RHIT Domain 3 - Practice questions AHIMA
The hospital-acquired infection rate for our hospital is 0.2%, whereas the rate at a similar hospital across town is 0.3%. This is an example of a: a. Benchmark b. Check sheet c. Data abstract d. Run chart
a. Benchmark
In this experimental study, blood pressure is taken before and after an experimental medication is used as the intervention in a sample of participants that were previously unable to control their blood pressure with other medications. In this example, the independent variable is the __________ and the dependent variable is the__________. a. Experimental medication; blood pressure b. Blood pressure; experimental medication c. Blood pressure; heart disease d. Experimental medication; heart disease
a. Experimental medication; blood pressure
In a frequency distribution, the lowest value is 5, and the highest value is 20. What is the range? a. 5 to 20 b. 15 c. 7.5 d. 20 to 5
b. 15 The range is the simplest measure of spread. It is the difference between the smallest and largest values in a frequency distribution
Community Hospital had 250 patients in the hospital at midnight on May 1. The hospital admitted 30 patients on May 2. The hospital discharged 40 patients, including deaths, on May 2. Two patients were both admitted and discharged on May 2. What was the total number of inpatient service days for May 2? a. 240 b. 242 c. 280 d. 320
b. 242
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: a. Scheduled for a coding audit b. Subjected to corrective action c. Recommended for staff reappointment d. Involved in an in-house training program
c. Recommended for staff reappointment
Community Hospital had a total of 3,000 inpatient service days for the month of September. What was the average daily census for the hospital during September? a. 10 patients b. 96.77 patients c. 97 patients d. 100 patients
d. 100 patients The average daily census is the average number of inpatients treated during a given period of time. There are 30 days in September, so 3,000 / 30 = 100
Based on the payment percentages provided in this table, which payer contributes most to the hospital's overall payments? Payer \ Charges \ Payments \ Adjustment \ Charges \ Payments \ Adjustments BC/BS \ $450,000 \ $360,000 \ $90,000 \ 23% \ 31% \ 12% Commercial \ $250,000 \ $200,000 \ $50,000 \ 13% \ 17% \ 6% Medicaid \ $350,000 \ $75,000 \ $275,000 \ 18% \ 6% \ 36% Medicare \ $750,000 \ $495,000 \ $255,000 \ 39% \ 42% \ 33% TRICARE \ $150,000 \ $50,000 \ $100,000 \ 7% \ 4% \ 13% Total \ $1,950,000 \ $1,180,000 \ $770,000 \ 100% \ 100% \ 100% a. BC/BS b. Commercial c. TRICARE d. Medicare
d. Medicare
In which type of distribution are the mean, median, and mode equal? a. Bimodal distribution b. Simple distribution c. Nonnormal distribution d. Normal distribution
d. Normal distribution
Which of the following is the unique identifier in the relational database patient table? Patient Table Patient # \ Patient Last Name \ Patient First Name \ Date of Birth \ 021234 \ Smith \ Donna \ 03/21/1944 022366 \ Jones \ Donna \ 04/09/1960 034457 \ Smith \ Mary \ 08/21/1977 a. Patient last name b. Patient last and first name c. Patient date of birth d. Patient number
d. Patient number
If you want to display the parts of a whole in graphic form, what graphic technique would you use? a. Table b. Histogram c. Line graph d. Pie chart
d. Pie chart
Which of the following uniquely identifies each record in a database table? a. Data definition b. Data element c. Foreign key d. Primary key
d. Primary key
Which of the following is a technique for graphically depicting the structure of a computer database? a. Data model b. Data flow diagram c. Foreign key d. Primary key
a. Data model
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: a. National Center for Health Statistics b. Agency for Healthcare Research and Quality c. Health Services Research d. National Statistics Research
a. National Center for Health Statistics
Data elements collected on large populations of individuals and stored in databases are referred to as: a. Statistics b. Information c. Aggregate data d. Standard
c. Aggregate data
This type of analytics allows users to prescribe a number of different possible actions: a. Descriptive analytics b. Predictive analytics c. Prescriptive analytics d. Real-time analysis
c. Prescriptive analytics
A secondary data source includes ________. a. Vital statistics b. The medical record c. The physician's index d. A videotape of a counseling session
c. The physician's index
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? a. 0.67 b. 0.45 c. 0.33 d. Unable to determine
a. 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
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? Community Hospital Electronic Signature System500 Physicians on Staff; 489 Using the System Site \ No. of Physicians Using the System at This Site \ % of Physicians Using the System at This Site Medicine, 2 West \ 54 \ 11.04% Medicine, 2 East \ 62 \ 12.68% Pediatrics, 3 West \ 42 \ 8.59% Obstetrics, 1 West \ 12 \ 2.45% Physician's lounge \ 87 \ 17.79% HIM department \ 65 \ 13.29% Personal mobile device \ 92 \ 18.81% Physician home \ 75 \ 15.34% a. 2.2% b. 2.45% c. 18.81% d. 99.99%
a. 2.2% 11 physicians not using the system × 100) / 500 = 1,100 / 500 = 2.2%
If an employee produces 2,080 hours of work in the course of one year, how many employees will be required for the coding area if the coding time on average for one record is 30 minutes and there are 12,500 records that must be coded each year? a. 3 b. 6 c. 36 d. 69
a. 3
Given the numbers 47, 20, 11, 33, 30, 30, 35, and 50, what is the mode? a. 30 b. 32 c. 32.5 d. 35
a. 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
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? a. 44.7% b. 67.0% c. 20.0% d. 447%
a. 44.7% (67/150) × 100 = 44.66 = 44.7%
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? a. 50 b. 60 c. 63 d. 65
a. 50
A coding supervisor wants to use a fixed percentage random sample of work output to determine coding quality for each coder. Given the work output for each of the four coders shown here, how many total records will be needed for the audit if a 5 percent random sample is used? Fixed Percentage Random Sample Audit Example Coder \ Work Output \ Records for 5% Audit A \ 500 B \ 480 C \ 300 D \ 360 a. 82 b. 156 c. 820 d. 1,550
a. 82 The calculation is: (500 × 0.05) + (480 × 0.05) + (300 × 0. 05) + (360 × 0.05) = 82 records.
