Chapter 13
Question 1
What is the primary purpose of system integration in a health care facility?
1. Provide reliable flow of information between facility and physician offices
2. Offer seamless data exchange among disparate information systems
3. Prevent system data errors via large scale electronic exchanges
4. Customize information systems within a department
Correct Answer: 2
Rationale 1:
The purpose of system integration is to ensure that disparate information systems can
communicate and exchange data among the different systems. Most health care facilities have
a variety of different users that need system data. Integration is defined as the process by
which different information systems are able to exchange data in a fashion that is seamless to
the end user. Providing a reliable flow of information between the facility and physician
offices is a specialized case and does not address the overall purpose.
Rationale 2:
The purpose of system integration is to ensure that disparate information systems can
communicate and exchange data among the different systems. Most health care facilities have
a variety of different users that need system data. Integration is defined as the process by
which different information systems are able to exchange data in a fashion that is seamless to
the end user. Customizing information systems within a department is a specialized case and
does not address the overall purpose.
Rationale 3:
The purpose of system integration is to ensure that disparate information systems can
communicate and exchange data among the different systems. Most health care facilities have
a variety of different users that need system data. Integration is defined as the process by
which different information systems are able to exchange data in a fashion that is seamless to
the end user. Preventing system data errors via large scale electronic exchanges does not
address the overall purpose.
Rationale 4:
The purpose of system integration is to ensure that disparate information systems can
communicate and exchange data among the different systems. Most health care facilities have
a variety of different users that need system data. Integration is defined as the process by
which different information systems are able to exchange data in a fashion that is seamless to
the end user. Customizing information systems within a department is a specialized case and
does not address the overall purpose.
Question 2
The timely flow of information is critical to institutional survival. Which of the following
statements about interfaces is accurate?
1. Interfaces use an open systems technology provided by the vendor.
2. Interfaces require installation of a Health Level Seven (HL7) device.
3. Interface connections between different information systems are invisible to the user.
4. Interfaces physically join two or more disparate information systems.
Correct Answer: 3
Rationale 1:
Interface connections between different information systems are invisible to the user. Vendors
often claim their products are based on open systems technology, which is the ability to
communicate with other systems. The reality is there has been little incentive for vendors to
market products that readily work with their competitors' products. Interfaces do not require
HL7 devices; open systems technology is a concept; and interfaces do not physically join
systems.
Rationale 2:
Interface connections between different information systems are invisible to the user. Vendors
often claim their products are based on open systems technology, which is the ability to
communicate with other systems. The reality is there has been little incentive for vendors to
market products that readily work with their competitors' products. Interfaces do not require
HL7 devices; open systems technology is a concept; and interfaces do not physically join
systems.
Rationale 3:
Interface connections between different information systems are invisible to the user. Vendors
often claim their products are based on open systems technology, which is the ability to
communicate with other systems. The reality is there has been little incentive for vendors to
market products that readily work with their competitors' products. Interfaces do not require
HL7 devices; open systems technology is a concept; and interfaces do not physically join
systems.
Rationale 4:
Interface connections between different information systems are invisible to the user. Vendors
often claim their products are based on open systems technology, which is the ability to
communicate with other systems. The reality is there has been little incentive for vendors to
market products that readily work with their competitors' products. Interfaces do not require
HL7 devices; open systems technology is a concept; and interfaces do not physically join
systems.
Question 3
Health Level Seven (HL7) standards are not the only standards that are evolving to fit the
changing health care model. What other organizations are instrumental in supporting the
development of standards and helping to define data exchange?
1. Department of Defense
2. Centers for Medicare and Medicare Services
3. National Science Foundation
4. Institute of Medicine
5. American Medical Informatics Association
Correct Answer: 2,3,4,5
Rationale 1:
Included in development of these standards are: National Science Foundation, Institute of
Medicine, American Medical Informatics Association, and Centers for Medicare and
Medicare Services. (There are also several others such as HIMSS.) Department of Defense is
not included.
Rationale 2:
Included in development of these standards are: National Science Foundation, Institute of
Medicine, American Medical Informatics Association, and Centers for Medicare and
Medicare Services. (There are also several others such as HIMSS.) Department of Defense is
not included.
Rationale 3:
Included in development of these standards are: National Science Foundation, Institute of
Medicine, American Medical Informatics Association, and Centers for Medicare and
Medicare Services. (There are also several others such as HIMSS.) Department of Defense is
not included.
