Health Informatics Final Exam
When did formalized home health and community-based systems originate in the United States?
1800
The first use of telehealth was documented in:
1897
The first book to include the term nursing informatics in the title was written in the:
1980s
How many "main points" does the Star Model have?
5
What defines the "Google generation"?
A person who desires immediate access to information and is internet savvy
Which of these best describes an example of usability?
A researcher is conducting a study of how nurses interact with electronic documentation to organize care handoffs.
What was the first professional association to express interest in accreditation for health informatics-related educational programs?
AHIMA
Which of the following is not a member organization but rather a group of organizations?
ANI
Which statement is not part of the Ten Commandments of CDS?
Alerting is the most effective approach to CDS
Which organization recognizes nursing terminologies as supporting nursing practice?
American Nurses Association (ANA)
Which is not a major driving force fueling the mHealth movement?
An aging society
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)
ICD-9 and ICD-10 are examples of which category of terminology?
Billing code
An example of a learning management system is:
Blackboard
What technology has been described as the next frontier for home health and related community-based systems?
CDS
Which redundant EHR application is critical to avoid disrupting nurses' care of patients during downtime?
CPOE and the MAR (medication administration record)
A healthcare provider forgets to update a patient's medications. Which fair information principle is being violated?
Data quality and integrity
The first country to implement ICD-10 codes was:
Denmark
Which government organization manages the largest telehealth program in the United States as of this writing?
Department of veterans affairs
Which group would have a financial incentive to implement CDS?
Depends on CDS and healthcare payment model
What are the two important purposes of the OASIS dataset?
Determine payment and measure quality and outcomes
Using the STAR Model, all of the following points indicated below include knowledge transformation has occurred?
False
An agency has just implemented electronic medication administration records (eMARs). This would be an example of what level of change?
First-level change
Which examples are natural disasters that could affect IT systems?
Flood, earthquake, hurricane
Why is it difficult to establish effective health IT governance?
Fundamentally, effective governance means that some stakeholders' informatics needs will need to be de-prioritized
Which term is analogous to futures research?
Futurology
The emergence of social media such as Facebook, Twitter, and Instagram marked the turn toward:
Health 2.0
Which international organization develops and maintains standards for data exchange?
Health Level 7 (HL7)
Which is an example of apomediation?
Healthcare providers direct patients to high-quality information on the web
Which international organization organizes an international conference on nursing informatics?
International Medical Informatics Association
You decide to interview all the key stakeholders involved in an informatics intervention as part of the planning process. Together you identify the resources available, the likely barriers, and the short-term and long-term objectives. Which kind of theoretical model are you using?
Logic model
Which of the following activities would be considered project management?
Overseeing a team of eight that's working for the next 3 months to create a new billing form
Which of the following shows three elements of the SLC as given in the chapter, in the correct order from earliest to latest?
Plan, test, evolve
If you choose to evaluate an informatics intervention by examining the impact on a clinician's ability to think ahead about future events, which level of situation awareness would you be measuring?
Projection
A(n) ________ is considered the gold standard research design for answering questions about the efficacy of treatments.
RCT
The _________ is one of the oldest, and still widely used methods for building and implementing software applications in IT arena
SDLC
Your task is to study and examine precisely what the project you are involved with is trying to accomplish, in order to set definable goals and boundaries. What aspect of the project are you working on?
Scope management
A hospital has just implemented barcoded medication administration (BCMA). This would be an example of what level of change?
Second-level change
Which incentive has the strongest potential to spur the nationwide adoption of advanced CDS?
Shift of healthcare payment from a fee-for-service model to approaches rewarding the delivery of better quality and outcomes at lower cost
What are the main types of PHRs?
Tethered, untethered, stand-alone, and networked
By what legal code or precedent are powers not granted to the federal government reserved by the states?
The 10th Amendment to the U.S. Constitution
What has recently been a complicating factor for implementing Meaningful Use criteria to certify EHRs?
