Which technical development created a tension between centralized and decentralized computer management in healthcare quizlet?

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1. Science
2. Medicine
3. Health Computing

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Terms in this set (60)

The historical roots of computer science can be traced to:

a.
language development, especially English.
b.
mathematics and engineering.
c.
library science.
d.
medicine and nursing.

B.) The historical roots of computer science can be traced back to mathematics and engineering. The historical roots of information science began in library science. Language development and medicine and nursing are not the roots of computer science.

The historical roots of information science can be traced to

a.
language development, especially English.
b.
mathematics and engineering.
c.
library science.
d.
medicine and nursing.

ANS: C
The historical roots of information science began in library science. The historical roots of computer science can be traced back to mathematics and engineering. Language development and medicine and nursing are not the roots of information science.

The first book to include the term nursing informatics in the title was written in the:

a.
1960s.
b.
1970s.
c.
1980s.
d.
1990s.

C.

As knowledge develops and expands within a discipline, which information source will include the oldest but best organized representation of that knowledge?

a.
Conference presentations
b.
Conference proceedings
c.
Journal articles
d.
Books

D. The information source that includes the oldest but best organized representation of knowledge is books.

Which technical development created a tension between centralized and decentralized computer management in healthcare?

a.
The development of punch cards
b.
The elimination of punch cards
c.
The development of the mainframe computer
d.
The development of the personal computer

ANS: D
The development of the personal computer created tension between centralized and decentralized computer management in healthcare. The other responses highlight aspects of decentralized computer management.

Which of the following is not a member organization but rather a group of organizations?

a.
AMIA
b.
HIMSS
c.
AHIMA
d.
ANI

D.

Which statement concerning educational programs in health informatics is correct?

a.
All health informatics programs are offered at the graduate level.
b.
Informatics programs offered by medical schools always require students to have earned an MD for admission.
c.
All health informatics programs are located within health-related departments or schools such as nursing, medicine, or pharmacy.
d.
Health informatics programs range from certificate programs offered at the community college level to post-doctoral programs offered at major research institutions.

ANS: D
The correct response is health informatics programs range from certificate programs offered at the community college level to post-doctoral programs offered at major research institutions. Not all informatics programs require an MD, are at the graduate level, or are located within schools of health sciences.

Which statement related to certification in health informatics is correct?

a.
A master's in nursing is required to sit for the NI examination offered by ANCC.
b.
To be certified in clinical informatics in association with AMIA, one must first be a physician.
c.
There are no specific educational requirements for CPHIMS certification through HIMSS, but three years of full-time clinical experience in health IT is required.
d.
To be certified as CPHIMS, you must be a nurse.

ANS: B
To be certified in clinical informatics in association with AMIA, one must first be a physician. You do not need to have an MSN to sit for the NI exam by the ANCC. There are specific requirements for CPHIMS, but being a nurse is not one of them.

The term informatics was derived from: (select all the apply)

a.
Dutch.
b.
English.
c.
Russian.
d.
Arabic.
e.
French.

ANS: B, C, E

When the AMIA model is used, which subfields are categorized as clinical informatics? (Select all that apply.)

a.
Medical informatics
b.
Nursing informatics
c.
Dental informatics
d.
Chemical informatics
e.
Business informatics

ANS: A, B, C

What is the primary difference between an open and closed system?

a.
An open system has no boundary, and therefore there are no limits to the inputs and outputs between an open system and the environment.
b.
An open system has a semipermeable boundary and therefore will filter both inputs and outputs when interacting with the environment.
c.
A closed system has a semipermeable boundary and therefore will filter both inputs and outputs when interacting with the environment.
d.
A closed system does not have a boundary and therefore will not interact with the environment.

ANS: B

The primary characteristics used to analyze an open system include:

a.
structure, purpose, and functions.
b.
sub-system, target system, and super-system.
c.
boundary, attributes, and environment.
d.
hierarchical, web, and hybrid.

ANS: A

A change made to any aspect of an open system, whether it is a health care system or a computer system, will produce change in other aspects of that same system. As a result, any change can produce unintended consequences. This process is called:

a.
dynamic homeostasis.
b.
semi-planned change.
c.
negentropy.
d.
reverberation.

ANS: D

Chaotic systems are in a constant state of change. This degree or scope of change that can occur has been described as the butterfly effect. The butterfly effect refers to:

a.
a minor change in input can create a major change in output, or a major change in input can result in minor changes in output.
b.
a major change in input will create a major change in output, and a minor change in input will create minor changes in output.
c.
a minor change in input can create a minor change in output; however, a major change in input will result in minor changes in output.
d.
a minor change in input may create a major change in output; however, a major change in input will create a major change in output.

