ABC

In order to effectively transmit healthcare data between a provider and a payer, both parties must adhere to which electronic data interchange standards? a. ASC X12N b. LOINC c. IEEE 1073 d. DICOM

a. ASC X12N

Which dimension of data quality is defined as "data that is free of errors"? a. Accuracy b. Granularity c. Precision d. Currency

a. Accuracy

You suspect that a user has viewed protected health information without due cause. Which of the following features would you consult to affirm this suspicion? a. Audit trails b. Edit checks c. Information Technology Asset Dispositions d. Transaction logs

a. Audit trails

A core data set developed by ASTM to communicate a patient's past and current health information as the patient transitions from one care setting to another is: a. Continuity of care record b. Minimum Data Set c. Ambulatory Care Data Set d. Uniform Hospital Discharge Data Set

a. Continuity of care record ASTM: American Society for Testing and Materials

Assuring that data have been accessed or modified only by those authorized to do so is a function of ______. a. Data integrity b. Data quality c. Data granularity d. Logging functions

a. Data integrity

The researcher's informed consent form stated that the patients' information would be anonymous. Later, in the application form for IRB approval, the researcher described a coding system to track respondents and non-respondents. The IRB returned the application to the researcher with stipulation that the informed consent must be changed. What raised the red flag? a. Description of the use of a coding system to track respondents and non-respondents b. The application form for the IRB approval c. The researcher's informed consent form d. Description of the use of a coding system to track respondents

a. Description of the use of a coding system to track respondents and non-respondents

Messaging standards for electronic data interchange in healthcare were developed by _____ a. HL7 b. IEE c. Joint Commission d. CMS

a. HL7

Which of the following statements is true of data quality management? a. It affects the collection, application, warehousing, and analysis of data to improve information quality b. It analyzes and interprets disease and procedure classifications and terminologies c. It includes system design, screen design, and report and forms design d. It involves appropriately responding to requests for information based on laws and policy.

a. It affects the collection, application, warehousing, and analysis of data to improve information quality

Secondary data source provide information that is _____ available by looking at individual health records. a. Not easily b. Easily c. Often. Never

a. Not easily

This health information exchange (HIE) consent model requires the patient to give their consent for the inclusion of their data in the HIE: a. Opt-in b. Opt-out c. Automatic consent d. No-consent

a. Opt-in

Which of the following is a data quality requirement for Information Systems? a. Standardized format b. Accurate values c. Storage in a relational database d. Realtime data collection

a. Standardized format

In general, which of the following statements about secondary data is true? a. There is an increased need for and use of secondary data b. The only successful secondary data collection efforts have been those that are federally mandated c. Data from secondary databases are rarely used in healthcare facilities d. Secondary data is sporadic and incomplete.

a. There is an increased need for and use of secondary data

Which of the following is an example of what an audit log checks for? a. Unauthorized access to a system b. Loss of data c. Presence of a virus d. Successful completion of a backup

a. Unauthorized access to a system

Which of the following individuals would be most likely to be responsible for the technical aspects of the DBMS? a. database administrator b. data administrator c. data resource manager d. Network administrator

a. database administrator

An EHR system can provide better security than a paper record system for protected health information due to _____. a. Handling by fewer clinical practitioners b. Access controls, audit trails, and authentication systems c. Easier data entry d. Safer storage

b. Access controls, audit trails, and authentication systems

You notice that end users are frequently making errors keying date values. For example, they often enter the wrong year in a discharge date. What is one system safeguard you could put in place for values keyed into date fields? a. A data model b. An edit check c. A trigger d. Referential integrity

b. An edit check

The process by which most healthcare informatics standards have been implemented is ____. a. Federal mandate b. Consensus and collaboration c. State regulation d. Trade association requirement

b. Consensus and collaboration

The attributes of data should be documented in an organization's ____. a. Data map b. Data dictionary c. Database d. Quality measures

b. Data dictionary

In general, the X12 workgroup of the American National Standards Workgroup focuses on standards related to ____ a. Privacy and security b. Electronic data interchange c. Claims billing d. Medication standards and terminology

b. Electronic data interchange

A health information exchange entity that has no access to personal health information is an example of this kind of architectural model: a. Centralized b. Federated c. Hybrid d. Banking