The 2015 change from ICD-9-CM to ICD-10-CM
A large medical center that specializes in high-risk pregnancies is implementing an entire suite of clinical applications such as CPOE, barcode medication administration (BCMA), nursing documentation, data acquisition system to collect clinical data from cardiac and fetal monitors and ventilators, laboratory system, radiology system, PACS, and cardiology. It has a large, highly skilled, experienced IT team. The project team decided to go with a Big Bang go-live versus an incremental or phased approach. Which factor best supports this decision?
The Big Bang approach decreases the possibility of errors
Which statement describes the measurement of information as defined by the Shannon and Weaver model?
The amount of information is measured by the extent the message decreases entropy
A large medical practice that specializes in cancer care is weighing the advantages and disadvantages of implementing the most recent version of a commercial EHR or building its own homegrown system for its office. The staff selects a commercial EHR from a major vendor. Which factor best supports this decision?
The commercial version is considered one of the "Best of Breed" products
Which factor would strongly influence the reliability of an EHR's repository?
The redundancy of storage hardware
What is the difference between the safe harbor and expert determination methods of de-identifying data?
The safe harbor method involves removal of 18 types of identifiers, and the expert determination method involves the application of statistical or scientific models
Which two hurdles does the STAR Model address in employing evidence-based practice?
The volume and for of knowledge
Which statement is true of Meaningful Use?
They are a set of criteria created by the ONC to determine eligibility for financial incentives for health information technology adoption and use.
Expert diagnostic decision support systems not integrated into clinical settings because?
True
Implementation, planning, and evaluation are part of the Staggers and Nelson systems life cycle, which is a guide for informatics projects.
True
Which list includes the three levels of theory relevant to evaluation?
Values, expectations of others, behaviors, and perceived self-efficacy
E-mailing fraudulent claims from an office in Houston, Texas, to a Medicare facility in Washington, D.C., for medical care not actually performed would constitute what?
Wire fraud as well as a violation of the False Claims Act
Which international organization develops and maintains a family of international classifications such as the International Classification of Diseases?
World Health Organization (WHO)
You want to make sure you consider crucial components as you design your first usability study. One of these components is to consider users and their characteristics. Other components are:
a developmental timeline, tasks, information, product, and context.
A financial information system (FIS) includes
accounts receivable management, accounts payable management, and fiscal reporting management.
Point-of-care decision support tools contained within a mobile device all rely on:
accurate algorithms and protocols
The FDA has announced that it will require premarket approval for mHealth apps that:
act as ECG machines.
Powers granted to both the federal and state governments are known as what?
concurrent powers
Which of these best describes participatory medicine?
cooperative care model
The HITECH portion of ARRA was meant to do all of the following EXCEPT:
coordinate healthcare delivery standards with international healthcare bodies
Standard terminologies can be used to do all of the following, except:
decrease system-wide susceptibility to malware and hacking.
One trend that is influencing healthcare reform is:
disruptive technology
The culture of the patient-clinician partnership always includes:
ePatients and clinicians working in collaboration toward shared goals
An important component of the informatics infrastructure is:
establishment and adoption of standards to support semantic interoperability
Your team is working on a mobile health (mHealth) device for diabetics to track their glucose levels, insulin, and preventive care appointments. They have just created the very first prototype, based on their understanding of the requirements. You want to assess, fairly informally, whether the application includes the appropriate content for users (consumers). You plan to ask patients from an ambulatory clinic to participate. The kind of test you would plan is a(n):
formative test
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.
In a social network analysis, each node is usually a(n):
individual or unit of analysis
The "digital divide" refers to:
lower adoption and use of information technologies among individuals from ethnic minorities, of lower socioeconomic status, and of older age.
Current research shows the lowest quality, or most limited, evidence for the usefulness of mHealth in:
managing asthma outcomes
The top three uses of the US Army's telehealth network include all of the following but
otolaryngology
The Kaiser Permanente PHR mobile app lets users do all of the following EXCEPT:
participate in telemedicine.