To use a data element for aggregation and reporting, that data element must be: a. Abstracted or indexed b. Searched c. Subject to case finding d. Registered
a. Abstracted or indexed
What number is assigned to a case when it is first entered in a cancer registry? a. Accession number b. Patient number c. Health record number d. Medical record number
a. Accession number
The Medical Staff Executive Committee has requested a report that identifies all medical staff members who have been suspended in the past six months due to delinquent health records. This is an example of what type of report? a. Ad hoc or demand b. Annual report c. Exception d. Periodic scheduled
a. Ad hoc or demand
The following data were derived from a comparative discharge database for hip and femur procedures: Comparative Data on Hip and Femur Procedures for Current Year Hospital A \ Hospital B \ Hospital C \ Hospital D Hip procedures \ 2,300 \ 1,467 \ 2,567 \ 1,100 Femur procedures \ 988 \ 1,245 \ 1,067 \ 678 These data can best be described as: a. Aggregate b. Identifiable c. Patient specific d. Primary
a. Aggregate
Secondary data is used for multiple reasons including: a. Assisting researchers in determining effectiveness of treatments b. Assisting physicians and other healthcare providers in providing patient care c. Billing for services provided to the patient d. Coding diagnoses and procedures treated
a. Assisting researchers in determining effectiveness of treatments
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? a. Average length of stay b. Total length of stay c. Patient length of stay d. Average patient census
a. 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
A PI Team is concerned with the time it is taking for patients to get through the registration process. To better understand the causes or reasons for the delay in this process the PI Team would like to gather observational data. What data collection tool would be appropriate for this team to develop for their observation data? a. Check sheet b. Ordinal data tool c. Balance sheet d. Nominal data tool
a. Check sheet
What formatting problem is found in the following table? Community Hospital Admissions by Gender, 20XX Male 3,546 | 42.4 Female 4,825 | 57.6 Total 8,371 | 100 a. Column headings are missing b. Title of the table is missing c. Column totals are inaccurate d. Variable names are missing
a. Column headings are missing
A record is considered a primary data source when it: a. Contains data about a patient and has been documented by the professionals who provided care to the patient b. Contains data abstracted from a patient record c. Includes data stored in a computer system d. Contains data that are entered into a disease-oriented database
a. Contains data about a patient and has been documented by the professionals who provided care to the patient
The process of extracting and analyzing large volumes of data from a database for the purpose of identifying hidden and sometimes subtle relationships or patterns and using those relationships to predict behaviors is called: a. Data mining b. Data warehouse c. Data searching d. Big data
a. Data mining
Your administrator has asked you to generate a report that gives the number of hypertension patients last year. This is an example of ________. a. Descriptive analytics b. Predictive analytics c. Prescriptive analytics d. Real-time analysis
a. Descriptive analytics
To be reliable, statistical data must: a. Have some consistency b. Be applicable to what is being measured c. Be collected from one source only d. Have multiple meanings
a. Have some consistency
Case finding is a method used to: a. Identify patients who have been seen or treated in a facility for a particular disease or condition for inclusion in a registry b. Define which cases are to be included in a registry c. Identify trends and changes in the incidence of disease d. Identify facility-based trends
a. Identify patients who have been seen or treated in a facility for a particular disease or condition for inclusion in a registry
Use the information provided to determine which of the following statements is correct? MS-DRG \ MDC \ Type \ MS-DRG Title \ Weight \ Discharges \ Geometric Mean \ Arithmetic Mean 191 \ 04 \ MED \ Chronic obstructive pulmonary disease w CC \ 0.9139 \ 10 \ 3.1 \ 3.7 192 \ 04 \ MED \ Chronic obstructive pulmonary disease w/o CC/MCC \ 0.7241 \ 20 \ 2.5 \ 3.0 193 \ 04 \ MED \ Simple pneumonia & pleurisy w MCC \ 1.3167 \ 10 \ 4.2 \ 5.2 194 \ 04 \ MED \ Simple pneumonia & pleurisy w CC \ 0.9002 \ 20 \ 3.3 \ 3.9 195 \ 04 \ MED \ Simple pneumonia & pleurisy w/o CC/MCC \ 0.6868 \ 10 \ 2.6 \ 3.1 a. In each MS-DRG, the geometric mean is lower than the arithmetic mean. b. In each MS-DRG, the arithmetic mean is lower than the geometric mean. c. The higher the number of patients in each MS-DRG, the greater the geometric mean for that MS-DRG. d. The geometric means are lower in MS-DRGs that are associated with a CC or MCC.
a. In each MS-DRG, the geometric mean is lower than the arithmetic mean.
