Test Bank for Understanding Health Information Systems for the Health Professions, 1st Edition by Ba

Chapter 1

Multiple Choice

1. What is the first activity that should take place when embarking on an HIS project?

A) Hiring a CIO. B) Developing a strategic plan.

C) Selecting a new system.

D) Creating a steering committee.

Answer: B A-Head: HIS Fundamentals Subject: Chapter 1 Complexity: Moderate Simplified Functional Taxonomy: Application

2. Good HIS Governance involves A) interdisciplinary communication B) accountability C) well-designed policies D) all of the above Answer: D A-Head: HIS Fundamentals Subject: Chapter 1 Complexity: East Simplified Functional Taxonomy: Recall

3. Which of the following is an implementation activity?

A) testing and evaluating B) transitioning processes C) activating new software on new hardware D) selecting a system [5] planning for a new system Answer: A, B, C A-Head: HIS Fundamentals Subject: Chapter 1 Complexity: Moderate Simplified Functional Taxonomy: Application

4. Elements of infrastructure include network components such as: A) fiberoptics B) routers C) bandwidth connectivity D) software [5] Internet capabilities.

Answer: A, B, C, E A-Head: HIS Terminology Subject: Chapter 1 Complexity: Moderate Simplified Functional Taxonomy: Recall

5. Since the advent of HIS in the 1960s, improvements to process have included: A) computers B) electricity C) air-cooled minicomputers D) code Answer: C A-Head: History of HIS Subject: Chapter 1 Complexity: Moderate Simplified Functional Taxonomy: Recall

6. In 1999, the Institutes of Medicine published the watershed report: A) To Err Is Human: Building a Safer Health Care System B) Fixing Health Information Systems in America C) Crossing the Quality Chasm Answer: A A-Head: History of HIS Subject: Chapter 1 Complexity: Moderate Simplified Functional Taxonomy: Recall

7. In 2001, the Institutes of Medicine published the watershed report: A) To Err Is Human: Building a Safer Health Care System B) Fixing Health Information Systems in America C) Crossing the Quality Chasm

Answer: C A-Head: History of HIS Subject: Chapter 1 Complexity: Moderate Simplified Functional Taxonomy: Recall

Fill-in-the-Blank

1. The HIS ______________ aligns the HIS systems and technologies to these strategic business directions and initiatives of the organization.

Answer: strategic plan A-Head: HIS Fundamentals Subject: Chapter 1 Complexity: Moderate Simplified Functional Taxonomy: Recall

2. Data _________ means manage, oversee, and take care of data as a resource.

Answer: stewardship A-Head: HIS Fundamentals Subject: Chapter 1 Complexity: Difficult Simplified Functional Taxonomy: Recall

True/False

1. Implementing an HIS system is the set of activities that results in a new or updated software system.

Answer: True A-Head: HIS Fundamentals Subject: Chapter 1 Complexity: Moderate Simplified Functional Taxonomy: Recall

Understanding Health Information Systems for the Health Professions, First Edition Jean Balgrosky Chapter 02

Multiple Choice

1. The scope of HIS includes: [1] all computer systems [2] networks [3] the data those systems create and capture Answer: 1, 2, 3 A-Head: Introduction Subject: Chapter 2 Complexity: Easy Simplified Functional Taxonomy: Recall

2. Data is: [1] captured by HIS. [2] used to create information [3] automatically useful once in an HIS. [4] required to be public.

Answer: 1, 2 A-Head: Systems and Their Management Subject: Chapter 2 Complexity: Moderate Simplified Functional Taxonomy: Application

3. Aggregated data can be analyzed according to many dimensions, such as: [1] demographic characteristics [2] an individual’s care plan [3] disease [4] providers [5] payment mechanisms Answer: 1, 3, 4, 5 A-Head: Systems and Their Management Subject: Chapter 2 Complexity: Moderate Simplified Functional Taxonomy: Application Copyright © 2020 by Jones & Bartlett Learning, LLC, an Ascend Learning Company ScholarFriends.com

Understanding Health Information Systems for the Health Professions, First Edition Jean Balgrosky

4. The progression of data captured in HIS as seen through the HIS conceptual model is as follows: [1] Foundation, Use, Learning/Knowledge, Change [2] Use, Learning/Knowledge, Change, Foundation [3] Change, Learning/Knowledge, Foundation, Use [4] Change, Use, Foundation/Knowledge, Foundation Answer: 1 A-Head: Systems and Their Management Subject: Chapter 2 Complexity: Moderate Simplified Functional Taxonomy: Recall

5. Sources of data for public health organizations include: [1] data from hospitals, clinics, and physicians’ practices [2] data from laboratories [3] data provided by U.S. senators [4] data provided to research organizations Answer: 1, 2, 4 A-Head: HIS Uses in Organizational and Community Settings Subject: Chapter 2 Complexity: Moderate Simplified Functional Taxonomy: Recall

6. Reporting relationships (e.g. provider to quality monitoring groups, payers, communities, or government agencies) represent a: [1] primary use of data [2] secondary use of data Answer: 2 A-Head: HIS Uses in Organizational and Community Settings Subject: Chapter 2 Complexity: Moderate Simplified Functional Taxonomy: Application

7. Information that assists in an individual’s care (e.g. contraindications involving prescriptions) represents a: [1] primary use of data Copyright © 2020 by Jones & Bartlett Learning, LLC, an Ascend Learning Company ScholarFriends.com

Understanding Health Information Systems for the Health Professions, First Edition Jean Balgrosky [2] secondary use of data Answer: 1 A-Head: HIS Uses in Organizational and Community Settings Subject: Chapter 2 Complexity: Moderate Simplified Functional Taxonomy: Application

Fill-in-the-Blank

1. _________ is the use of information systems and technology to redesign, improve, and recreate the way work is done in disciplines such as the practice of medicine, nursing, medical imaging, and public health.

Answer: Informatics A-Head: Systems and Their Management Subject: Chapter 2 Complexity: Moderate Simplified Functional Taxonomy: Recall

2. While primary uses of data involve the transactions that support day-to-day activities of professionals and organizations, the only way to create ___________ is through the aggregation and compilation of these data to create something greater than the single units of data.

Answer: information A-Head: Systems and Their Management Subject: Chapter 2 Complexity: Moderate Simplified Functional Taxonomy: Recall

3. ______________ data, or many points of data compiled in an HIS, is more useful to informatics and the progression of health care than is piecemeal data.

Answer: Aggregated A-Head: Systems and Their Management Subject: Chapter 2 Complexity: Difficult Simplified Functional Taxonomy: Analysis

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Chapter 3

Multiple Choice

1. The three major challenges that describe health care today in this country are also the three areas facing significant change in future. These are: [1] Fee-for-service, untenable costs, and ineffective care.

[2] Value-based care, the uninsured, and access to care.

[3] Fee-for-service, value-based care, and creating a single-payer system.

[4] The politicization of health care, creating single-payer system, and untenable costs.

Answer: 1 A-Head: Health Care’s Current State Subject: Chapter 3 Complexity: Difficult Simplified Functional Taxonomy: Recall

2. The model for fee-for-service care, billing payers for procedures and not value, came into being because: [1] It is easier to bill payers.

[2] The first HIS were built upon billing systems.

[3] It’s a federal mandate.

Answer: 1, 2 A-Head: Health Care’s Current State Subject: Chapter 3 Complexity: Easy Simplified Functional Taxonomy: Recall

3. Approximately 30 percent of the U.S.’s health care spending is wasted. This amounts to: [1] $887 million [2] $3.2 billion [3] $785 billion [4] $785 million Answer: 3 A-Head: Health Care’s Current State Subject: Chapter 3 Complexity: Difficult Simplified Functional Taxonomy: Recall

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4. Per person, in 2012 U.S. federal health care spending was: [1] $5,015 [2] $3,215 [3] $10,115 [4] $8,915 Answer: 4 A-Head: Health Care’s Current State Subject: Chapter 3 Complexity: Difficult Simplified Functional Taxonomy: Recall

5. Crossing the Quality Chasm outlines six key aims necessary to improve the quality of care: [1] Safe, effective, payer centered, timely, affordable, equitable.

[2] Safe, effective, patient centered, timely, efficient, equitable.

[3] Safe, error-free, doctor centered, timely, efficient, equitable.

[4] Safe, effective, patient center, computer based, timely, free.

Answer: 2 A-Head: Health Care’s Current State Subject: Chapter 3 Complexity: Moderate Simplified Functional Taxonomy: Recall

6. The U.S. ranks _____ among eleven high-income countries in financial access to care, with barriers to care highest for those who are uninsured.

[1] second [2] fourth [3] last [4] first Answer: 4 A-Head: Health Care’s Current State Subject: Chapter 3 Complexity: Easy Simplified Functional Taxonomy: Recall

7. Interoperability requires cooperation amongst: [1] patients [2] vendors

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[3] systems [4] providers Answer: 2, 3, 4 A-Head: Health Care’s Current State Subject: Chapter 3 Complexity: Difficult Simplified Functional Taxonomy: Analysis

8. An example of interoperability is: [1] A patient’s clinical summary is sent via a health information exchange (H8IE) from physician office to a hospital emergency room across town.

[2] A donor giving a kidney.

[3] A patient filling out paper forms at a specialist’s office.

Answer: 2, 3, 4 A-Head: Health Care’s Current State Subject: Chapter 3 Complexity: Difficult Simplified Functional Taxonomy: Analysis

9. PHI in health care stands for: [1] private health information [2] personal health incentives [3] protected health information Answer: 3 A-Head: Current HIS Initiatives Subject: Chapter 3 Complexity: Easy Simplified Functional Taxonomy: Recall

10. The Congressional Budget Office estimates that as a result of HITECH, approximately ____ percent of physicians and ____ percent of hospitals will be using comprehensive EHR systems by 2020.

[1] 90, 70 [2] 100, 100 [3] 50, 70 [4] 50, 50 Answer: 1 A-Head: Current HIS Initiatives Subject: Chapter 3 Complexity: Moderate

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Simplified Functional Taxonomy: Recall

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Chapter 4

Multiple Choice

1. How many quadrants does the HIS Planning Framework have?

[1] 1 [2] 3 [3] 4 [4] 6 Answer: 3 A-Head: HIS Planning Framework Subject: Chapter 4 Complexity: Easy Simplified Functional Taxonomy: Recall

2. Typically, in ____________ years, the software maintenance fees alone exceed the original purchase fees for the license itself.

[1] seven to ten [2] twenty to thirty [3] ten to fifteen [4] three to four Answer: 4 A-Head: HIS Planning Framework Subject: Chapter 4 Complexity: Moderate Simplified Functional Taxonomy: Recall

3. A carefully detailed HIS strategic plan is essential to avoid: [1] unhappy financial surprises [2] missed project deadlines [3] the organization’s culture suffering [4] the necessity of redirecting budget funds such as using resources intended for personnel or other important expenses to make up the shortfall.

Answer: 1, 2, 3, 4 A-Head: HIS Planning Framework Subject: Chapter 4 Complexity: Moderate

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Simplified Functional Taxonomy: Recall

4. How are the mission, vision, and values communicated to employees, trustees, and other constituents of the healthcare organization?

[1] The mission, vision, and values should be communicated about only with C-suite leaders and trustees.

[2] The statements are often printed on posters and posted in offices.

[3] The statements may be part of the onboarding materials for new hires.

[4] Official communication to staff—meetings, performance reviews, newsletters—should be centered on those statements.

Answer: 2, 3, 4 A-Head: HIS Strategy: Using Organizational Strategy as a Roadmap Subject: Chapter 4 Complexity: Moderate Simplified Functional Taxonomy: Recall

5. What is a helpful question for framing an organization’s vision?

[1] What do we want this organization to look like in 10 years?

[2] How did we do things 10 years ago?

[3] What are the most helpful strategies for smooth daily operations?

Answer: 1 A-Head: HIS Strategy: Using Organizational Strategy as a Roadmap Subject: Chapter 4 Complexity: Easy Simplified Functional Taxonomy: Application

6. Some of the reasons to allow the organizational strategic plan guide the HIS strategic plan are: [1] HIS vendors have persuasive salespeople who might lead the voyage off course (and at a high cost).

[2] Misaligned objectives within an organization can waste time, money, and goodwill.

[3] Plans must be customized for the specific organization.

