CPHIMS exam 1 2023 with verified questions and answers

A universal goal to improve patient safety is the use of surgical pause. This is one of the main goals of The Joint Commission International Center for Patient Safety. When setting up relational databases, the primary key refers to a field or set of fields that uniquely identifies each record stored in the table. Technology assessment within a project is used to: consider the effect of technology when it is introduced, extended, or modified. MUMPS or M traditional database model of healthcare (similar to NoSQL) - hierarchical database MUMPS advantage Elastic horizontal scaling across multiple low-cost commodity servers. Designed to support Big Data quantities of data beyond the capabilities of RDBMS with extremely high performance. Extremely simple to administer requiring essentially no DBAs. Very low cost resulting from commodity hardware and open source code. Flexible data modeling able to easily duplicate the features of RDBMS, key value, columnar, document, and graph architectures. Readily supports advanced analytics and BI with SQL. Full ACID for OLTP Object-oriented databases An object-oriented database management system (OODBMS) provides a fast way to access images and sound information and can understand multiple programming languages. hypermedia databases access to objects, video and audio files. distributed database allows for space to be added so the database can grow and remain working if one of its contributing databases stops working master patient index (MPI) identify the patient's records with numbers that all people who access the database use Evidence-based medicine, or EBM a collaborative database of conclusions based on patient cases that can be used as a source for healthcare providers. Systems related to healthcare are divided into 3 groups, which are? mechanical systems, human systems, and man-machine systems Mechanical systems systems necessary for a healthcare organization to function mechanically, including the capability of maintaining the physical environments of the organization human system system relating to people, including patients and physicians and their relationships. Man-machine systems systems that are used to aid a person in the healthcare process. Define a healthcare system 1. A system is something that has oneness and can be described based on its unique characteristics. A system will be its own entity and elicit a precise description. 2. A system contains interwoven parts that are numerous and rely on each other for the system to function. A healthcare system will have many levels and each level can be broken down into smaller levels. 3. A system will change when necessary and resist deterioration when system upgrades are necessary. 4. A system must be able to react to defined situations and to situations that are not defined. It must be adaptable to human needs. 5. The system must be able to receive information, process the information and provide a response to the information. 6. The system has to be able to adjust itself to the response or output it provides, a process that is referred to as feedback. 7. An open system can be affected by external sources while a closed system is self-contained and cannot be affected by outside sources. Health maintenance organizations (HMOs) physicians that see patients within a specific insurance plan for a prearranged price set between the insurance company and HMO preferred provider organization (PPO) physician who provides medical services for a lower cost to a predefined group of people What type of software is used in the healthcare industry to evaluate costs and track patient care? Spreadsheets What software is used to analyze input from user by applying statistical methods to the data? Statistical software What software is used to allow users to create access and manipulate variety of databases, or collection of information? Database management software What software is used to create image of information that needs to be analyzed so users can experiment with the data without changing the original data? Simulation software Mobile computing type of technology that can be used to access and manipulate data away from an internet connection. A laptop or other mobile device is used, but the information the user needs to access must be transferred to the mobile computer from the main computer before the information can be altered. Electronic data interchange, or EDI information sent back and forth between terminals without a person involved in the exchange Terminal-Host System centralized system that uses a main computer to process information and perform all computing tasks. What is the most common way in which the healthcare industry protects private information? Password clinical data repository (CDR) The healthcare industry uses a clinical data repository (CDR) to maintain patient's records. These records include when they seek healthcare, their financial status with the medical facility, the conclusion of tests performed on the patient, and surgical procedures pertaining to the heart. The four reasons why a healthcare organization should develop strategies regarding the use of information technology 1. ensure the information technology is best used to meet an organization's standards 2. make sure the computer systems are being used at their optimum value 3. manipulate the computer systems technologically to meet the unique goals of the organization 4. determine how much money will be spent on the computer systems Passive CDSS systems organize the information in a functional and orderly fashion so the doctor can easily analyze the patient's information active CDSS known medical information is stored in the active CDSS so the computer can analyze patient's problems and apply known medical treatments to give the doctor some suggestions for how best to treat the patient What is the primary reason that healthcare organizations use financial information system? Government regulations. Financial information systems are important to the healthcare industry because the industry is subject to government oversight and there are many providers offering