Which unit of measure is used to indicate the services received by one inpatient in a 24-hour period? a. Inpatient service day b. Volume of services c. Average occupancy charges d. Length of services provided
a. Inpatient service day
Why is the MEDPAR file limited in terms of being used for research purposes? a. It only contains Medicare patients. b. It only provides demographic data about patients. c. It uses diagnoses and procedure codes. d. It breaks charges down by specific types of service.
a. It only contains Medicare patients.
Which of the following is made up of claims data from Medicare claims submitted by acute-care hospitals and skilled nursing facilities? a. NPDB b. MEDPAR c. HIPDB d. UHDDS
b. MEDPAR
Which of the following is the first step in analyzing data? a. Knowing your objectives or purpose of the data analysis b. Starting with basic types of data analysis and work up to more sophisticated analysis c. Utilizing a statistician to analyze the data d. Presenting your findings to administration
a. Knowing your objectives or purpose of the data analysis The first step in analyzing data is to know your objective or the purpose of the data analysis
Which of the following types of data does not have a natural order? a. Nominal b. Ordinal c. Ratio d. Interval
a. Nominal
A health data analyst has been asked to abstract patient demographic information into an electronic database. Which of the following would the analyst include in the database? a. Patient date of birth b. Name of attending physician c. Patient room number d. Admitting diagnosis
a. Patient date of birth
Which of the following best represents the definition of the term data? a. Patient's laboratory value is 50. b. Patient's SGOT is higher than 50 and outside of normal limits. c. Patient's resting heartbeat is 70, which is within normal range. d. Patient's laboratory value is consistent with liver disease.
a. Patient's laboratory value is 50
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? a. Structural b. Descriptive c. Administrative d. Modeling
a. Structural
Which events must occur in order to maintain patient identity data integrity? a. The data must be accurately queried b. The data must be accurately analyzed c. The data must be accurately normalized d. The data must be accurately coded
a. The data must be accurately queried
An employee views a patient's electronic health record. It is a trigger event if: a. The employee and patient have the same last name b. The patient was admitted through the emergency department c. The patient is over 89 years old d. A dietitian views a patient's nutrition care plan
a. The employee and patient have the same last name
Within the context of the inpatient prospective payment system, how is the case-mix index calculated? a. The sum of all relative weights divided by the total number of discharges b. The total number of inpatient service days divided by the total number of discharges c. The sum of all MDCs divided by the total number of discharges d. The total number of inpatient beds divided by the total number of discharges
a. The sum of all relative weights divided by the total number of discharges
Recently, a local professional athlete was admitted to your facility for a procedure. During this patient's hospital stay, access logs may need to be checked daily in order to determine: a. Whether access by employees is appropriate b. If the patient is satisfied with their stay c. If it is necessary to order prescriptions for the patient d. Whether the care to the patient meets quality standards
a. Whether access by employees is appropriate
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. Community HospitalHealth Information Management DepartmentCoding SectionAbsentee ReportAnnual Statistics, 20XX Employee Name \ Vacation Hours Used \ Sick Leave Hours Used A \ 40 \ 6 B \ 22 \ 16 C \ 36 \ 8 D \ 80 \ 32 E \ 16 \ 40 What is the total sick leave rate for this group of employees for the year? a. 0.29% b. 0.98% c. 1.29% d. 1.54%
b. 0.98% (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
In May, 270 women were admitted to the obstetrics service. Of these, 263 women delivered; 33 deliveries were by C-section. What is the denominator for calculating the C-section rate? a. 33 b. 263 c. 270 d. 296
b. 263 The denominator (the number of times an event could have occurred) in this case would be 263 as 263 women delivered
The coding department at Community Physician's Clinic developed the following report for the denials committee at the clinic. Use the billing report to determine how many hours it will take to reconcile these denials if each denial takes 1.5 hours to review and resubmit the bill. Community Physician's Clinic Coding Department Denials - October, 20XX Payment Source \ Number of Claims Sent \ Number of Denials \ Percentage of Denials Medicare \ 460 \ 43 \ 9.35% Medicaid \ 345 \ 35 \ 10.14% Tricare/Military \ 182 \ 14 \ 7.69% Commercial payers \ 1307 \ 83 \ 6.35% Worker's Compensation \ 6 \ 1 \ 16.17% Total \ 2300 \ 176 \ 7.65% a. 11.46 hours b. 264 hours c. 3450 hours d. Unable to determine
b. 264 hours 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 hour
Given the numbers 47, 20, 11, 33, 30, 30, 35, and 50, what is the median? a. 30 b. 31.5 c. 32 d. 35
b. 31.5 It is found by averaging the two middle scores, (x + y) / 2. In the example, the median is 31.5: ([30 + 33] / 2)
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 58 patients, 3 patients died. What is the case fatality rate for influenza for January? a. 1.60% b. 5.17% c. 0.10% d. 94.8%
b. 5.17% (3 ×100) / 58 = 300 / 58 = 5.17%
Community Hospital discharged 9 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; for patient I, 9 days. What was the average length of stay for these nine patients? a. 5 days b. 6 days c. 8 days d. 9 days
b. 6 days
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? a. The ROI function continues to cost more than revenue generated. b. Annualized revenue for YR-7 is more than the costs. c. The ROI function costs are inversely related to revenue generated. d. The ROI costs for YR-7 are greater than the revenue.
