Comp 11

1.

What is a legacy system?

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2. 6. A computerized order entry system (CPOE) was installed last month. Three times the system shut-down during the day shift, twice in the evening shift, and none overnight. The physicians are threatening to go back to the paper order entry system. As a member of the post-implementation team, how would you improve this situation?

Evaluate training materialsDevelop a survey for user satisfactionAnalyze issues that have been brought to your attention

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3.

You are on the project team of a successful implementation. What would your recommend to the team as ways to mark the success?

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4. 8. Define what is meant by a "champion" in the electronic health record migration process.

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5. 10. Discuss why training is important in the pre-implementation, during implementation, and the post-implementation.

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6.

Who should sit on the project team for migration to an EHR?

ChampionsClinical areas affectedAncillary areas affected,Non-clinical areas that use data collected,Change agents,Technology specialists,Work flow analysts

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7.

Explain the important of an RFP

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8.

Why is 24/7 support important during and post-implementation?

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9.

Define what is meant by a "champion."

Those enthusiastic about EHR who are willing to lead the migration to and electronic health record.

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10.

State the basic components of a strategic plan that are important to the migration to an electronic health record.

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11.

What do you need to do to prepare for maintenance of the system?

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12. 1. How are critical access hospitals different from other acute care hospitals?

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13. 2. How will use cases in acute care help in the implementation of an EHR?

Answer: Use cases will guide the design, development, and support of the new system that automates the process.

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14. 3. What are some of the types of facilities that are considered ambulatory care?

Answer: Ambulatory care facilities include physician officers, clinics and hospital outpatient services.

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15. 5. What are some areas other than acute and ambulatory care where electronic health records are being used?

Answer: Home Health Care, Extended care facilities for rehab, Long term care facilities, Senior Residence Housing

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16. 6. No matter what site an implementation takes place, what is the underlying goal?

Answer: Increase the quality of patient care

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17. 7. Why would it be important to consider using an electronic health record in a Senior Housing facility?

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18. 8. In the home health example there were many successes. What four things were they based on?

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19.

Discuss why training is important in pre-implementation phase, during implementation, and post-implementation.

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20.

Why is it important to discuss employees concerns about change?

To build trustTo acclimate employees to the changeTo avoid sabotage or purposeful slow-down of work flow

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21.

What are some post-implementation tips?

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22. 4. What are the data capture methods that may exist in an EHR and which one is the most desirable?

Answer: (1) Entering data directly, (2) Scanning handwritten documents, (3) Transcribing text reports, (4) Interfacing data from other information systems.

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23.

Define what is meant by a hybrid record

Can include scanned documents and electronic systems such as pharmacy, radiology, lab.

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24.

What are at least 3 components of a change management program?

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25.

You have been assigned the responsibility to set up an assessment of the implementation for quality improvement. What are some things you would include in this?

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26. 9. What are the unique documentation requirements in long term care that are not a part of the documentation requirements of other care settings?

Answer: Resident Assessment Instrument (RAI), Minimum Data Set (MDS), Resident assessment protocols (RAPs)

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27.

Encryption and decryption of information being transferred supports the following meaningful use principle.

A. Improving quality, safety and efficiency

B. Engaging patients in their care

C. Increasing coordination of care

D. Improving the health status of the population

E. Ensuring privacy and security

F. None of the above

28. 6. What is the best level to manage order sets in CPOE?

A. Individual, i.e., let every clinician manage his or her order sets

B. Departmental, i.e., let every specialty group manage their order sets

C. Institutional, i.e., have sets developed for an entire hospital

D. National, i.e., have order sets developed in a standardized way for the entire country

29. In Stage I Meaningful Use 2011 payment year threshold requirements of lab data in a structured format is:

A. 30%

B. 50%

C. 70%

D. 80%

30. 5. ICD and CPT are:

A. coding systems that are used for billing

B. used to retrieve information for research

C. used for pulling secondary information

D. a, c

E. all of the above

31. 5. Which of the following represents the condition in a clinical event monitor?