b. Federated d. Banking

The security devices situated between the routers of a private network and a public network to protect the private network from unauthorized users are called ___. a. Audit trails b. Firewalls c. Passwords d. Encryption technology

b. Firewalls

Which of the following variables are not considered PHI? a. Procedure date b. Gender c. Medical Record Number d. Date of Birth

b. Gender

Health information loses PHI status and is no longer protected by the HIPAA Privacy Rule when it _____ . a. Becomes an oral communication b. Is deidentified c. Is used for TPO d. Is individually identifiable

b. Is deidentified

Information standards that provide clear descriptors of data elements to be included in electronic health record system are called ____ standards. a. Vocabulary b. Structure and content c. Transaction d. Security

b. Structure and content

Audit control standard recognizes that regardless of the controls put into place to prevent unauthorized access, there must be a way to track and record user activities in the system. Tracking using the audit logs can be used to do which of the following? a. To monitor intentional actions by users b. To monitor intentional and unintentional actions by users c. To monitor intentional activities by users d. To block intentional and unintentional actions by users

b. To monitor intentional and unintentional actions by users

The inpatient data set incorporated into federal law and required for Medicare reporting is the ____. a. Ambulatory Care Data Set b. Uniform Hospital Discharge Data Set c. Minimum Data Set for Long-term care d. Health Plan Employer Data and Information Set

b. Uniform Hospital Discharge Data Set

Which of the following is an identifier under the Privacy Rule? a. Gender b. Vehicle license plate c. Age d. Vital sign recordings

b. Vehicle license plate

A data dictionary is ____ a. A diagram depicting the tables in a database b. As software tool that maintains a database c. A roadmap to the contents of a database. d. A textbook used in database courses

c. A roadmap to the contents of a database

HIPAA mandated that healthcare business partners and covered entities implement a common standard for data and information transfer. That standard is _____. a. ICD-10-CM b. HL7 c. ASC X12 d. CPT

c. ASC X12

Which of the following is not an identifier under the Privacy Rule ? a. Visa account 2773 985 0468 b. Vehicle license plate BZLITYR c. Age 75 d. Street address 265 Cherry Valley Road

c. Age 75

Which of the following statements about an intranet is false? a. An intranet is a web site that is contained inside an organization firewall b. An intranet allows users to search content c. An intranet connects allow users outside the organization to search content d. An intranet allows users inside the organization to communicate

c. An intranet connects allow users outside the organization to search content

Which of the following is critical to achieve interoperability and connectivity of health information across organizational lines? a. Memorandums of agreements between each healthcare organization that is exchange data b. Best of breed health information systems c. Commonly accepted health informatics standards d. Elimination of legacy systems in healthcare facilities

c. Commonly accepted health informatics standards

The ____ mandated the development of transaction and code set standards for electronic health records. a. Medicare and Medicaid legislation of 1965 b. Prospective Payment Act of 1983 c. Health Insurance Portability and Accountability Act of 1996 d. Balanced Budget Act of 1997

c. Health Insurance Portability and Accountability Act of 1996

When undertaking an LHR (Legal Health Record) project the stakeholder group must include individuals from various levels of the organization. Which of the following should be included among the stakeholders? a. Contracting b. Independent physicians and clinicians c. Information technology staff d. Patients and family members

c. Information technology staff

Which of the following indexes and databases includes patient-identifiable information? a. MEDLINE b. Clinical trials database c. Master population/patient index d. UMLS

c. Master population/patient index

An important part of the maintenance of the master patient index is to resolve situations where a one patient's clinical information is assigned another patient's medical record number. This is an example of which of the following? a. Duplicate medical record number b. Overlap c. Overlay d. Redundancy

c. Overlay

Which of the following is not a characteristic of data quality? a. Granular b. Valid c. Precise d. Current

c. Precise

Achieving interoperability with another facility or organization requires: a. Privacy standards b. Performance standards c. Health informatics standards d. All of the above

d. All of the above

The term that describes the ability of one information system to exchange data with another information system is _____. a. Certified b. Deterministic c. Integrated d. Interoperability

d. Interoperability

Selection of the correct research design ensures ______. a. Accuracy of decisions b. Collectable data c. IRB approval d. Reliable data

d. Reliable data

One key benefit of building an accurate data dictionary is _____. a. allowance for varying naming schemes b. data can be stored in multiple places c. improved security d. improved data accuracy

d. improved data accuracy

Industry Standards for Data Management (Access, Analysis, and Submission):

- Health Level 7 (HL7): - International Classification of Diseases (ICD): - National Institute of Standards and Technology (NIST): - Secure File Transfer Protocol (SFTP): - ANSI X12: -

Secure File Transfer Protocol (SFTP):

- SFTP is commonly used in healthcare to securely transfer data files, ensuring that they are transmitted safely and without unauthorized access.