Answer: 1, 2, 3 A-Head: HIS Strategy: Using Organizational Strategy as a Roadmap Subject: Chapter 4 Complexity: Easy Simplified Functional Taxonomy: Application

7. The HIS Planning Framework is designed to:

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[1] Explain the selection of software to clinicians after it has already been purchased.

[2] Strategize and plan a balanced portfolio of software application systems needed to support the clinical and business functions and capabilities, using a interdisciplinary group.

[3] Plan for within the IT or HIS group only.

[4] Help large, multi-hospital systems plan their complex HIS programs. It is not designed for small practices, community hospitals, or other smaller organizations.

Answer: 2 A-Head: HIS Strategy: Using Organizational Strategy as a Roadmap Subject: Chapter 4 Complexity: Easy Simplified Functional Taxonomy: Application

8. The HIS Planning Framework is a generic format to be used to engage in interdisciplinary dialogue to estimate the systems needed to support various organizational configurations that might be contemplated, such as: [1] Groups of practices or an additional hospital or clinic as might be brought together through acquisition.

[2] An example for educational purposes for groups of professionals who might be entering a planning exercise together.

[3] Considering various options for organizational priorities and budgetary allocations.

Fill-in-the-Blank

1. At the uppermost levels of an organization’s agenda are directional statements or overarching aims directly tied to mission and vision, the ways that the organization successfully moves itself forward toward its purpose. These are __________.

Answer: strategies A-Head: HIS Strategy: Using Organizational Strategy as a Roadmap Subject: Chapter 4 Complexity: Moderate Simplified Functional Taxonomy: Recall

2. The reflective statement explaining the organization’s reason for existing is its __________.

Answer: mission A-Head: HIS Strategy: Using Organizational Strategy as a Roadmap Subject: Chapter 4 Complexity: Moderate Simplified Functional Taxonomy: Recall

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Chapter 5

Multiple Choice

1. The HIS Planning Hierarchy figure consists of seven levels: Mission, Vision, Values; Organizational Strategy; HIS Strategy; Strategic HIS Initiatives; HIS Projects; Departmental Functions and Annual Objectives; and Individual Contributors. Which four fall under the Strategic HIS Planning category?

[1] Strategic HIS Initiatives; HIS Projects; Departmental Functions and Annual Objectives; and Individual Contributors.

[2] Organizational Strategy; HIS Strategy; Strategic HIS Initiatives; and HIS Projects.

[3] Mission, Vision, Values; Organizational Strategy; HIS Strategy; and Strategic HIS Initiatives.

[4] Individual Contributors; HIS Strategy; Mission, Vision, Values; and Departmental Functions and Annual Objectives.

Answer: 3 A-Head: Introduction Subject: Chapter 5 Complexity: Easy Simplified Functional Taxonomy: Recall

2. The HIS Planning Hierarchy figure consists of seven levels: Mission, Vision, Values; Organizational Strategy; HIS Strategy; Strategic HIS Initiatives; HIS Projects; Departmental Functions and Annual Objectives; and Individual Contributors. Which four fall under the HIS Planning Tools category?

[1] Strategic HIS Initiatives; HIS Projects; Departmental Functions and Annual Objectives; and Individual Contributors.

[2] Organizational Strategy; HIS Strategy; Strategic HIS Initiatives; and HIS Projects.

[3] Mission, Vision, Values; Organizational Strategy; HIS Strategy; and Strategic HIS Initiatives.

[4] Individual Contributors; HIS Strategy; Mission, Vision, Values; and Departmental Functions and Annual Objectives.

Answer: 1 A-Head: Introduction Subject: Chapter 5 Complexity: Easy Simplified Functional Taxonomy: Recall

3. Steps in creating and deploying guiding principles are:

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[1] Articulating the organization’s values.

[2] Identifying how things are (current state) and what barriers are associated with that.

[3] Developing the guiding principles.

[4] Applying the guiding principles.

Answer: 1 A-Head: HIS Planning Tools and Techniques Subject: Chapter 5 Complexity: Moderate Simplified Functional Taxonomy: Recall

4. In health care, unlike other industries, if a system goes down for a few hours: [1] Clients may have to wait longer for service.

[2] The lights may start flickering.

[3] Patients’ lives can hang in the balance.

[4] Administrative workers jobs get harder.

Answer: 3 A-Head: HIS Plans and Projects Derive from the Strategic HIS Plan Subject: Chapter 5 Complexity: Moderate Simplified Functional Taxonomy: Application

5. A data plan: [1] creates the infrastructure needed to implement new HIS. [2] establishes principles and policies by which data will be managed and stewarded by the organization as part of the implementation and use of its HIS and technology.

[3] should include data standards, a data dictionary, and a data model/map, showing the relationship between the various data elements created and captured by HIS. Answer: 2, 3 A-Head: HIS Plans and Projects Derive from the Strategic HIS Plan Subject: Chapter 5 Complexity: Moderate Simplified Functional Taxonomy: Recall

6. The most advantageous way for a healthcare organization to structure payments to a vendor is: [1] based on time.

[2] based on milestones.

Answer: 2 A-Head: HIS Planning: Tools and Techniques Subject: Chapter 5 Complexity: Easy

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Simplified Functional Taxonomy: Application

7. Effective HIS governance: [1] Provides assurance that the HIS and technology plans align with the strategic goals of the organization.

[2] Protects the organization from taking on too much risk with the HIS and technology projects and is compliant with applicable regulations.

[3] Ensures adequate personnel resources and skills sets are available to these disruptive initiatives.

[4] Ensures itself that the job is getting done properly and in a timely fashion.

Answer: 2 A-Head: HIS Planning: Tools and Techniques Subject: Chapter 5 Complexity: Moderate Simplified Functional Taxonomy: Recall

Fill-in-the-Blank

1. The overall Strategic HIS Plan is then broken down into ______________, which are the linkage between strategy and actionable projects, each of which consists of numerous projects that, together, comprise the initiative.

Answer: strategic initiatives A-Head: HIS Plans and Projects Derive from the Strategic HIS Plan Subject: Chapter 5 Complexity: Moderate Simplified Functional Taxonomy: Recall

2. ____________ is the “electronic highway” that carries data, images, voice, and information traffic between the myriad users of the systems and technology, all at the speed of light.

Answer: Infrastructure A-Head: HIS Plans and Projects Derive from the Strategic HIS Plan Subject: Chapter 5 Complexity: Easy Simplified Functional Taxonomy: Recall

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3. The __________ describes who needs to share data with whom among the various functions and departments within the organization, and who inside the organization needs to share data with which outside business and clinical partners and suppliers.

Answer: data plan A-Head: HIS Plans and Projects Derive from the Strategic HIS Plan Subject: Chapter 5 Complexity: Easy Simplified Functional Taxonomy: Recall

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Chapter 6

Multiple Choice

1. Large instances of data are normally stored in a: [1] spreadsheet.

[2] document.

[3] database.

[4] notepad file.

Answer: 3 A-Head: HIS Applications Subject: Chapter 6 Complexity: Moderate Simplified Functional Taxonomy: Recall

2. What is the software development life cycle methodology stage that comprises developing the preliminary and detailed designs, including how the system will meet functional requirements?

[1] Development and Testing [2] Implementation [3] Disposition [4] Conceptual Planning [5] Design Answer: 5 A-Head: HIS Applications Subject: Chapter 6 Complexity: Moderate Simplified Functional Taxonomy: Recall

3. The process of developing applications to share data and use a common database instead of bridging application is called: [1] risk management [2] integration [3] interface development [4] database archiving Answer: 2 A-Head: HIS Applications Subject: Chapter 6

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Complexity: Moderate Simplified Functional Taxonomy: Recall

4. What systems support image management, image processing, enhancement, visualization, and storage?

[1] radiology information systems (RISs) [2] picture archiving and communication systems (PACSs) [3] medical imaging systems (MISs) [4] lab information systems (LISs) Answer: 3 A-Head: HIS Applications Subject: Chapter 6 Complexity: Moderate Simplified Functional Taxonomy: Recall

5. Examples of administrative applications include: [1] cardiology information systems (CISs) [2] enterprise resources planning (ERP) systems [3] customer resource management (CRM) systems [4] supply chain management (SCM) systems Answer: 2, 3, 4 A-Head: HIS Applications Subject: Chapter 6 Complexity: Difficult Simplified Functional Taxonomy: Recall

6. What is not a commonly categorized network type?

[1] local area networks (LANs) [2] backbone networks (BNs) [3] machine area networks (MANs) [4] wide area networks (WANs) Answer: 3 A-Head: Technology Subject: Chapter 6 Complexity: Moderate Simplified Functional Taxonomy: Recall

7. What protocol does the Internet use to transfer data?

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[1] Transport Layer (TP) protocol [2] Transmission Control Protocol/Internet Protocol (TCP/IP) [3] Data Link Layer (DLL) protocol [4] Open Systems Interconnection (OSI) protocol Answer: 2 A-Head: Technology Subject: Chapter 6 Complexity: Moderate Simplified Functional Taxonomy: Recall

8. A technology system that can eliminate dead spots and other areas of poor cellular signal coverage within hospital buildings is called a: [1] bring-your-own-device (BYOD) system [2] code-division multiple access (CDMA) system [3] universal mobile telecommunications system (UMTS); [4] distributed antennae system (DAS) Answer: 4 A-Head: Technology Subject: Chapter 6 Complexity: Moderate Simplified Functional Taxonomy: Recall

9. Voice over wireless local area network (VoWLAN) offers which of the following benefits?

[1] improved workflow and productivity by delivering ubiquitous, robust coverage [2] roaming of voice clients and high-quality voice communications [3] minimized roam time and client connectivity issues) [4] advanced quality of service (QoS), extended talk-time, and call security Answer: 1, 2, 3, 4 A-Head: Technology Subject: Chapter 6 Complexity: Moderate Simplified Functional Taxonomy: Application

10. Which hosted solution is an example of a cloud vendor who installs and manages the data center, server and network hardware, operating system, application, and database?

[1] software-as-a-service (SaaS) [2] infrastructure-as-a-service (IaaS) [3] platform-as-a-service (PaaS) [4] data center-as-a-service (DaaS), Answer: 2

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A-Head: Technology Subject: Chapter 6 Complexity: Moderate Simplified Functional Taxonomy: Application

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Chapter 7

Multiple Choice

1. The term used to describe the processes that ensure effective and efficient use of IT in enabling an organization to achieve its goals is called: [1] information technology oversight (ITO) [2] problem management (PM) [3] information technology governance (ITG) [4] health information systems (HIS) Answer: 3 A-Head: Managing Process Subject: Chapter 7 Complexity: Moderate Simplified Functional Taxonomy: Recall

2. The ITG framework that is the most widely adopted by healthcare organizations is: [1] International Organization for Standardization (ISO) [2] Control Objectives for Information and Related Technology (COBIT) [3] International Electrotechnical Commission (IEC) [4] Information Technology Infrastructure Library (ITIL) Answer: 4 A-Head: Managing Process Subject: Chapter 7 Complexity: Moderate Simplified Functional Taxonomy: Recall

3. The IT service support process areas in the context for HIS support include the following elements: [1] support management [2] incident management [3] problem management [4] change management [5] release management Answer: 2, 3, 4, 5 A-Head: Managing Process Subject: Chapter 7

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Complexity: Moderate Simplified Functional Taxonomy: Recall

4. The IT service delivery process areas in the context of HIS services include the following elements: [1] service level management [2] capacity management [3] vendor management [4] service continuity management [5] software development management Answer: 1, 2, 4 A-Head: Managing Process Subject: Chapter 7 Complexity: Moderate Simplified Functional Taxonomy: Recall

5. To address financial and budget risks, HIS management should be knowledgeable in the following areas: [1] budgeting and planning [2] purchasing options such as capitalized and depreciated assets [3] operating expenses, basic accounting principles, and standards [4] financial models and methods [5] compliance regulations Answer: 1, 2, 3, 4, 5 A-Head: Managing Process Subject: Chapter 7 Complexity: Moderate Simplified Functional Taxonomy: Recall

6. What are best practices for managing budget risk?

[1] Plan budgets using best estimates during the middle of project.

[2] Avoid contingency funds in project budgets.

[3] Collaborate with other departments in annual budget processes.

[4] Understand the significant components of the budget.