A. Notify the physician

B. The serum creatinine level has doubled in one day (indicating rapid kidney function deterioration)

C. The patient has had a serum creatinine level checked to assess kidney function

D. The insurance company is billed

32. 2. Sometimes we create a group or set of facts (data) with uniform definitions to be used for a special use. This is called a(an)

A. Data

B. Data sets

C. Structured data

D. Unstructured data

33.

Which of the following does NOT describe a characteristic of HIE?

A. HIE can be both bi-directional and uni-directional.

B. HIE can only be achieved if the EHR is certified.

C. HIE supports the mobilization of health care information electronically.

D. HIE only refers to hardware and software components of the health information system.

E. Only b and c

F. Only a and c.

34.

HIE allows EHRs to automatically check with national online databases for the most up-to-date information on drug-drug interactions and adverse reactions. Which meaningful use principle does this HIE enabled function support?

A. Improving quality, safety and efficiency

B. Engaging patients in their care

C. Increasing coordination of care

D. Improving the health status of the population

E. Ensuring privacy and security

F. None of the above

35. 4. What is a use of a data dictionary?

A. Supports interoperability of systems within the organization

B. Supports movement towards national interoperability

C. Provides clarity on the meaning for collection

D. All of the above

36. Measures of processes, experiences, and/or outcome of patient care, observations or treatment that relate to one or more quality aims for health care is the definition for:

A. Certification of Health Records

B. Quality Measures

C. Stage One Meaningful Use

D. Stage Two Meaningful Use

37. For 2013 and beyond payment year quality care measures are likely to expand to

A. Hospitals measures

B. Pediatric measures

C. Long-term care measures

D. All of the above

E. B, C only

38. 1. The configuration, structure, and relationships of hardware (the machinery of the computer including input/output devices, storage devices, and so on) in an information system

A. Data architecture

B. Data infrastructure

C. Unstructured data

D. Structured data

39. 3. A hybrid medical record is:

A. A totally electronic health record

B. A totally paper base system

C. A paper-based with some electronic systems

D. A totally scanned digital record

40. 2. Training of employees is important:

A. During pre-implementation

B. During implementation

D. Post implementation

D. A and B

E. A, B and C

41. 5. The most important reason for twenty four hour, seven day a week support (24/7) is:

A. Reduce frustration of clinicians in using CPOE

B. Improve team relationships

C. Show appreciation to 24 hour staff

D. Provide back up for quality of patient care

42. 6. A frequently updated health care data base, with detailed patient level data, that is available to users is:

A. Clinical Data Repository

B. Configuration Repository

C. Data Repository

D. Data Warehouse

43. 7. A data dictionary

A. ensures data consistency

B. allows for flexibility in interpreting fields

C. does not affect patient care

D. all of the above

44.

Which of the following metrics are included in Stage 1 security metrics required for meaningful use?

B. The EP/EH has enabled all drug-drug, drug-allergy, drug-formulary checks (available through the EHR).

C. An encrypted and integrity protected link must be implemented (e.g., TLS, IPv6, IPv4 with IPsec).

D. None of the above.

E. All of the above.

F. Only a and c.

45. For EHs in the 2011 payment year____quality measures are proposed:

A. 15

B. 25

C. 35

D. 45

46. 1. What is true about work flow analysis process?

A. will most likely change with the EHR

B. Experts and users of EHR work separately on work flow analysis

C. Work flow usually does not change with the EHR

D. B and C

47.

Which of the following is NOT a good reason for EHR certification?

B. EHR certification is required to qualify for CMS financial incentives.

C. EHR certification is required by law in order for a vendor to market their system.

D. EHR certification represents an evaluation by an independent and knowledgeable 3rd party.

E. EHR certification provides some assurance that the expected benefit of improved patient care can be

F. All of the above

48.

Which of the following metrics are included in the stage 1 functions metrics required for meaningful use?

A. Provide summary of record for at least 80% of transitions of care and referrals.

B. Insurance eligibility checked electronically for 80% of all unique patients seen by the EP or admitted to the EH.

D. At least 75% of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology

E. All of the above

F. Only a. and c

49. 1. Which of the following measures for a finding is most likely to rule out a disease in Internist-1/QMR?

A. A high evoking strength

B. A low evoking strength

C. A high frequency

D. A low frequency

50. 2. Which of the following is true with regards to CPOE?