ANS: A

Which statement describes the measurement of information as defined by the Shannon and Weaver model?

a.
The amount of information is measured by the amount of data in the message.
b.
The amount of information is measured by the number of meanings that can be assigned to a message.
c.
The amount of information is measured by the extent the message decreases entropy.
d.
The amount of information is measured by the number of characters used to create the message.

ANS: C

The number 190 is an example of:

a.
data.
b.
information.
c.
knowledge.
d.
wisdom.

ANS: A

Knowing when and how to use knowledge is referred to as:

a.
procedural knowledge.
b.
cognitive knowledge.
c.
decision support system.
d.
wisdom.

ANS: D

Which concepts are used to describe the different types of learning outcomes and can be used to write learning objectives?

a.
Input, throughput, and output
b.
Adult learning theories, constructionist theories, and learning styles
c.
Cognitive, affective, and psychomotor
d.
Short, intermediate, and long-term memory

ANS: C

Which group will test out new technology but are not usually seen as leaders within an organization?

a.
Innovators
b.
Early adopters
c.
Early majority
d.
Late majority

ANS: A

The systems life cycle (SLC) is a guide for informatics projects. Typical phases of the SLC include (select all that apply):

a.
implementation.
b.
planning.
c.
evaluation.
d.
security.
e.
diagnosis.

ANS: A, B, C

Which measure is most important for evaluating the performance of classifiers, models that predict class membership?

a.
Root mean squared error (RMSE)
b.
Area under the receiver operating characteristic (ROC) curve
c.
Percentage of correctly classified cases
d.
Hosmer-Lemeshow statistic

ANS: B

Which specialized method(s) is (are) used in knowledge discovery and data mining?

a.
Stratified sampling
b.
Conceptual analytic methods
c.
Selection of the optimal subset of variables/features for use in modeling
d.
Machine learning

ANS: C

The process of knowledge discovery and data mining is best characterized as:

a.
machine learning, use of statistical methods, large amounts of data.
b.
a process wherein patients are selected for clinical trials.
c.
"fishing" for information in data.
d.
cleaning data for further analysis using other methods.

ANS: A

Which characteristic is an advantage that practice-based evidence studies have over RCTs?

a.
Large sample sizes can be obtained easily.
b.
Multiple sites are typically enrolled, resulting in greater generalizability.
c.
Study efficacy is greater.
d.
Multiple variables can be studied.

ANS: C

Which is not a common step in a practice-based evidence study?

a.
Assemble a multidisciplinary project team
b.
Measure patient severity
c.
Obtain patient consent
d.
Collect data

ANS: C

Practice-based evidence studies differ from traditional observational designs in several main ways. What is one of those main differences?

a.
Exhaustive attention paid to patient characteristics
b.
Excluding clinicians in the study design to improve treatment efficacy
c.
Use of small sample sizes and specific patient sources/settings
d.
General, unstructured documentation of interventions

ANS: A

Which methods are examples of data mining? (Select all that apply.)

a.
Decision trees
b.
Stratified random sampling
c.
Bayesian networks
d.
Artificial neural networks
e.
Factor analysis

ANS: A, C, D

Practice-based evidence requires close partnering with informatics specialists to: (select all that apply)

a.
design screens and terms to capture interventions.
b.
create and maintain the databases required for PBE studies.
c.
upgrade EHR modules so all sites are on the same version of software.
d.
ensure all end users are trained.

ANS: A, B

In which aspects does practice-based evidence differ from evidence-based practice? (select all that apply)

a.
PBE incorporates patient choices in decision-making.
b.
EBP determines best practices using best evidence like results from RCTs.
c.
PBE includes family involvement.
d.
PBE is prospective, while EBP is retrospective.
e.
PBE attempts to capture the complexity and variability of actual clinical care.

ANS: B, D, E

Which description best defines the electronic health record (EHR)?

a.
An electronic version of the traditional paper record created and used by the healthcare provider
b.
An electronic stand-alone database implemented and used in hospitals
c.
An electronic version of a patient's medical record used in the clinical setting
d.
An electronic record of patient health information created by encounters across multiple settings

ANS: D

The Health Information Management Systems Society (HIMSS) developed an EMR adoption model that includes eight stages toward creating a paperless patient record environment. All application capabilities within each stage must be operational before the next stage can be achieved. Your organization has implemented systems for Stages 1 and 2. Which system should your organization consider as Stage 3 adoption?