the same type of services, which creates a competitive environment. Financial information systems have the ability to track costs and produce reports so management can make sound financial decisions What is the purpose of executive information systems? Ensure proper functioning of a healthcare organization, monitor how all areas of an organization are functioning and provides upper management a way to retrieve the data as a whole or in smaller pieces to be analyzed Human resources information systems indicate how the employees are functioning, including the rate at which they are leaving the company or getting terminated, and the level of happiness they have with their jobs. Computerized resource utilization systems minimize costs and ensure that resources are used accurately and efficiently Scheduling systems having healthcare providers with time to perform procedures and visit patients. managed care When a group of doctors or practices provide medical care to a set of defined people Exclusive provider arrangements (EPAs) a company pays a specific physician to provide medical services to all of their employees without the use of an insurance company A decision-support system (DSS) contains: user interface, model manager, model library, database, database-management system, and a report writer. Data is input through the user interface. A model manager accesses information that has been created to evaluate a problem. The model library contains the various models used to analyze a problem including the use of math, visual displays, and financial models that determine possible outcomes. The DSS gets information from a database which is usually a relational database. The database management system oversees and guides the communication between the user and the database. The outcomes of using the DSS are provided to the user through the report writer. model manager accesses information that has been created to evaluate a problem model library contains the various models used to analyze a problem including the use of math, visual displays, and financial models that determine possible outcomes. Expert systems a type of DSS system that can have authority over and make decisions about areas needing support in the healthcare field. The expert system has several parts including a section with known information, a section that holds information called a database and a section that applies rules to determine possible outcomes. Government hospitals research based and partner with schools or are designed to meet some need within the general public. healthcare organizations (HCOs) Many banded together in a central location with other providers offering different medical services. Centrally locating physicians means they can share expenses and work together to create cost-saving strategies. HCOs are convenient to patients, acting as a one-stop shop for medical services. Some diversity exists in the success of HCOs because their success largely depends on variables such as the type of customers within the population they service and the HCO's location. What type of organization ensures that financial transactions are completed fairly for both the insured and the company paying for benefits? Quality Improvement Organization prospective payment system (PPS) determine a fee that would be paid per sickness, referred to as a diagnosis related group (DRG) by Medicare for patients entering the hospital. Doctor's fees were determined by the relative value scale. Insurance companies followed suit and set limits on their payments. continuous quality improvement (CQI) customer service must constantly be monitored and made better governing board A group of people oversee the entire HCO. Governing boards are necessary to ensure everyone contributing to the HCO is working together effectively so goals created by the board for the HCO are achieved. The governing board acts as a liaison between the HCO and everyone contributing to it. The overall purpose of board members is to make the most money possible for the owners of the HCO and they are measured by how much money they can make for the organization. HCO operation balanced scorecard 1. Demand for services (# visits, # patients) 2. Resources (# physical units, #employees, #equipment, #inventory) 3. Outputs (#production) 4. Quality of care subsidiary board Separate governing board in each healthcare center under HCO cybernetic system detect areas that are not in compliance with expected results and make necessary changes to regain compliance Epidemiologic planning model In order to determine how many people within the population surrounding an HCO will need to use its facilities for inpatient or outpatient care The mesh model one person, who is the supervisor, has communication over many different channels, and the various departments have unique organizational goals that may be different from the main organization's goals. The mesh system leads to the creation of groups within the organization called service lines. Service lines reflect the needs of their specific patients rather than a generic goal prevention of illnesses When a shot is given to stop a person from getting sick or any action is taken to avoid an illness, primary prevention is applied. Once an illness has already been established in a patient, secondary prevention is used to lower the negative effects caused by the disease. In order to stop a sickness from happening again or to avoid unnecessary side effects of the disease, tertiary prevention techniques are followed. What is the purpose of applying a decision model when diagnosing a patient's illness? To ensure that the physical and monetary price of a procedure is necessary for proper treatment decision model determining the best medical course of treatment, the patient can feel secure that whatever treatment is used will be beneficial and necessary. Many times there is more than one way to treat an illness, but applying the decision model assures that the best treatment is chosen. Applying a decision model in the beginning will avoid unnecessary time being wasted on incorrect treatments. Clinical expectations standards for what resources will be