Chapter 16
Question 1
What is a private, secure application through which an individual may access, manage, and
share his or her health information?
1. Personal health record
2. Clinical data network
3. Best practice model
4. Online scheduling database
Correct Answer: 1
Rationale 1:
A personal health record (PHR) is an electronic system that allows people to record, access,
and share health-related information in order to help them better manage their health and
health care.
Rationale 2:
A personal health record is a private, secure application through which an individual may
access, manage, and share his or her health information.
Rationale 3:
A personal health record is a private, secure application through which an individual may
access, manage, and share his or her health information.
Rationale 4:
A personal health record is a private, secure application through which an individual may
access, manage, and share his or her health information.
Question 2
Which of the following is considered a core personal health record element?
1. Data accessed by IT
2. Analysis of data
3. Applicability of data
4. Information inputted by the patient
Correct Answer: 4
Rationale 1:
Some believe PHRs should only refer to data that are accessible to the patient and that come
from a provider or health system electronic health record (EHR), i.e.--data generated by
clinicians or other staff. Others feel information created and inputted by the patient is a core
PHR element.
Rationale 2:
Some believe PHRs should only refer to data that are accessible to the patient and that come
from a provider or health system electronic health record (EHR), i.e.--data generated by
clinicians or other staff. Others feel information created and inputted by the patient is a core
PHR element.
Rationale 3:
Some believe PHRs should only refer to data that are accessible to the patient and that come
from a provider or health system electronic health record (EHR), i.e.--data generated by
clinicians or other staff. Others feel information created and inputted by the patient is a core
PHR element.
Rationale 4:
Some believe PHRs should only refer to data that are accessible to the patient and that come
from a provider or health system electronic health record (EHR), i.e.--data generated by
clinicians or other staff. Others feel information created and inputted by the patient is a core
PHR element.
Question 3
Markle’s Common Framework offers valuable guidance for the development and deployment
of patient-centered PHRs. The Framework identifies seven attributes of an ideal PHR. Which
of the following are considered attributes of the Common Framework?
1. PHRs permit easy exchange of information across health care systems.
2. PHRs contain information from one’s entire lifetime.
3. PHRs contain information from all health care providers.
4. PHRs are accessible from any place at any time.
5. PHRs are private and secure.
Correct Answer: 1, 2, 3, 4, 5
Rationale 1:
The Common Framework emphasizes the importance of PHRs permitting the easy exchange
of information across different health care systems. This attribute ensures that relevant health
information can be shared seamlessly, enhancing continuity of care.
Rationale 2:
An attribute of the Common Framework is that PHRs contain information from one's entire
lifetime. This aspect ensures that comprehensive health records are maintained, providing a
longitudinal view of an individual's health history.
Rationale 3:
PHRs within the Common Framework are expected to contain information from all health
care providers. This attribute ensures that relevant health information from various sources is
aggregated into a single record, promoting comprehensive and coordinated care.
Rationale 4:
The Common Framework advocates for PHRs to be accessible from any place at any time.
This attribute emphasizes the importance of ensuring that individuals can access their health
records conveniently, which is essential for empowering patients and facilitating timely
decision-making.
Rationale 5:
Privacy and security are critical attributes of the Common Framework. PHRs are expected to
be private and secure, ensuring that individuals' health information is protected from
unauthorized access or disclosure. This attribute is essential for fostering trust in PHR
systems and encouraging individuals to actively engage in managing their health information.
Question 4
The PHR is considered a ________________________ lifetime health record.
Correct Answer: consumer-centric
Rationale:
The PHR is a consumer-centric, lifetime health record. Early forms were entirely paperbased. Recent developments make the PHR available via Internet connections
Question 5
Which of the following are characteristics of stand-alone PHRs?
1. Patient accessible information is tethered to data in a specific health system’s EHR.
2. Some fully standalone applications are available commercially.
3. The PHR is not tied to any particular health care system.
4. Some fully standalone applications are available in formats such as smart card, CD, or
flash drive.
5. Standalone PHRs such as those on thumb drive devices have been found to have
significant security risks.
Correct Answer: 2,3,4,5
Rationale 1:
Standalone systems are not tied to another health care system. Some fully standalone
applications are available commercially through the Internet or other formats such as smart
card, CD, or flash drive. These tools rely on an individual or caregiver to enter their own
health information. Standalone PHRs such as those on thumb drive devices have been found
to have significant security risks
Rationale 2:
Standalone systems are not tied to another health care system. Some fully standalone
applications are available commercially through the Internet or other formats such as smart
card, CD, or flash drive. These tools rely on an individual or caregiver to enter their own
health information. Standalone PHRs such as those on thumb drive devices have been found
to have significant security risks.