HL7 is a standard for data exchange* in healthcare, especially for clinical* data.

- The HL7 V2 and HL7 FHIR* (Fast Healthcare Interoperability Resources) standards are widely used to enable healthcare systems to communicate with each other, ensuring consistency and privacy in data exchange.

ANSI X12:

- This is a standard for electronic data interchange (EDI) used for healthcare transactions, such as claims billing, payment remittance, and insurance verification. It ensures that the data exchanged follows a standardized format, which is essential for efficient data submission.

Federal law: The Medicare program

A federal insurance program for people aged 65 and older, as well as for certain younger individuals with disabilities, requires healthcare providers to report specific data for reimbursement purposes.

Master Patient Index

A permanent database including patient-identifiable data for every patient ever admitted to or treated by the facility. (Glossary-HIM textbook- 1038) A patient-identifying directory referencing all patients related to an organization and which also serves as a link to the patient record or information, facilitates patient identification, and assists in maintaining a longitudinal patient record from birth to death.

Which data set is primarily used by health insurance companies to measure healthcare quality and plan performance?

Answer: Health Plan Employer Data and Information Set (HEDIS).

Why is the UHDDS important for Medicare?

Answer: It ensures consistent data reporting for Medicare reimbursement and helps maintain compliance with federal regulations.

What data set is used for long-term care facilities to assess patient needs and report to federal agencies?

Answer: The Minimum Data Set (MDS).

What is the primary purpose of HIPAA's Safe Harbor method?

Answer: The Safe Harbor method involves removing specific identifiers (e.g., name, Social Security number) to ensure that health data is de-identified and can be safely shared.

How does the UHDDS help with healthcare reporting?

Answer: The UHDDS collects key data elements such as diagnosis codes and procedure codes, which are essential for accurate billing and healthcare quality reporting.

What is the UHDDS used for?

Answer: The UHDDS is used to collect standardized data for Medicare reporting on inpatient hospital discharges.

What is the purpose of Expert Determination and Safe Harbor under HIPAA?

Answer: The purpose of Expert Determination and Safe Harbor is to ensure de-identification of health data, making it safe for sharing while maintaining privacy and compliance with HIPAA.

What is the role of X12 in healthcare?

Answer: X12 develops standards for electronic transactions like claims billing, remittance advice, and payment processing to ensure that these transactions can be exchanged securely and efficiently across the healthcare system.

Which of the following standards is used for electronic claims submission in healthcare? A) ICD-10 B) X12 EDI standards C) HIPAA Security Rule D) HL7 standard

B) X12 EDI standards

Minimum Data Set for Long-term Care (MDS):

Definition: The MDS is used for long-term care facilities, specifically for residents in nursing homes. It is used to assess the care needs of individuals but is not used for inpatient Medicare data.

Uniform Hospital Discharge Data Set (UHDDS):

Definition: The UHDDS is an inpatient data set that was incorporated into federal law for Medicare reporting. It is required for hospital discharge data and includes important variables such as diagnosis codes, procedures, and patient demographics. This data set is used to collect standardized information for Medicare and other federal health programs.

Ambulatory Care Data Set:

Definition: This data set is typically used for outpatient care and is not specific to inpatient care or Medicare reporting.

electronic data interchange (EDI)

EDI refers to the exchange of data between organizations using standardized formats, such as those used in healthcare for billing, claims processing, and other administrative functions.

HIPAA Privacy Rule:

Ensures the confidentiality* of protected health information (PHI) by setting standards for its use, access, and disclosure. (Deidentification)

HIPAA Enforcement Rule:

Establishes penalties* for non-compliance with HIPAA regulations, with fines based on the severity of the violation.