A. Its use in US hospitals is widespread

B. A majority of overridden lab tests are not justifiable

C. Implementation success is not related to institutional support

D. Custom order sets do not make it more acceptable to physicians

51. 4. Which of the following represents the event in a clinical event monitor?

A. Notify the physician

B. The serum creatinine level has doubled in one day (indicating rapid kidney function deterioration)

C. The patient has had a serum creatinine level checked to assess kidney function

D. The insurance company is billed

52. 4. Go-live- Post-Implementation means:

A. Super-Users have completed their work

B. Everyone is ready for the implementation

C. One on one training may still be needed

D. Back-up support systems are not needed

53.

HIE supports timely reminders and alerts on medications, testing, public health risks & environmental health risks by

A. Encouraging patients to be interested.

B. Increasing coordination of care

C. Supporting a variety of protocols (and hence systems) through which the information can be communicated.

D. Using pull technologies.

E. Enforcing stringent security that prevents information from moving between EHRs

F. None of the above

54.

Discuss the components of work flow analysis.

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55.

__________ is the authority that approves an organizations as an Authorized Testing and Certification Body (ATCB)

A. CMS – Centers for Medicare and Medicaid Services

B. ONC - Office of the National Coordinator

C. CCHIT-Certificate Commission for Health Information Technology

D. HIMSS – Health Information Management

E. AHIMA – American Health Information Management Association.

F. All of the above

56.

Which of the following are included in stage 1 data collection metrics required for meaningful use?

C. At least 80% of all claims filed electronically by the EP or EH (both public and private payers).

D. For EPs, CPOE is used for at least 80% of all orders.

E. Both a and c.

F. None of the above.

57. 3. A system that immediately notifies a clinician of a critical test result is what type of clinical decision support?

A. Information display

B. Reminder

C. Alert

D. Clinical practice guideline

E. Computerized physician order entry

58. For EPs In the 2011 payment year,_____ quality measures are proposed:

A. 60

B. 70

C. 80

D. 90

59. 9. Discuss the components of work flow analysis.

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60.

Interoperability

A. Only refers to hardware and software components of an information system

B. Can only occur within an organizations health information system.

C. Principles at work in the health care system will produce the same basic result as implementing Health Information Exchange principles.

D. Would not include standardized coding.

E. Both B and c

F. None of the above

61. 3. An example of structured data in an EHR is

A. Registration Data

B. Document imaging

C. Transcribed reports

D. Videos

Comp 11

1. What is a legacy system?

2.

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

3. You are on the project team of a successful implementation. What would your recommend to the team as ways to mark the success?

4. 8. Define what is meant by a "champion" in the electronic health record migration process.

5. 10. Discuss why training is important in the pre-implementation, during implementation, and the post-implementation.

6. Who should sit on the project team for migration to an EHR?

7. Explain the important of an RFP

8. Why is 24/7 support important during and post-implementation?

9. Define what is meant by a "champion."

10. State the basic components of a strategic plan that are important to the migration to an electronic health record.

11. What do you need to do to prepare for maintenance of the system?

12. 1. How are critical access hospitals different from other acute care hospitals?

13. 2. How will use cases in acute care help in the implementation of an EHR?

14. 3. What are some of the types of facilities that are considered ambulatory care?

15. 5. What are some areas other than acute and ambulatory care where electronic health records are being used?

16. 6. No matter what site an implementation takes place, what is the underlying goal?

17. 7. Why would it be important to consider using an electronic health record in a Senior Housing facility?

18. 8. In the home health example there were many successes. What four things were they based on?

19. Discuss why training is important in pre-implementation phase, during implementation, and post-implementation.

20. Why is it important to discuss employees concerns about change?

21. What are some post-implementation tips?

22. 4. What are the data capture methods that may exist in an EHR and which one is the most desirable?

23. Define what is meant by a hybrid record

24. What are at least 3 components of a change management program?

25. You have been assigned the responsibility to set up an assessment of the implementation for quality improvement. What are some things you would include in this?

26. 9. What are the unique documentation requirements in long term care that are not a part of the documentation requirements of other care settings?

