Health care informatics
Which item is an example of information we might find in an EHR's clinical data repository?
The result of a patient's microbiology lab test
Schools, occupational health, public health, parish nursing, and nurse-managed health centers are examples of
home healthcare
Benefits of the health information exchange infrastructure for public health include the ability to:
communicate with selected providers and patient populations through secure messaging to receive lab reports and sending alerts on potential outbreaks
Which definition most accurately describes data integrity
Accuracy and completeness of health information
Telemedicine practice guidelines for healthcare professionals' practice is identified by the
American Telemedicine Association.
Social, political, and other factors influence the implementation of public informatics solutions. which of the following has been the largest challenge to enhancing future public health infrastructure?
Lack of resources
Which example best describes knowledge base content?
Standard admission order sets based on presenting problems
Which would be considered a niche application?
Surgical information system (SIS)
The general attitude of consumers toward health information technology is positive. Which items are perceived EHR benefits for the consumer?
Timely access to personal health information b. Collaborative interaction between patients and providers d. Customized care through reminders e. Online access to educational materials
Best practices for clinical decision support design that improves practitioner performance and patient outcomes consist of which four function categories?
Triggers, input data, interventions, and action steps
Which type of personal health record does not link to healthcare providers and does not let users e-mail their doctor, request medication refills, or schedule appointments but does offer maximum control over content?
Untethered PHR
Social media policies addressing information disclosure, professional integrity, and appropriate use should be developed by a team comprising:
physicians, nurses, IT, legal, and community representatives
Telehealth tools to enable self-care in consumer informatics include
pill identifiers and drug interaction checkers. c. symptom checkers, fitness trackers, and personal health records
Identify two reasons why knowledge discovery and data mining (KDDM) is a preferred method
b. analyzes complex nonlinear relationships e. analyzes very large repositories of clinical data from large data warehouse with standard and local sets of variables
Three clinical practice considerations for telehealth-delivered care for health professionals are:
b. confidentiality and privacy. c. competency of physicians and nurses. d. equal to face-to-face care.
A commonly used model for healthcare system change is the systems life cycle (SLC). This model describes stages or phases of an informatics project and it guides system implementation from initial feasibility through a more completed stage of maintenance and evaluation of the products. The Staggers and Nelson Systems Life Cycle Model (SLCM) includes:
. Analyze, plan, develop/purchase, test, implement/go-live/maintenance and evolve, and evaluate and return to analyze.
The categories of prescriptive and predictive analytics are used to analyze data. Which method involves machine and statistical learning?
. Knowledge discovery and data mining methods
Choose the best two responses to describe evaluation research
. Research with statistical evaluation of models d. Methods selected and few targeted outcomes
Information technology and clinical staff members have roles in system downtime planning. What two roles are specific to the IT staff in addressing system downtime planning?
.Establish methods to communicate to senior leadership, staff, and the community. e. Test the new functionality and discover any dependencies.
In the national road map led by Osheroff and colleagues, clinical decision support was described as:
interventions to provide knowledge and person-specific information, intelligently filtered or presented at appropriate times, to clinicians, staff, patients, or other individuals to enhance health and healthcare.
Which description best defines the electronic health record (EHR)
An electronic record of patient health information created by encounters across multiple settings
The definition of healthcare informatics is defined by several organizations. Which of these statements would best define healthcare informatics in the understanding of clinicians such as nurses and other professional caregivers?
An interdisciplinary professional specialty and scientific discipline that integrates the health sciences, computer science, and information science as well as other analytic sciences with the goal of managing and communicating data, information, knowledge, and wisdom in providing care for individuals, families, groups, and communities.
Which system is recommended as a method to address patient safety and reduce errors that occur during the actual administration of medicines?
Barcode medication administration (BCMA)
A university hospital wants to implement a closed-loop medication management system. Current systems include registration, computerized provider order entry, electronic medication administration record, laboratory, radiology, and pharmacy. Which system is needed to complete the loop
Barcoding system
The Agency for Healthcare Research and Quality suggested which strategies for disseminating advanced clinical decision support on a national level?
CDS developed once and used by many
What guides development of the ideal personal health record (PHR)?
Comprehensive longitudinal record and data ownership, control, and privacy
What affects the adoption and function of current personal health records?
Desire for functions such as prescription refill, messaging, results, and plan that PHRs offer
The ACE Star Model of Knowledge Transformation is a model of five points to integrate evidence-based practice into informatics solutions. Which activities represent the five points of the star?