How do apply the Concept to real-world scenarios : X!2 Workgroup? Example 1: Claims Billing in Healthcare Example 2: Electronic Remittance Advice

Example 1: Claims Billing in Healthcare When a hospital submits a Medicare claim electronically, they use the X12 standards for creating the claim's electronic format (e.g., ANSI X12 837). This ensures that the claim can be transmitted between the hospital and Medicare in a standardized, efficient, and secure way, minimizing the chance of errors or delays in processing. Example 2: Electronic Remittance Advice Similarly, after a healthcare provider submits a claim, they might receive an electronic remittance advice (ERA), which is also based on X12 standards (ANSI X12 835). The ERA details how much the provider will be paid, explaining any adjustments or denials, and follows a standard format for easy interpretation by healthcare providers.

Connect Concepts to Real-World Scenarios: how UHDDS and MDS data sets are used in practice?

For example: In a hospital, when a patient is discharged, the UHDDS is used to record essential information about their diagnosis and treatment. This information is then sent to Medicare for reimbursement. Similarly, when a long-term care facility is reporting patient care data to the government, they use the MDS to assess and report on the care needs of their residents, ensuring that facilities are adequately reimbursed and compliant with regulations.

HIPAA Security Rule:

Mandates safeguards* to protect the integrity*, confidentiality*, and availability* of electronic protected health information (ePHI)*. Requires physical*, technical*, and administrative* safeguards* such as data encryption__, access control__, and audit logs__ to track who accesses or modifies ePHI.

National Institute of Standards and Technology (NIST):

NIST provides frameworks and guidelines for information security* and risk management*, such as the NIST Cybersecurity Framework*, which is widely used to assess and mitigate risks associated with healthcare data access and analysis.

Other Key Health Data Laws besides HIPAA that govern healthcare data: HITECH Act (Health Information Technology for Economic and Clinical Health Act):

Promotes the adoption* of electronic* health records (EHRs)* and improves the privacy and security protections under HIPAA, especially for ePHI*. Includes provisions for breach notification and requires healthcare organizations to encrypt ePHI for better protection.

Inpatient data set:

Refers to the structured data collected about patients who are admitted to a hospital or healthcare facility for inpatient care (as opposed to outpatient or emergency care).

HIPAA Breach Notification Rule:

Requires healthcare entities to notify* patients* and the Department of Health and Human Services (HHS)* in the event of a breach of PHI. Defines breach thresholds and mandates timely reporting (within 60 days*).

International Classification of Diseases (ICD):

The ICD-10 coding* system standardizes* the classification* of diseases and health conditions*. It is used in data analysis* and submission* for purposes such as diagnosis reporting* and billing*, and is critical in healthcare data processing.

Medicare reporting:

The collection of data that is used for billing and ensuring compliance with Medicare regulations.

The primary goal of database design

The primary goal of database design is to ensure that data is organized efficiently, is easy to access, and maintains data integrity.

HIPAA (Health Insurance Portability and Accountability Act)

The primary regulation governing the privacy* and security* of healthcare data in the United States

Other Key Health Data Laws besides HIPAA that govern healthcare data: General Data Protection Regulation (GDPR):

While GDPR applies primarily to European Union (EU)* residents, U.S.-based organizations that deal with EU residents' data must comply with its stringent privacy* and security* requirements. It emphasizes data minimization*, transparency*, and giving individuals control over their personal data, which may overlap with HIPAA in some cases (for example, protecting sensitive health data).

Which of the following methods helps ensure the data is anonymized by using an expert's judgment on reidentification risks?

Answer: Expert Determination.

Which data set is used for outpatient care and is commonly used in ambulatory settings?

Answer: Ambulatory Care Data Set.

How does an audit log help in security?

Answer: An audit log helps in identifying suspicious activity and reconstructing events that may indicate a security breach, making it an essential tool for monitoring and compliance.

What is X12 Workgroup? What does X12 focus on?

A standards organization that plays a critical role in developing electronic data interchange (EDI) standards in various industries, including healthcare. The X12 Workgroup focuses on electronic data interchange (EDI) standards, which are used for data exchanges in healthcare, including claims, remittance, and other administrative transactions.

What is the purpose of an audit log?