required in completion of a medical procedure or patient care. These standards are set and accepted by the medical profession as a whole so patients, insurance providers, and physicians all know in advance what they will need to complete a patient's treatment patient management protocols Protocols that are established by profession and accepted by a healthcare organization The goal of the HCO not to see people in the community for preventable illnesses. By using a decision theory model, the HCO weighs the price of care for an illness against the expenses used to help the person avoid the illness. The HCO looks for ways to provide the community with services to prevent illnesses that make the most financial sense to the organization and that can affect the largest number of people-- a process known as optimization of preventive activity. Privileging Doctors are evaluated based on a system called privileging. The goal of privileging and credentialing is to ensure physicians are qualified to provide medical care How does HCO determine the number of physicians required? conceptual planning model: #ppl with medical x #total illness / #illness prev year physician recruitment plan estimate how many people will need specific types of care, how many and how much care their current physicians will provide, and what specialty physicians will be needed to provide patient care What is the purpose of the Behavioral Risk Factor Surveillance Survey? The Behavioral Risk Factor Surveillance Survey can be accessed to find out state-wide healthcare information which the HCO can use to compare itself against transaction accounting locating and tracking any financial dealing that has bearing upon the HCO Ombudsman act as an intermediary to represent the employee in front of the necessary parties. The goal is to diffuse the situation transformational management help employees get better through training and encouragement, rather than through discipline and reprimand Which type of marketing strategy helps a HCO determine areas that are in need of change Formal surveys What is the most important element for providing quality clinical services? Proper training of clinical support services employees Interrelations between HCO 1. Enable access to comprehensive care services 2. Assuring effective transfers of care 3. Ensuring the general portability of care 4. Reporting public and population health information 5. Obtaining appropriate reimbursement for quality care 6. Supporting particular organization model of care Integrated Delivery System (IDS) A system that combines the financial and clinical aspects of healthcare and uses a group of healthcare providers, selected on the basis of quality and cost management criteria, to furnish comprehensive health services across the continuum of care Among the multiple types of hospital ownership, which is not a common model? A. Public (government) owned and managed B. Private, not for profit (nonprofit) C. Physician owned D. Private, for profit Physician owned In considering the purpose for interrelationships among healthcare organizations, identify the purpose below that is correct: Ensure effective transfers of care facilitated by the provision of essential health information An example of the secondary use of a patient's health information would be when the information is shared With public health officials for statistical reporting or in support of clinical research Key information technology and information management professionals in healthcare organizations include the Chief information officer (CIO), chief security officer (CSO), and chief medical information officer (CMIO) When defining problems and opportunities, major areas of change can occur in the following areas: Clinical, administrative, financial, and application Sustainable controls for IT implementation can result in A. Uncontrolled security B. Serving minimum purpose possible C. Determining what is practical for local area implementation and testing D. Satisfying integration with policy regulations C. Determining what is practical for local area implementation and testing When performing cost-benefit analysis, important variables to be considered include A. Sustainability versus total costs per month B. Time and cost of implementation C. Impact on internal parties D. Process mappin B. Time and cost of implementation The benefits of developing proposals in support of integrating healthcare practices can include A. Secure information sharing B. Minimal communication between various localized care providers C. Stand-alone architectures for various equipment and software applications D. Enhanced efficiency in the communication flow A. Secure information sharing When presenting your analysis to your executive leadership, key elements may include A. Possible changes in the project implementation that can be driven by changes in technology standards B. Requirements that may change, affecting the strategic capability of the proposal C. Sensitivity to challenges or changes in the internal environment that may rely on the establishment of a support team within the organization D. Expectations that the implementation of analysis and subsequent proposals will rely on the presence of standard operational processes in the internal environment A. Possible changes in the project implementation that can be driven by changes in technology standards When managing projects and resources, it is important to have a work plan that A. Is aimed at establishing a generic implementation setup for a project B. Includes equipment costs C. Plans the intended workflow processes by managing personnel D. Analyzes processes and evaluates outcomes D. Analyzes processes and evaluates outcomes Promotion and application of system analysis can include A. Evaluating past operational situations in an average healthcare facility B. Identifying the minor problems in processes with respect to optimization of IT use C. Identifying primary solutions to problems through the implementation of IT policies D. Evaluating alternative solutions' alignment with the specific objectives set out in the plan D. Evaluating alternative solutions' alignment