Comp14-2

1. 6. Identify FIVE (5) staffing categories that should be incorporated in an EHR implementation team. Answer:

Physician champion

Project director

Project manager

Principal trainer

Network support

True

False

2. 8. Identify SIX (6) roles that on-site consultants can play during an EHR project. Answer:

EHR selection

EHR implementation

Meaningful Use

EHR vendors

IT consulting

EHR review

EHR training

EHR certification

True

False

3. 11. Identify TWO (2) potential concerns of linking EHRs to PHRs. Answer (Any two): Logistics to work out to prevent misinformed patients Clinicians have to change the way they document Privacy concerns for patients, institutions

True

False

4. 4. Identify TWO (2) advantages and TWO (2) disadvantages of a big-bang rollout and a phased rollout. Big-Bang Rollout Advantage: Advantage: Disadvantage: Disadvantage: Phased Rollout Advantage: Advantage: Disadvantage: Disadvantage: Answer: Big-Bang Rollout Advantage: short-term disruption Advantage: no need for linking Advantage: only one system to support Disadvantage: higher risk to organization Disadvantage: requires comprehensive planning Disadvantage: mass training required. Phased Rollout Advantage: focused planning Advantage: isolated disruptions Advantage: smaller groups of users Disadvantage: need to maintain two systems Disadvantage: risk of stagnation Disadvantage: need to correlate information from both systems

True

False

5. 11. List the SIX (6) steps of system change management, as given in Component 14. Answer:

Record/classify

Assess

Plan

Build/test

Implement

Close/gain acceptance

True

False

6. 7. Identify the THREE (3) categories of rules for implementing clinical decision support alerts. Answer: Communication Monitoring Intervention Techniques

True

False

7. 10. Identify THREE (3) benefits of personal health records (PHRs) for patients. Answer (any three): Greater sense of empowerment More engaged in their care Higher satisfaction Increased adherence to their care plans Better health outcomes

True

False

8. 8. For items i-vi, match the type of database with its component using either response A or B. A. Relational database B. Hierarchical database i. SQL Server: ii. PureXML iii. Structured as formally-described tables: iv. Structured tree-like with branching: v. Oracle: vi. Intersystems-Cache: Answer: i. A ii. B iii. A iv. B v. A vi. B

True

False

9. 1. For Items i-vii indicate whether True or False based on the information provided in Component 14.

Staffing issues are key factors to consider before implementation of vendor-specific Electronic Health Record (EHR) systems. ____

"Big bang" is a metaphor for a gradual but large-scale implementation of a new EHR system.

One advantage of a phased rollout of a new EHR system is that it is a planned and focused implementation method.

Change management is necessary part of implementing vendor specific EHR systems.

There is no need for monitoring use of a new EHR system if it is of high quality.

Physicians and nurses are not a part of the staffing structure necessary for implementation of a vendor-provided EHR system. _

On-site consultants facilitate the concept of "meaningful use" during implementation of a vendor-specific EHR system. _____

Answer:

T

F

T

T

F

F

T

True

False

10. 5. Identify TWO (2) credible sources for terminology standards discussed in Unit 6. Answer: ICD-9 CPT-4 SNOMED-CT LOINC

True

False

11. 4. Which of the following diagnostic expert system was developed at the University of Pittsburgh and utilizes patient observations to create differential diagnoses?

A. INTERNIST

B. Quick Medical Reference (QMR)

C. MYCIN

D. DXplain

12. 2. Which of the following diagnostic expert system was designed to diagnose certain blood infections and is represented by as a set of IF-THEN rules?

A. INTERNIST

B. Quick Medical Reference (QMR)

C. MYCIN

D. DXplain

13. 11. Identify FOUR (4) recommended EHR security measures according to the AHIMA e-HIM work group on Security of Personal Health Information. Answer: A. Ability to assign an alias to a patient B. Ability to restrict patients from physicians who are not the "physician of record" C. Ability to block access to specific progress note or lab result D. Ability to track versioning or mask sensitive entries for release of information E. Role-based security that restricts access to predefined categories of patients, encounters, and documents based on the access a user needs to perform his or her job. F. VIP status indicators that restrict especially identified patients and encounters to those individuals with permission for VIP encounters and patients.

True

False

14. 3. Which of the following is a non-profit organization that aids in the development of universal healthcare standards to improve technical interoperability?

A. CPT-4

B. HLN-7

C. ICD-9

D. SNOMED-CT

E. LOINC

15. 1. Which component of interoperability focuses on the consistent meaning of terms specific to the application?

A. Technical

B. Semantic

C. Process

D. Outcome

E. Terminal

16. 6. Which of the following is/are example(s) of a health information system that may be included in EHRs?

A. Pharmacy

B. Radiology

C. Laboratory

D. A and B only

E. All of the above

17. 5. Which type of EHR hardware platform may use online document processors as opposed to the traditional software?