Rationale 3:
Standalone systems are not tied to another health care system. Some fully standalone
applications are available commercially through the Internet or other formats such as smart
card, CD, or flash drive. These tools rely on an individual or caregiver to enter their own
health information. Standalone PHRs such as those on thumb drive devices have been found
to have significant security risks.
Rationale 4:
Standalone systems are not tied to another health care system. Some fully standalone
applications are available commercially through the Internet or other formats such as smart
card, CD, or flash drive. These tools rely on an individual or caregiver to enter their own
health information. Standalone PHRs such as those on thumb drive devices have been found
to have significant security risks.
Rationale 5:
Standalone systems are not tied to another health care system. Some fully standalone
applications are available commercially through the Internet or other formats such as smart
card, CD, or flash drive. These tools rely on an individual or caregiver to enter their own
health information. Standalone PHRs such as those on thumb drive devices have been found
to have significant security risks.
Question 6
Which of the following best defines a tethered PHR?
1. A tethered PHR is inextricably linked to a single entity or health system.
2. A tethered system is a stand alone system.
3. A tethered system can be found on a thumb drive.
4. A tethered system cannot access a patient portal.
Correct Answer: 1
Rationale 1:
A tethered PHR is inextricably linked to a single entity or health system. Through a secure
connection, select elements of the EHR can be accessed such as medication lists, test results,
visit history and after-visit summaries. Additional functionality may be provided with a
tethered PHR, such as online medication refills or secure messaging with a provider or health
care team. In essence, these tools are the patient-facing component of the EHR.
Rationale 2:
Through a secure connection, select elements of the EHR can be accessed such as medication
lists, test results, visit history and after-visit summaries. Additional functionality may be
provided with a tethered PHR, such as online medication refills or secure messaging with a
provider or health care team. In essence, these tools are the patient-facing component of the
EHR.
Rationale 3:
A tethered PHR is inextricably linked to a single entity or health system. Through a secure
connection, select elements of the EHR can be accessed such as medication lists, test results,
visit history and after-visit summaries. Additional functionality may be provided with a
tethered PHR, such as online medication refills or secure messaging with a provider or health
care team. In essence, these tools are the patient-facing component of the EHR. A stand alone
PHR can be found on a thumb drive.
Rationale 4:
A tethered PHR is inextricably linked to a single entity or health system. Through a secure
connection, select elements of the EHR can be accessed such as medication lists, test results,
visit history and after-visit summaries. Additional functionality may be provided with a
tethered PHR, such as online medication refills or secure messaging with a provider or health
care team. In essence, these tools are the patient-facing component of the EHR. Access can be
provided through a patient portal, ideally offering patients a longitudinal view of their record.
Question 7
________________________ PHRs are extensions of physicians' offices.
Correct Answer: Integrated
Rationale:
Integrated PHRs are extensions of physicians' offices. The health care provider determines
how much data and communication consumers can access from their PHR. Conversely, a
stand-alone PHR can immediately access health data from a site like Google Health. The
patient must input and maintain their own personal data.
Question 8
Which of the following functionalities can be found within the personal health record (PHR)?
1. Entering medical history
2. Entering allergies
3. Entering present medication alerts
4. Entering past social history
5. Entering family history
Correct Answer: 1, 2, 3, 4, 5
Rationale 1:
PHRs typically include the functionality to enter and maintain a comprehensive medical
history, including past diagnoses, surgeries, and treatments. This information helps healthcare
providers gain a holistic understanding of the individual's health status.
Rationale 2:
Entering allergies into a PHR is a common functionality. Allergy information is crucial for
healthcare providers to avoid adverse reactions when prescribing medications or treatments.
Rationale 3:
PHRs often allow individuals to enter present medication alerts, such as reminders for
medication doses or potential interactions between medications. This functionality helps
individuals manage their medication regimens effectively.
Rationale 4:
PHRs may include the functionality to enter past social history, including factors such as
tobacco or alcohol use, occupation, and living environment. This information can provide
valuable context for understanding an individual's health risks and needs.
Rationale 5:
Family history functionality is commonly found in PHRs, enabling individuals to document
and track familial health conditions and genetic predispositions. This information is essential
for assessing an individual's risk of inherited diseases and guiding preventive care measures.
Question 9
Some functionalities require integration between the PHR and a scheduling application.
Which of the following is a benefit of this communication?