Answer: 3, 4 A-Head: Managing Process Subject: Chapter 7 Complexity: Difficult Simplified Functional Taxonomy: Analysis

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7. During the vendor selection process, the technical aspects of the proposed system such as the hardware platform, operating system, device requirements, network, and security that should be identified are called: [1] technical architecture [2] technology standards [3] technology strategy [4] technical components Answer: 4 A-Head: Managing Process Subject: Chapter 7 Complexity: Difficult Simplified Functional Taxonomy: Application

8. HIS contracts specify which important requirements?

[1] change control [2] maintenance costs [3] interface requirements [4] ownership of data [5] regulatory compliance Answer: 1, 2, 3, 4, 5 A-Head: Managing Process Subject: Chapter 7 Complexity: Moderate Simplified Functional Taxonomy: Recall

9. Each HIS implementation can and should be categorized as: [1] a strategy [2] a project [3] an ongoing operational initiative [4] a proof of concept Answer: 2 A-Head: Managing Process Subject: Chapter 7 Complexity: Easy Simplified Functional Taxonomy: Recall

10. Project managers have a critical role related to bringing projects to successful completion, and generally have the following responsibilities:

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[1] Manages project scope, schedule, and cost [2] Has executive sponsorship and oversight of the project [3] Facilitates and resolves issues, conflict, risks, and other items detrimental to a project [4] Controls the assigned project resources to best meet the project objectives Answer: 1, 3, 4 A-Head: Managing Process Subject: Chapter 7 Complexity: Moderate Simplified Functional Taxonomy: Application

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Chapter 8

Multiple Choice

1. Implementation is a moment to: [1] Do something really significant for the quality of an organization’s health care delivery.

[2] Help healthcare professionals do their job more efficiently.

[3] Select a vendor.

[4] Get buy-in from constituents, such as clinicians.

Answer: 1, 2 A-Head: Implementation Subject: Chapter 8 Complexity: Moderate Simplified Functional Taxonomy: Application

2. Elements critical to implementation success include: [1] Comprehensive planning [2] Adherence to organizational principles of governance.

[3] Following the HIS strategic plan.

[4] Competent management of initiatives and projects.

[5] Creating a culture of trust and collaboration.

Answer: 1, 2, 3, 4, 5 A-Head: Implementation Subject: Chapter 8 Complexity: Moderate Simplified Functional Taxonomy: Recall

3. One reason for failure at the stage of HIS implementation is: [1] Too much planning.

[2] Too much listening to subject matter experts.

[3] Lack of comprehensive HIS education on behalf of healthcare leaders.

Answer: 3 A-Head: Implementation Subject: Chapter 8 Complexity: Moderate Simplified Functional Taxonomy: Recall

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4. The stages of an implementation include: [1] Phase 1: Foundational Infrastructure [2] Phase 1: Strategic Plan [3] Phase 2: Basic Core Systems [4] Phase 3: Advanced Capabilities [5] Phase 3: Evaluation Answer: 1, 3, 4 A-Head: Implementation Subject: Chapter 8 Complexity: Moderate Simplified Functional Taxonomy: Recall

5. Phase I: Foundation HIS Infrastructure consists of: [1] BI/CI solutions [2] network infrastructure [3] internet/intranet/extranet capabilities [4] HIEs [5] devices for connecting end-users to the network and systems [6] establishment of secure computing environments Answer: 2, 3, 5, 6 A-Head: Implementation Subject: Chapter 8 Complexity: Moderate Simplified Functional Taxonomy: Recall

6. Phase II: Basic Core HIS Capabilities includes: [1] establishing the MPI [2] BI/CI solutions [3] implementing the basic elements of the EHR [4] a core capability of any modern healthcare organization [5] the enterprise resource planning (ERP) system [6] enterprise reporting and analytical systems and capabilities Answer: 3, 4, 5, 6 A-Head: Implementation Subject: Chapter 8 Complexity: Moderate Simplified Functional Taxonomy: Recall

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7. Phase III initiatives may involve: [1] quality management [2] outcomes analysis and reporting [3] BI/CI solutions [4] computerized provider order entry [5] enhanced user interface for clinical documentation [6] establishing the MPI Answer: 1, 2, 3, 4, 5 A-Head: Implementation Subject: Chapter 8 Complexity: Moderate Simplified Functional Taxonomy: Recall

8. The triad of software selection criteria are: [1] software functionality, newest technology, quickest go-live.

[2] current vendor, newest technology, and business relationship.

[3] software functionality, technology, and business relationship.

Answer: 3 A-Head: Implementation Subject: Chapter 8 Complexity: Moderate Simplified Functional Taxonomy: Recall

9. Infrastructure devices are selected in: [1] Phase I [2] Phase II [3] Phase III Answer: 1 A-Head: Implementation Subject: Chapter 8 Complexity: Moderate Simplified Functional Taxonomy: Recall

10. A “go-live” is the moment when: [1] A healthcare provider or organization signs a contract with a vendor.

[2] A vendor sends an RFP to a healthcare provider.

[3] The moment when a new HIS is activated.

Answer: 3 A-Head: Implementation Subject: Chapter 8

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Complexity: Easy Simplified Functional Taxonomy: Recall

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Chapter 9

Multiple Choice

1. Trends that are pushing the healthcare industry toward innovation include: [1] the desire to mix it up [2] unsustainable costs [3] the move to value-based care and reimbursement [4] patient-centric consumerism Answer: 2, 3, 4 A-Head: The Context of HIS Innovation Subject: Chapter 9 Complexity: Easy Simplified Functional Taxonomy: Recall

2. Which of the following are stated aims of HITECH 2009 legislation?

[1] improving the accuracy, timeliness, and availability of health information to care providers [2] improving access to information, thereby allowing providers to better anticipate the diagnostic and health needs of their patients and share this information among other providers as appropriate [3] establishing EHRs as a widespread technology.

[4] empowering patients to more actively participate in their health care and wellness, and have access and input to their health data Answer: 1, 2, 4 A-Head: The Context of HIS Innovation Subject: Chapter 9 Complexity: Easy Simplified Functional Taxonomy: Recall

3. Rogers describes has five groups or segments that play roles in the adoption of disruptive, new technologies. These groups are: [1] Creators [2] Innovators [3] Early Adopters [4] Early Majority [5] Late Majority [6] Laggards

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Answer: 2, 3, 4, 5, 6 A-Head: The Context of HIS Innovation Subject: Chapter 9 Complexity: Easy Simplified Functional Taxonomy: Recall

4. Early HIS innovations occurred at a small number of noteworthy healthcare organizations: Intermountain Health, U.S. Department of Veterans Affairs, Regenstrief Institute, Partners Health and a few others. These four organizations are responsibly for a full _____ percent of all studies of HIS in between 1995 and 2007.

[1] 5 [2] 10 [3] 25 [4] 50 Answer: 3 A-Head: The Context of HIS Innovation Subject: Chapter 9 Complexity: Difficult Simplified Functional Taxonomy: Recall

5. Historic places of HIS innovation include: [1] clinical computer laboratories [2] home offices and garages [3] hospital data processing centers [4] vendors Answer: 1, 2, 3, 4, A-Head: The History of HIS Innovation Subject: Chapter 9 Complexity: Moderate Simplified Functional Taxonomy: Recall

6. The certifications of Registered Health Information Administrator (RHIA) and Registered Health Information Technicians (RHIT) are issued by: [1] HIMSS [2] MACRA [3] AHIMA [4] HIPPA Answer: 3 A-Head: Role of Professional Organizations in Adopting New Technologies Subject: Chapter 9

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Complexity: Moderate Simplified Functional Taxonomy: Recall

7. Formed in 1989, AMIA is the result of the combination of three organizations with complementary missions: [1] the American Association for Medical Systems and Informatics (AAMSI) [2] the American College of Medical Informatics (ACMI) [3] the American Medical Informatics Association (AMIA) [4] the Symposium on Computer Applications in Medical Care (SCAMC) [5] the Alliance for Nursing Informatics (ANI) Answer: 1, 2, 4 A-Head: Role of Professional Organizations in Adopting New Technologies Subject: Chapter 9 Complexity: Difficult Simplified Functional Taxonomy: Recall

8. Medical professional organizations promote the development of HIS and technology and its integration into clinical practice. These organizations include: [1] the American Medical Association (AMA) [2] Medical Group Management Association (MGMA) [3] American Hospital and Health Network Association (AHA) [4] Health Care Management Association (HFMA) [5] American College of Health Care Executives (ACHE) Answer: 1, 2, 3, 4, 5 A-Head: Role of Professional Organizations in Adopting New Technologies Subject: Chapter 9 Complexity: Moderate Simplified Functional Taxonomy: Application

9. EMRAM was developed with the intention of assisting healthcare organizations measuring and tracking progress towards more robust EHR systems. How many graduating levels EMR functionality does the EMRAM use?

[1] 2 [2] 5 [3] 7 [4] 8 Answer: 4 A-Head: Impact of New Technologies on Existing HIS Subject: Chapter 9 Complexity: Easy

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Simplified Functional Taxonomy: Recall

10. A Level 1 EMRAM includes: [1] laboratory HIS [2] analytics [3] external HIS reporting [4] pharmacy HIS Answer: 1, 4 A-Head: Impact of New Technologies on Existing HIS Subject: Chapter 9 Complexity: Moderate Simplified Functional Taxonomy: Recall

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Chapter 10

Multiple Choice

1. How many healthcare software applications are there for both Android and iOS operating systems: [1] Between 50,000 and 55,000 [2] 108,000 [3] Hundreds of thousands [4] One million Answer: 3 A-Head: Introduction Subject: Chapter 10 Complexity: Moderate Simplified Functional Taxonomy: Recall

2. The U.S. spends an approximate average of how much money for every American: [1] $2,150 [2] $10,400 [3] $14,950 [4] $19,400 Answer: 2 A-Head: Exponential Growth of Data Subject: Chapter 10 Complexity: Easy Simplified Functional Taxonomy: Recall

3. The portion of the U.S. GDP attributable to healthcare is: [1] 9% [2] 12% [3] 19% [4] 24% Answer: 3 A-Head: Exponential Growth of Data Subject: Chapter 10 Complexity: Easy Simplified Functional Taxonomy: Recall

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4. The number of retired and active military participants in the VHA system is: [1] 20 million [2] 30 million [3] 45 million [4] 52 million Answer: 1 A-Head: Exponential Growth of Data Subject: Chapter 10 Complexity: Difficult Simplified Functional Taxonomy: Recall

5. Which are the 3V’s?

[1] Velocity [2] Volume [3] Veracity [4] Variety Answer: 1, 2, 4 A-Head: Big Data & Thick Data Subject: Chapter 10 Complexity: Easy Simplified Functional Taxonomy: Recall

6. A data information “silo” is: [1] A separate collection of data used for agricultural purposes [2] A separate collection of data used by a specific software application [3] Both Answer: 2 A-Head: Exponential Growth of Data Subject: Chapter 10 Complexity: Difficult Simplified Functional Taxonomy: Recall

7. Within the American Recovery and Reinvestment Act of 2009 (ARRA) legislation, there is a significant financial and compliance incentive to install and use EHRs. ARRA has specified that the chosen EHR system will be: [1] Cerner [2] EPIC

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[3] Meditech [4] No such mandate Answer: 4 A-Head: The Three Big Data Sources Subject: Chapter 10 Complexity: Moderate Simplified Functional Taxonomy: Application

8. If all Type II diabetics were to properly test their blood glucose at least twice daily how many tests would occur annually: [1] 2 million [2] 6.5 million [3] 1 billion [4] 22 billion Answer: 4 A-Head: The Three Big Data Sources Subject: Chapter 10 Complexity: Moderate Simplified Functional Taxonomy: Recall

9. Among the doctor’s office, hospital, and/or insurance company, the usual controlling group of the patient data is: [1] IT [2] Accounting [3] Administration [4] Medical Records [5] Varies Answer: 5 A-Head: Data Ownership Subject: Chapter 10 Complexity: Moderate Simplified Functional Taxonomy: Application

10. One of the greatest challenges for the industry is the fact that data is often not normalized, and it may be siloed in disparate software applications. Who’s at fault for this reality?