A. Thick client

B. Thin client

C. Web based

D. Citrix

18. 3. Which type of EHR hardware platform exists independent of a central server?

A. Thick client

B. Thin client

C. Web based

D. Citrix

19. 1. Which of the following is/are component(s) of the architecture of an Electronic Health Record (EHR)?

A. Users of EHR

B. Pharmacy

C. Clinical data repository

D. A and C only

E. All of the above

20. 6. Which of the following is/are component(s) of the Medical Logic Modules (MLM)?

A. Data

B. Evoke

C. Inaction

D. A and B only

E. A, B, and C

21. 10. In which project phase is change management an important aspect?

A. Project planning phase

B. Implementation phase

C. Immediate post go-live phase

D. Maintenance phase

22. 1. Which of the following is/are characteristic(s) of clinical decision support programs?

A. Assist with clinical decisions

B. Interpret medical data

C. Considered an expert system

D. A and B only

E. All of the above

23. 2. Which of the following is an example of "front end" hardware platforms for EHRs?

A. Database server

B. Application server

C. Mobile device

D. A and C only

E. All of the above

24. 2. Which component of interoperability refers to the electronic sharing and exchange of electronic health information?

A. Technical

B. Semantic

C. Process

D. Outcome

E. Terminal

25. 7. Which of the following is/are example(s) of operating systems for EHRs?

A. MacOS

B. Linux

C. Oracle

D. A and B only

E. All of the above

26. 5. Staffing requirements for EHR implementation are influenced by all of the following EXCEPT for which factor?

A. Application module

B. Time of year

C. Physical location

D. Type of roll-out

27. 7. Which of the following process interoperability components includes evidence-based medicine to enhance automation systems?

A. Nomenclature tools

B. Rules editor

C. Clinical knowledge sources

D. Clinical measurement

28. 5. All of the following are functions of alerts/reminders in clinical decision support programs EXCEPT for which one?

A. Identify critical abnormalities in laboratory reports

B. Identify contraindications for drug prescriptions

C. Create a list of diagnoses based upon symptoms

D. Alert providers of incorrect drug dosages

29. 4. Which type of EHR hardware platform requires that most of its business logic take place on a desktop PC?

A. Thick client

B. Thin client

C. Web based

D. Citrix

30. 10. Based upon the EHR system reviews in unit 5, which EHR system uses software that is centered around SQL Server database?

A. Epic

B. Eclipsys

C. Quadramed

D. NextGen

E. eClinicalWorks

31. 12. Which of the following is/are benefit(s) of audit logs of an EHR system?

A. Allows the client to know when the system is used most.

B. Allows the client to know who uses the system and how often.

C. Allows the client to access audit logs to enhance information security.

D. A and B only

E. All of the above

32. 3. Which of the following is a disadvantage of a phased rollout method of implementation of a new EHR system?

A. High risk to the organization

B. Risk of stagnation

C. Mass training required

D. Requires comprehensive planning

33. 7. During which of the following phases is a command center fully operational?

A. Project planning phase

B. Implementation phase

C. Immediate after the “go-live” phase

D. Maintenance phase

34. 9. Based upon the EHR system reviews in unit 5, which EHR system uses software that is centered around the MUMPS/Cache database?

A. Epic

B. Eclipsys

C. Quadramed

D. NextGen

E. eClinicalWorks

35. 9. All of the following are examples of usage monitoring EXCEPT for which one?

A. Number of documents created

B. Number of staff on project by project phase

C. Orders written during the implementation phase

D. Orders filled during the implementation phase

E. Prescriptions written by project phase

36. 6. Which of the following classification system(s) will be implemented by a deadline of October 1, 2013?

A. ICD-9-CM

B. ICD-10-CM

C. ICD-10-PCS

D. B and C only

E. All of the above

37. 9. Which vendor system provides tools for managing standards related to medication management?

A. Micromedex

B. Health Language, Inc.

C. MediSpan

D. A and C only

E. All of the above

38. 4. Which of the following is/are barrier(s) to enhancing technical interoperability?

A. Extensive and dense medical concepts

B. Multiple synonyms for medical concepts

C. Various types and formats of health reports

D. A and B only

E. All of the above

39. 3. Which of the following diagnostic expert system produces a ranked list of diagnoses using a Bayesian Network?

A. INTERNIST

B. Quick Medical Reference (QMR)

C. MYCIN

D. DXplain

40. 2. All of the following are advantages of a big-bang rollout EXCEPT for which one?

A. Short term disruption

B. Only one system to support

C. Focused planning

D. No need for linking old and new systems

41. 8. Which Electronic Health Record (EHR) system discussed in Unit 6 uses a vocabulary manager to map internal codes to well-known classification systems?

A. Cerner

B. Eclipsys

C. eClinicalWorks

D. A and B only

E. All of the above

42. 8. Which of the following is/are solution(s) to the challenge of modifying or implementing alerts?

