is required to work 2,080 hours annually. The table below shows the amount of time that five employees were absent from work over the past year. Which employee had the highest absentee rate?

Employee D 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. Employee D had the highest absentee rate. In this situation the vacation hours used is added to the sick leave hours used and multiplied by 100 divided by 2,080 hours (for a full time employee). The absentee rate for each employee is calculated as follows: Employee A: [(40 + 6) × 100] / 2,080 = 4,600 / 2,080 = 2.21%; Employee B: [(22 + 16) × 100] / 2,080 = 3,800 / 2,080 = 1.826 = 1.83%; Employee C: [(36 + 8) × 100] / 2,080 = 4,400 / 2,080 = 2.115 = 2.12%; Employee D: [(80 + 32) × 100] / 2,080 = 11,200 / 2,080 = 5.38% (Horton 2016a, 23).

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? - Clinical pathway - Evidence-based medicine - Patient-centered care - Morbidity indicators

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 (Shaw and Carter 2015, 174).

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 ________. - Internal data - External data - Ratio data - Nominal data

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 (Horton 2016a, 323).

[See p. 110 # 255] The following table compares Community Hospital's pneumonia length of stay (observed LOS) to the pneumonia LOS of similar hospitals (expected LOS). Given this data, where might Community Hospital want to focus attention on its pneumonia LOS? - Cardiology - Endocrinology - Family practice - Internal medicine

Family practice Family practice has the largest variance with the potential for the most savings (Shaw and Carter 2015, 95-97).

[See p. 111 #256] The following data has been collected about the HIM department's coding productivity as part of the organization's total quality improvement program. Which of the following is the best assessment of this data? - Part-time coders are more productive than full-time coders. - Full-time coders are more productive than part-time coders. - All coders produce more than the departmental average. - Part-time coders exceed the departmental average.

Full-time coders are more productive than part-time coders. Reading this graph, the full-time coder productivity is higher than part-time coder productivity. The cause for this difference must be identified before any solution can be developed to increase the productivity of the part-time coders (Prater 2016, 588).

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? - Net - Gross - Hospital - Average

Gross A gross autopsy rate is the proportion or percentage of deaths that are followed by the performance of autopsy (Horton 2016b, 395-396).

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

Gross hospital death rate The gross hospital 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 (Horton 2016b, 392-393).

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

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 (Horton 2016a, 3).

[See p. 121 #297] Given the following information, which of the following has the lowest work RVU? - Office visit - I&D of pilonidal cyst, simple - Colonoscopy with biopsy - TURP, complete

I&D of pilonidal cyst, simple When analyzing this table one is able to determine that 1.22 is the lowest relative value unit (RVU) (Brinda 2016, 150; Watzlaf 2016, 347).

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

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 (Sharp 2016, 176).

[See table p. 108 #245] Use the information provided to determine which of the following statements is correct? - In each MS-DRG, the geometric mean is lower than the arithmetic mean. - In each MS-DRG, the arithmetic mean is lower than the geometric mean - The higher the number of patients in each MS-DRG, the greater the geometric mean for that MS-DRG. - The geometric means are lower in MS-DRGs that are associated with a CC or MCC.

In each MS-DRG, the geometric mean is lower than the arithmetic mean. The geometric mean LOS is defined as the total days of service, excluding any outliers or transfers, divided by the total number of patients. Given the examples, the geometric means are lower than the arithmetic means (Casto and Forrestal 2015, 116).

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: - Descriptive statistics - Inferential statistics - Generalized statistics - Mathematical statistics

Inferential statistics Inferential statistics help make inferences or guesses about a larger group of data by drawing conclusions from a small group of data (Horton 2016a, 3-4).

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

Inpatient service day A unit of measure that reflects the services received by one inpatient during a 24-hour period is an inpatient service day (IPSD). 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 (Horton 2016b, 386).

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

It only contains Medicare patients. 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 MSDRGs. The limitation of the MEDPAR data for research purposes is that the file contains only Medicare patients (Sharp 2016, 185).

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

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 (Horton 2016b, 390).

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

MEDPAR The Medicare Provider Analysis and Review (MEDPAR) file is made up of acute care hospital and 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 (Sharp 2016, 185).

Which of the following reportable diseases usually requires telephone reporting as opposed to other methods of reporting? - Chicken pox - Influenza - Measles - Pertussis

Measles All states have a health department with a division that is required to track and record communicable diseases. When a patient is diagnosed with one of the diseases from the health department's communicable disease list, the healthcare organization must notify the public health department. Measles usually requires immediate notification to the public health department. The other three need to be reported, but not necessarily immediately (Shaw and Carter 2015, 189).