[1] Competitive delivery system [2] Competitive software vendors [3] Unaligned industry financial incentives [4] Politics Answer: 1, 2, 3, 4

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A-Head: Data Ownership Subject: Chapter 10 Complexity: Moderate Simplified Functional Taxonomy: Analysis

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Chapter 11

Multiple Response

1. Which healthcare professionals or consumers use BI and/or CI? [1] Physicians [2] Nurses [3] Hospital Administrators [4] Patients Answer: 1, 2, 3 A-Head: Introduction Subject: Chapter 11 Complexity: Moderate Simplified Functional Taxonomy: Application

2. A survey by Forbes for some of the most viable professions includes: [1] Computer system analysts [2] Bio-medical Engineers [3] Dental hygienists [4] Statisticians Answer: 1, 2, 3, 4 A-Head: Models for Data Architecture and Strategy Subject: Chapter 11 Complexity: Easy Simplified Functional Taxonomy: Application

3. Which of the following attributes are necessary for a useful implementation of a BI/CI software application?

[1] Scalability [2] Roles based use [3] Agnostic data use [4] Programmer only content design tools [5] Data normalization capability Answer: 1, 2, 3, 4 A-Head: Models for Data Architecture and Strategy Subject: Chapter 11 Complexity: Moderate

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Simplified Functional Taxonomy: Application

4. Which requirements are necessary for a successful BI/CI implementation: [1] Accessibility [2] Usability [3] Assignable [4] Actionable Answer: 1, 2, 4 A-Head: Models for Data Architecture and Strategy Subject: Chapter 11 Complexity: Difficult Simplified Functional Taxonomy: Application

Multiple Choice

1. IBM’s latest super computer, Summit, can perform how many calculations per second?

[1] 900 billion [2] 200 trillion [3] 650 trillion [4] 50 quadrillion Answer: 2 A-Head: Models for Data Architecture and Strategy Subject: Chapter 11 Complexity: Difficult Simplified Functional Taxonomy: Recall

2. Which healthcare entity is best able to affect industry change?

[1] Providers [2] Payers [3] Government Answer: 1 A-Head: Introduction Subject: Chapter 11 Complexity: Moderate Simplified Functional Taxonomy: Analysis

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3. Which technology is not strategic for health care?

[1] Artificial Intelligence [2] Machine Learning [3] Cloud Based Management Answer: 3 A-Head: Introduction Subject: Chapter 11 Complexity: Moderate Simplified Functional Taxonomy: Analysis

4. Health care’s number of discrete clinical and business data elements are in the: [1] Hundreds [2] Thousands [3] Tens of thousands [4] Hundreds of thousands Answer: 4 A-Head: Introduction Subject: Chapter 11 Complexity: Easy Simplified Functional Taxonomy: Recall

5. Which items below have contributed to the slower adoption of BI/CI? [1] Competing mandates [2] Restricted implementation resources [3] Cost [4] Limited true information needs Answer: 4 A-Head: Healthcare Business and Clinical Intelligence (BI/CI) Subject: Chapter 11 Complexity: Easy Simplified Functional Taxonomy: Recall

6. In a roles-based BI/CI implementation the targeted users include: [1] Executives [2] Clinicians [3] Administrators [4] All employees Answer: 4 A-Head: Models for Data Architecture and Strategy

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Subject: Chapter 11 Complexity: Easy Simplified Functional Taxonomy: Application

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Chapter 12

Multiple Response

1. Types of AI include: [1] deep learning [2] machine learning [3] genomic sequencing [4] predictive analytics Answer: 1, 2, 4 A-Head: Approaches to Digital Health in HIS Subject: Chapter 12 Complexity: Easy Simplified Functional Taxonomy: Recall

2. Telemedicine and telehealth may employ: [1] smart phones [2] the Internet [3] secure email [4] in-person consults [5] video transmission Answer: 1, 2, 3, 5 A-Head: Digital Health: Connecting the Unconnected Subject: Chapter 12 Complexity: Easy Simplified Functional Taxonomy: Recall

3. The goals of digital health include: [1] improving outcomes [2] supporting behavioral change [3] improving efficiencies and cost performance.

Answer: 1, 2, 3 A-Head: Digital Health: Connecting the Unconnected Subject: Chapter 12 Complexity: Difficult Simplified Functional Taxonomy: Recall

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4. Examples of telemedicine and telehealth include: [1] remote radiology interpretations [2] intensive care monitoring by clinicians for hospitals located remotely or smaller organizations that cannot afford full-time specialists 24 hours a day [3] clinician-patient consults over live video [4] remote patient monitoring for heart disease, diabetes, or other common, chronic conditions [5] education and networking for patients via support groups and specialized health information [6] continuing education credits for providers Answer: 1, 2, 3, 4, 5, 6 A-Head: Digital Health: Connecting the Unconnected Subject: Chapter 12 Complexity: Moderate Simplified Functional Taxonomy: Recall

5. New data sources include: [1] HIEs [2] wearable devices [3] EHRs Answer: 1, 2 A-Head: The Importance of Informatics in Adopting HIS and New Technologies Subject: Chapter 12 Complexity: Moderate Simplified Functional Taxonomy: Recall

6. Of the 17 technologies analyzed on Gartner’s 2018 Hype Cycle, five categories or trends are identified: [1] democratized AI [2] digitalized ecosystems [3] do-it-yourself biohacking [4] transparently immersive experiences [5] ubiquitous infrastructure [6] genomic medicine Answer: 1, 2, 3, 4, 5 A-Head: Digital Health: Connecting the Unconnected Subject: Chapter 12 Complexity: Difficult Simplified Functional Taxonomy: Recall

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Multiple Choice

1. Telehealth is reaching levels of massive growth, with a market for virtual health applications and activities expected to reach $3.5 billion by ______ according to Verify Markets.

[1] 2022 [2] 2032 [3] 2042 [4] 2062 Answer: 1 A-Head: Digital Health: Connecting the Unconnected Subject: Chapter 12 Complexity: Moderate Simplified Functional Taxonomy: Recall

2. More than _____ percent of hospitals are planning and implementing telehealth initiatives across all areas, moving away from initial departmental projects.

[1] 15 [2] 25 [3] 50 [4] 80 Answer: 3 A-Head: Digital Health: Connecting the Unconnected Subject: Chapter 12 Complexity: Moderate Simplified Functional Taxonomy: Recall

3. For physicians, every one hour spent with patients requires an additional _____ hour(s) spent in the EHR system.

[1] 0.5 [2] 1 [3] 2 [4] 2.5 Answer: 3 A-Head: The Importance of Informatics in Adopting HIS and New Technologies Subject: Chapter 12 Complexity: Moderate Simplified Functional Taxonomy: Recall

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True/False

1. New categories of technologies—such as Artificial Intelligence (AI), telehealth, telemedicine, medical devices, and others—can be applied to improve outcomes on the dimensions of quality of care, cost, service, and satisfaction.

Answer: true A-Head: Introduction Subject: Chapter 12 Complexity: Easy Simplified Functional Taxonomy: Recall

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Chapter 13 zes

Multiple Response

1) Good questions to analyze another country’s health system are: A) Is access to health care universal or selective?

B) Who has access to health care and how are HIS and digital health used to facilitate that access?

C) What role do HIS systems play in achieving the results in health outcomes and cost in that country?

D) What are the strengths and weaknesses of HIS in this particular country?

Answer: A, B, C, D A-Head: Introduction Subject: Chapter 13 Complexity: Moderate Simplified Functional Taxonomy: Application

2) How a country approaches health care is shaped by: A) Social media B) Societal forces C) Markets D) Regulations and laws E) Distance from the north pole Answer: B, C, D A-Head: Uses of HIS in Other Countries Subject: Chapter 13 Complexity: Moderate Simplified Functional Taxonomy: Application

3) According to the OECD, personal health care spending includes: A) public health initiatives care B) national health administration C) rehabilitation D) long term care E) medical goods Answer: C, D, E A-Head: Uses of HIS in Other Countries

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Subject: Chapter 13 Complexity: Difficult Simplified Functional Taxonomy: Recall

4) The main driver of the high cost of health care in the U.S. is A) more people use the services B) that prices are higher for services C) supplies such as pharmaceuticals and medical devices are more expensive D) illegal immigration causes high usage of services Answer: B, C A-Head: The High Cost of Care in the U.S. Subject: Chapter 13 Complexity: Moderate Simplified Functional Taxonomy: Recall

5) The “Triple Aims” of HIS are: A) cool looking machines B) improved outcomes C) better patient care D) compete for international health consumers E) lower costs Answer: B, C, E A-Head: The High Cost of Care in the U.S. Subject: Chapter 13 Complexity: Moderate Simplified Functional Taxonomy: Recall

6) The Commonwealth Fund ranking of performance in health care takes into consideration: A) care processes B) access to care C) administrative efficiency D) equity E) health outcomes Answer: A, B, C, D, E A-Head: The High Cost of Care in the U.S. Subject: Chapter 13 Complexity: Moderate Simplified Functional Taxonomy: Recall

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Multiple Choice

1) In study in 2008, ____ percent of general practitioners in Australia, New Zealand, the Netherlands, and the United Kingdom reportedly used EHRs, whereas ___ percent of practitioners in ambulatory settings in the U.S. and Canada used EHRs. A) 90, 30 B) 30, 90 C) 50, 60 D) 60, 50 E) 100, 100 Answer: A A-Head: Uses of HIS in Other Countries Subject: Chapter 13 Complexity: Moderate Simplified Functional Taxonomy: Application

2) _________, a setting in which a national EHR system and “smart card” for 80 million citizens’ personal health records made major headway between 2000 and 2010, ran into strong opposition based on mounting concerns about privacy.

A) Japan B) Germany C) Taiwan C) Uganda Answer: B A-Head: Uses of HIS in Other Countries Subject: Chapter 13 Complexity: Easy Simplified Functional Taxonomy: Recall

3) In comparing healthcare costs as a percent of gross domestic product, the U.S. spends _______ percentage at 17.1 percent.

A) the lowest B) the highest C) an average D) a higher Answer: B A-Head: Uses of HIS in Other Countries Subject: Chapter 13 Complexity: Moderate

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Simplified Functional Taxonomy: Recall

4) The U.S. established the Office of the National Coordinator of Health Information Technology in ______; in contrast, Germany established a similar office in _______.

A) 2004, 1993 B) 2018, 2012 C) 2000, 2000 D) 1990, 2000 Answer: A A-Head: The High Cost of Care in the U.S. Subject: Chapter 13 Complexity: Difficult Simplified Functional Taxonomy: Recall

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Chapter 14

Multiple Response

1) The future of HIS is more about: A) new core HIS B) redesigning existing systems C) accommodating value-based care Answer: B, C A-Head: Introduction Subject: Chapter 14 Complexity: Easy Simplified Functional Taxonomy: Application

2) Some of the rational for adopting new technologies is their capacity for: A) helping change organizational models B) engaging with patients C) providing health care outside the four walls of institutions D) anticipating, preventing, and more effectively treating chronic illnesses E) keeping the explosion of data tamed so that intelligence, not just sense, can be made of it F) assuring security data and systems Answer: B, C A-Head: Introduction Subject: Chapter 14 Complexity: Easy Simplified Functional Taxonomy: Application

3) Factors spurring on innovation and cultural changes in health care include: A) generational change B) government intervention Answer: A, B A-Head: Understanding the Future of HIS Subject: Chapter 14 Complexity: Easy Simplified Functional Taxonomy: Application

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4) Virtual reality is helping health care by: A) ameliorating bedside manner B) helping train medical students C) prepping surgeons for tumor removal Answer: B, C A-Head: Digital Health: Merging eHealth, mHealth, Social Media, Telemedicine, and Telehealth Subject: Chapter 14 Complexity: Moderate Simplified Functional Taxonomy: Recall

Multiple Choice

1) In the United States, the number of adults using mobile phones for health information increased from 232.2 million in 2012 to 258 million in 2015, with a projected 276.7 million in ________.

A) 2019 B) 2020 C) 2021 D) 2025 Answer: A A-Head: Digital Health: Merging eHealth, mHealth, Social Media, Telemedicine, and Telehealth Subject: Chapter 14 Complexity: Moderate Simplified Functional Taxonomy: Recall

2) Value-based care requires a move to reimbursement plans that reward efficiency and improved outcomes. One such program is __________, that shifts risk to providers, and pays physicians a fixed fee per patient.

A) Medicare Advantage B) HIPAA C) OEPC D) Medicaid Answer: A A-Head: Future Directions in Informatics, Data, and Analytics Subject: Chapter 14 Complexity: Difficult Simplified Functional Taxonomy: Recall

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3) In 2017, __ percent of eligible clinicians in the MIPS track of the Quality Payment Program (QPP) received positive payment adjustments for their 2017 performance.