Rationale 4:
Included in development of these standards are: National Science Foundation, Institute of
Medicine, American Medical Informatics Association, and Centers for Medicare and
Medicare Services. (There are also several others such as HIMSS.) Department of Defense is
not included.
Rationale 5:
Included in development of these standards are: National Science Foundation, Institute of
Medicine, American Medical Informatics Association, and Centers for Medicare and
Medicare Services. (There are also several others such as HIMSS.) Department of Defense is
not included.
Question 4
The master patient index (MPI) is a database that lists all identifiers assigned to one client in
all the information systems used within an enterprise. It assigns a global identification
number for each client and allows clients to be identified by demographic information
provided at the point of care. When the MPI cannot match a client's record based on
demographic data, what is provided to the user?
1. The data dictionary resources
2. Non-citizen information so that the user may find a different identifier
3. All possible matches so that the user may view and select
4. The Social Security number
Correct Answer: 3
Rationale 1:
When the MPI cannot match a client's record based on demographic data, all possible
matches are provided for the user to view and select. The MPI may use first and last names,
birthdates, Social Security numbers, and driver's license numbers. It cannot rely on a single
type of number, such as a Social Security number, because of duplicates and the fact that
some people, such as noncitizens, may not have one.
Rationale 2:
When the MPI cannot match a client's record based on demographic data, all possible
matches are provided for the user to view and select. The MPI may use first and last names,
birthdates, Social Security numbers, and driver's license numbers. It cannot rely on a single
type of number, such as a Social Security number, because of duplicates and the fact that
some people, such as noncitizens, may not have one.
Rationale 3:
When the MPI cannot match a client's record based on demographic data, all possible
matches are provided for the user to view and select. The MPI may use first and last names,
birthdates, Social Security numbers, and driver's license numbers. It cannot rely on a single
type of number, such as a Social Security number, because of duplicates and the fact that
some people, such as noncitizens, may not have one.
Rationale 4:
When the MPI cannot match a client's record based on demographic data, all possible
matches are provided for the user to view and select. The MPI may use first and last names,
birthdates, Social Security numbers, and driver's license numbers. It cannot rely on a single
type of number, such as a Social Security number, because of duplicates and the fact that
some people, such as noncitizens, may not have one.
Question 5
The master patient index (MPI) saves work because vital information can be obtained from
the database rather than rekeyed with each client visit. This decreases the possibility of
making a mistake and eliminates the inadvertent creation of duplicate records. Which of the
following are key features of an effective MPI?
1. It is flexible enough to allow inclusion of additional identification.
2. It facilitates the evaluation of client care.
3. It locates records in real time for timely retrieval of information.
4. It is easily reconfigured to accommodate network changes.
5. It can grow to fit an organization of any size.
Correct Answer: 1,3,4,5
Rationale 1:
Key features of an effective MPI are: locates records in real time for timely retrieval of
information, is flexible enough to allow inclusion of additional identification, is easily
reconfigured to accommodate network changes, and can grow to fit an organization of any
size. Facilitating the evaluation of client care would apply to NANDA, NIC, and NOC.
Rationale 2:
Key features of an effective MPI are: locates records in real time for timely retrieval of
information, is flexible enough to allow inclusion of additional identification, is easily
reconfigured to accommodate network changes, and can grow to fit an organization of any
size. Facilitating the evaluation of client care would apply to NANDA, NIC, and NOC.
Rationale 3:
Key features of an effective MPI are: locates records in real time for timely retrieval of
information, is flexible enough to allow inclusion of additional identification, is easily
reconfigured to accommodate network changes, and can grow to fit an organization of any
size. Facilitating the evaluation of client care would apply to NANDA, NIC, and NOC.
Rationale 4:
Key features of an effective MPI are: locates records in real time for timely retrieval of
information, is flexible enough to allow inclusion of additional identification, is easily
reconfigured to accommodate network changes, and can grow to fit an organization of any
size. Facilitating the evaluation of client care would apply to NANDA, NIC, and NOC.
Rationale 5:
Key features of an effective MPI are: locates records in real time for timely retrieval of
information, is flexible enough to allow inclusion of additional identification, is easily
reconfigured to accommodate network changes, and can grow to fit an organization of any
size. Facilitating the evaluation of client care would apply to NANDA, NIC, and NOC.