Computerized provider order entry (CPOE) and clinical decision support
Nursing/clinical documentation (flow sheets) and clinical decision support
Closed loop medication administration
Physician-structured documentation and clinical decision support

B

Which system is recommended as a method to address patient safety and reduce errors that occur during the actual administration of medicines?

a.
Computerized provider order entry (CPOE)
b.
Bar code medication administration (BCMA)
c.
Electronic medication administration record (eMAR)
d.
Electronic prescribing (eprescribing)

ANS: B

Which would be considered a niche application?

a.
Computerized provider order entry (CPOE)
b.
Laboratory information system (LIS)
c.
Clinical decision support system (CDSS)
d.
Surgical information system (SIS)

ANS: D

A university hospital wants to implement a "closed-loop" medication management system. Current systems include registration, computerized provider order entry, electronic medication administration record, laboratory, radiology, and pharmacy. Which system is needed to complete the loop?

a.
Clinical documentation
b.
Clinical decision support system
c.
Bar-coding system
d.
Electronic prescribing

ANS: C

As the U.S. moves toward the implementation of an interoperable EHR, which statement about the future "ownership" of the patient record is appropriate?

a.
The electronic medical record will be the property of the service institution.
b.
Provider access to the electronic record would not require consumer consent.
c.
Ownership may be driven by who has control and access to the data.
d.
Consumers will control and own the record.

ANS: C

As EHR adoption expands to include data from multiple healthcare entities, more opportunities for error exist. Which process can affect data integrity?

a.
System failure
b.
Data analysis
c.
Data downloading
d.
Data mining

ANS: A

Which issues are considered impediments to a fully functional electronic health record (EHR) system? (Select all that apply.)

a.
Cost
b.
Standardization
c.
Care coordination
d.
Organizational culture
e.
Privacy and confidentiality
f.
Education

ANS: A, B, D, E

The core set of Stage 1 Meaningful Use objectives requires hospitals and providers to take which actions? (Select all that apply.)

a.
Use computerized provider order entry for medication orders
b.
Transmit prescriptions electronically
c.
Provide patients with discharge instructions or summary of office visit
d.
Record and chart changes in vital signs as structured data
e.
Maintain current problem and diagnoses list

ANS: A, B, C, E

The university hospital is getting ready to implement computerized provider order entry and some decision support capabilities to include drug-drug and drug-allergy alerts. Which actions should the implementation team take to increase user acceptance of the system? (Select all that apply.)

a.
Involve users early in the design, testing, and implementation of the system
b.
Conduct a quantitative research study to provide deeper insight into CPOE issues
c.
Design the new system to support communication and work flow
d.
Educate clinicians on how to use the system features
e.
Plan for continuous safety monitoring

ANS: A, C, D, E

The general attitude of consumers toward health information technology is positive. Which items are perceived EHR benefits for the consumer? (Select all that apply.)

a.
Collaborative interaction between patients and providers
b.
Security and privacy of personal information
c.
Timely access to personal health information
d.
Online access to educational materials
e.
Customize care through reminders

ANS: A, C, D, E

A financial information system (FIS) includes:

a.
accounts receivable management, accounts payable management, and fiscal reporting management.
b.
clinical systems management, accounts receivable management, and fiscal reporting management.
c.
accounts payable management, accounts receivable management, and clinical systems management.
d.
fiscal reporting management, accounts payable management, and clinical systems management.

ANS: A

Financial reporting is a vital part of decision making in healthcare organizations. Which report would be used to show a snapshot of the bottom line?

a.
Balance sheet or statement of financial position
b.
Cash flow statements
c.
Assets, liabilities, and equity
d.
Income statement or statement of operation

ANS: D

3. Return on investment (ROI) in financial information systems (FISs) is challenging because:

a.
patient accounting is considered an intangible asset.
b.
FISs systems are very complex.
c.
FISs often lose money due to complexity.
d.
staff requires substantial training, which is very costly.

ANS: A

The supply item master is:

a.
an electronic history of all transactions.
b.
an electronic pricing list of all supplies and services.
c.
a list of all items available to order in the organization.
d.
a list of vendors who supply items to the organization.

ANS: C

Business practices and information systems in the supply chain must:

a.
counterbalance each other to ensure safety.
b.
work together to best manage the system and support patient care.
c.
never work in tandem to minimize errors.
d.
only provide financial information for the organization.

