Domain IV – Info Technology (12%)

1. Domain IV – Info Technology (12%) RHIT Prep Workshop 2014

2. Info Technology Content Outline Task 1 Train Users on Software Healthcare/health information management computer applications and support systems Encoder/Grouper software Third party payers Intent: RHITs should know how to develop & implement staff training programs & provide consultation, education & training to internal users of HI (providers, administrators…).

3. Which of the following is often under-budgeted and considered one of the last tasks in an implementation plan but should be integrated as an ongoing part of the process? A. Contract review B. Clinical pathways development C. Training D. System performance checks

4. Info Technology Content OutlineTasks 2, 7, & 11 Maintain Database; (7) Create Database & 11) Design Data Archive/Backup Policies Health record data structure, content & stds Healthcare/health information management computer applications and support systems Healthcare delivery systems Confidentiality guidelines Federal regulations

5. Info Technology Content OutlineTasks 2, 7 & 11 (Cont’d) Intent: Use technology, including hardware & software, to ensure: data collection, storage, analysis, retrieval, & reporting of info and use common software apps in the execution of work processes (databases etc.). Additionally, create policies that protect data integrity (i.e., complete, accurate, consistent, current) using software and/or hardware technology (e.g. a policy for securely archiving all data).

6. Which database uses a two-level tree as its basic structure? • A. Hierarchical database • B. Network database • C. Object-oriented database • D. Relational database

7. Which database structure is constructed using tables that do not specify how to retrieve the required data or navigate through predefined paths? • A. Hierarchical database • B. Network database • C. Object-oriented database • D. Relational database

8. 4. Which of the following statements is the most accurate regarding EHR system security? • Purchasing a turnkey EHR from a reputable vendor and training anyone with legitimate access to the system how to do their job-specific functions meets the minimum HIPAA security requirements • B. Security relates to all aspects of an EHR from policies and procedures to the hardware and software that safeguard data and ensure system performance • C. Comprehensive policies and procedures that are well communicated and enforced can be implemented in such a manner that an EHR system doesn’t need to have any technical safeguards in place. • D. Security relates to the functionality and interaction of all hardware and software that is part of a robust EHR but the policies and procedures that govern use of the system fall under the privacy rather than the security rule.

9. Info Technology Content OutlineTASK 3, 5, & 8 3) Set up secure access; (5) Create user accounts; and (8) Perform end user audits A) Healthcare/health information management computer applications and support systems B) Confidentiality guidelines C) Analytical skills Intent: Apply confidentiality/security measures & departmental/organizational data/info system security policies for PHI and use/summarize audit trail data

10. Which of the following choices would be the best method of ensuring that data breaches are minimized on home computers of employees who code from home when those computers are unattended? • A. Cable locks • B. Encryption • C. Password protocols • D. Automatic session termination

11. Which of the following choices would be the best method of protecting laptop and network data from a virus introduced from an external device in home health nursing visits when the nurse uses a laptop connected to the agency’s network to key in home visit clinical notes? Personal firewall software Encryption Biometrics Password protocols

12. Info Technology Content OutlineTasks 4, 6 & 12 4) Evaluate the functionality of applications & 6) Trouble-shoot HIM software/support systems 12) Perform maintenance of software & systems Healthcare/health information management computer applications and support systems Forms/screen design, revision, implementation Transcription applications Encoder/grouper software Health information filing systems

13. Info Technology Content OutlineTasks 4, 6, & 12 (Cont’d) Intent: Coordinate, use, and maintain archival and retrieval systems for patient information including multiple formats including performing system maintenance such as backing up data

14. Which of the following is necessary to ensure that each term used in an EHR has the same meaning to all users? • Encoded vocabulary • B. Controlled vocabulary • C. Data exchange standards • D. Forms field standards

15. Questions on 4, 6, 12? • A. Daily review of the audit trails • B. User passwords are different for each application • C. A written contingency plan • D. Specified formats for user passwords

16. Info Technology Content OutlineTasks 9 & 10 9) Participate in vendor selection; and (10) Perform end-user analysis Healthcare/health information management computer applications and support systems Analytical skills Health record data structure, content, and standards Healthcare delivery systems

17. Info Technology Content OutlineTasks 9 & 10 (Cont’d) Intent: Use analytical skills; knowledge of HI systems and health records; and, quality improvement tools and techniques to assess, report, and improve processes. Use the same knowledge/skills to assess user needs and help with the vendor selection process and implementation of an EHR.

18. Which method of system testing ensures that each data element is captured correctly? Acceptance testing B. Integration testing C. General system testing D. Unit testing

19. In the following EHR entry, “chief complaint” is: Chief complaint: Stomach ache A. Reflection of original data B. Structured data C.Value D. Variable

20. Info Technology Content Outline TASK 13 13) Create data dictionaries Health record data structure, content and standards Vocabularies, terminologies and classification systems

21. Info Technology Content Outline TASK 13 (Cont’d) Know the definitions of: Databases (DB) and their structures/functions and Database Management Systems (DBMS) Flat file database structure Hierarchical database structure Network database structure Relational database structure Object-oriented database structure Object-relational database structure

22. Info Technology Content Outline TASK 13 (Cont’d) Database functions: Transactional database (also called operational) Analytical database (online analytical processing-OLAP) used for executive decision support, quality improvement and clinical decision support (CDS) Data Repository [a transactional database requiring data integration functions: data transformation, data cleansing, linkage (e.g. enterprise-wide master person index (EMPI)]