Discovery research, evidence summary, translation to guidelines, practice integration, and evaluation of process and outcome
Identify which domain of mHealth applications this example supports. A program provides pregnant women with stage-appropriate information through text messages about pregnancy, birth, and care of an infant.
Domain for client education and behavior change
Which are major trends and their implications for future developments in healthcare, health informatics, and informatics research?
EHR optimized with decision support, improving the user experience for health IT, big data and data visualization, and nanotechnology and nanoinformatics
Which of the statements best describes current federal and state laws regulating privacy and security practices and procedures?
Federal and state laws increased privacy protections for genetic information by prohibiting most health plans from using or disclosing it for underwriting purposes.
Which statement is true regarding the techniques used to analyze and distinguish forecasters from futurists when planning for future directions and trends?
Forecasters focus on incremental changes from existing trends, while futurists focus on systemic transformational change.
When managing the interrelationships among the stakeholders to further develop EHR systems, health information technology (HIT) professionals need to facilitate life-cycle change. Select the foundational health informatics knowledge HIT professionals need to consider?
Healthcare providers advocate for their involvement in selecting systems that directly and indirectly impact patient care.
Which of these statements best describes the unique features of mHealth when compared to health IT applications?
Mobile configuration, wireless, consumer-grade hardware, short messaging service
Computer applications are grouped according to the objects (data, information, and/or knowledge) they processed. Several models illustrated the types of objects processed. Wisdom was added to what model to manage and solve human problems?
Nelson's mode
The Health Information Management Systems Society (HIMSS) developed an EMR adoption model that includes eight stages toward creating a paperless patient record environment. All application capabilities within each stage must be operational before the next stage can be achieved. Your organization has implemented systems for Stages 1 and 2. Which system should your organization consider as Stage 3 adoption?
Nursing/clinical documentation (flow sheets) and clinical decision support
The use of opinion leaders and real-time feedback about patient outcomes are examples of which type of intervention?
Offer mechanisms to diffuse and adopt new knowledge and include innovation
Standardized datasets used in electronic health records (EHRs) and information systems in home care practice sites include
Outcome and Assessment Information Set (OASIS).
As the United States moves toward the implementation of an interoperable EHR, which statement about the future "ownership" of the patient record is appropriate
Ownership may be driven by who has control and access to the data.
What is the difference between personal privacy and information privacy?
Personal privacy involves access to one's person, and information privacy involves access to health data about one's person
What is the greatest challenge associated with the use of social media in healthcare?
Privacy and confidentiality
Which key public health application for infectious and chronic diseases makes comparing information within public health systems challenging because of varying policies among states, cities, and counties
Public health reporting
Which statement best describes the impact of health informatics on the advantages and disadvantages of nanotechnology?
Reliable information about the safety of nanomaterials lags behind their fabrication
A nurse working in a healthcare facility forgets to lock her computer after accessing a patient's personal health information, allowing an unauthorized user access to the file. Which fair information principle is being violated in this case?
Safeguards
What is a critical regulatory issue associated with the use of social media in healthcare education and services?
Support net neutrality
Which type of telehealth uses interactive telecommunications technology and/or patient monitoring technologies to connect a provider and patient for direct care?
Synchronous telehealth
As EHR adoption expands to include data from multiple healthcare entities, more opportunities for error exist. Which process can affect data integrity?
System failure
Data and information within the EHR systems provide opportunities to generate knowledge. Healthcare providers must have an understanding of health informatics. Which of the following statements best describes their role in knowledge generation?
The clinician supports the use of standardized languages to document patient care to allow others such as patients and other clinicians to search the terms to understand the assessments, diagnoses, treatment procedures, therapy, or intervention.
Which statement describes a repository with central storage of a longitudinal record?
The information collected by the organization is stored in a single database no matter when or where the patient was seen.
Which factor would strongly influence the reliability of an EHR's repository?
The redundancy of storage hardware
What led to the development and adoption of electronic personal health records?
Use of personal computers, internet, and EHRs
Which examples describe how clinical applications are tied to other components in the EHR infrastructure?