ANS: B

A vendor master file is:

a.
a list of federally approved pharmaceutical companies.
b.
a list of suppliers used by the organization.
c.
a list of criteria for supplier compliance.
d.
a list of EHR vendors.
B

Open shift management:

a.
refers to a theory of peer-based leadership in which no single person is in charge.
b.
forecasts openings in the schedule using predictive models.
c.
refers to a form of scheduling expediency in which staff qualifications are not considered when making scheduling assignments.
d.
is a form of web-based self-scheduling.

ANS: D

When using the online billing and payment tool, which functions directly benefit the patient? (Select all that apply.)

a.
Self-management of open accounts
b.
Ability to pay outstanding balances
c.
Gives providers a dashboard to view critical clinical and financial information
d.
Secure communication on a 24/7 basis with the business office
e.
Ability to update address or demographic changes
f.
Automate the provider's day as much as possible

ANS: A, B, D, E

The supply chain in healthcare includes: (Select all that apply.)

a.
transportation of supplies.
b.
storage of supplies.
c.
management of supplies.
d.
prediction of supplies used.

ANS: A, B, C

Supply charge capture is a process that: (Select all that apply.)

a.
uses the CDM to charge a patient for supplies used in the patient's care.
b.
is a method to manage and inventory supplies.
c.
accounts for pharmaceutical supplies based on federal requirements.
d.
closely links the supply chain to the revenue management system.

ANS: A, D

Which item is an example of information we might find in an EHR's clinical data repository

a.
A physician's surgical schedule
b.
The list of medications available in a hospital's formulary
c.
The result of a patient's microbiology lab test
d.
Monthly billing charges for the radiology department

ANS: C

Which factor would strongly influence the reliability of an EHR's repository?

a.
Technical architecture, such as replication of the repository on standby servers
b.
Clinician training on EHR applications
c.
The coding system used for laboratory results
d.
The use of strong passwords

ANS: A

Which statement describes a repository with central storage of a longitudinal record?

a.
Patient data are from a single hospital's data for the most current encounters.
b.
Data from multiple hospitals are kept compact and efficient by deleting "old" data.
c.
Portions of a patient's lifetime medical record are stored in databases at the facility where the data were collected.
d.
The information collected by the organization is stored in a single database no matter when or where the patient was seen.

ANS: D

Which example best describes knowledge base content?

a.
Standard admission order sets based on presenting problems
b.
Patient contact information
c.
Organizational structure of a healthcare enterprise
d.
The most recent lab results for current inpatients

ANS: A

You are leading an effort to implement a clinical decision support system. In order to improve the patient specificity of your CDS rules, you would:

a.
make sure that rules cannot be changed once they are implemented.
b.
give the results of the rules directly to the patient.
c.
store rules in a knowledge base and allow clinician experts to review and update the rules.
d.
ensure that the rules were written in the most up-to-date programming language available.

ANS: C

For healthcare infrastructures with many communicating systems, an interface engine is helpful because

a.
it increases the administrative overhead with maintaining interfaces.
b.
it decreases the number of interfaces that must be maintained and lessens complexity.
c.
there is no other way to connect systems.
d.
government regulations require the use of an interface engine in healthcare settings.

ANS: B

A method for exchanging patient data between healthcare organizations that is endorsed by the federal government is:

a.
copying information to a secure USB drive and giving it to another organization.
b.
providing EHR log-in accounts to providers outside the organization.
c.
implementing a secure Internet connection using components of the Nationwide Health Information Network (NwHIN).
d.
The federal government does not endorse sharing health information between organizations.

ANS: C

Which is a significant challenge to technical infrastructures in healthcare environments?

a.
Implementing a data repository that will grow with changes in medicine and store a patient's lifetime health data
b.
Arranging data entry components properly in a documentation application to improve data collection efficiency
c.
Training clinicians to use EHRs effectively
d.
Agreeing on policies for sharing information between healthcare organizations

ANS: A

Which examples describe how clinical applications are tied to other components in the EHR infrastructure? (Select all that apply.)

a.
Searching and extracting data from the repository for reporting purposes
b.
Using the data dictionary to code assessment information with a documentation application
c.
Utilizing clinical decision support system rules to assist with appropriate lab test ordering
d.
Utilizing the master patient index to document vital signs
e.
Utilizing the financial system to determine patient insurance copays

ANS: A, B, C

Which functions are characteristic of a master person index? (Select all that apply.)

a.
Store the current and former names of a patient
b.
Store the most recent vital signs information for each patient
c.
Coordinate the various identifiers a patient uses, such as medical record number, insurance account number, and driver's license ID
d.
Provide a unique identifier for each patient that is used by components of the EHR to positively identify the patient

ANS: A, C, D

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