Return on investment (ROI) in financial information systems (FISs) is challenging because:
patient accounting is considered an intangible asset.
Which group is allowed to share personal health information on social media sites?
patients/consumers
Which of the following typically is considered most all-encompassing?
portfolio management
Health informatics is both a ______________________ as well as a(n) _____________________.
profession; discipline
Studying a project's potential opportunities is part of what area of management?
risk
In a license agreement, the questions of who the users are, whether software can be distributed, and the number of copies that can be run all fall under the category of:
scope
An ePatient is best described as one who:
seeks health information from various sources and uses the information for decision making with health providers
Secure PHR messaging refers to the capacity to:
send messages from patients to providers via a tethered PHR
The NANDA-I classification is a:
set of nursing diagnoses of actual problems, risks, and health enhancement needs.
A primary characteristic used to analyze an open system include?
structure, purpose, and functions
What are the two overarching types of telehealth technologies?
synchronous and asynchronous
As EHR adoption expands to include data from multiple healthcare entities, more opportunities for error exist. Which process can affect data integrity?
system failure
Which type of review is considered the most rigorous?
systematic reviews
The EHR incentive Meaningful Use criteria are adapted from work done by:
the National Priorities Partnership
Which technical development created a tension between centralized and decentralized computer management in healthcare?
The development of the personal computer
Which statement is true of PHRs?
They have been used in paper form for many years, but electronic versions offer new functionality
A case manager wants to communicate with her clients on a regular basis by sending short messages that encourage health promotion tips. The tool best suited for this task is:
Those living with chronic conditions
Innovators are the group that will test out new technology but are not usually seen as leaders within an organization.
True
Knowing when and how to use knowledge is referred to as wisdom
True
On its own, the number 190 is an example of datat
True
Reverberation is when change is expanded, creating an unintended consequence down the line, producing an initial change
True
Standardized terminology is requisite for: naming evidence, classifying evidence, and tagging evidence
True
The goal of the intersection of informatics and evidence-based practice is to transform healthcare to be reliable, safe, and effective
True
These are all a part of evidence summaries? literature reviews, systematic reviews, and integrative reviews
True
These are examples that describe how clinical applications are tied to other components in the EHR infrastructure? (1) Using the data dictionary to code assessment information with a documentation application (2) Utilizing clinical decision support system rules to assist with appropriate lab test ordering and (3) Searching and extracting data from the repository for reporting purposes
True
These are the following practices that are included in the CDS Five Rights?
True
According to the Informatics Capability Maturity Model, the degree to which IT is innovatively leveraged to enable leaner processes and seamless information flows represents which dimension?
Using information technology
A vendor master file is:
a list of suppliers used by the organization
An unintended consequence associated with the use of an electronic health system occurs when:
a physician enters orders on a patient who was incorrectly selected from a drop-down list of the physician's personal patient list
A healthcare system has implemented a functionality where patients who are overdue or almost due for a mammogram are sent letters notifying them to schedule a mammogram based on available data and current clinical care guidelines. Which type of CDS system is this?
a reminder system
Which is an example of healthcare IT physical infrastructure?
biomedical devices
The main objective behind the health IT incentives provided by the American Recovery and Reinvestment Act is:
improving health and healthcare
All of the following are among the three biggest mHealth challenges identified by experts in the U.S. except:
interoperability.
The NIC system includes:
interventions for illness prevention.
Open shift management:
is a form of web-based self-scheduling
The Informatics Capability Maturity Model:
is a qualitative model that measures an organization's capabilities along five dimensions
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
The stages of change identified in diffusion of innovation theory are:
knowledge, persuasion, decision, implementation, and confirmation
The butterfly effect describes a situation in which a minor change in input can have a major change on output. This aspect of a chaotic system illustrates the property of:
preordained periodic behavior
SERMO for MDs and ANA's NurseSpace are two examples of what kind of social media structure?
provider-provider
The Office of the National Coordinator for Health Information Technology (ONC) is best described as:
the principal federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information.