Utilizing clinical decision support system rules to assist with appropriate lab test ordering c. Using the data dictionary to code assessment information with a documentation application e. Searching and extracting data from the repository for reporting purposes
An organization's emergency preparedness and disaster planning groups will have a component of IT downtime as part of a disaster drill. A best practice assessment tool for evaluating a downtime event is
a configuration management database
Select the activities that are part of the informatics specialist role in KDDM and PBE in healthcare environments?
a. Adapt and calibrate models for different settings and populations. d. Design data capture for clinical records and research records. e. Collaborate with investigators to develop queries and select relevant clinical data.
Which statements describe the field of nanotechnology?
a. Creating materials, devices, and other structures at the nanoscale (1-1000 nm) c. Field requiring collaboration across engineering, physics, chemistry, biology, and materials d. Controlling and altering matter at the atomic or molecular level
The university hospital is getting ready to implement computerized provider order entry and some decision support capabilities to include drug-drug and drug-allergy alerts. Which actions should the implementation team take to increase user acceptance of the system
a. Design the new system to support communication and workflow c. Plan for continuous safety monitoring d. Involve users early in the design, testing, and implementation of the system e. Educate clinicians on how to use the system features
Driving forces that are behind the mHealth movement include:
access, cost savings, better functionality, research, connected globally, and public engagement.
Current research regarding the effectiveness of personal health records as an approach to improving healthcare has shown that
b. the use of secure messaging in the PHR by individuals with diabetes was associated with better glycemic control. c. increased use of secure messaging by individuals with diabetes was associated with increased outpatient visits. d. personal health record use was associated with reduced telephone calls to the clinic and a reduced number of outpatient visits per year.
A business continuity plan for your organization would include
b. which systems can be excluded from initial recovery. d. exercises to test the plan. e. expected time to recovery based on the requirement for service and available resources.
Applying futurology methodology of envisioning a desired endpoint and working back to determine what activities and policies to achieve a possible, probable, and preferred future describes:
backcasting.
The four operational and organizational factors that enhance or hinder telehealth are
bandwidth, education, leadership, and technology
Identify the three levels of theory relevant to program evaluation
c. Scientific theory d. Implementation models e. Program theory
The barriers to the wide adoption of clinical decision support include:
culture of quality improvement.
Which is a significant challenge to technical infrastructures in healthcare environments
implementing a data repository that will be able to handle unanticipated new information and advances in medicine
A method for exchanging patient data among healthcare organizations that is endorsed by the federal government is
implementing a secure internet connection using components of the eHealth Exchange.
Research design involves a balance of internal validity (the validity of the causal inference that the treatment is the "true" cause of the outcome) and external validity (the validity that the causal inference can be generalized to other subjects, forms of the treatment, measures of the outcome, practitioners, and settings). The weaknesses of practice-based evidence observational designs include: (Select all that apply.)
internal validity. e. causality between treatment and outcomes.
For healthcare infrastructures with many communicating systems, an interface engine is helpful because
it decreases the number of interfaces that must be maintained and lessens complexity.
Patient care workflow and relevant patient information or summaries of prominent aspects of a patient's record are:
major types of clinical decision support
The visual representation that illustrates what is occurring and how one understands the intervention to solve a problem is called a:
model
The three biggest mHealth challenges associated with implementation include:
patients misinterpret their own data, make poor health decisions, and data privacy and legal risks.
Information systems and applications for delivery of healthcare are addressing needs associated with health informatics. Three essentials to explore with each of these systems and applications would include:
purpose, functions, and internal and external structures
The primary benefits of point-of-care standardized terminologies in home health clinical information systems are:
quantitative data for outcomes reporting and disclosing patient outcomes disparities. c. maintain accurate lists of problems and medications, and reuse of information. f. real-time and one-time external monitoring and documentation. g. prerequisite for decision support to improve performance.
A downtime risk assessment will be developed based on
root cause and degree of impact
The STEEEP recommendations and redesign principles reflected in health professional education programs to improve the quality of care are best described as
safe, timely, effective, efficient, equitable, and patient-centered
You are leading an effort to implement a clinical decision support system. In order to improve the patient specificity of your CDS rules, you would:
store rules in a knowledge base and allow clinician experts to review and update the rules.
Nurses, pharmacists, physicians, therapists, and patients learn new informatics applications from using organizing structures and outlines that are based on previous practice knowledge. Which technology-related literacies guide this learning process?