A) 3 B) 53 C) 63 D) 93 Answer: D A-Head: Alignment between HIS and Population Health Management and Value-based Care Subject: Chapter 14 Complexity: Difficult Simplified Functional Taxonomy: Recall

4) In a recent study, ________ of physicians responded that they are considering non-clinical career options, due to the administrative and regulatory burden of practicing medicine in today’s environment—this represents an increase of 11 percent over the past three years.

A) 10% B) 25% C) 66% D) 98% Answer: C A-Head: Unintended Consequences Subject: Chapter 14 Complexity: Moderate Simplified Functional Taxonomy: Recall

5) Since HITECH was enacted, more than _______ HIS-related jobs have been created.

A) 10,000 B) 20,000 C) 30,000 D) 50,000 Answer: D A-Head: Finding the Way Forward Subject: Chapter 14 Complexity: Moderate Simplified Functional Taxonomy: Recall

True/False

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1) True or False? Health care is adopting new technologies faster than other industries.

Answer: false A-Head: Understanding the Future of HIS Subject: Chapter 14 Complexity: Easy Simplified Functional Taxonomy: Application

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Import Settings: Base Settings: Brownstone Default Information Field: Complexity Information Field: Ahead Information Field: Subject Information Field: Title Information Field: Feedback Information Field: Taxonomy Information Field: Objective Highest Answer Letter: D Multiple Keywords in Same Paragraph: No NAS ISBN13: 9781284149609, add to Ahead, Title tags

Chapter: Midterm

True False 1. The first type of healthcare software concerned accounting functions.

Answer: True A-head_9781284149609: Vendor and Provider Relations Subject: Chapter 1 Title_9781284149609: Health Information Systems Fundamentals Complexity: Moderate Simplified Functional Taxonomy: Recall

2. Since the 2001 publication Crossing the Quality Chasm, the vendors, healthcare providers, and governmental regulators have been able to address all of the issues mentioned in the report.

Answer: False A-head_9781284149609: History of HIS Subject: Chapter 1 Title_9781284149609: Health Information Systems Fundamentals Complexity: Moderate Simplified Functional Taxonomy: Application

Short Answer

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1. In your own words, define the concept of “fundamentals.”

Answer: (will vary) Fundamentals are the basic building blocks of any industry, practice, or discipline. Without these foundational understandings, it’s impossible to build anything effective, high-quality, or lasting.

A-head_9781284149609: HIS Fundamentals Subject: Chapter 1 Title_9781284149609: Health Information Systems Fundamentals Complexity: Easy Simplified Functional Taxonomy: Recall

2. How might having a solid base in fundamentals help an HIS professional recover from a failed objective in HIS? Answer: (will vary) Knowing the basics and using them as a foundation means anyone can return to them at any time. Fundamentals are a critical part of course correction and learning in the HIS professions.

A-head_9781284149609: HIS Fundamentals Subject: Chapter 1 Title_9781284149609: Health Information Systems Fundamentals Complexity: Moderate Simplified Functional Taxonomy: Application

3. Why should HIS activities warrant the highest levels of attention?

Answer: (will vary) HIS planning and investment represents a huge investment of the organization’s time and money, and is therefore a high-risk and reward proposition. It affects every aspect of the organization’s ability to provide care and develop as a provider.

A-head_9781284149609: HIS Fundamentals Subject: Chapter 1 Title_9781284149609: Health Information Systems Fundamentals Complexity: Difficult Simplified Functional Taxonomy: Analysis

4. What is the role of the HIS Steering Committee?

Answer: (will vary) The HIS Steering Committee is responsible for overseeing the process, and the rules of engagement are published at the outset so that expectations are clear and adhered to throughout the selection process.

A-head_9781284149609: HIS Fundamentals Subject: Chapter 1 Title_9781284149609: Health Information Systems Fundamentals Complexity: Difficult Simplified Functional Taxonomy: Recall

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5. Why is the provider/vendor interface so important in health care?

Answer: (will vary) Healthcare providers are about the business of providing care, not creating software (at least these days). This necessitates partnering with companies that are in the business of software. Almost without exception, these vendors are for-profit companies whose financial motivations are at odds with quality of care and the budgetary concerns of the healthcare organization.

A-head_9781284149609: HIS Fundamentals Subject: Chapter 1 Title_9781284149609: Health Information Systems Fundamentals Complexity: Moderate Simplified Functional Taxonomy: Analysis

True/False

1. Just as healthcare provider organizations must automate their clinical and administrative processes using HIS, so public health organizations must design, implement, and use computer systems to collect and analyze data reflecting the health of a population.

Answer: True A-head_9781284149609: HIS Uses in Organizational and Community Settings Subject: Chapter 02 Title_9781284149609: The Scope, Definition, and Conceptual Model of HIS Complexity: Easy Simplified Functional Taxonomy: Application

2. If the health information system is strong enough, the quality of data is irrelevant.

Answer: False A-head_9781284149609: HIS Uses in Organizational and Community Settings Subject: Chapter 02 Title_9781284149609: The Scope, Definition, and Conceptual Model of HIS Complexity: Moderate Simplified Functional Taxonomy: Application

Short Answer

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1. How important is “workflow” to the functionality of HIS? Answer: (may vary) Workflow is extremely important to the success of HIS in any healthcare setting. If the user interface and workflow in HIS doesn’t reflect an emphasis on provider support and value-based care, then the technology isn’t functioning as it should. However, HIS planning is an excellent opportunity to re-examine and re-design workflows. (Just because it’s “always been done this way” doesn’t mean there isn’t a better way.)

A-head_9781284149609: Summary Subject: Chapter 02 Title_9781284149609: The Scope, Definition, and Conceptual Model of HIS Complexity: Difficult Simplified Functional Taxonomy: Application

2. Describe business intelligence.

Answer: (may vary) Business intelligence is a popular term for the value realized by flexibly analyzing comprehensive stores of data representing the totality of an organization or provider’s scope of activity. In other words, data from various systems that support clinical and financial transactions can be combined to enable analysis that reveals insights into the entirety of the activities within the scope of that entity. In health care, this concept leads to the notion of clinical intelligence.

A-head_9781284149609: Systems and Their Management Subject: Chapter 02 Title_9781284149609: The Scope, Definition, and Conceptual Model of HIS Complexity: Moderate Simplified Functional Taxonomy: Recall

3. Describe how healthcare data use is change care in terms of patient’s access to information or care from home.

Answer: (may vary) Consistent with the spread of mobile computing and use of the Internet throughout our society and world, patients can increasingly access their patient records and providers wherever they chose to do so, as well as monitor their personalized health data.

Additionally, vast sources of health-related information are accessible for consumers through the Internet for those interested in learning about various health or medical conditions, services, and products. The age of patient engagement is upon us: increasingly members of the C-suites of healthcare institutions have realized that they can achieve the best outcomes in organizational performance and clinical care by enlisting patients in the process. Likewise, many people now expect to be part of their own healthcare process, consistent with how they drive participation in other types of commerce and consumption of goods and services. Modern-day consumers are playing an increasing role in their health care by taking advantage of the connectivity and empowerment of access to information—a role inherent to the information age. Just as we use computers to research and obtain services and products in retail, food, and entertainment, so we

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now expect to be able to access our personal health information from providers and interact electronically in the care process from our homes or places of work.

A-head_9781284149609: HIS Uses in Organizational and Community Settings Subject: Chapter 02 Title_9781284149609: The Scope, Definition, and Conceptual Model of HIS Complexity: Moderate Simplified Functional Taxonomy: Application

4. Discuss different types of payers.

Answer: (may vary) Private payers or health insurance companies include companies such as United Health, Aetna, Blue Cross/Blue Shield, Cigna, and others. Government-funded health coverage programs include Medicare (health insurance for people age 65 or older or with certain illnesses such as permanent kidney failure and those with certain disabilities), Medicaid/MediCal (state-specific health insurance for people and families with low incomes), State Children’s Health Insurance Plan (SCHIP, state-administered programs using federal money for uninsured children younger than 19 years of age from low-income families), TriCare (health insurance for active and retired members of the military and their families), and Department of Veterans Affairs (government-sponsored programs for military veterans, covering the care they receive from doctors, hospitals, emergency rooms, and immunizations). Self-pay is becoming a larger piece of the healthcare pie now with increased proportion of plans, including high-deductibles: many people choose to forgo health insurance altogether due to the high cost and lack of accessibility due to denials and other barriers.

A-head_9781284149609: HIS Uses in Organizational and Community Settings Subject: Chapter 02 Title_9781284149609: The Scope, Definition, and Conceptual Model of HIS Complexity: Moderate Simplified Functional Taxonomy: Recall

5. Compare and contrast VistA and commercial HIS products.

Answer: The VistA system: supports in-patient and ambulatory care; has analytical and research support capabilities; is integrated; is distributed but standardized, with data from all VA hospitals and clinics is available for analytics and benchmarking purposes; and is interoperable. Contrary to commercial EHR vendors, VistA does not withhold functionality in order to maximize profit.

Rather, it was built with taxpayer dollars and therefore is in the public domain. The software is available for the cost of the medium for delivering it. It is open source, meaning the code underpinning the system is freely available and may be redistributed. VistA is interoperable, built using standard programs, and built collaboratively with physicians who guided the functionality on behalf of clinical care.

A-head_9781284149609: HIS Uses in Organizational and Community Settings Subject: Chapter 02 Title_9781284149609: The Scope, Definition, and Conceptual Model of HIS Complexity: Moderate

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Simplified Functional Taxonomy: Analysis

True/False

1. For decades, doctors and hospitals have not been paid based on the quality of their services or on patient outcomes.

Answer: True A-head_9781284149609: Health Care’s Current State Subject: Chapter 03 Title_9781284149609: Aligning HIS in the Dynamic Healthcare Environment Complexity: Easy Simplified Functional Taxonomy: Application

2. The transfer from fee-for-service to value-based care will be smooth.

Answer: False A-head_9781284149609: Current HIS Initiatives Subject: Chapter 03 Title_9781284149609: Aligning HIS in the Dynamic Healthcare Environment Complexity: Easy Simplified Functional Taxonomy: Application

3. Sharing data among providers varies widely.

Answer: True A-head_9781284149609: Current HIS Initiatives Subject: Chapter 03 Title_9781284149609: Aligning HIS in the Dynamic Healthcare Environment Complexity: Easy Simplified Functional Taxonomy: Recall

4. In the U.S., requirements of reimbursement and attendant regulations not only force change, but shape the forms and types of health care services available to patients.

Answer: True A-head_9781284149609: Current HIS Initiatives Subject: Chapter 03 Title_9781284149609: Aligning HIS in the Dynamic Healthcare Environment Complexity: Difficult

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Simplified Functional Taxonomy: Application

5. Some of the challenges associated with transferring to value-based care include building a new system from the ground up, volatility due to politics, regulatory adjustments, government contracts such as the Department of Defense, the Veterans’ Administration (VA), and the massive size of programs such as Medicare.

Answer: True A-head_9781284149609: Current HIS Initiatives Subject: Chapter 03 Title_9781284149609: Aligning HIS in the Dynamic Healthcare Environment Complexity: Easy Simplified Functional Taxonomy: Application

6. HIS will not play a major role in moving toward value-based care.

Answer: False A-head_9781284149609: Current HIS Initiatives Subject: Chapter 03 Title_9781284149609: Aligning HIS in the Dynamic Healthcare Environment Complexity: Easy Simplified Functional Taxonomy: Application

7. Unfortunately, HIPAA doesn’t mandate electronic data interchange (EDI).

Answer: False A-head_9781284149609: Current HIS Initiatives Subject: Chapter 03 Title_9781284149609: Aligning HIS in the Dynamic Healthcare Environment Complexity: Easy Simplified Functional Taxonomy: Recall

True/False

1. The HIS strategy of any organization should be to build the information technology (IT) capabilities and systems necessary to enable the organization’s overall strategies and support these business and clinical goals and objectives.

Answer: True A-head_9781284149609: HIS Planning Framework

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Subject: Chapter 04 Title_9781284149609: HIS Strategic Planning Complexity: Moderate Simplified Functional Taxonomy: Application

2. Elements of a strategic plan include the mission statement, the target population and communities served, future challenges, SWOT analysis, implementation strategies, and more.