b. 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
Review of disease indexes, pathology reports, and radiation therapy reports are parts of which function in the cancer registry? a. Case definition b. Case finding c. Follow-up d. Reporting
b. Case finding
The number of inpatients present in a healthcare facility at any given time is called a ________. a. Survey b. Census c. Sample d. Enumeration
b. Census
What term is used for the number of inpatients present at any one time in a healthcare facility? a. Average daily census b. Census c. Inpatient service day d. Length of stay
b. Census
A quality goal for the hospital is that 98 percent of the heart attack patients receive aspirin within 24 hours of arrival at the hospital. In conducting an audit of heart attack patients, the data showed that 94 percent of the patients received aspirin within 24 hours of arriving at the hospital. Given this data, which of the following actions would be best? a. Alert the Joint Commission that the hospital has not met its quality goal b. Determine whether there was a medical or other reason why patients were not given aspirin c. Institute an in-service training program for clinical staff on the importance of administering aspirin within 24 hours d. Determine which physicians did not order aspirin
b. Determine whether there was a medical or other reason why patients were not given aspirin
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? a. Elective b. Emergency c. Newborn d. Urgent
b. Emergency
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? a. Clinical pathway b. Evidence-based medicine c. Patient-centered care d. Morbidity indicators
b. Evidence-based medicine
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 ________. a. Internal data b. External data c. Ratio data d. Nominal data
b. External data
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? a. Average b. Percentage c. Proportion d. Rate
c. Proportion
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? Coder \ Work Output(All RecordsCoded) \ Total Hours Worked \ AverageWork Output per Hour \ Completed Work Percentage \ Completed Work Output (RecordsCoded Accurately) \ Completed Work per Hour Worked A \ 500 \ 140 (full time) \ 3.57 \ 91% \ 455 \ 3.25 B \ 475 \ 140 (full time) \ 3.39 \ 96% \ 456 \ 3.26 C \ 300 \ 80 (part time) \ 3.75 \ 85% \ 240 \ 3.00 D \ 350 \ 80 (part time) \ 4.69 \ 70% \ 245 \ 3.06 Department Average \ 3.69 \ 3.17 a. Part-time coders are more productive than full-time coders. b. Full-time coders are more productive than part-time coders. c. All coders produce more than the departmental average. d. Part-time coders exceed the departmental average.
b. Full-time coders are more productive than part-time coders.
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? a. Net b. Gross c. Hospital d. Average
b. Gross
Given the following information, which of the following has the lowest work RVU? Sample RVUs for Selected HCPCS Codes HCPCSCode \ Description \ Work RVU \ Practice Expense RVU \ MalpracticeExpense RVU 99204 \ Office visit \ 2.43 \ 1.20 \ 0.23 10080 \ I&D of pilonidal cyst, simple \ 1.22 \ 1.58 \ 0.20 45380 \ Colonoscopy with biopsy \ 4.43 \ 2.72 \ 0.67 52601 \ TURP, complete \ 15.26 \ 8.04 \ 1.50 a. Office visit b. I&D of pilonidal cyst, simple c. Colonoscopy with biopsy d. TURP, complete
b. I&D of pilonidal cyst, simple
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: a. Descriptive statistics b. Inferential statistics c. Generalized statistics d. Mathematical statistics
b. Inferential statistics
Why is the MEDPAR file limited in terms of being used for research purposes? a. It only provides demographic data about patients b. It only contains Medicare patients c. It uses ICD-10-CM diagnoses and procedure codes d. It breaks charges down by specific type of service
b. It only contains Medicare patients
Which term is used to describe the number of calendar days that a patient is hospitalized? a. Average length of stay b. Length of stay c. Occupancy rate d. Level of service
b. Length of stay
Sometimes data do not follow a normal distribution and are pulled toward the tails of the curve. When this occurs, it is referred to as having a skewed distribution. Because the mean is sensitive to extreme values or outliers, it gravitates in the direction of the extreme values thus making a long tail when a distribution is skewed. When the tail is pulled toward the right side, it is called a __________. a. Negatively skewed distribution b. Positively skewed distribution c. Bimodal distribution d. Normal distribution
b. Positively skewed distribution
.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 ________. a. Descriptive analytics b. Predictive analytics c. Inferential statistics d. Descriptive statistics
b. Predictive analytics
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 ________. a. Descriptive analytics b. Predictive modeling c. Prescriptive analytics d. Real-time analysis
b. Predictive modeling
Health departments use the health record to monitor outbreaks of diseases. In this situation what type of use of the health record does this represent? a. Educational b. Public health and research c. Medical review organization d. Patient care
b. Public health and research
Which tool is used to display performance data over time? a. Status process control chart b. Run chart c. Benchmark d. Time ladder
b. Run chart A run chart displays data points over a period of time to provide information about performance. The measured points of a process are plotted on a graph at regular time intervals to help team members see whether there are substantial changes in the numbers over time