Question 6
The term interoperability is used when discussing the large scale electronic exchange of
health care information across enterprises for the purpose of accessing and maintaining
longitudinal health records. The term interoperability is understood to mean which of the
following?
1. Has the ability to exchange the structure of the data, but not the meaning of data
2. Has the ability to exchange the structure of data and meaning of data
3. Has the ability to exchange the meaning of data, but not the structure of data
4. Is the ability of two entities, whether human or machine, to exchange and use data
5. It is accurate to use the term interoperability interchangeably with the term interface
Correct Answer: 2,4
Rationale 1:
The structure and meaning of the data can both be exchanged. Interoperability is the ability of
two entities, whether human or machine, to exchange and predictably use data or information
while retaining the original meaning of that data. It is inaccurate to use the terms interface
and interoperability interchangeably. The interface engine routes information from one
system to another but stops short of enabling the second system to understand and use that
information. Most discussions that involve the large scale electronic exchange of health care
information across enterprises for the purpose of accessing and maintaining longitudinal
health records speak of interoperability.
Rationale 2:
The structure and meaning of the data can both be exchanged. Interoperability is the ability of
two entities, whether human or machine, to exchange and predictably use data or information
while retaining the original meaning of that data. It is inaccurate to use the terms interface
and interoperability interchangeably. The interface engine routes information from one
system to another but stops short of enabling the second system to understand and use that
information. Most discussions that involve the large scale electronic exchange of health care
information across enterprises for the purpose of accessing and maintaining longitudinal
health records speak of interoperability.
Rationale 3:
The structure and meaning of the data can both be exchanged. Interoperability is the ability of
two entities, whether human or machine, to exchange and predictably use data or information
while retaining the original meaning of that data. It is inaccurate to use the terms interface
and interoperability interchangeably. The interface engine routes information from one
system to another but stops short of enabling the second system to understand and use that
information. Most discussions that involve the large scale electronic exchange of health care
information across enterprises for the purpose of accessing and maintaining longitudinal
health records speak of interoperability.
Rationale 4:
The structure and meaning of the data can both be exchanged. Interoperability is the ability of
two entities, whether human or machine, to exchange and predictably use data or information
while retaining the original meaning of that data. It is inaccurate to use the terms interface
and interoperability interchangeably. The interface engine routes information from one
system to another but stops short of enabling the second system to understand and use that
information. Most discussions that involve the large scale electronic exchange of health care
information across enterprises for the purpose of accessing and maintaining longitudinal
health records speak of interoperability.
Rationale 5:
The structure and meaning of the data can both be exchanged. Interoperability is the ability of
two entities, whether human or machine, to exchange and predictably use data or information
while retaining the original meaning of that data. It is inaccurate to use the terms interface
and interoperability interchangeably. The interface engine routes information from one
system to another but stops short of enabling the second system to understand and use that
information. Most discussions that involve the large scale electronic exchange of health care
information across enterprises for the purpose of accessing and maintaining longitudinal
health records speak of interoperability.
Question 7
What are the benefits of data integration?
1. Potential for improved remote access of clinical data from various systems
2. Trend analysis of financial and clinical data
3. Encouraging the use of systems customized to meet department specifications
4. Development of a computer-based patient record
5. Facilitation of data collection for accreditation purposes
Correct Answer: 1,2,4,5
Rationale 1:
Data integration benefits include: development of a computer-based patient record; trend
analysis of financial and clinical data; potential for improved remote access of clinical data
from various systems; and facilitation of data collection for accreditation purposes.
Integration is a necessary component for the development of the electronic health record and
for integrated delivery systems. The use of systems that are highly customized to meet
individual department specifications is discouraged because it complicates the integration
process.
Rationale 2:
Data integration benefits include: development of a computer-based patient record; trend
analysis of financial and clinical data; potential for improved remote access of clinical data
from various systems; and facilitation of data collection for accreditation purposes.
Integration is a necessary component for the development of the electronic health record and
for integrated delivery systems. The use of systems that are highly customized to meet
individual department specifications is discouraged because it complicates the integration
process.
Rationale 3:
Data integration benefits include: development of a computer-based patient record; trend
analysis of financial and clinical data; potential for improved remote access of clinical data
from various systems; and facilitation of data collection for accreditation purposes.
Integration is a necessary component for the development of the electronic health record and
for integrated delivery systems. The use of systems that are highly customized to meet
individual department specifications is discouraged because it complicates the integration
process.