27. Encryption and decryption of information being transferred supports the following meaningful use principle.

28. 6. What is the best level to manage order sets in CPOE?

29. In Stage I Meaningful Use 2011 payment year threshold requirements of lab data in a structured format is:

30. 5. ICD and CPT are:

31. 5. Which of the following represents the condition in a clinical event monitor?

32. 2. Sometimes we create a group or set of facts (data) with uniform definitions to be used for a special use. This is called a(an)

33. Which of the following does NOT describe a characteristic of HIE?

34. HIE allows EHRs to automatically check with national online databases for the most up-to-date information on drug-drug interactions and adverse reactions. Which meaningful use principle does this HIE enabled function support?

35. 4. What is a use of a data dictionary?

36. Measures of processes, experiences, and/or outcome of patient care, observations or treatment that relate to one or more quality aims for health care is the definition for:

37. For 2013 and beyond payment year quality care measures are likely to expand to

38. 1. The configuration, structure, and relationships of hardware (the machinery of the computer including input/output devices, storage devices, and so on) in an information system

39. 3. A hybrid medical record is:

40. 2. Training of employees is important:

41. 5. The most important reason for twenty four hour, seven day a week support (24/7) is:

42. 6. A frequently updated health care data base, with detailed patient level data, that is available to users is:

43. 7. A data dictionary

44. Which of the following metrics are included in Stage 1 security metrics required for meaningful use?

45. For EHs in the 2011 payment year____quality measures are proposed:

46. 1. What is true about work flow analysis process?

47. Which of the following is NOT a good reason for EHR certification?

48. Which of the following metrics are included in the stage 1 functions metrics required for meaningful use?

49. 1. Which of the following measures for a finding is most likely to rule out a disease in Internist-1/QMR?

50. 2. Which of the following is true with regards to CPOE?

51. 4. Which of the following represents the event in a clinical event monitor?

52. 4. Go-live- Post-Implementation means:

53. HIE supports timely reminders and alerts on medications, testing, public health risks & environmental health risks by

54. Discuss the components of work flow analysis.

55. __________ is the authority that approves an organizations as an Authorized Testing and Certification Body (ATCB)

56. Which of the following are included in stage 1 data collection metrics required for meaningful use?

57. 3. A system that immediately notifies a clinician of a critical test result is what type of clinical decision support?

58. For EPs In the 2011 payment year,_____ quality measures are proposed:

59. 9. Discuss the components of work flow analysis.

60. Interoperability

61. 3. An example of structured data in an EHR is

1.

What is a legacy system?

3.

You are on the project team of a successful implementation. What would your recommend to the team as ways to mark the success?

6.

Who should sit on the project team for migration to an EHR?

7.

Explain the important of an RFP

8.

Why is 24/7 support important during and post-implementation?

9.

Define what is meant by a "champion."

10.

State the basic components of a strategic plan that are important to the migration to an electronic health record.

11.

What do you need to do to prepare for maintenance of the system?

19.

Discuss why training is important in pre-implementation phase, during implementation, and post-implementation.

20.

Why is it important to discuss employees concerns about change?

21.

What are some post-implementation tips?

23.

Define what is meant by a hybrid record

24.

What are at least 3 components of a change management program?

25.

You have been assigned the responsibility to set up an assessment of the implementation for quality improvement. What are some things you would include in this?

27.

Encryption and decryption of information being transferred supports the following meaningful use principle.

33.

Which of the following does NOT describe a characteristic of HIE?

34.

HIE allows EHRs to automatically check with national online databases for the most up-to-date information on drug-drug interactions and adverse reactions. Which meaningful use principle does this HIE enabled function support?

44.

Which of the following metrics are included in Stage 1 security metrics required for meaningful use?

47.

Which of the following is NOT a good reason for EHR certification?

48.

Which of the following metrics are included in the stage 1 functions metrics required for meaningful use?

53.

HIE supports timely reminders and alerts on medications, testing, public health risks & environmental health risks by

54.

Discuss the components of work flow analysis.

55.

__________ is the authority that approves an organizations as an Authorized Testing and Certification Body (ATCB)

56.

Which of the following are included in stage 1 data collection metrics required for meaningful use?

60.

Interoperability