Basic, computer, information, digital, and health literacies
A complex adaptive system is an entity consisting of many diverse and autonomous parts that are interrelated, interdependent, linked through many interconnections, and that behave as a unified whole in learning from experience and in adjusting (not just reacting) to changes in the environment. Characteristics of complex adaptive systems include which of the following
Change occurs through nonlinear interdependencies. e. Learning and behavior change is constant with parts self-organizing.
What are two major theories that help us analyze and explain the occurrences or instances of certain phenomena with health informatics? (Select all that apply.)
Chaos theory d. Information theory
The eight-stage EMR model requires which of the following to have been implemented by the end of Stage 3? (Select all that apply.)
a. Major ancillary systems including Laboratory, Radiology, and Pharmacy d. A PACS available outside Radiology e. A basic CDS system
which issues are considered impediments to a fully functional electronic health record (EHR) system?
a. Organizational culture c. Standardization d. Privacy and confidentiality e. Cost
Which best describe the benefits for healthcare from using social media tools?
a. Study content on sites, collect data for research c. Finding others with similar conditions and treatments d. Improve provider to provider, patient to provider, provider to patient communication
Healthcare systems can best use social media in healthcare by
a. communicating vital information during crises or disasters. b. linking patients within a network, developing collaborative content, and disseminating content. c. sharing bookmarks with others and promoting facility activities
Cloud computing is critical to the future of public health informatics because it
a. locates a suite of application services to a remote site to share resources with a variety of users. c. shares databases for transforming and managing data. e. configures and standardizes any customization efforts for all to use.
Differences between formative and summative evaluation include:
assessment
Three core public health functions and workflows supported by information technology include
assessment, policy development, and assurance.
Two studies have reported that if fully using electronic health records (EHRs) within American hospitals, the volume of preventable fatal hospital-based events each year could be reduced by 78,800 to 132,000. What were the critical considerations to achieve such a significant improvement to patient safety? (Select all that apply.)
b. Clinicians can document treatment completely within the EHR c. Health informaticians fully involved in the design, selection, and implementation e. Healthcare providers who maximize their use of EHRs to care for patients
Which functions are characteristic of a master person index?
b. Coordinate the various identifiers a patient uses, such as medical record number, insurance account number, and driver's license ID d. Store the current and former names of a patient e. Provide a unique identifier for each patient that is used by components of the EHR to positively identify the patient
The Centers for Disease Control and Prevention provides a six-step framework for program evaluation of a locally developed project. Select steps for program evaluation
b. Justify conclusions by comparing to standards and expert review. c. Assess usefulness, feasibility, ethics, and accuracy. f. Engage stakeholders to contribute to goals and metrics.
Which components are associated with community-based healthcare?
b. Patients who are knowledgeable about their own healthcare c. Work with patients and their families over time d. Interprofessional collaboratio
Which characteristics of informatics interventions are measured during program evaluation?
b. Reach of targeted people d. Effectiveness in decision support or identifying patients
Implications for mHealth research encourage the use of guides that have been endorsed by major donor organizations and outline best practices for technology-enabled programs. Identify the strategies that best support mHealth research.
b. Reuse and improve existing tools and platforms rather than build new ones c. Mitigate overlap and waste of implementing mHealth projects e. Sustainability in mHealth projects
The role of evidence-based practice (EBP) in developing informatics-based solutions for managing patient care includes solutions that generate support for clinical decisions through:
designing EBP documentation screens, order sets, Infobuttons, and clinical reminders.
The component of information security that converts data into a form, called a ciphertext, which cannot be easily understood by unauthorized people is an example of:
encryption.
The primary goal of home health agency providers in using technology to work with accountable care organizations is to
facilitate communication and collaboration.
When very large amounts of data are available, large sets can be sampled for model development and validation. Which statement best describes key elements of model development and validation:
training data, incremental testing of data examples during training, and data held out from the training process for the purpose of unbiased performance estimation.
An emerging approach to knowledge building includes measuring the effectiveness of EBP guidelines. This approach requires steps to obtain clinical data through the application of PBE research design techniques. These techniques include:
using collected electronic data with cohort samples of patients with identified characteristics to detect subtle patterns within comprehensive standardized data about practice interventions and treatment
The characteristics of big data include:
volume, variety, value, veracity, and velocity
Communication strategies for planned and unplanned downtime in your organization should provide clinicians and support staff enough information, but not too much. A good strategy is a template message explaining:
what is down, when it began, how long, why, what changed, who is impacted, what to expect, and what procedures to follow