[See p. 112 #258] Given the following information, from which payer does the hospital proportionately receive the least amount of payment? - BC/BS - TRICARE - Medicare - Medicaid

Medicaid Medicaid charges are larger than the charges to commercial insurance and TRICARE; however, the facility receives a smaller payment from Medicaid. There is an adjustment of 36 percent, meaning that the facility had to adjust their charges 36 percent from the actual amount billed and the amount they receive in payment (Watzlaf 2016, 347; Gordon and Gordon 2016a, 423).

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: - National Center for Health Statistics - Agency for Healthcare Research and Quality - Health Services Research - National Statistics Research

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 (Horton 2016a, 4).

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

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 (Horton 2016a, 322-323).

[See p. 108 #246] Given the following information, in which city is the GPCI the highest for practice expense? - St. Louis - Dallas - Seattle - Philadelphia

Seattle Geographic practice cost index (GPCI) is the number used to multiply each RVU so that it better reflects a geographical area's relative costs. The practice expense GPCI is higher in Seattle at 1.098 (Casto and Forrestal 2015, 152).

[See p. 115 #275] In the relational database shown here, the patient table and the visit table are related by: - Visit number - Date of visit - Patient number - Practitioner number

Patient number Relations are established in a relational database by the primary key of one table becoming a foreign key in another table. In this case, the patient number is the primary key in the patient table and used as the foreign key in the visit table (Johns 2015, 127-128).

[See p. 109 #248] Which of the following is the unique identifier in the relational database patient table? - Patient last name - Patient last name and first name - Patient date of birth - Patient number

Patient number The unique identifier in the patient table is the patient number. It is unique to each patient. Patient last name, first name, and date of birth can be shared with other patients, but the identifier will not be shared (Sayles and Trawick 2014, 56).

What do the wedges or divisions in a pie graph represent?

Percentages Pie charts are best to use when you want to show each category's percentage of the total. They do not show changes over time. A circle is divided into sections such as wedges or slices. These represent percentages of the total (100 percent) (Horton 2016a, 258).

[See p. 118 #285] The Information Services Department has requested information about the electronic signature system being used in your facility. They would like to know the locations where physicians are accessing the system. Review the information in the table below and determine which site has the highest percentage of use. - HIM department - Obstetrics, 1 West - Personal mobile device - Physician home

Personal mobile device A table is an orderly arrangement of values that groups data into rows and columns. Almost any type of quantitative information can be grouped into tables. Columns allow you to read data up and down, and rows allow you to read data across. The columns and rows should be labeled. In this table, personal mobile device has the highest percent of physicians using the system (Horton 2016a, 249-250).

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

Pie chart A pie chart is an easily understood chart in which the sizes of the slices of the pie show the proportional contribution of each part. Pie charts can be used to show the component parts of a single group or variable (Watzlaf 2016, 351).

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 ________. - Descriptive analytics - Predictive analytics - Inferential statistics - Descriptive statistics

Predictive analytics Predictive analytics is a branch of data mining concerned with the prediction of future probabilities and trends, also called forecasting (Horton 2016a, 322).

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 ________. - Descriptive analytics - Predictive modeling - Prescriptive analytics - Real-time analysis

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 (Horton 2016a, 324).

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

Prescriptive analytics Prescriptive analytics is a relatively new field of analytics that allows users to prescribe a number of different possible actions. This type of analytics predicts what will happen, but also provides recommendations that will take advantage of the predictions (Horton 2016a, 325).

Which of the following uniquely identifies each record in a database table? - Data definition - Data element - Foreign key - Primary key

Primary key 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 (Johns 2015, 127-128).

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? - Average - Percentage - Proportion - Rate

Proportion A proportion is a particular type of ratio in which x is a portion of the whole (x + y ) (Horton 2016b, 383).

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? - Nominal - Interval - Qualitative - Quantitative

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 (Horton 2016a, 322).

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 ________. - Descriptive analytics - Predictive analytics - Prescriptive analytics - Real-time analysis

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 (Horton 2016a, 325).

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: - Scheduled for a coding audit - Subjected to corrective action - Recommended for staff reappointment - Involved in an in-house training program

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 (Schraffenberger and Kuehn 2011, 443).

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

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 (Watzlaf 2016, 353).

[See Chart p. 101 #218] The HIM data analytics professional is reviewing a chart (shown here) on nosocomial infections presented by the hospital's infection control committee. The committee is reporting that the decrease in infection rate has accelerated during the past 10 years. What comments should the data analytics professional make?