Rationale 4:
Data integration benefits include: development of a computer-based patient record; trend
analysis of financial and clinical data; potential for improved remote access of clinical data
from various systems; and facilitation of data collection for accreditation purposes.
Integration is a necessary component for the development of the electronic health record and
for integrated delivery systems. The use of systems that are highly customized to meet
individual department specifications is discouraged because it complicates the integration
process.
Rationale 5:
Data integration benefits include: development of a computer-based patient record; trend
analysis of financial and clinical data; potential for improved remote access of clinical data
from various systems; and facilitation of data collection for accreditation purposes.
Integration is a necessary component for the development of the electronic health record and
for integrated delivery systems. The use of systems that are highly customized to meet
individual department specifications is discouraged because it complicates the integration
process.
Question 8
Which of the following answers are factors that slow systems integration?
1. Vendors’ false claims that their information systems are interoperable with other systems
2. Unrealistic institutional timetable set due to a lack of understanding of the complexity of
the integration process.
3. Vendors who do not provide enough support and assistance to facilitate the integration
efforts.
4. Existing systems are insufficiently documented.
5. Merged institutions do not agree on which systems to use.
Correct Answer: 1,2,3,4,5
Rationale 1:
Factors that slow systems integration include:
1. Vendors often falsely promise that their information systems are interoperable with other
systems.
2. Unrealistic institutional timetable set due to a lack of understanding of the complexity of
the integration process.
3. User specifications change as the integration process proceeds; users frequently request
additional capabilities or change their minds regarding initial specifications.
4. Vendors may not provide enough support and assistance to facilitate the integration efforts.
5. Existing systems are insufficiently documented which is imperative for achieving
successful integration.
6. Merged institutions may not agree on which systems to use which means there are more
systems to integrate.
7. All components of a vendor's products may not work together.
Rationale 2:
Factors that slow systems integration include:
1. Vendors often falsely promise that their information systems are interoperable with other
systems.
2. Unrealistic institutional timetable set due to a lack of understanding of the complexity of
the integration process.
3. User specifications change as the integration process proceeds; users frequently request
additional capabilities or change their minds regarding initial specifications.
4. Vendors may not provide enough support and assistance to facilitate the integration efforts.
5. Existing systems are insufficiently documented which is imperative for achieving
successful integration.
6. Merged institutions may not agree on which systems to use which means there are more
systems to integrate.
7. All components of a vendor's products may not work together.
Rationale 3:
Factors that slow systems integration include:
1. Vendors often falsely promise that their information systems are interoperable with other
systems.
2. Unrealistic institutional timetable set due to a lack of understanding of the complexity of
the integration process.
3. User specifications change as the integration process proceeds; users frequently request
additional capabilities or change their minds regarding initial specifications.
4. Vendors may not provide enough support and assistance to facilitate the integration efforts.
5. Existing systems are insufficiently documented which is imperative for achieving
successful integration.
6. Merged institutions may not agree on which systems to use which means there are more
systems to integrate.
7. All components of a vendor's products may not work together.
Rationale 4:
Factors that slow systems integration include:
1. Vendors often falsely promise that their information systems are interoperable with other
systems.
2. Unrealistic institutional timetable set due to a lack of understanding of the complexity of
the integration process.
3. User specifications change as the integration process proceeds; users frequently request
additional capabilities or change their minds regarding initial specifications.
4. Vendors may not provide enough support and assistance to facilitate the integration efforts.
5. Existing systems are insufficiently documented which is imperative for achieving
successful integration.
6. Merged institutions may not agree on which systems to use which means there are more
systems to integrate.
7. All components of a vendor's products may not work together.
Rationale 5:
Factors that slow systems integration include:
1. Vendors often falsely promise that their information systems are interoperable with other
systems.
2. Unrealistic institutional timetable set due to a lack of understanding of the complexity of
the integration process.
3. User specifications change as the integration process proceeds; users frequently request
additional capabilities or change their minds regarding initial specifications.
4. Vendors may not provide enough support and assistance to facilitate the integration efforts.
5. Existing systems are insufficiently documented which is imperative for achieving
successful integration.
6. Merged institutions may not agree on which systems to use which means there are more
systems to integrate.
7. All components of a vendor's products may not work together.
Question 9
A female client goes to the clinic's office complaining of a cough and fever. She gives her
name and date of birth at the admitting registration desk. The registration clerk verifies her
current address and asks if she is still covered by IVY insurance. Client responds yes, is given
a chart with the number 3948JAV04830 on it, and is directed to the physician's exam room.