Answer: An audit log tracks system events, recording actions taken within a system, such as who accessed or modified data, when it happened, and what actions were performed. It is primarily used for reconstructing events and ensuring accountability.

What does de-identification mean in the context of healthcare data?

Answer: De-identification refers to the process of removing or obscuring personal identifiers from health data so that the data cannot be traced back to an individual.

What does the term "de-identified data" mean?

Answer: De-identified data refers to health data that has had personal identifiers removed or obfuscated to protect individual privacy.

What kind of events can be reconstructed using an audit log?

Answer: Electronic events, such as unauthorized access to patient data, changes to records, failed login attempts, and security incidents.

What is the difference between Expert Determination and Safe Harbor?

Answer: Expert Determination involves an expert ensuring that the risk of reidentification is extremely low, while Safe Harbor involves the removal of specific identifiers (like name or SSN) to ensure the data is de-identified.

Key Uses of an Audit Log:

Accountability: Ensures that individuals can be held accountable for their actions on a system. Security and Compliance: Helps monitor security events and is used for regulatory compliance (e.g., HIPAA). Reconstruction: Enables organizations to review and reconstruct events to understand what happened and when.

Hierarchical Database Design: Advantages & Disadvantages

Advantages: - Simple Relationships: Works well for structured, tree-like data with a clear parent-child relationship. - Fast Retrieval: Data retrieval can be quicker when the hierarchy is well-structured. Disadvantages: - Limited Flexibility: Doesn't handle many-to-many relationships well. - Complexity: Data can be hard to rearrange, as each piece of data must fit into the hierarchy.

Relational Database Design (RDBMS): Advantages & Disadvantages

Advantages: - Structured data: Suitable for well-organized, tabular data. - Consistency: Data integrity is ensured using primary keys and foreign keys. - Querying: SQL allows for complex querying across multiple tables. Disadvantages: - Scalability: Can struggle with very large datasets or complex queries. - Performance: Large joins between tables can impact performance.

Object-Oriented Database Design (OODBMS): Advantages & Disadvantages

Advantages: Complex Data: Better suited for applications that require storing complex data structures (e.g., multimedia). Modeling: Supports a more natural representation of real-world entities. Disadvantages: Complex Queries: Not as easy to query as relational databases, especially for those not familiar with object-oriented programming. Scalability: Can be less efficient with large volumes of simple data compared to relational models.

Network Database Design: Advantages & Disadvantages

Advantages: Flexibility: Handles complex relationships better than hierarchical databases. Efficiency: Suitable for handling large volumes of interrelated data. Disadvantages: Complexity: The schema can become difficult to manage, especially as the number of relationships increases. Limited Support: Older network databases might not be as well-supported or scalable as modern relational databases.

NoSQL Database Design: Advantages & Disadvantages

Advantages: Scalable: Excellent for large datasets and applications that need to scale horizontally. Flexible: Suitable for semi-structured data or rapidly changing schema. Disadvantages: Lack of Standardization: NoSQL databases often lack standardized querying mechanisms like SQL, making them less intuitive for traditional relational database users. Consistency: Some NoSQL databases trade off consistency for availability and partition tolerance (CAP Theorem).

Other Key Health Data Laws besides HIPAA that govern healthcare data: 21st Century Cures Act:

Aims to enhance healthcare innovation, streamline data sharing, and address interoperability* of health data systems. Introduces regulations on data blocking*, aiming to improve data access* and sharing* across healthcare systems while maintaining security and privacy.

What is an Audit Log?

An audit log (or audit trail) is a chronological record of events that provides a detailed history of system activities. It tracks actions related to data access, data modifications, and other events within a system. In healthcare, an audit log typically records actions related to accessing, modifying, or sharing patient data.

Expert Determination and Safe Harbor:

Both are methods for de-identifying data under HIPAA. They allow healthcare entities to share patient data for research or other purposes without violating privacy regulations. Expert Determination: A method where an expert in data de-identification ensures that the risk of identifying an individual from the data is very low. Safe Harbor: A method where specific identifiers (e.g., names, social security numbers) are removed from the dataset to make the data anonymous.