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? a. Every access to every data element or document type that occurred within the facility b. Whether the person viewed, created, updated, or deleted information belonging to a patient with the same last name c. Physical location of the redundant servers used for backup d. Whether all patients setup accounts in the patient portal
b. Whether the person viewed, created, updated, or deleted information belonging to a patient with the same last name
The facility privacy officer receives a phone call from a patient who is concerned that her former sister-in-law who is a hospital employee has accessed her health record. The privacy officer requests an audit log of activity within the patient's health record. What part of the audit log must be analyzed to determine if this complaint has merit? a. The patient demographic information b. Which employees viewed, created, updated, or deleted information c. The ownership of the record d. Whether the patient had requested to be omitted from the facility patient directory
b. Which employees viewed, created, updated, or deleted information
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? a. $3.36 per record b. $4.49 per record c. $5.43 per record d. $5.51 per record
c. $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
The HIM manager recently performed an audit of health record documentation in the EHR looking for reports that had been indexed incorrectly. The audit showed that for the 100 records reviewed there was a 4 percent error rate. Given that the national average labor cost of each misindexed report is $200, what is the labor cost for the department for handling these misindexed reports? a. $8,000 b. $500 c. $800 d. $500,000
c. $800 (100 x 0.04) x $200= $800
Mr. Jones was admitted to the hospital on March 21 and discharged on April 1. What was the length of stay for Mr. Jones? a. 5 days b. 10 days c. 11 days d. 15 days
c. 11 days
What is the mean for the following frequency distribution: 10, 15, 20, 25, 25? a. 47.5 b. 20 c. 19 d. 95
c. 19 the sum of all the values in a frequency distribution divided by the frequency: (10 + 15 + 20 + 25 + 25) / 5 = 19
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? a. 0.02% b. 5% c. 20% d. 200%
c. 20%
Using the information in the table below, calculate the C-section rate at University Hospital for the semiannual period. University Hospital Obstetrics Service Semiannual Statistics July-December, 20XX Admissions - 672 Discharges and Deaths: Delivered - 504 Not Delivered - 147 Aborted - 21 Vaginal deliveries - 403 C-sections - 101 a. 15.03% b. 19.24% c. 20.04% d. 25.06%
c. 20.04% C-section rate: (101 × 100) / 504 = 10,100 / 504 = 20.039 = 20.04%
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: a. 0.05% b. 2% c. 5% d. 20%
c. 5% 25/500 = 0.05 × 100 = 5%
Based on this output table, what is the average coding test score for the beginner coder? Coding Test Score Coder Status \ Mean \ N \ Standard Deviation Advanced \ 93.0000 \ 3 \ 5.00000 Intermediate \ 89.5000 \ 2 \ .70711 Beginner \ 73.3333 \ 3 \ 6.42910 Total \ 84.7500 \ 8 \ 10.51190 a. 93 b. 6.4 c. 73 d. 90
c. 73 Since the mean is the average and the value next to the "beginner" under coder status is 73.3333, round the value to a whole number and the best answer is 73
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? a. 5 days b. 6 days c. 8 days d. 9 days
c. 8 days The median is the midpoint of a frequency distribution.
Information that has been taken from the health records of injured patients and entered into the trauma registry database has been: a. Aggregated b. Mapped c. Abstracted d. Queried
c. Abstracted
Community Hospital wants to compare its hospital-acquired urinary tract infection (UTI) rate for Medicare patients with the national average. The hospital is using the MEDPAR database for its comparison. The MEDPAR database contains 13,000,000 discharges. Of these individuals, 200,000 were admitted with a principal diagnosis of UTI; another 300,000 were admitted with a principal diagnosis of infectious disease, and 700,000 had a diagnosis of hypertension. Given this information, which of the following would provide the best comparison data for Community Hospital? a. All individuals in the MEDPAR database b. All individuals in the MEDPAR database except those admitted with a principal diagnosis of UTI c. All individuals in the MEDPAR database except those admitted with a principal diagnosis of UTI or infectious disease d. All individuals in the MEDPAR database except those admitted with a diagnosis of hypertension
c. All individuals in the MEDPAR database except those admitted with a principal diagnosis of UTI or infectious disease
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? a. Patient-specific b. Administrative c. Comparative d. Detailed
c. Comparative
For research purposes, an advantage of the Healthcare Cost and Utilization Project (HCUP) is that it: a. Contains only Medicare data b. Is used to determine pay for performance c. Contains data on all payer types d. Contains bibliographic listings from medical journals
c. Contains data on all payer types
Community Hospital performed a cost-savings analysis between its current on-site coding processes and an e-WebCoding telecommuting model. What does the cost analysis show in the graph below? a. The current system saves more than the e-WebCoding system would. b. The current system reduces DNFB significantly. c. Cost comparison reflects a net reduction in overall expenses on a monthly basis for the e-WebCoding system. d. There is not enough information to make a determination.