The physician orders a chest x-ray. The client is sent to the radiology department and checks
in with the registration desk. The registration clerk verifies her current address and asks if she
is still covered by IVY insurance. The client responds yes and is given an order sheet with the
number 3948JAV04830 on it. The admitting office for the clinic and the radiology office use
different information systems. The process depicted in this scenario illustrates the use of
which of the following?
1. Uniform language
2. Master patient index
3. Data dictionary
4. Clinical data repository
Correct Answer: 2
Rationale 1:
This scenario is an example of the use of the MPI of patient identifiers. Both information
systems, though different, used the same global identification number for the client and
allowed for client identification at the point of care. The data dictionary defines terminology,
the clinical data repository is a database where collective data from all information systems
are stored, and many efforts to develop uniform languages are under way in the health care
arena.
Rationale 2:
This scenario is an example of the use of the MPI of patient identifiers. Both information
systems, though different, used the same global identification number for the client and
allowed for client identification at the point of care. The data dictionary defines terminology,
the clinical data repository is a database where collective data from all information systems
are stored, and many efforts to develop uniform languages are under way in the health care
arena.
Rationale 3:
This scenario is an example of the use of the MPI of patient identifiers. Both information
systems, though different, used the same global identification number for the client and
allowed for client identification at the point of care. The data dictionary defines terminology,
the clinical data repository is a database where collective data from all information systems
are stored, and many efforts to develop uniform languages are under way in the health care
arena.
Rationale 4:
This scenario is an example of the use of the MPI of patient identifiers. Both information
systems, though different, used the same global identification number for the client and
allowed for client identification at the point of care. The data dictionary defines terminology,
the clinical data repository is a database where collective data from all information systems
are stored, and many efforts to develop uniform languages are under way in the health care
arena.
Question 10
Which of the following is a classification system for surgical, diagnostic, and therapeutic
procedures and is used for hospital billing and payer reimbursement?
1. NOC
2. CPT-4
3. NIC
4. NANDA
Correct Answer: 2
Rationale 1:
CPT-4 is a classification system for surgical, diagnostic, and therapeutic procedures and is
used for hospital billing and payer reimbursement.
Rationale 2:
CPT-4 is a classification system for surgical, diagnostic, and therapeutic procedures and is
used for hospital billing and payer reimbursement.
Rationale 3:
CPT-4 is a classification system for surgical, diagnostic, and therapeutic procedures and is
used for hospital billing and payer reimbursement. NIC categorizes nursing interventions
based on clinical judgment.
Rationale 4:
NANDA is a classification system used for nursing diagnoses.
Question 11
The role of the nurse in the system integration efforts should include which of the following?
1. Ensuring that data will be collected in only one system and shared as needed among others
2. Involvement in the formation and maintenance of the electronic health record
3. Promoting the development and maintenance of archetypes
4. Determining measures to assure the quality of data
5. Identifying and defining data elements
Correct Answer: 1,2,4,5
Rationale 1:
The role the nurse in the system integration efforts should include the formation and
maintenance of the electronic health record; ensuring that data will be collected in only one
system and shared among all other systems requiring it (eliminates redundant efforts while
ensuring data integrity); identifying and defining data elements; and assuring the quality of
data. Developing archetypes and creating communications standards would not be
appropriate for nurses.
Rationale 2:
The role the nurse in the system integration efforts should include the formation and
maintenance of the electronic health record; ensuring that data will be collected in only one
system and shared among all other systems requiring it (eliminates redundant efforts while
ensuring data integrity); identifying and defining data elements; and assuring the quality of
data. Developing archetypes and creating communications standards would not be
appropriate for nurses.
Rationale 3:
The role the nurse in the system integration efforts should include the formation and
maintenance of the electronic health record; ensuring that data will be collected in only one
system and shared among all other systems requiring it (eliminates redundant efforts while
ensuring data integrity); identifying and defining data elements; and assuring the quality of
data. Developing archetypes and creating communications standards would not be
appropriate for nurses.
Rationale 4:
The role the nurse in the system integration efforts should include the formation and
maintenance of the electronic health record; ensuring that data will be collected in only one
system and shared among all other systems requiring it (eliminates redundant efforts while
ensuring data integrity); identifying and defining data elements; and assuring the quality of
data. Developing archetypes and creating communications standards would not be
appropriate for nurses.