What organization is responsible for setting standards for electronic transactions in healthcare? A) HL7 B) NCPDP C) X12 Workgroup D) SNOMED CT

C) X12 Workgroup

Health Plan Employer Data and Information Set (HEDIS):

Definition: HEDIS is used by health insurance companies to measure the performance of healthcare plans based on various indicators. It is not focused on inpatient data or Medicare reporting, but rather on health plans' quality of care.

Relational Database Design (RDBMS): definition and key features

Definition: - A relational database organizes data into tables (also known as relations) that are related to each other by means of foreign keys and primary keys. - Tables consist of rows (records) and columns (attributes), where each row represents an entity (like a patient or order), and each column represents a data attribute (like name or order date). Key Features: - Normalization: The process of organizing the data to reduce redundancy and dependency. This usually involves breaking down large tables into smaller, related tables. - Schema: Defined by a set of tables, views, and relationships between them. - SQL: Structured Query Language (SQL) is used to manage and query the data in relational databases. Examples: Healthcare: A relational database might store patient records in one table and doctor information in another, with a foreign key connecting them. Companies: Employee records, departments, and salaries might each be stored in separate tables.

Data Warehouse (DWH) Design: Definition & Key Features

Definition: A data warehouse is a specialized type of database designed for querying and reporting, often used for analytical purposes. It consolidates data from multiple sources, enabling complex analysis and business intelligence. Key Features: Subject-Oriented: Data is organized by subjects like sales, finance, etc. Time-Variant: Data is stored over time, allowing historical analysis. Non-Volatile: Once data is entered, it is generally not updated, making it suitable for analysis. Examples: Healthcare: A data warehouse might store patient data from multiple clinics, which can be analyzed for trends in diseases or healthcare outcomes. Retail: Data from different stores can be consolidated to analyze purchasing patterns and optimize inventory.

Hierarchical Database Design: definition & key features

Definition: A hierarchical database organizes data in a tree-like structure, where each record has a single parent and may have multiple child records. This is often used for one-to-many relationships. Key Features: - Parent-Child Relationship: Data is organized in a hierarchy with parent-child relationships. - Tree Structure: Each node (record) can have one or more children but only one parent. - Data Access: Data retrieval follows a top-down path, starting from the root node to the leaves. Examples: - Organizational Charts: A hierarchical database could represent an organization's structure, where a manager (parent) has several employees (children). - File Systems: Data stored in a hierarchical structure such as folders and subfolders on a computer.

Network Database Design: Definition & Key Features

Definition: A network database is similar to a hierarchical database but allows more complex relationships, where a record can have multiple parent nodes and multiple child nodes. Key Features: - Graph Structure: Data is organized in a graph with records as nodes and relationships as edges. - Many-to-Many Relationships: Unlike hierarchical databases, network databases support many-to-many relationships between records. - Pointers: Each record contains pointers to its related records, allowing for multiple connections. Examples: - University Database: A student may belong to several courses (many-to-many), and a course may have many students. - Library System: A book might be checked out by several borrowers, and a borrower might have multiple books checked out.

Object-Oriented Database Design (OODBMS): Definition & Key Features

Definition: An object-oriented database stores data as objects, similar to how data is represented in object-oriented programming (OOP). Each object is an instance of a class, which is defined by its properties (attributes) and methods (functions). Key Features: Objects: Data is stored as objects, with properties and methods associated with the data. Classes: Data is organized into classes, and objects are instances of these classes. Inheritance: Classes can inherit properties and methods from other classes, promoting reusability. Examples: Healthcare: A patient record could be an object with attributes like name, age, and medical history, and methods for updating or querying the record. E-Commerce: Product objects can have properties like price, description, and methods like apply Discount.

NoSQL Database Design: Definition & Key Features

Definition: NoSQL databases are designed for large-scale, distributed data storage. They are particularly suited for applications that require high scalability, flexible schema, and the ability to store unstructured or semi-structured data. Key Features: - Non-relational: NoSQL databases do not use traditional table structures and do not rely on SQL for querying. - Flexible Schema: Allows for storing data in various formats such as key-value pairs, documents, or graphs. Scalability: Designed for distributed systems, making them suitable for large datasets and high-volume applications. Examples: MongoDB: A document-oriented database often used for storing JSON-like data. Cassandra: A wide-column store that handles massive amounts of data across distributed systems. Redis: A key-value store that can be used for caching and fast lookups.