Answer: True A-head_9781284149609: HIS Planning Framework Subject: Chapter 04 Title_9781284149609: HIS Strategic Planning Complexity: Moderate Simplified Functional Taxonomy: Application

3. The HIS strategies of many organizations focus far too much on system selection. This is only one aspect of HIS planning.

Answer: True A-head_9781284149609: HIS Planning Framework Subject: Chapter 04 Title_9781284149609: HIS Strategic Planning Complexity: Easy Simplified Functional Taxonomy: Recall

4. Siloed systems help the organization move forward in a coordinated, comprehensive fashion— enterprise systems do not.

Answer: True A-head_9781284149609: HIS Planning Framework Subject: Chapter 04 Title_9781284149609: HIS Strategic Planning Complexity: Easy Simplified Functional Taxonomy: Analysis

5. It is a combination of “top-down” and “bottom-up” perspectives that makes for a realistic, comprehensive, and forward-thinking HIS plan.

Answer: True A-head_9781284149609: HIS Planning Framework Subject: Chapter 04 Title_9781284149609: HIS Strategic Planning

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Complexity: Moderate Simplified Functional Taxonomy: Recall

6. A good HIS plan advances the organization’s performance—for example, by reducing costs, reducing waste, improving revenues, enhancing service, improving the quality of care, and increasing patient, employee, and provider satisfaction.

Answer: True A-head_9781284149609: HIS Planning Framework Subject: Chapter 04 Title_9781284149609: HIS Strategic Planning Complexity: Moderate Simplified Functional Taxonomy: Application

Short Answer

1. What is the first step in determining the HIS needs of an organization?

Answer: (may vary) The first step in understanding where an organization ought to put its efforts and resources, and which types of efforts or strategies those might be used toward, is for the organization to define its mission, vision, and values. When these overarching and most essential statements of purpose and principle are agreed upon, they become the beacons that guide the organization through its many decisions and challenges. The mission, vision, and values are essentially the compass by which the organization sets its direction for long-term growth and moves to adapt to ever-changing environmental and market conditions. Once these tenets are defined, and then collectively and officially embraced, the organization knows the direction in which it should be trying to go. The next step is to determine how the organization should go about doing so and which activities will get it moving in that direction.

A-head_9781284149609: HIS Strategy: Using Organizational Strategy as a Roadmap Subject: Chapter 04 Title_9781284149609: HIS Strategic Planning Complexity: Moderate Simplified Functional Taxonomy: Application

True/False

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1. When it comes to implementing an EHR system, nothing is more important than active participation of physician, nursing, and other clinical leadership.

Answer: True A-head_9781284149609: HIS Planning: Tools and Techniques Subject: Chapter 05 Title_9781284149609: HIS Tactical Planning Complexity: Moderate Simplified Functional Taxonomy: Application

2. What has been termed quality assurance or quality control is now being elevated and emphasized culturally in healthcare organizations with the role of Chief Quality Officer.

Answer: True A-head_9781284149609: HIS Planning: Tools and Techniques Subject: Chapter 05 Title_9781284149609: HIS Tactical Planning Complexity: Easy Simplified Functional Taxonomy: Recall

3. Communication tools for major HIS projects may include monthly newsletters.

Answer: True A-head_9781284149609: Communication Tools for HIS Plans and Projects Subject: Chapter 05 Title_9781284149609: HIS Tactical Planning Complexity: Easy Simplified Functional Taxonomy: Recall

Matching

1. Match the major categories of HIS to the Quadrant in the HIS Planning Framework.

[1] Clinical care: Supports day-to-day activities involving patients, providers, ancillary support services, and families Answer: Quadrant I [2] Institutional business: Supports day-to-day administrative transactions for financial, billing, human resources, and supply and inventory functions Answer: Quadrant II [3] Clinical intelligence and quality: Supports clinical analytics, reporting, and measurement of clinical outcomes and quality improvement

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Quadrant III [4] Business intelligence and management: Supports business analytics, reporting, management controls, and measurement of budgetary and cost outcomes Answer: Quadrant IV A-head_9781284149609: HIS Plans and Projects Derive from the Strategic HIS Plan Subject: Chapter 05 Title_9781284149609: HIS Tactical Planning Complexity: Difficult Simplified Functional Taxonomy: Analysis

Short Answer

1. How might HIS support a strategic initiative?

Answer: (may vary) With HIS enabling technology, the organization can integrate its primary and specialty physician practices, and connect with patients in their homes and as they go about their daily lives through an app accessed on mobile devices: this makes for more complete and seamless care experience for patients between office visits, ensuring gaps in care are filled and are minimized. Alternatively, the organization might use HIS to integrate operations and data flow between hospital and university research settings, thereby connecting the “research bench to the bed” in ways that speedily identify candidates for clinical trials and research as well as helping scientific advancements reach patient care settings more quickly. An efficiency-oriented organizational strategy might apply HIS to improve supplies management by shifting an organization to “just-in-time” inventory control rather than the older “first-in, first-out” or “firstin, last-out” materials management methods. Each of these three strategies would be implemented very differently if the organization did not have access to capable, modern HIS and technology that support new streamlined processes or enable brand new models of care.

A-head_9781284149609: Introduction Subject: Chapter 05 Title_9781284149609: HIS Tactical Planning Complexity: Difficult Simplified Functional Taxonomy: Application

2. What are some examples of HIS guiding principles?

Answer: (may vary) (1) The patient comes first. This principle is typically one that those working in health care arrive at first and agree on. (2) Be flexible. To what degree are people willing to adjust their habits, tendencies, and methods that have worked for them in the past, to meet a shared goal of the future? HIS strategies and projects should always challenge the status quo and current ways of doing things, otherwise, there is missed opportunity in a major way. Flexibility could be a very important principle to guide decisions and help people remain connected to their values, and not to their habits or current methods or job descriptions. (3) Integration over

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interfacing for enterprise systems. The investment of money, opportunity, energy, and time to define, acquire, build, test, train, implement, and support over the long haul for core HIS systems should be done with the long-term plan in mind. Synergy, safety, and simplicity accompany an integrated enterprise system. Thinking interfaces can create these benefits over time is foolhardy and usually motivated by self-interest, resistance to change, and perhaps loyalty to a commercial vendor versus the organization’s overall best interest. (4) Say no to silos. This guiding principle is related to the “integration over interfacing” principle above, yet “say no to silos” spans not only the systems themselves, but a way of thinking and architecting HIS. Silos are defined as a tower, pit, or chamber designed to hold one type of thing: examples of siloes in health care may be a departmental HIS that only communicates with itself, or a department culture that makes decision independently rather than collaboratively. (5) Manage the vendor; don’t let the vendor manage you. Doesn’t matter what the product is—software, hardware, services, or consulting.

Vendors have a way of gaining undue influence in an organization, or at least with certain groups within an organization. Influence within groups is usually due to their connection to that area, there being some sort of mutual interest. For instance, a billing department might align with and therefore be unduly influenced by a vendor of accounts receivable software and services. Or, a clinical department, such as cardiology, might be largely in favor of a silo vendor of software that addresses the needs of cardiology exclusively. Another way that healthcare organizations occasionally allow vendors to manage them, rather than the other way around, is accepting contracts written by the vendor.

A-head_9781284149609: HIS Planning Tools and Techniques Subject: Chapter 05 Title_9781284149609: HIS Tactical Planning Complexity: Moderate Simplified Functional Taxonomy: Application

3. Why are siloes of data a bad thing for a healthcare organization?

Answer: (may vary) These silo systems, or islands of data, produce information in a vacuum, isolated from other systems and data, and requiring some form of interfacing, integration, or manual combining and comparing with other sources of information. Worse yet, these silos often overlap with the content of other systems, causing arguments and confusion about which source of the same type of information is correct, sanctioned by the organization, and should be used for decision making. These sources also are hazardous, in that they can be used to prepared beautiful reports and graphics, but the data may be only a subset of the total picture that should create that information, thus misleading the clinical or business decision maker. At a minimum, these siloed data sources cause consternation and ineffectiveness organizationally because meetings that should be productive are usually spent debating whose data is right, rather than getting to the task at hand and making good decisions for the organization and patients. At their worst, silos can create bad or misinformed business decisions and clinical errors. Be courageous. Address the tough issues and follow your guiding principles that put the patient first. Avoid silos.

A-head_9781284149609: HIS Planning Tools and Techniques Subject: Chapter 05 Title_9781284149609: HIS Tactical Planning Complexity: Moderate

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Simplified Functional Taxonomy: Application

True/False

1. Wireless local area networks (WLANs) operate by transmitting data from a wireless access point (WAP) through the medium of air using radio frequencies.

Answer: True A-head_9781284149609: Technology Subject: Chapter 6 Title_9781284149609: Application Systems and Technology Complexity: Moderate Simplified Functional Taxonomy: Application

2. Two common storage area networks (SANs) that dedicated back-end computer systems designed to efficiently and cost-effectively store and transfer a healthcare organization’s server data include fiber channel (FC) SANs and network attached storage (NAS).

Answer: True A-head_9781284149609: Technology Subject: Chapter 6 Title_9781284149609: Application Systems and Technology Complexity: Moderate Simplified Functional Taxonomy: Recall

3. Ubiquitous communications (UC) is a technology that involves the integration of real-time communication services, such as instant messaging and presence, voice over IP (VoIP), and voice over wireless LAN (VoWLAN), video conferencing, and web conferencing.

Answer: False A-head_9781284149609: Technology Subject: Chapter 6 Title_9781284149609: Application Systems and Technology Complexity: Moderate Simplified Functional Taxonomy: Application

4. Service-oriented architecture (SOA) is an emergent technology that simplifies how modern data centers are operated by managing applications, servers, networks, compute, storage, and memory as a single software-based platform.

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Answer: False A-head_9781284149609: Technology Subject: Chapter 6 Title_9781284149609: Application Systems and Technology Complexity: Difficult Simplified Functional Taxonomy: Application

5. Cold sites are data centers that can provide rapid, automated, and full system and data recovery in less than a minute, and are more expensive options than warm, tepid, and hot sites.

Answer: False A-head_9781284149609: Technology Subject: Chapter 6 Title_9781284149609: Application Systems and Technology Complexity: Moderate Simplified Functional Taxonomy: Application

6. Domain Name System (DNS) servers enable users and servers to contact websites and other servers by maintaining a directory listing of server and website names.

Answer: True A-head_9781284149609: Technology Subject: Chapter 6 Title_9781284149609: Application Systems and Technology Complexity: Moderate Simplified Functional Taxonomy: Recall

7. Signature pads are designed to electronically accept patient and clinician signatures, and are frequently deployed at hospital admission and patient accounting areas.

Answer: True A-head_9781284149609: Technology Subject: Chapter 6 Title_9781284149609: Application Systems and Technology Complexity: Moderate Simplified Functional Taxonomy: Application

True/False

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1. Typically, strategically aligned vendor companies will have a large portfolio of products and services that can offer value in tandem with standardization and consistency across the organization.

Answer: True A-head_9781284149609: Managing Process Subject: Chapter 07 Title_9781284149609: HIS Management and Technology Services Complexity: Moderate Simplified Functional Taxonomy: Application

2. Vendor selection should not be confused with vendor management. Equal importance should be given to managing the vendor relationship both during and after the selection and contracting phase. Healthcare customer organizations should not necessarily select the vendor that offers its products or services for the lowest price.

Answer: True A-head_9781284149609: Managing Process Subject: Chapter 07 Title_9781284149609: HIS Management and Technology Services Complexity: Moderate Simplified Functional Taxonomy: Application

3. For HIS initiatives to deliver the maximum value with the desired outcomes, healthcare organizations must develop a strategic plan, ensure architectural excellence is established, and always include aggressive process redesign in every implementation.

Answer: False A-head_9781284149609: Managing Process Subject: Chapter 07 Title_9781284149609: HIS Management and Technology Services Complexity: Difficult Simplified Functional Taxonomy: Analysis

4. The primary purpose of project time management is to ensure that all the required work is performed to complete the project successfully, and includes activities such as the scope plan, scope definition, WBS, scope control, and scope verification.

Answer: False A-head_9781284149609: Managing Process Subject: Chapter 07 Title_9781284149609: HIS Management and Technology Services Complexity: Moderate Simplified Functional Taxonomy: Application

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5. A data breach is defined as an acquisition, access, use, or disclosure of protected health information (PHI) that is not permitted by the HIPAA Privacy Rule, and that compromises the security or privacy of PHI. Answer: True A-head_9781284149609: Managing Process Subject: Chapter 07 Title_9781284149609: HIS Management and Technology Services Complexity: Moderate Simplified Functional Taxonomy: Recall

6. Ransomware is a type of malware that denies access to data by encrypting an organization’s data with a key known only to the attacker who deployed the ransomware.