Rationale 5:
The role the nurse in the system integration efforts should include the formation and
maintenance of the electronic health record; ensuring that data will be collected in only one
system and shared among all other systems requiring it (eliminates redundant efforts while
ensuring data integrity); identifying and defining data elements; and assuring the quality of
data. Developing archetypes and creating communications standards would not be
appropriate for nurses.
Question 12
One step in the integration process is the development of a uniform definition of terms, or
language. The American Nurses Association sponsors the Congress of Nursing Practice
Steering Committee on Databases. Which of the following is a primary goal of this steering
committee?
1. Categorize interventions that nurses carry out.
2. Measure client outcome position.
3. Develop a mapping system to link various classification schemes.
4. Identify client care problems that nurses treat independently.
Correct Answer: 3
Rationale 1:
A primary goal of the Congress of Nursing Practice Steering Committee on Databases is to
develop a mapping system to link the various classification schemes. This would allow for
the development of national data sets for use by nursing. The following are actually special
classification systems: categorize interventions that nurses carry out is NIC; identify client
care problems that nurses treat independently is NANDA; measure client outcome is NOC.
Rationale 2:
A primary goal of the Congress of Nursing Practice Steering Committee on Databases is to
develop a mapping system to link the various classification schemes. This would allow for
the development of national data sets for use by nursing. The following are actually special
classification systems: categorize interventions that nurses carry out is NIC; identify client
care problems that nurses treat independently is NANDA; measure client outcome is NOC.
Rationale 3:
Developing a mapping system to link the various classification schemes would allow for the
development of national data sets for use by nursing. The following are actually special
classification systems: categorize interventions that nurses carry out is NIC; identify client
care problems that nurses treat independently is NANDA; measure client outcome is NOC.
Rationale 4:
A primary goal of the Congress of Nursing Practice Steering Committee on Databases is to
develop a mapping system to link the various classification schemes. This would allow for
the development of national data sets for use by nursing. The following are actually special
classification systems: categorize interventions that nurses carry out is NIC; identify client
care problems that nurses treat independently is NANDA; measure client outcome is NOC.
Question 13
Web-based tools can provide benefits of an alternative method for obtaining patient
information from diverse information systems. Which of the following is accurate regarding
recent advances toward interoperability?
1. The framework has been built and is in place.
2. National priorities will be set within the next five years.
3. Data exchange standards need to be developed.
4. Interoperability of electronic health data will be costly.
Correct Answer: 4
Rationale 1:
Interoperability of electronic health data will be costly and much work lies ahead. Recently
though, data exchange standards have been refined, national priorities have been set, and
work has started on building the framework needed to make interoperability of electronic
health data a reality. This will not be easy or quick but the promised benefits will be
immeasurable.
Rationale 2:
Interoperability of electronic health data will be costly and much work lies ahead. Recently
though, data exchange standards have been refined, national priorities have been set, and
work has started on building the framework needed to make interoperability of electronic
health data a reality. This will not be easy or quick but the promised benefits will be
immeasurable.
Rationale 3:
Interoperability of electronic health data will be costly and much work lies ahead. Recently
though, data exchange standards have been refined, national priorities have been set, and
work has started on building the framework needed to make interoperability of electronic
health data a reality. This will not be easy or quick but the promised benefits will be
immeasurable.
Rationale 4:
Interoperability of electronic health data will indeed be costly and much work lies ahead.
Recently though, data exchange standards have been refined, national priorities have been
set, and work has started on building the framework needed to make interoperability of
electronic health data a reality. This will not be easy or quick but the promised benefits will
be immeasurable.
Question 14
Interface engines work in the background and are not seen by the user. This technology
allows applications to interact with hardware and other applications. Which of the following
are considered benefits associated with the use of interface engines?