1. Integration between a scheduling application and the PHR allows the patient to locate a
physician's practice in a new region.
2. Integration between a scheduling application and the PHR allows the patient to have
instant access with a health care provider's staff.
3. Integration between a scheduling application and the PHR allows the patient to schedule an
appointment without making a telephone call.
4. Integration between a scheduling application and the PHR allows the patient to send notes
and updates to the health care provider's office.
Correct Answer: 3
Rationale 1:
Integration between a scheduling application and the PHR allows the patient the ability to
request an appointment or confirm a specific appointment. Similar to selecting a seat on an
airline flight, a patient is shown available slots for the visit (or care type--e.g. eye exam) and
clicks on a desired time.
Rationale 2:
Integration between a scheduling application and the PHR allows the patient the ability to
request an appointment or confirm a specific appointment. Similar to selecting a seat on an
airline flight, a patient is shown available slots for the visit (or care type--e.g. eye exam) and
clicks on a desired time.
Rationale 3:
Integration between a scheduling application and the PHR allows the patient the ability to
request an appointment or confirm a specific appointment. Similar to selecting a seat on an
airline flight, a patient is shown available slots for the visit (or care type--e.g. eye exam) and
clicks on a desired time.
Rationale 4:
Integration between a scheduling application and the PHR allows the patient the ability to
request an appointment or confirm a specific appointment. Similar to selecting a seat on an
airline flight, a patient is shown available slots for the visit (or care type--e.g. eye exam) and
clicks on a desired time.
Question 10
In its simplest form, the PHR is a stand alone system where the _______________enters data.
Correct Answer: patient
Rationale:
In its simplest form, the PHR is a stand alone system where the patient enters his or her own
data. On the other hand, PHR functionality can be provided by allowing patients to view their
own health information that is stored in their health care provider's EHR. There are
commercially available PHRs ranging from stand-alone systems to Web-based applications.
Question 11
PHRs and their functions are becoming more important in health care delivery systems. There
are a multitude of benefits associated with the PHR. Which of the following is not a potential
benefit associated with the PHR and laboratory tests?
1. May confuse and worry patients
2. Avoids letters and phone calls
3. Reduces patient waiting time
4. All data are confidential
Correct Answer: 1
Rationale 1:
Patients who obtain the results of tests and do not know how to interpret the results may
become anxious until they are able to speak to their health care provider for the actual
analysis.
Rationale 2:
Avoiding phone calls and letters is considered a benefit.
Rationale 3:
Decreasing waiting time is considered a benefit.
Rationale 4:
Sensitive lab or test information must be discussed in person or on the telephone.
Question 12
PHRs can enhance a healthcare provider's clinical practice in a number of ways. Which of the
following are associated with the benefits of the PHR and medication management?
1. Allows patients to check and improve quality of medication list (medication reconciliation)
2. Encourages discussion with doctor to improve adherence
3. Patient can share medication information with other providers
4. Health care provider can access information on prescription refills
5. Allows the healthcare provider and patient immediate communication with the pharmacy
Correct Answer: 1, 2, 3, 4, 5
Rationale 1:
PHRs enable patients to check and improve the quality of their medication list through a
process called medication reconciliation. By reviewing and updating their medication list in
the PHR, patients can ensure accuracy and completeness, which is crucial for safe and
effective medication management.
Rationale 2:
The availability of medication information in a PHR encourages discussions between patients
and their healthcare providers to improve medication adherence. Healthcare providers can
review medication records with patients, discuss treatment plans, address concerns, and
provide education to promote better adherence to prescribed regimens.
Rationale 3:
PHRs allow patients to share medication information with other healthcare providers
involved in their care, facilitating coordination and continuity of care. This ensures that all
providers have access to up-to-date medication lists and can make informed decisions about
treatment plans.
Rationale 4:
Healthcare providers can access information on prescription refills through a patient's PHR,
which helps them stay informed about medication adherence and refill patterns. This
information enables providers to monitor patients' medication usage and intervene if there are
concerns about compliance or medication management.
Rationale 5:
PHRs facilitate immediate communication between healthcare providers and pharmacies,
allowing for efficient transmission of prescription orders, refill requests, and medicationrelated inquiries. This streamlined communication enhances medication management
processes and ensures timely access to medications for patients.
Question 13
Which of the following are considered patient benefits of EHR personal health information?