A. Closed architecture

B. Open architecture

C. Rigid standards

D. A and C only

E. A, B, and C

Comp14-2

1. 6. Identify FIVE (5) staffing categories that should be incorporated in an EHR implementation team. Answer: Physician champion Project director Project manager Principal trainer Network support

2.

What first name or nickname would you like us to use?

2. 8. Identify SIX (6) roles that on-site consultants can play during an EHR project. Answer: EHR selection EHR implementation Meaningful Use EHR vendors IT consulting EHR review EHR training EHR certification

3. 11. Identify TWO (2) potential concerns of linking EHRs to PHRs. Answer (Any two): Logistics to work out to prevent misinformed patients Clinicians have to change the way they document Privacy concerns for patients, institutions

5. 11. List the SIX (6) steps of system change management, as given in Component 14. Answer: Record/classify Assess Plan Build/test Implement Close/gain acceptance

6. 7. Identify the THREE (3) categories of rules for implementing clinical decision support alerts. Answer: Communication Monitoring Intervention Techniques

7. 10. Identify THREE (3) benefits of personal health records (PHRs) for patients. Answer (any three): Greater sense of empowerment More engaged in their care Higher satisfaction Increased adherence to their care plans Better health outcomes

10. 5. Identify TWO (2) credible sources for terminology standards discussed in Unit 6. Answer: ICD-9 CPT-4 SNOMED-CT LOINC

11. 4. Which of the following diagnostic expert system was developed at the University of Pittsburgh and utilizes patient observations to create differential diagnoses?

12. 2. Which of the following diagnostic expert system was designed to diagnose certain blood infections and is represented by as a set of IF-THEN rules?

14. 3. Which of the following is a non-profit organization that aids in the development of universal healthcare standards to improve technical interoperability?

15. 1. Which component of interoperability focuses on the consistent meaning of terms specific to the application?

16. 6. Which of the following is/are example(s) of a health information system that may be included in EHRs?

17. 5. Which type of EHR hardware platform may use online document processors as opposed to the traditional software?

18. 3. Which type of EHR hardware platform exists independent of a central server?

19. 1. Which of the following is/are component(s) of the architecture of an Electronic Health Record (EHR)?

20. 6. Which of the following is/are component(s) of the Medical Logic Modules (MLM)?

21. 10. In which project phase is change management an important aspect?

22. 1. Which of the following is/are characteristic(s) of clinical decision support programs?

23. 2. Which of the following is an example of "front end" hardware platforms for EHRs?

24. 2. Which component of interoperability refers to the electronic sharing and exchange of electronic health information?

25. 7. Which of the following is/are example(s) of operating systems for EHRs?

26. 5. Staffing requirements for EHR implementation are influenced by all of the following EXCEPT for which factor?

27. 7. Which of the following process interoperability components includes evidence-based medicine to enhance automation systems?

28. 5. All of the following are functions of alerts/reminders in clinical decision support programs EXCEPT for which one?

29. 4. Which type of EHR hardware platform requires that most of its business logic take place on a desktop PC?

30. 10. Based upon the EHR system reviews in unit 5, which EHR system uses software that is centered around SQL Server database?

31. 12. Which of the following is/are benefit(s) of audit logs of an EHR system?

32. 3. Which of the following is a disadvantage of a phased rollout method of implementation of a new EHR system?

33. 7. During which of the following phases is a command center fully operational?

34. 9. Based upon the EHR system reviews in unit 5, which EHR system uses software that is centered around the MUMPS/Cache database?

35. 9. All of the following are examples of usage monitoring EXCEPT for which one?

36. 6. Which of the following classification system(s) will be implemented by a deadline of October 1, 2013?

37. 9. Which vendor system provides tools for managing standards related to medication management?

38. 4. Which of the following is/are barrier(s) to enhancing technical interoperability?

39. 3. Which of the following diagnostic expert system produces a ranked list of diagnoses using a Bayesian Network?

40. 2. All of the following are advantages of a big-bang rollout EXCEPT for which one?

41. 8. Which Electronic Health Record (EHR) system discussed in Unit 6 uses a vocabulary manager to map internal codes to well-known classification systems?

42. 8. Which of the following is/are solution(s) to the challenge of modifying or implementing alerts?

1. 6. Identify FIVE (5) staffing categories that should be incorporated in an EHR implementation team. Answer:

Physician champion

Project director

Project manager

Principal trainer

Network support

2. 8. Identify SIX (6) roles that on-site consultants can play during an EHR project. Answer:

EHR selection

EHR implementation

Meaningful Use

EHR vendors

IT consulting

EHR review

EHR training

EHR certification

5. 11. List the SIX (6) steps of system change management, as given in Component 14. Answer:

Record/classify

Assess

Plan

Build/test

Implement

Close/gain acceptance