Answer: True A-head_9781284149609: Managing Process Subject: Chapter 07 Title_9781284149609: HIS Management and Technology Services Complexity: Moderate Simplified Functional Taxonomy: Application

7. The Chief Technology Officer (CTO) is generally the most senior-level IT executive in healthcare organizations.

Answer: False A-head_9781284149609: Managing People Subject: Chapter 07 Title_9781284149609: HIS Management and Technology Services Complexity: Moderate Simplified Functional Taxonomy: Recall

Short Answer

1. What is a steering committee and why is it an important group for moving HIS initiatives forward?

Answer: (may vary) A steering committee is an advisory committee that is usually made up of high-level stakeholders and experts who provide guidance on key issues such as company policy and objectives, budgetary control, marketing strategy, resource allocation, and decisions

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involving large expenditures. HIS steering committees provide guidance that moves HIS initiatives forward, bring closure to projects, and enable system selection and ongoing system needs.

A-head_9781284149609: Managing People Subject: Chapter 07 Title_9781284149609: HIS Management and Technology Services Complexity: Difficult Simplified Functional Taxonomy: Analysis

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Import Settings: Base Settings: Brownstone Default Information Field: Complexity Information Field: Ahead Information Field: Subject Information Field: Title Information Field: Feedback Information Field: Taxonomy Information Field: Objective Highest Answer Letter: D Multiple Keywords in Same Paragraph: No NAS ISBN13: 9781284149609, add to Ahead, Title tags

Chapter: Final

Fill-in-the-Blank

1. ____ out of ten physicians have adopted electronic record keeping.

Answer: Nine A-head_9781284149609: Implementation Subject: Chapter 08 Title_9781284149609: Managing Change—HIS Implementation Complexity: Moderate Simplified Functional Taxonomy: Recall

2. Given that it takes years for most organizations to implement a Strategic HIS Plan, a good approach to breaking this mission-critical effort for the enterprise into recognizable, executable portions is to create _________.

Answer: Phases A-head_9781284149609: Implementation Subject: Chapter 08 Title_9781284149609: Managing Change—HIS Implementation Complexity: Moderate Simplified Functional Taxonomy: Recall

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3. Each Phase contains strategic initiatives and key related projects, each with multiple ______ that encompass early foundational work.

Answer: stages A-head_9781284149609: Implementation Subject: Chapter 08 Title_9781284149609: Managing Change—HIS Implementation Complexity: Moderate Simplified Functional Taxonomy: Recall

4. A key component of Phase I is the development of the ______________, a unique patient identifier.

Answer: master patient index (MPI) A-head_9781284149609: Implementation Subject: Chapter 08 Title_9781284149609: Managing Change—HIS Implementation Complexity: Moderate Simplified Functional Taxonomy: Recall

5. SME stands for ________________.

Answer: subject matter expert A-head_9781284149609: Implementation Subject: Chapter 08 Title_9781284149609: Managing Change—HIS Implementation Complexity: Moderate Simplified Functional Taxonomy: Recall

6. RFP stands for __________________.

Answer: Request for Proposal A-head_9781284149609: Implementation Subject: Chapter 08 Title_9781284149609: Managing Change—HIS Implementation Complexity: Easy Simplified Functional Taxonomy: Recall

Fill-in-the-Blank

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1. Physician David Eddy asserted, “The complexity of modern medicine exceeds the inherent limitations of the unaided ________.”

Answer: human value A-head_9781284149609: The Value of Adopting New Technologies Subject: Chapter 09 Title_9781284149609: Adopting New Technologies Complexity: Easy Simplified Functional Taxonomy: Application

2. According to Rogers’s Theory __________ are the initiators of the change—the curious, restless, brave types who enjoy being on the cutting edge, who are comfortable with uncertainty and failure, and who always want to try something new, get a new tool, or experiment with new methods to do their work.

Answer: innovators A-head_9781284149609: Rogers’s Theory of Diffusion of Innovation: Adoption of New HIS and Technology Subject: Chapter 09 Title_9781284149609: Adopting New Technologies Complexity: Moderate Simplified Functional Taxonomy: Recall

3. On Rogers’s adoption curve, __________ are described as traditionalists, resistant to change, who prefer the old ways of doing things. They adapt to the innovation only when it has become the norm and is not seen as complying with anything radical or drastic.

Answer: laggards A-head_9781284149609: Rogers’s Theory of Diffusion of Innovation: Adoption of New HIS and Technology Subject: Chapter 09 Title_9781284149609: Adopting New Technologies Complexity: Moderate Simplified Functional Taxonomy: Recall

4. EMRAM stands for _______________________.

Answer: Electronic Medical Record Adoption Model A-head_9781284149609: Impact of New Technologies on Existing HIS Subject: Chapter 09 Title_9781284149609: Adopting New Technologies Complexity: Moderate Simplified Functional Taxonomy: Recall

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5. O-EMRAM stands for _________________________.

Answer: Outpatient Electronic Medical Record Adoption Model (EMRAM) A-head_9781284149609: Impact of New Technologies on Existing HIS Subject: Chapter 09 Title_9781284149609: Adopting New Technologies Complexity: Moderate Simplified Functional Taxonomy: Recall

6. Vanderbilt’s recent replacement of proprietary software with Epic software resulted in a 60 percent ________ in operating revenue the first year.

Answer: reduction A-head_9781284149609: Impact of New Technologies on Existing HIS Subject: Chapter 09 Title_9781284149609: Adopting New Technologies Complexity: Moderate Simplified Functional Taxonomy: Recall

True/False

1. To fully implement MACRA, formidable new work by practices, programmers, database architects, and software vendors will be necessary, including the development of new electronic communication methods and security software.

Answer: True A-head_9781284149609: MACRA Subject: Chapter 10 Title_9781284149609: Data Complexity: Moderate Simplified Functional Taxonomy: Application

2. CMS’s Merit-Based Incentive Payment System (MIPS) will lead to a variable incentive payment or loss of payment starting in 2019 at 16 percent and increasing to 23 percent in 2022.

Answer: False A-head_9781284149609: MACRA Subject: Chapter 10 Title_9781284149609: Data Complexity: Difficult

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Simplified Functional Taxonomy: Recall

3. MACRA should lead to providing patients with better transparency for procedural cost and institutional quality measurement.

Answer: True A-head_9781284149609: MACRA Subject: Chapter 10 Title_9781284149609: Data Complexity: Moderate Simplified Functional Taxonomy: Application

4. Big Data refers to large, discrete data elements such as “elephant” or “mountain” or “planet” and such.

Answer: False A-head_9781284149609: Big Data and Thick Data Subject: Chapter 10 Title_9781284149609: Data Complexity: Easy Simplified Functional Taxonomy: Application

5. Social media is one of the largest contributors to Big Data and it is growing exponentially.

Much of this data may have value in our healthcare system.

Answer: False A-head_9781284149609: Big Data and Thick Data Subject: Chapter 10 Title_9781284149609: Data Complexity: Easy Simplified Functional Taxonomy: Application

6. Thick Data is by nature more subjective, visceral, and intuitive.

Answer: True A-head_9781284149609: Big Data and Thick Data Subject: Chapter 10 Title_9781284149609: Data Complexity: Easy Simplified Functional Taxonomy: Recall

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True/False

1. Extraction, Transformation, and Load (ETL) of source data used in BI/CI is an essential process and only needs to be accomplished one time as the original data is static forever.

Answer: False A-head_9781284149609: Models for Data Architecture and Strategy Subject: Chapter 11 Title_9781284149609: Analytics, Business Intelligence and Clinical Intelligence Complexity: Difficult Simplified Functional Taxonomy: Application

2. “Data about data” is the simplest definition for metadata.

Answer: True A-head_9781284149609: Models for Data Architecture and Strategy Subject: Chapter 11 Title_9781284149609: Analytics, Business Intelligence and Clinical Intelligence Complexity: Easy Simplified Functional Taxonomy: Recall

3. Some hospitals may have as many as 50 discrete applications making the repository analytical functionality most difficult.

Answer: True A-head_9781284149609: Models for Data Architecture and Strategy Subject: Chapter 11 Title_9781284149609: Analytics, Business Intelligence and Clinical Intelligence Complexity: Moderate Simplified Functional Taxonomy: Recall

4. Forbes magazine writes, “health care will be the last industry to benefit from Artificial Intelligence.”

Answer: False A-head_9781284149609: Models for Data Architecture and Strategy Subject: Chapter 11 Title_9781284149609: Analytics, Business Intelligence and Clinical Intelligence Complexity: Moderate Simplified Functional Taxonomy: Recall

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5. Over time, Thick Data will be “learned” and AI will save diagnostic and treatment decision time. This will preserve valuable physician resources.

Answer: True A-head_9781284149609: Models for Data Architecture and Strategy Subject: Chapter 11 Title_9781284149609: Analytics, Business Intelligence and Clinical Intelligence Complexity: Moderate Simplified Functional Taxonomy: Recall

6. Leading organizations, such as Healthcare Information and Management Systems Society (HIMSS) and the Medical Group Management Association (MGMA), consistently espouse the need for better BI. Answer: True A-head_9781284149609: The Future of BI/CI Subject: Chapter 11 Title_9781284149609: Analytics, Business Intelligence and Clinical Intelligence Complexity: Easy Simplified Functional Taxonomy: Analysis

Fill-in-the-Blank

1. UI stands for ____________.

Answer: User Interface A-head_9781284149609: Human-Centered Design: User Interface and User Experience Subject: Chapter 12 Title_9781284149609: HIS and Digital Health Complexity: Easy Simplified Functional Taxonomy: Recall

2. UX stands for ____________.

Answer: User Experience A-head_9781284149609: Human-Centered Design: User Interface and User Experience Subject: Chapter 12 Title_9781284149609: HIS and Digital Health Complexity: Easy Simplified Functional Taxonomy: Recall

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3. ____________ design is a term that emerged in application to computer systems UI/UX over the past decade, to address methods for creating not computer interactions that would produce accurate, automated work, but create interactions between humans and computers that are useful and pleasant.

Answer: Human-centered A-head_9781284149609: Human-Centered Design: User Interface and User Experience Subject: Chapter 12 Title_9781284149609: HIS and Digital Health Complexity: Easy Simplified Functional Taxonomy: Recall

4. A ________ cycle identifies current trends in technology and pinpoints where they are on a continuum from nascent to widely adopted.

Answer: hype A-head_9781284149609: Human-Centered Design: User Interface and User Experience Subject: Chapter 12 Title_9781284149609: HIS and Digital Health Complexity: Easy Simplified Functional Taxonomy: Recall

5. _______________ is the study and development of treatments that take advantage of the body’s immune system to fight cancer.

Answer: Immuno-Oncology A-head_9781284149609: The Importance of Informatics in Adopting HIS and New Technologies Subject: Chapter 12 Title_9781284149609: HIS and Digital Health Complexity: Moderate Simplified Functional Taxonomy: Recall

6. A University of Wisconsin study found that social and economic factors comprise a full ___ percent of determinants of health, _______ that of the role of medical and health services.

Answer: 40, twice A-head_9781284149609: The Importance of Informatics in Adopting HIS and New Technologies Subject: Chapter 12 Title_9781284149609: HIS and Digital Health

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Complexity: Difficult Simplified Functional Taxonomy: Recall

Fill-in-the-Blank

1. ______ has long been identified as an essential element to improving outcomes as well as reducing costs, in the U.S. and in OECD countries.

Answer: HIS A-head_9781284149609: Uses of HIS in Other Countries Subject: Chapter 13 Title_9781284149609: HIS Around the Globe Complexity: Moderate Simplified Functional Taxonomy: Recall

2. U.S. system ranks _________ compared with all other OECD countries on Overall Performance, considering cost compared to outcomes.

Answer: lowest A-head_9781284149609: Uses of HIS in Other Countries Subject: Chapter 13 Title_9781284149609: HIS Around the Globe Complexity: easy Simplified Functional Taxonomy: Recall

3. An _______ relationship exists between expenditures and outcomes in U.S. health care.

Answer: inverse A-head_9781284149609: Uses of HIS in Other Countries Subject: Chapter 13 Title_9781284149609: HIS Around the Globe Complexity: Difficult Simplified Functional Taxonomy: Analysis

4. The number of preventable deaths in the U.S., including infant mortality, is _________ compared to countries with similar economies.