1. Self-entered data
2. Appointment request
3. Medication management
4. Appointment views
5. Access to test results
Correct Answer: 2, 3, 4, 5
Rationale 1:
Self-entered data refers to information that patients input into their electronic health records
(EHRs) themselves. While this can be a feature of some EHR systems, it's not universally
applicable, and it's not listed among the provided options for patient benefits.
Rationale 2:
Appointment request functionality allows patients to request appointments with healthcare
providers through their EHR system. This feature enhances patient convenience by enabling
them to schedule appointments at their convenience without the need for phone calls or
additional communication.
Rationale 3:
Medication management features in EHR systems provide patients with tools to manage their
medications, including refills, reminders, and medication lists. This enhances patient safety,
adherence, and overall medication management.
Rationale 4:
Appointment views allow patients to access and view their upcoming appointments within
their EHR system. This feature helps patients keep track of their appointments and plan
accordingly, contributing to improved appointment adherence and healthcare management.
Rationale 5:
Access to test results is a significant patient benefit of EHR personal health information.
Patients can conveniently view their test results, such as laboratory tests or imaging reports,
through their EHR system. This promotes transparency, empowers patients to engage in their
healthcare decisions, and facilitates timely follow-up with healthcare providers if necessary.
Question 14
Which of the following health systems was an early pioneer in adopting the PHR?
1. Tenet Health System
2. Jefferson Medical System
3. Nationwide Health Care System
4. Palo Alto Medical Foundation
Correct Answer: 4
Rationale 1:
Tenet Health System was not notably recognized as an early pioneer in adopting the PHR.
While Tenet Health System is a large healthcare organization, it hasn't been particularly
associated with pioneering efforts in PHR adoption.
Rationale 2:
Jefferson Medical System, while an esteemed institution, was not among the early pioneers in
adopting the PHR. The institution may have adopted PHRs at some point, but it's not
recognized as a trailblazer in this regard.
Rationale 3:
Nationwide Health Care System is a hypothetical option and not a specific healthcare
organization. Therefore, it cannot be considered an early pioneer in adopting the PHR.
Rationale 4:
Palo Alto Medical Foundation is recognized as an early pioneer in adopting the PHR. It has
been involved in innovative healthcare initiatives, including early implementations of
personal health records (PHRs), making it a notable organization in the advancement of
patient-centric health information technology solutions.
Question 15
Beth Israel Deaconess Medical Center was one of the early adopters of PHRs. Which type of
PHRs are used throughout the system?
1. Stand alone
2. Tethered
3. Integrated
4. Integrated alone
Correct Answer: 2
Rationale 1:
A sizable number of patients served by those health systems currently use a tethered PHR on
a regular basis.
Rationale 2:
Beth Israel Deaconess Medical Center was an early adopter of PHRs A sizable number of
patients served by those health systems currently use a tethered PHR on a regular basis.
Rationale 3:
Beth Israel Deaconess Medical Center was an early adopter of PHRs A sizable number of
patients served by those health systems currently use a tethered PHR on a regular basis.
Rationale 4:
Beth Israel Deaconess Medical Center was an early adopter of PHRs A sizable number of
patients served by those health systems currently use a tethered PHR on a regular basis.
Question 16
The largest health system to deploy a PHR in the United States is __________________:
Correct Answer: Veterans Health Administration
Rationale:
Veterans Health Administration is the largest health system to deploy a PHR in the United
States.
Question 17
Which of the following are considered disadvantages of the PHR?
1. E-literacy
2. Lack of access in poor and rural regions
3. Patient satisfaction
4. Cost
5. Enhanced therapeutic alliances
Correct Answer: 1,2,4
Rationale 1:
The disadvantages include the need to overcome multiple barriers including cost, lack of
access in poor and rural regions, awareness of the trend, usability and ease of access, eliteracy, and patient care provider clinical integration.
Rationale 2:
The disadvantages include the need to overcome multiple barriers including cost, lack of
access in poor and rural regions, awareness of the trend, usability and ease of access, eliteracy, and patient care provider clinical integration.
Rationale 3:
The disadvantages include the need to overcome multiple barriers including cost, lack of
access in poor and rural regions, awareness of the trend, usability and ease of access, eliteracy, and patient care provider clinical integration.
Rationale 4:
The disadvantages include the need to overcome multiple barriers including cost, lack of
access in poor and rural regions, awareness of the trend, usability and ease of access, eliteracy, and patient care provider clinical integration.
Rationale 5:
The disadvantages include the need to overcome multiple barriers including cost, lack of
access in poor and rural regions, awareness of the trend, usability and ease of access, eliteracy, and patient care provider clinical integration.