with the specific objectives set out in the plan What are possible characteristics that you may encounter when analyzing future healthcare IT trends? A. Integration of possible entities within an organization in preparation for standardization B. Alignment with emerging trends on the local IT platform C. Loss of a low volume of business due to nonalignment of health sector players D. Importance of implementing an operational work plan to align the healthcare sector with current IT trends A. Integration of possible entities within an organization in preparation for standardization All of the following are parts of a request for information (RFI) except A. Background B. Submittal information C. Cost requirements D. Introduction C. Cost requirements Detailed technical specifications address all of the following except A. System monitoring B. Programming language C. Security and data encryption D. Government regulations B. Programming language Functional requirements could include the following: A. Printers B. Workflow redesign C. Backup and recovery plans D. System documentation B. Workflow redesign Which is a characteristic of a request for proposal? A collection of documents with detailed requirements Implementation execution includes the following: A. Definition of the team's roles and responsibilities B. Decision on implementation strategy C. Planning for how to manage organizational changes D. System configuration or build D. System configuration or build The implementation strategy in which all functionality is implemented in one location followed by everywhere else is called Pilot End-user training should be completed at what point in the implementation? Right before the activation After the system is live, which of these should be measured and evaluated? A. System usability B. Duration of the implementation C. Quantity of printers D. Number of vendors responding to the request for proposal (RFP) A. System usability The fundamental purpose of information systems testing is To manage risks of developing, producing, operating, and sustaining systems manual test tool Test script Testing performed to validate successful system implementation is called Acceptance testing System controls are implemented to protect the confidentiality, integrity, and _________ of data during testing Availability Test reporting occurs throughout the testing process and, at a minimum, should address The mission of the test The AAA, or triple-A, approach deals with which area? User access controls The company's statement that defines where it wants to go or what it wants to be is known as the Vision statement A control chart typically contains each of the following 1. Upper control limit 2. Mean 3. Lower control limit SBARC includes situation, background, assessment, recommendation, and communication Each of the following is a recommended initial assessment tool except A. Face-to-face interviews B. Web surveys C. Unit or departmental meetings D. Focus group meetings B. Web surveys An IT steering committee An advisory committee made up of high-level stakeholders or experts who provide guidance on key issues such as company policy and objectives, budgetary control, marketing strategy, resource allocation, and decisions involving large expenditures An important step to avoid when managing budgets is to Negotiate a good budget at the close of the budget cycle Accountable Care Organization (ACO) An organization of healthcare providers accountable for the quality, cost, and overall care of Medicare beneficiaries who are assigned and enrolled in the traditional fee-for-service program to ensure that patients get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors. When an ACO succeeds both in delivering high-quality care and spending health care dollars more wisely, the ACO will share in the savings it achieves for the Medicare program. Chief Security Officer (CSO) secure the healthcare organization's computing and communications assets from either intentional or unintentional security breaches from inside or outside the organization. Chief Technology Officer (CTO) technical architecture of the IT systems supporting the organization and often looks toward the developing market in HIM and IT to try and keep the organization competitive from a technology perspective (mobile computing platforms, cloud based computing, and state-of-the-art clinical applications) Clinical Informatics the scientific discipline that seeks to enhance human health by implementing novel information technology, computer science and knowledge management methodologies to prevent disease, deliver more efficient and safer patient care, increase the effectiveness of translational research, and improve biomedical knowledge access Accreditation organization (AO) serve on behalf of federal organizations to ensure specific standards or conditions of participation (CoP) are met Billing system Systems have to handle charge posting via both orders and manual charge entry, payment posting, and billing based on the providers. Insurance, coinsurance, and deductibles have to be part of the calculations, as do revenue codes, supplies, tests, and medications General Ledger A general ledger must accurately track charges, bills, and payments Interoperability the extent to which systems and devices can exchange data and interpret that shared data Clinical and Business Intelligence Committee technologies, applications and practices for the collection, integration, analysis, and presentation of clinical information, for the purpose of better clinical decision-making. In recent times, quality in healthcare is being shaped by evidence-based medicine and the proper utilization of data Automated dispensing machines (ADMs) aid in drug dispensing electronic materials management (EMM) manage information processing regarding pharmaceuticals, new drug development, and coding, among other functions Healthcare industry's priority 1. Patient safety and security 2. Standardization 3. Ease of process 4. Profitability Individual facilities' priorities 1. Patient safety and security 2. Profitability 3. Ease of process 4. Standardization Usability model Phase 1: Unrecognized