Request a new data chart be presented that accurately reflects the trend of infection rate Both x and y axes are in unequal measures, so data are not accurately represented. Line graphs are used to display time trends as opposed to a histogram or bar chart (Watzlaf 2016, 351).

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? - Create a new policy about high-profile patient privacy - Start by discussing the situation with the media to resolve their inquiries - Make contact with employees in the facility - Review audit trail information to determine which employees have accessed this patient's information

Review audit trail information to determine which employees have accessed this patient's information The HIPAA Security Rule requires that access to electronic PHI in information systems is monitored. Included in the same standard is the requirement that covered entities examine the activity using access audit logs. Often they record time stamps that record access and use of the data elements and documents; what was viewed, created, updated, or deleted; the user's identification; the owner of the record; and the physical location on the network where the access occurred. Reviewing the audit trail information would be the first step to identify all employees who have accessed this patient's information (Thomason 2013, 177).

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? - Structural - Descriptive - Administrative - Modeling

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 (Sayles and Kavanaugh-Burke 2018, 249).

[See table p. 105 #230] What is (are) the format problem(s) with the following table? - The title is missing. - Variable names are missing. - There are blank cells. - Row totals are inaccurate.

There are blank cells. A table should contain all the information the user needs to understand the data in it. A table should not have blank cells. When no information is available for a particular cell, the cell should contain a zero (Watzlaf 2016, 347).

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? - Make no comment since this is a medical staff meeting. - Agree with the physician that the data suggest a quality issue. - Suggest that the data be adjusted for possible differences in type and volume of patients treated. - Suggest that an audit be done immediately to determine the cause of deaths within the hospital.

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 (Shaw and Carter 2015, 46).

[See p.119 #289] The coding department at Community Physician's Clinic developed the following report for the denials committee at the clinic. The billing report shows the following information. Using the information below, identify which payment source has the highest denial rate. - Medicare - Commercial payers - Worker's compensation - Tricare/Military

Worker's Compensation A table is an orderly arrangement of values that groups data into rows and columns. Almost any type of quantitative information can be grouped into tables. Columns allow you to read data up and down, and rows allow you to read data across. The columns and rows should be labeled. In this table, the payment source with the highest denial rate is Worker's Compensation (Horton 2016a, 249-250).

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

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 (Horton 2016a, 5).

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

The sum of all relative weights divided by the total number of discharges To determine the case-mix index, take the sum of all relative weights and divide by the total number of discharges. The formula for computing case-mix is: The sum of the weights of MS-DRGs for patients discharged during a given period divided by the total number of patients discharged (Horton 2016a, 204).

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? - Whether or not the patient is fit to continue public service - What information should be shared with the media - That the patient has received adequate care - Whether all access by hospital employees was appropriate

Whether all access by hospital employees was appropriate In order to maintain patient privacy certain audits may need to be completed daily. If a high profile patient is currently in a facility, for example, access logs may need to be checked daily to determine whether all access to this patient's information by workforce is appropriate (Thomason 2013, 173).

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? - Every access to every data element or document type that occurred within the facility - Whether the person viewed, created, updated, or deleted information belonging to a patient with the same last name - Physical location of the redundant servers used for backup - Whether all patients setup accounts in the patient portal

Whether the person viewed, created, updated, or deleted information belonging to a patient with the same last name The HIPAA Security Rule requires that access to electronic PHI in information systems is monitored. Included in the same standard is the requirement that covered entities examine the activity using access audit logs. Often they record time stamps that record access and use of the data elements and documents; what was viewed, created, updated, or deleted; the user's identification; the owner of the record; and the physical location on the network where the access occurred. Reviewing the audit trail information would be the first step to identify all employees who have accessed this patient's information (Thomason 2013, 177).

The facility privacy officer is visited at the hospital by a recent patient that is concerned that her nosy neighbor, who happens to be a hospital employee, accessed her electronic health record 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? - The physician documentation from her recent stay regarding the patient's health conditions - Whether the patient had requested any amendments to her record - If the record has any deficiencies that would cause the record to be delinquent - Which employees viewed, created, updated, or deleted information

Which employees viewed, created, updated, or deleted information It is a requirement of the HIPAA Security Rule to implement ways that document access to information systems that contain electronic PHI. One of the ways to do this is to review the individuals that have viewed, created, updated, or deleted information within a health record. In this instance the Privacy Officer should review this information to determine if the patient complaint is valid (Thomason 2013, 177).