c. 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
What is the official count of inpatients taken at midnight called? a. Average daily census b. Census c. Daily inpatient census d. Inpatient service days
c. Daily inpatient census
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 ________. a. Big data b. Descriptive analytics screen c. Dashboard d. Descriptive tablet
c. Dashboard
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? LOS Summary for Pneumonia by Clinical Specialty Clinical Specialty | Cases | Observed LOS | Expected LOS | Savings Opportunity Cardiology | 1 | 6 | 6.36 | 0 Family Practice | 17 | 8.47 6.26 38 Internal Medicine | 34 | 3.82 | 4.89 | -36 Endocrinology | 1 | 3 | 3.93 | -1 Pediatrics | 7 | 3.43 | 3.55 | -1 a. Cardiology b. Endocrinology c. Family practice d. Internal medicine
c. Family practice
Community Hospital has been collecting quarterly data on the average monthly health record delinquency rate for the hospital. This graph depicts the trend in the delinquency rate. The hospital has established a 35 percent benchmark. Given this data, what should the hospital's Performance Improvement Council recommend? a. Continue tracking the delinquency rate to see if the last two quarters' trend continues b. Establish a higher benchmark to accommodate an increase in delinquent records c. Further analyze the data to determine why the benchmark is not being met d. Take an average of all the data points to arrive at a new benchmark
c. Further analyze the data to determine why the benchmark is not being met
Which rate is used to compare the number of inpatient deaths to the total number of inpatient deaths and discharges? a. Net hospital death rate b. Fetal/newborn/maternal hospital death rate c. Gross hospital death rate d. Adjusted hospital death rate
c. Gross hospital death rate
Which rate describes the probability or risk of illness in a population over a period of time? a. Mortality b. Prevalence c. Incidence d. Morbidity
c. Incidence
Suppose you want to display the number of deaths due to breast cancer for the years 2005 through 2015. What is the best graphic technique to use? a. Table b. Histogram c. Line graph d. Bar chart
c. Line graph
Which of the following reportable diseases usually requires reporting within 24 hours of a suspected diagnosis? a. Chicken pox b. Mumps c. Measles d. Pertussis
c. Measles
The following data fields comprise a database table: patient last name, patient first name, street address, city, state, zip code, patient date of birth. Given this information, which of the following is a true statement about maintaining the data integrity of the database table? a. Patient last name should be used as the primary key for the table. b. Patient date of birth should be used as the primary key for the table. c. None of the data fields are adequate to use as a primary key for the table. d. Patient last and first name should be used as the primary key for the table.
c. None of the data fields are adequate to use as a primary key for the table.
In the relational database shown here, the patient table and the visit table are related by: Patient Table Patient # \ Patient Last Name \ Patient First Name \ Date of Birth 021234 \ Smith \ Donna \ 03/21/194 4022366 \ Jones \ William \ 04/09/1960 034457 \ Collins \ Mary \ 08/21/1977 Visit Table Visit # \ Date of Visit \ Practitioner # \ Patient # 0045678 \ 11/12/2008 \ 456 \ 021234 0045679 \ 11/12/2008 \ 997 \ 021234 0045680 \ 11/12/2008 \ 456 \ 034457 a. Visit number b. Date of visit c. Patient number d. Practitioner number
c. Patient number
What do the wedges or divisions in a pie graph represent? a. Frequency groups b. Various data c. Percentages d. Classes
c. Percentages
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. Community Hospital Electronic Signature System 500 Physicians on Staff; 489 Using the System Site \ No. of Physicians Using the System at This Site \ % of Physicians Using the System at This Site Medicine, 2 West \ 54 \ 11.04% Medicine, 2 East \ 62 \ 12.68% Pediatrics, 3 West \ 42 \ 8.59% Obstetrics, 1 West \ 12 \ 2.45% Physician's lounge \ 87 \ 17.79% HIM department \ 65 \ 13.29% Personal mobile device \ 92 \ 18.81% Physician home \ 75 \ 15.34% a. HIM department b. Obstetrics, 1 West c. Personal mobile device d. Physician home
c. Personal mobile device
General Hospital is performing peer reviews of their medical providers for quality outcomes of care. The hospital has more than 500 providers on its medical staff. The process to peer review even 10 cases for each provider is quite extensive. The quality department has concluded that to accomplish this review process, they will review 20 percent of each provider's inpatient admissions to the hospital every other year. In this situation, the quality department has applied to their review process. a. Benchmarking b. Data analysis c. Sampling d. Skewing
c. Sampling
Given the following information, in which city is the GPCI the highest for practice expense? Sample Geographical Practice Cost Indices (GPCI) for Selected Cities City \ Work GPCI \ Practice Expense GPCI \ Malpractice Expense GPCI St. Louis \ 1.000 \ 0.968 \ 1.064 Dallas \ 1.009 \ 1.001 \ 0.969 Seattle \ 1.020 \ 1.098 \ 0.785 Philadelphia \ 1.015 \ 1.084 \ 1.619 a. St. Louis b. Dallas c. Seattle d. Philadelphia
c. 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
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? a. Make no comment since this is a medical staff meeting. b. Agree with the physician that the data suggest a quality issue. c. Suggest that the data be adjusted for possible differences in type and volume of patients treated. d. Suggest that an audit be done immediately to determine the cause of deaths within the hospital.