Phase 2: Preliminary Phase 3: Implemented Phase 4: Integrated Phase 5: Strategic Lean production an approach to production that emphasizes the elimination of waste in all aspects of production processes Six Sigma A business process for improving quality, reducing costs, and increasing customer satisfaction DMAIC Define, measure, analyze, improve, and control: emphasizes the various phases of the Six Sigma methodology. Request for Information (RFI) A request sent to software vendors containing a high level description of the information system an organization needs, so that vendors can describe their products that may fit (introduction, background, requirement, submittal information) - May or may not include budget or cost information Request for Proposal (RFP) A type of procurement document used to request proposals from prospective sellers of products or services (information of request - technical evaluation selection process , requested service/function, deployment & development schedule, training/warranty, service fee, reference) Always includes timelines and budget or cost information Big bang Going live with all functionality to be implemented in all locations at the same time Phased by location Going live with all functionality to be implemented in one location at a time. Phased by functionality Going live in all locations with one feature at a time Pilot Going live initially with one location as a pilot test, and then following with everyone else in a phased big-bang process Like for like Going live with the same functionality that was in place prior to the project test methodology 1.Define the test strategy 2.Develop testing tools 3.Test execution 4.Employ test controls 5.Test reporting 6.Final evaluation White Box Testing Testing based on an analysis of the internal structure of the component or system. the tester is not concerned with what the system is supposed to do, but rather with how the system is supposed to operate on an internal level Black-box testing A testing approach that focuses on the functionality of the application or product and does not require knowledge of the code intervals. the tester is only aware of what the system or application is supposed to do and has no knowledge of the internal operations of the system. gray-box testing which is a combination of white-box and black-box testing approaches; the tester has some knowledge of internal structures and also understands the expected system functionalities. Gray-box testing is most useful when performing tests on existing systems levels of testing unit-level testing, integration testing, and system testing testing objective stress, acceptance, operational testing, and regression testing Unit testing test individual units or pieces of code for a system by developers and white-box testers Integration testing verify that separate systems can work together passing data back and forth correctly by gray-box testing best System testing Testing the entire system as one entity to ensure that it is working properly with its specified requirements by black-box testers stress testing determine the stability of a given system in conditions of insufficient computational resources (such as memory or disk space), unusually high concurrency, or denial-of-service attacks. Acceptance testing The process whereby actual users test a completed information system, the end result of which is the users' acceptance of it. Regression Testing Testing of a previously tested program following modification to ensure that defects have not been introduced or uncovered in unchanged areas of the software, as a result of the changes made. It is performed when the software or its environment is changed. Version control A process to keep track of what changes were made to what files so that a specific version can be referred to and improvements in multiple versions can be merged together. Security audits manual or automatic systematic, measurable technical assessments of a system or application Change control Maintaining full control over requests, implementation, traceability, and proper documentation of changes. mission statement of why the organization exists—its purpose statement Vision the company statement that defines where it wants to go or what it wants to be. Quality of Service (QoS) control chart Upper Control Limit, Lower Control Limit, Goal stretch goals performance targets that we have to work extra hard and stretch to reach Scope Creep The uncontrolled expansion to product or project scope without adjustments to time, cost, and resources. 360-degree method of performance appraisal other individuals are asked to rate the employee on specific criteria project portfolio management (PPM) centralized management of processes, methods, and technologies used by project managers (PMs) and project management offices (PMOs) to analyze and collectively manage a group of current or proposed projects based on numerous key characteristics Project management has the following phases: 1. Initiating phase 2. Planning phase 3. Executing phase 4. Monitoring and controlling phase 5. Closing phase knowledge management areas of PM 1. Project scope management 2. Project time management 3. Project cost management 4. Project human resource management 5. Project procurement management 6. Project risk management 7. Project quality management 8. Project integration management 9. Project communications management vendor management three common pitfalls 1. manage the vendor relationship during and after the selection and contracting phases 2. do not select a vendor based on price alone. 3. do not forget to evaluate how your vendor relationships affect your business 10 vendor management principles 1. Use project management methodology 2. Understand vendor management is multifaceted 3. Be aware of the contract details 4. Formal documentation is key 5. Contract complexity should be consistent with project risk 6. Include all important deliverables in the contract 7. Management commitment is key 8. Focus on benefiting both the customer and the vendor 9. Clarify contractual terms and expectations 10. Ensure vendor and customer roles and responsibilities are clear