When commercial software is distributed, typically:
the source code is withheld
Healthcare providers should friend patients only if:
they understand their social media policy at work
A quantified selfer is best described as one who:
tracks personal metrics
International Classification of Nursing Practice is a:
unified nursing language system into which nursing terminologies can be cross-mapped.
The most commonly used functions of personal health records are:
viewing test results and medication refills.
In the future, social media in healthcare is likely to be:
widely used and deeply integrated
Which of the following would be regulated by the FDA?
An app that functions as a medical device
Which description best defines the electronic health record (EHR)?
An electronic record of patient health information created by encounters across multiple settings
What is the main idea of the subsection titled "Why Informatics in Healthcare: An Example"?
An interoperable healthcare system that provides clear, concise patient data and information among institutes is lacking in many facilities, and its presence would greatly facilitate things such as patient transfers
What is the primary difference between an open and closed system?
An open system has a semipermeable boundary and therefore will filter both inputs and outputs when interacting with the environment
Which of the following statements about EHRs is false?
By 2014, 50% of physicians in the US had implemented an EHR, with another 13% in the process of implementing one
According to the text, which example of the use of mHealth can be facilitated by SMS, the simplest core mobile phone function?
Connecting patients to providers
A nurse is asked by the nursing manager to review electronic comments left by patients on the unit's Facebook page. The nurse examines the comments for common themes. This is an example of:
Content analysis
Which system is an example of a core clinical application?
Electronic health record
Of the following, which of these steps in the CDC's six-step program evaluation framework comes first?
Engage stakeholders
The eHealth network is a voluntary network of representatives from where?
Europe
Documentation for support is considered a deliverable at which stage of the project management process?
Execution
Social media tools include all of the following: social networks and microblogging. wikis and blogs. desktop computers.video and picture sharing, and medical reference websites.
False
The three types of learned behaviors are: (1) cognitive, (2) long-term memory, and (3) psychomotor
False
These tools are examples of CDS? (1) An order set (2) A reminder (3) A phone call (4) An infobutton (5) An expert system
False
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
Your organization acknowledges that providers want to improve their user experience with health information technology (IT) products. You want to raise awareness of the potential benefits to the organization. You could draw on stated benefits such as:
Improved productivity, patient safety, and decreased customer support costs
Financial reporting is a vital part of decision making in healthcare organizations. Which report would be used to show a snapshot of the bottom line?
Income statement or statement of operations
Your organization hires you to conduct a formative evaluation of a new informatics intervention. Which areas would you focus on in a formative evaluation?
Intervention fidelity, implementation quality, and types of personnel
At which stage of defining requirements are tools for analyzing strengths, weaknesses, opportunities, and threats useful?
Interview and observe staff
Which two events led to the expansion of the field of nanotechnology?
Invention of the scanning tunneling microscope and the discovery of fullerenes
Why is the PSQRD a useful framework for research and practice?
It supports implementation, performance improvement, and rigorous research methodologies
Why have most clinical decision support (CDS) systems not shown to significantly impact patient outcomes in clinical trials, despite the fact that a majority of systems have been shown to significantly improve care processes?
Many CDS system evaluation trials are underpowered to detect changes in care outcomes.
The historical roots of computer science can be traced to:
Mathematics and engineering
Which payer is the largest for home health services?
Medicare
Which is most available throughout Africa?
Mobile phone service
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
Which of the following is true?
Patent protection applies to inventions
When evaluating quality and patient safety, which approach defines the framework for Patient Safety and Quality Research Design (PSQRD)?
Quality and safety are based on organizational structure, management and clinical processes, and their linkages to patient outcomes.
Which terminology serves as a resource to represent domain knowledge of interest and thus facilitates data collection, processing, and aggregation using computer processing?
Reference terminology