c. Suggest that the data be adjusted for possible differences in type and volume of patients treated.
What is (are) the format problem(s) with the following table? Community Hospital Discharges by Sex Sex \ Number \ Percentage Male \ 3,000 \ 37.5% Female \ 5,000 \ 62.5% Unknown \ — \ — Total \ 8,000 \ 100% a. The title is missing. b. Variable names are missing. c. There are blank cells. d. Row totals are inaccurate.
c. 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
In the scatter chart below what can be concluded about the relationship between age and income. a. There is a strong negative relationship between age and income b. There is no relationship between age and income c. There is a strong positive relationship between age and income d. There is not enough information to determine the relationship
c. There is a strong positive relationship between age and income The scatter chart is showing a strong positive relationship between age and income because as age increases so does income. A negative relationship would show that as age increases income decreases, and that is not the case in this scatter chart example
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. Community Physician's ClinicCoding DepartmentDenials - October, 20XX Payment Source \ Number of Claims Sent \ Number of Denials \ Percentage of Denials Medicare \ 460 \ 43 \ 9.35% Medicaid \ 345 \ 35 \ 10.14% Tricare/Military \ 182 \ 14 \ 7.69% Commercial payers \ 1307 \ 83 \ 6.35% Worker's Compensation \ 6 \ 1 \ 16.17% Total \ 2300 \ 176 \ 7.65% a. Medicare b. Commercial payers c. Worker's Compensation d. Tricare/Military
c. Worker's Compensation
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? a. $3.36 per record b. $4.49 per record c. $5.43 per record d. $5.51 per record
d. $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
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. Community Hospital Health Information Services Physician Documentation Deficiencies January 20XX Physician No. \ No. Admissions \ No. of H&Ps Not Completed within24 Hours of Admission \ Rate of Deficiency 102 \ 189 \ 5 \ 2.64 237 \ 234 \ 4 \ 1.71 391 \ 98\ 8 \ 8.16 518 \ 122 \ 5 \ 4.10 637 \178 \ 3 \ 1.69 a. 102 b. 237 c. 391 d. 637
d. 637
Using the information in the table below, calculate the vaginal delivery rate at University Hospital for the semiannual period. University Hospital Obstetrics Service Semiannual Statistic sJuly-December, 20XX Admissions - 672 Discharges and Deaths: Delivered - 504 Not Delivered - 147 Aborted - 21 Vaginal deliveries - 403 C-sections - 101 a. 20.04% b. 59.97% c. 84.13% d. 79.96%
d. 79.96% Vaginal delivery rate: (403 × 100) / 504 = 40,300 / 504 = 79.96%
Community Hospital's HIM department conducted a random sample of 200 inpatient health records to determine the timeliness of the history and physicals completion. Nine records were found to be out of compliance with the 24-hour requirement. Which of the following percentages represents the H&P timeliness rate at Community Hospital? a. 4.5% b. 21.2% c. 66.7% d. 95.5%
d. 95.5% The calculation is (191/200) × 100 = 95.5%
Which of the following is an example of how an internal user utilizes secondary data? a. State infectious disease reporting b. Birth certificates c. Death certificates d. Benchmarking with other facilities
d. Benchmarking with other facilities
After the types of cases to be included in a cancer registry have been determined, what is the next step in data acquisition? a. Case registration b. Case definition c. Case abstracting d. Case finding
d. Case finding
After the types of cases to be included in a trauma registry have been determined, what is the next step in data acquisition? a. Registering b. Defining c. Abstracting d. Case finding
d. Case finding
A consumer nonprofit organization wants to conduct studies on the quality of care provided to Medicare patients in a specific region. An HIT professional has been hired to manage this project. The nonprofit organization asks the HIT professional about the viability of using billing data as the basis for its analysis. Which of the following would not be a quality consideration in using billing data? a. Accuracy of the data b. Consistency of the data c. Appropriateness of the data elements d. Cost to process the data
d. Cost to process the data
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? a. Inpatient bed occupancy rate b. Bed count c. Average daily census d. Daily inpatient census
d. Daily inpatient census
What is data called that consists of factual details aggregated or summarized from a group of health records the provides no means to identify specific patients? a. Original b. Source c. Protected d. Derived
d. Derived
At Community Hospital, each full-time employee is required to work 2,080 hours annually. The table below shows the amount of time that four employees were absent from work over the past year. Community HospitalHealth Information Management DepartmentCoding SectionAbsentee ReportAnnual Statistics, 20XX Employee Name \ Vacation Hours Used \ Sick Leave Hours Used A \ 40 \ 6 B \ 22 \ 16 C \ 36 \ 8 D \ 80 \ 32 Which employee had the highest absentee rate? a. Employee A b. Employee B c. Employee C d. Employee D