Answer: highest A-head_9781284149609: Uses of HIS in Other Countries Subject: Chapter 13

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Title_9781284149609: HIS Around the Globe Complexity: Difficult Simplified Functional Taxonomy: Analysis

5. Health system structure, compensation for providers, and ________ adoption work together to drive care delivery behavior and patient access to health data.

Answer: HIS A-head_9781284149609: Uses of HIS in Other Countries Subject: Chapter 13 Title_9781284149609: HIS Around the Globe Complexity: Easy Simplified Functional Taxonomy: Recall

Short Answer

1. Compare and contrast the early investments of nations, including the U.S. on HIS planning and expenditures. How did these early investments play out in the countries’ HIS landscapes and health care overall?

Answer: (may vary) As of 2003, levels of effort and expenditure towards a national HIS and EHR footprint varied widely between countries. For example, the U.S. established the Office of the National Coordinator of Health Information Technology in 2004, with expectations to begin a 10-year initiative in 2006, ending in 2016, to create electronic patient records and connectivity nationally. In contrast, Germany began efforts towards the same in 1993, including a smart care initiative for individual citizens’ health records and national network of HIS by 2003. Norway and Canada began in earnest in 1997, with Canada’s embracing the goal of half their citizens having electronic health records by 2009. While the U.K. has had mixed results, they initiated a massive effort in 2002 and have invested heavily in a national information technology network and automated patient records. As of 2005, during early forays into automating healthcare records and processes in their countries, expected expenditures and investment for each country’s multi-year initiatives varied widely. The U.S. expected to spend a mere $125M or $0.43 per capita: this is incredibly telling as to the understanding and intent of truly investing in this effort for a country the size and population of the U.S., since individual hospitals and health systems currently regularly spend hundreds of millions of dollars themselves implementing an EHR system. Australia planned for $97.9M or $4.93 per capita, Canada $1.0B or $31.85 per capita, Germany $1.8B or $21.20 per capita, Norway $57M or $11.43 per capita, and the U.K. $11.5B or $192.79 per capita. The bottom line is other countries started much earlier than the U.S. and outspent the U.S., per capita by orders of magnitude.

Answer: highest A-head_9781284149609: Uses of HIS in Other Countries Subject: Chapter 13

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Title_9781284149609: HIS Around the Globe Complexity: Difficult Simplified Functional Taxonomy: Analysis

Fill-in-the-Blank

1. M2M stands for _______________.

Answer: machine-to-machine A-head_9781284149609: Digital Health: Merging eHealth, mHealth, Social Media, Telemedicine, and Telehealth Subject: Chapter 14 Title_9781284149609: Future HIS: Key Issues and Opportunities Complexity: Easy Simplified Functional Taxonomy: Recall

2. The volumes of ______ will continue to experience exponential growth in the future, surpassing current abilities to manage and make use of it.

Answer: data A-head_9781284149609: Future Directions in Informatics, Data, and Analytics Subject: Chapter 14 Title_9781284149609: Future HIS: Key Issues and Opportunities Complexity: Easy Simplified Functional Taxonomy: Recall

3. Data ________ skills are increasingly a desired skillset and a requisite for administrative and BI/CI decision making.

Answer: analytics A-head_9781284149609: Future Directions in Informatics, Data, and Analytics Subject: Chapter 14 Title_9781284149609: Future HIS: Key Issues and Opportunities Complexity: Moderate Simplified Functional Taxonomy: Recall

4. Continued progress along the lines of ________ functionality will reveal whether we have accomplished truly functional EHRs. Answer: Meaningful Use (MU)

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A-head_9781284149609: Alignment between HIS and Population Health Management and Value-based Care Subject: Chapter 14 Title_9781284149609: Future HIS: Key Issues and Opportunities Complexity: Moderate Simplified Functional Taxonomy: Recall

5. With increased availability of HIS and access to data is the flip side of the accessibility coin— violation of privacy and security of _______________.

Answer: personal health information (PHI) A-head_9781284149609: Issues to Consider as the Future of HIS Unfolds Subject: Chapter 14 Title_9781284149609: Future HIS: Key Issues and Opportunities Complexity: Moderate Simplified Functional Taxonomy: Application

Short Answer

1. List ways technologies are already widely applied and solving problems in today’s healthcare environments.

Answer: (may vary) Innovations using technology in inpatient settings, such as location tracking, fall prevention, infection surveillance, and nurse communications advances, are helping solve long-standing safety and quality of care problems. Service improvement through the use of digital membership cards connected to software on a smartphone can allow for all sorts of technology integration and consumer-friendly software applications to improve the patient experience. Forward-thinking organizations are using technology to implement service improvements including wayfinding; digital (cell phone) insurance cards; taking co-payments online or by a staff member circulating through the admitting and registration areas with mobile credit card receiving capabilities (eliminating the need for patients to stand in lines, and reducing wait times); improving specialty scheduling delays; and other innovations that reduce mistakes, delays, frustrations, and inefficiencies. Through the use of technology, providers are able to place greater emphasis on patient involvement, education, and social media groups to help with chronic disease management. Predictive analytics can run against population data bases gathered through health information exchanges (HIE) to anticipate those patients at greatest risk of advancing illness so that less intense, earlier interventions can stave off the worsening of a condition and keep patients’ illnesses from worsening.

A-head_9781284149609: Understanding the Future of HIS Subject: Chapter 14 Title_9781284149609: Future HIS: Key Issues and Opportunities Complexity: Moderate

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Simplified Functional Taxonomy: Recall

2. What is the relationship between HIS and data?

Answer: (may vary) HIS create enormous amounts of data. Good HIS, which is preceded by solid strategic planning, creates data and then makes it available for use.

A-head_9781284149609: HIS Fundamentals Subject: Chapter 1 Title_9781284149609: Health Information Systems Fundamentals Complexity: Difficult Simplified Functional Taxonomy: Analysis

3. Describe how health information exchanges came into being.

Answer: (may vary) Since the early 2000s, provider organizations in some regions have been entering into collaborative arrangements of varying scopes and business models with the goal of sharing patient-related health information, securely, between providers organized into not-forprofit, collaborative “data sharing” organizations in that region. Examples of regional organizations that might participate in these consortia include hospitals and hospital systems, clinics, physician practices, emergency responders such as paramedics, tumor registries, imaging centers, community clinics, public health institutions, and others. The idea is that these providers seek to make patient data that they have in their own systems available to other providers if needed to support care for the same patient. The aim is to improve the timeliness of data availability, support clinicians in emergency situations when patients need care at an organization where they typically do not receive care, make existing data available in an emergency to help speed diagnosis and treatment, reduce the need to repeat tests that have been performed at another clinical setting for which the results are stored and readily available within that organization’s EHR, save the patient the discomfort and inconvenience of repeated care and testing, facilitate cross-continuum care models such as accountable care organizations (ACOs) and medical homes, and reduce costs and waste when possible.

A-head_9781284149609: HIS Uses in Organizational and Community Settings Subject: Chapter 02 Title_9781284149609: The Scope, Definition, and Conceptual Model of HIS Complexity: Difficult Simplified Functional Taxonomy: Application

4. Why can the healthcare field be described as dynamic?

Answer: (may vary) Lives are at stake, over 13 million people have jobs in health care, and the government is very invested in the work that we do. The U.S. fee-for-service based health system is reeling as it tries to transition to value-based care, challenged to cost-effectively care for an aging, chronically ill population. About 150 million Americans have at least one chronic condition, 100 million have more than one, and 30 million live with five or more chronic

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conditions—those 30 million Americans account for 40 percent of healthcare spending. In a world that is rapidly changing, so is health care. Technologies move forward, and yet only some HIS processes do. This chapter examines what this means to surviving and thriving in this environment of change and how HIS can help pave the way. There is special attention to the issues of moving from fee-for-service to value-based care, value-based reimbursement, and population health management.

A-head_9781284149609: Introduction Subject: Chapter 03 Title_9781284149609: Aligning HIS in the Dynamic Healthcare Environment Complexity: Moderate Simplified Functional Taxonomy: Application

5. What happens if your organization does not have a strategic plan and you need to develop a strategic HIS plan and make major HIS decisions and investments?

Answer: (may vary) Take charge and create the strategic organizational plan as best you can before launching off to develop and implement the HIS strategy. The strategic organizational planning must come first. Document everything you can about what people are thinking about the future directions and plans of the organization. Be a leader. Pull a group of people together, interview people from all disciplines and levels of the organization, and write down everything you learn according to the outlines provided in this text. Circulate what you document and get people’s reactions—and then adjust your documentation based on this feedback. In addition to getting guidance from executive management, ask entry-level employees, grass-roots workers, nurses, physicians, departmental process experts, patients, senior leaders, people in the community, board members (might want to get permission on that one first), and administrative assistants (especially!) what they think. You will likely be pleasantly surprised at what you learn: thoughtful people know the truth about what is going on; they know how to make things work more efficiently and effectively. Everything you learn in this process will be important input for your work of HIS strategy development. Be organized as you go about this process: systematically interview a subset of the people in each category with a structured set of questions and all others you think have a perspective on the work of the organization. This research will paint a picture of what is important to various constituents in the organization and in the community, whose interests all need to be served by the organization and, therefore, by its computer systems and information capabilities. The bottom line is that the HIS strategy should be like a reflection in the pool of the organization’s future—it should contemplate the present and lay a path to its desired future.

A-head_9781284149609: HIS Strategy: Using Organizational Strategy as a Roadmap Subject: Chapter 04 Title_9781284149609: HIS Strategic Planning Complexity: Moderate Simplified Functional Taxonomy: Application

6. What might the phrase “Picking a vendor is not a strategy” mean?

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Answer: (may vary) So much attention is paid these days to which EHR or ERP system vendor will be selected and implemented by an organization. But this is not the highest priority. Nor does this result in an organization-driven strategy being achieved. The organization must develop its own Strategic HIS Plan as a reflection of its strategies and goals, as outlined in Chapter 4, to then populate its well-thought and balanced portfolio of application software to propel it to its desired future state. Too much focus too early on which vendor “should” be selected spoils that comprehensive and strategic aim. When the organization controls its own destiny and exerts the discipline to define detailed requirements based on strategic needs, the selection of a vendor will be more successful and can better position the business relationship with the vendor, while also being future-reaching. If the selection of a particular vendor for its EHR system is the primary strategic target, the vendor has the organization in its hand: the organization is about to get twisted in the wind, and they’ll pay for the privilege. Anytime a true selection is taking place (meaning there are minimum of two vendors for any HIS system that could be chosen and be acceptable to the organization), the organization wins. Anytime the converse it true, meaning there is only one vendor the organization has its heart set on, there is not a real negotiation.

When that happens, the vendor wins.

A-head_9781284149609: HIS Planning Tools and Techniques Subject: Chapter 05 Title_9781284149609: HIS Tactical Planning Complexity: Moderate Simplified Functional Taxonomy: Application

7. What is involved in the Planning and Requirements Definition phase of the software development life cycle methodology?

Answer: This phase involves identifying functional, support, and training requirements, as well as developing the initial life-cycle management plans, the project plans, and other operations requirements.

A-head_9781284149609: HIS Applications Subject: Chapter 06 Title_9781284149609: Application Systems and Technology Complexity: Moderate Simplified Functional Taxonomy: Recall

True/False

1. Certifications that help enhance healthcare professional development are the Certified Professional in Healthcare Information and Management Systems (CPHIMS), Project Management Professional (PMP), ITIL, and Lean Six Sigma certifications.

Answer: True A-head_9781284149609: Managing People

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Subject: Chapter 07 Title_9781284149609: HIS Management and Technology Services Complexity: Moderate Simplified Functional Taxonomy: Application

Short Answer

1. Why is IT service support needed in healthcare organizations?

Answer: (may vary) IT service support is needed to (1) quickly solve issues encountered by staff when using HIS, (2) train staff on how to best use the software, or (3) manage requests for modifications or upgrades in a non-impactful way.

A-head_9781284149609: Managing Process Subject: Chapter 07 Title_9781284149609: HIS Management and Technology Services Complexity: Difficult Simplified Functional Taxonomy: Analysis

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