Question 18
Which of the following is a barrier associated with patient use of PHRs in rural regions?
1. Access
2. Awareness
3. Usability
4. eHealth literacy
Correct Answer: 1
Rationale 1:
Clinical Integration. Nurses, physicians, and other professionals providing care have an
important role in the successful deployment and adoption of PHRs. As patients will continue
to see health professionals as a source of expert information, encouraging and demonstrating
use of these tools to patients and families will be important.
Rationale 2:
Clinical Integration. Nurses, physicians, and other professionals providing care have an
important role in the successful deployment and adoption of PHRs. As patients will continue
to see health professionals as a source of expert information, encouraging and demonstrating
use of these tools to patients and families will be important.
Rationale 3:
Clinical Integration. Nurses, physicians, and other professionals providing care have an
important role in the successful deployment and adoption of PHRs. As patients will continue
to see health professionals as a source of expert information, encouraging and demonstrating
use of these tools to patients and families will be important.
Rationale 4:
Clinical Integration. Nurses, physicians, and other professionals providing care have an
important role in the successful deployment and adoption of PHRs. As patients will continue
to see health professionals as a source of expert information, encouraging and demonstrating
use of these tools to patients and families will be important.
Question 19
Patients bring a wide variation in their capacity to use information technology. Which of the
following does not increase the usability of PHRs?
1. Easy navigation
2. Simple functionality
3. Decreased e-literacy
4. Readability
Correct Answer: 3
Rationale 1:
Ensuring a high level of usability, including easy navigation, simple functionality, and
readability can enhance willingness and ability to use the PHR.
Rationale 2:
Ensuring a high level of usability, including easy navigation, simple functionality, and
readability can enhance willingness and ability to use the PHR.
Rationale 3:
Decreased e-literacy decreases an individual's ability to use and understand the PHR.
Rationale 4:
Ensuring a high level of usability, including easy navigation, simple functionality, and
readability can enhance willingness and ability to use the PHR.
Question 20
As PHRs become the established norm, healthcare providers are aware of issues that can
emerge from patient self-disclosure. Which of the following is a key concern associated with
patient self-entered data?
1. Electronic medication refills
2. Automated appointment schedules
3. Data review responsibility
4. Downloading accurate data
Correct Answer: 3
Rationale 1:
Electronic medication refills are not directly related to concerns associated with patient selfentered data. While medication management may be impacted by the accuracy of patiententered data, it is not the primary concern associated with patient self-disclosure.
Rationale 2:
Automated appointment schedules are also not directly related to concerns associated with
patient self-entered data. While incorrect information entered by patients could potentially
impact appointment scheduling, it is not the primary concern associated with self-disclosed
patient data.
Rationale 3:
Data review responsibility refers to the concern that healthcare providers may bear the
responsibility of reviewing and validating patient-entered data in PHRs. Since patients may
not always accurately enter their health information, healthcare providers must review and
verify this data to ensure its accuracy and reliability for clinical decision-making.
Rationale 4:
Downloading accurate data is not a key concern associated with patient self-entered data.
While accuracy of data is important, this option does not specifically address the
responsibility of healthcare providers in reviewing patient-entered data within PHRs.
Question 21
Which of the following is not a PHR concern?
1. Insurance claims
2. Privacy
3. Portability
4. Accuracy of data
Correct Answer: 1
Rationale 1:
Insurance claims are not typically a primary concern directly associated with personal health
records (PHRs). Insurance claims relate more closely to the billing and reimbursement
processes within healthcare systems, rather than the management or functionality of PHRs.
Rationale 2:
Privacy is a significant concern regarding PHRs as they contain sensitive health information.
Patients and healthcare providers alike are concerned about ensuring the confidentiality and
security of health data stored within PHRs to prevent unauthorized access or breaches.
Rationale 3:
Portability refers to the ability to access and transfer PHR data across different healthcare
providers or systems. Ensuring that PHRs are portable allows individuals to maintain
continuity of care and access their health information regardless of where they receive care.
Rationale 4:
Accuracy of data is a critical concern with PHRs as the reliability of health information
directly impacts clinical decision-making and patient safety. Ensuring that data entered into
PHRs is accurate and up-to-date is essential for maintaining the integrity and usefulness of
the information stored within them.
Test Bank for Handbook of Informatics for Nurses and Healthcare Professionals
Toni Lee Hebda, Patricia Czar, Theresa Calderone
9780132574952, 9780132959544, 9780134711010, 9780131512627, 9780130311023, 9780805373264, 9780135205433, 9780135043943