d. Employee D The absentee rate for each employee is calculated as follows: Coder A: [(40 + 6) × 100] / 2,080 = 4,600 / 2,080 = 2.21%; Coder B: [(22 + 16) × 100] / 2,080 = 3,800 / 2,080 = 1.826 = 1.83%; Coder C: [(36 + 8) × 100] / 2,080 = 4,400 / 2,080 = 2.115 = 2.12%; Coder D: [(80 + 32) × 100] / 2,080 = 11,200 / 2,080 = 5.38%
This type of chart plots all data points as a cell for two given variables of interest and, depending on frequency of observations in each cell, provides color to visualize high or low frequency. a. Barplot b. Scatter plot c. Boxplot d. Heatmap
d. Heatmap
Given the following information, from which payer does the hospital proportionately receive the least amount of payment? Payer \ Charges \ Payments \ Adjustments \ Charges \ Payments \ Adjustments BC/BS \ $450,000 \ $360,000 \ $90,000 \ 23% \ 31% \ 12% Commercial \ $250,000 \ $200,000 \ $50,000 \ 13% \ 17% \ 6% Medicaid \ $350,000 \ $75,000 \ $275,000 \ 18% \ 6% \ 36% Medicare \ $750,000 \ $495,000 \ $255,000 \ 39% \ 42% \ 33% TRICARE \ $150,000 \ $50,000 \ $100,000 \ 7% \ 4% \ 13% Total \ $1,950,000 \ $1,180,000 \ $770,000 \ 100% \ 100% \ 100% a. BC/BS b. TRICARE c. Medicare d. Medicaid
d. Medicaid
The hospital's Performance Improvement Council has compiled the following data on the volume of procedures performed. Given this data, which procedures should the council scrutinize in evaluating performance. a. Procedures 1, 4 b. Procedures 2, 3, 5 c. Procedures 6, 7 d. Procedures 1, 4, 6, 7
d. Procedures 1, 4, 6, 7 Performance measurement in healthcare provides an indication of an organization's performance in relation to a specified process or outcome. Healthcare performance improvement philosophies most often focus on measuring performance in the areas of systems, processes, and outcomes. Outcomes should be scrutinized whether they are positive and appropriate or negative and diminishing
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? a. Qualitative b. Interval c. Nominal d. Quantitative
d. Quantitative
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 ________. a. Descriptive analytics b. Predictive analytics c. Prescriptive analytics d. Real-time analysis
d. Real-time analysis
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? a. Concur with the conclusion of the committee b. State that the greatest decrease in infection rate in a year took place in 2005 c. State that the greatest decrease in infection rate occurred in 1960 and 1970 d. Request a new data chart be presented that accurately reflects the trend of infection rate
d. 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
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? a. Create a new policy about high-profile patient privacy b. Start by discussing the situation with the media to resolve their inquiries c. Contact employees in the facility d. Review audit trail information to determine which employees have accessed this patient's information
d. Review audit trail information to determine which employees have accessed this patient's information
Which of the following is used to plot the points for two variables that may be related to each other in some way? a. Force-field analysis b. Pareto chart c. Root cause analysis d. Scatter diagram
d. 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
Which of the following is true about a primary key in a database table? a. Usually is not a unique number b. Changes in value c. Is dependent on the data in the table d. Uniquely identifies each row in a table
d. Uniquely identifies each row in a table
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? a. Whether or not the patient is fit to continue public service b. What information should be shared with the media c. That the patient has received adequate care d. Whether all access by hospital employees was appropriate
d. Whether all access by hospital employees was appropriate
As part of your job responsibilities, you are responsible for reviewing audit trails of access to patient information. The following are all types of activities that you would monitor except: a. Every access to every data element or document type b. Whether the person viewed, created, updated, or deleted the information c. Physical location on the network where the access occurred d. Whether the patient setup an account in the patient portal
d. Whether the patient setup an account in the patient portal
The facility privacy officer is visited at the hospital by a recent patient who is concerned that her nosy neighbor, who happens to be a hospital employee, accessed her EHR 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? a. The physician documentation from her recent stay regarding the patient's health conditions b. Whether the patient had requested any amendments to her record c. If the record has any deficiencies that would cause the record to be delinquent d. Which employees viewed, created, updated, or deleted information
d. Which employees viewed, created, updated, or deleted information