23. Info Technology Content Outline TASK 13 (Cont’d) Database Management Systems have been developed to assist in utilizing and structuring data. Data management includes data modeling, data dictionary maintenance, controlled vocabulary and coding system usage and knowledge representation. Data modeling defines data fields, records of which fields may be a part of or have any association or interdependence among records

24. Info Technology Content Outline TASK 13 (Cont’d) Database Management (Cont’d) Data dictionary (metadata repository/registry), captures the results of data modeling, which are data about the data in the data model for a given database or set of databases. Data about data is known as metadata. An international standard, ISO/IEC 11179, Information Technology, Metadata Registries (MDR) describes how a data dictionary should be maintained to organize metadata and make it useful across different databases.

25. Info Technology Content Outline TASK 13 (Cont’d) Database Management, Data Dictionary (Cont’d) AHIMA developed “Guidelines for Developing a Data Dictionary” and defined data dictionary as “a descriptive set of names (also called representations or displays), definitions, and attributes of data elements to be collected in an information system or database. The purpose is a means to standardize definitions and ensure consistency of use.” Data dictionaries are maintained in databases themselves.

26. Info Technology Content Outline TASK 13 (Cont’d) Database Management, Data Dictionary (Cont’d) Content of data dictionaries include names of entities, tables and major categories of data elements; descriptions of data attributes such as logical and physical name, synonym, definition, source of definition, source of data, format…, processing rules, relationships and keys or links.

27. Info Technology Content Outline TASK 13 (Cont’d) Vocabulary Standards/Terminology/Classif Know the following Definitions/Classification Systems Vocabulary, controlled vocabulary Terminology (CPT is a terminology used in medical billing). Controlled terminology types include: Application, Reference, & Administrative terminologies. Nomenclature (SNOMED-CT, developed by College of American Pathologists, is most common example)

28. Info Technology Content Outline TASK 13 (Cont’d) Vocabulary Standards/Terminology/Classif (Cont’d) Classification (a grouping of terms of similar meaning) example ICD. (Taxonomy is associated) Sometimes all of these terms are used interchangeably and in some instances, such as CPT, the grouping is both a terminology and a classification system or a nomenclature and a classification system.

29. Info Technology Content Outline TASK 13 (Cont’d) Developing and maintaining policies is part of this task also but cross-covered under other Domains in this review.

30. Which device below would be both an input and output device? A. Display screen B. Scanner C. Touch pad D. Speech recognition

31. Additional Domain IV Questions The remaining slides for Domain IV include sample questions from any of the Domain topics.

32. Given the Internet address: http://www.fhima.org what does the “www.fhima.org” represent? • A. The extension name • B. The server and domain name • C. The path name of the document • D. The file name

33. The HL7 messaging standard is the accepted protocol for communicating what type of data? • A. Administrative • B. Medical device • C. Clinical • D. Prescriptions

34. An initiative to help overcome the limitation that health data are textual and contextual is: A. Adoption of SNOMED B. Capability to reuse data C. Incorporation of narrative notes D. Providing links to definitions of terms

35. Which form of data entry may be able to produce structured data from narrative notes:A. Electronic document management systems • B. Natural language processing • C. Speech recognition • D. Templates

36. Under which step of the SDLC for acquiring an EHR does training super users fall? A. Initiation B. Planning C. Acquisition D. Implementation

37. Which of the following EHR functions help meet legal requirements to assure the accuracy of health records: A. Digitized signature B. Encryption logic C. Automated reminders pertaining to proper documentation D. Concurrent editing logic

38. A key strategy to gain user involvement in an EHR is: A. Assign as many users as possible to committees B. Avoid discussing the EHR with users until close to go-live C. Communicate with users frequently to educate and alleviate concerns D. Require each user to take a course in the EHR being implemented from the vendor

39. In the EHR adoption process, which tool helps an organization determine the timeline for its migration to an EHR? A. Assessment of industry experience B. Organizational strategic plan C. User readiness assessment D. Vendor implementation plan

40. The first step a medical practice should take in order to determine it has the necessary infrastructure to support an EHR is: A. Perform a comparative analysis of two known EHR vendors B. Conduct a functional needs assessment C. Conduct an analysis of data requirements D. Perform a technology assessment

41. Which of the following is an NCVHS core terminology? A. ICD-10-CM B. ICD-9-CM C. SNOMED CT D. HCPCS

42. Which is used to capture the results of data modeling? A. Data dictionary B. Entity-relationship model C. Object-oriented model D. Data warehouse

43. In order to view diagnostic images at the medical grade level, the user needs: A. Dual monitors B. High resolution screens C. Large screens D. Special 3-D monitors

44. Once the vendor selection process has narrowed the selection down to the top few, the key factor in making the final decision about which vendor to use is: A. Ability to customize to meet your current workflows and processes B. How easy the system is for new users to use C. How well the product will meet the organization’s goals D. Price and contract terms

45. Which of the following functions is more commonly included in an ambulatory EHR than in and EHR designed for hospitals? A. Charge capture B. Computer Assisted E&M Coding C. Patient instruction D. All of the above

46. The Continuity of Care Document (CCD) is a combination of: A. CCR and CDA B EHR and PHR C. HIE and PHR D. EMR and EHR

47. Any Questions????