1. Improves timeliness and availability of critical administrative and clinical data
2. Improves data quality because of data mapping and consistent use of terms
3. Allows clients to select the best system for their needs
4. Preserves institutional investment in existing systems
5. Preserves institutional investment in existing systems
Correct Answer: 1,2,3,4,5
Rationale 1:
1. Improves timeliness and availability of critical administrative and clinical data
2. Decreases integration costs by providing an alternative to customized point-to-point
interface application programming
3. Improves data quality because of data mapping and consistent use of terms
4. Allows clients to select the best system for their needs
5. Preserves institutional investment in existing systems
6. Simplifies the administration of health care data processing
7. Simplifies systems integration efforts
8. Shortens the time required for integration
9. Improves management of care, the financial tracking of care rendered, and efficacy of
treatment
Rationale 2:
1. Improves timeliness and availability of critical administrative and clinical data
2. Decreases integration costs by providing an alternative to customized point-to-point
interface application programming
3. Improves data quality because of data mapping and consistent use of terms
4. Allows clients to select the best system for their needs
5. Preserves institutional investment in existing systems
6. Simplifies the administration of health care data processing
7. Simplifies systems integration efforts
8. Shortens the time required for integration
9. Improves management of care, the financial tracking of care rendered, and efficacy of
treatment
Rationale 3:
1. Improves timeliness and availability of critical administrative and clinical data
2. Decreases integration costs by providing an alternative to customized point-to-point
interface application programming
3. Improves data quality because of data mapping and consistent use of terms
4. Allows clients to select the best system for their needs
5. Preserves institutional investment in existing systems
6. Simplifies the administration of health care data processing
7. Simplifies systems integration efforts
8. Shortens the time required for integration
9. Improves management of care, the financial tracking of care rendered, and efficacy of
treatment
Rationale 4:
1. Improves timeliness and availability of critical administrative and clinical data
2. Decreases integration costs by providing an alternative to customized point-to-point
interface application programming
3. Improves data quality because of data mapping and consistent use of terms
4. Allows clients to select the best system for their needs
5. Preserves institutional investment in existing systems
6. Simplifies the administration of health care data processing
7. Simplifies systems integration efforts
8. Shortens the time required for integration
9. Improves management of care, the financial tracking of care rendered, and efficacy of
treatment
Rationale 5:
1. Improves timeliness and availability of critical administrative and clinical data
2. Decreases integration costs by providing an alternative to customized point-to-point
interface application programming
3. Improves data quality because of data mapping and consistent use of terms
4. Allows clients to select the best system for their needs
5. Preserves institutional investment in existing systems
6. Simplifies the administration of health care data processing
7. Simplifies systems integration efforts
8. Shortens the time required for integration
9. Improves management of care, the financial tracking of care rendered, and efficacy of
treatment
Question 15
Integration is a massive project within institutions and enterprises. It generally requires more
time and effort than originally projected. Which of the following are factors that may slow
down the integration process?
1. Unrealistic institutional timetable
2. Lack of agreement among merged institution
3. Insufficient documentation
4. Changing user specifications
5. Lack of vendor support
Correct Answer: 1,2,3,4,5
Rationale 1:
An unrealistic institutional timetable is often based on a lack of understanding of the
complexity of the integration process.
Rationale 2:
Individual facilities within a merged enterprise may wish to continue use of their existing
systems. This means there are more systems to integrate.
Rationale 3:
Information regarding existing systems and related programming is imperative for achieving
successful integration.
Rationale 4:
As the integration process proceeds, users frequently request additional capabilities or change
their minds regarding initial specifications.
Rationale 5:
Vendors may not provide enough support and assistance to facilitate the integration efforts.
Question 16
Nursing can reap significant benefits from integration. Which of the following integration
statements is accurate for nursing?
1. Trends in client care data and cost analysis can be used to justify nursing staffing levels.
2. Nursing should be sure that data will be collected in several systems for sharing.
3. The use of a data dictionary can interfere with system integration processes.
4. Nursing involvement is unnecessary so long as I.S. staff members are given requirements.
Correct Answer: 1
Rationale 1:
Nursing can benefit from integration and data exchange such as trends in client care data and
cost analysis that can be used to justify nursing staffing levels in the hospital setting. In
addition, integration provides a tool to build nursing knowledge. Nursing should be sure that
data will be collected in only one system; nurses must be involved in identifying and defining
data elements that an interface may be able to supply; and the use of the data dictionary and
interface engine actually facilitates integration and allows for the collection of aggregate data.
Rationale 2:
Nursing can benefit from integration and data exchange such as trends in client care data and
cost analysis that can be used to justify nursing staffing levels in the hospital setting. In
addition, integration provides a tool to build nursing knowledge. Nursing should be sure that
data will be collected in only one system; nurses must be involved in identifying and defining
data elements that an interface may be able to supply; and the use of the data dictionary and
interface engine actually facilitates integration and allows for the collection of aggregate data.
Rationale 3:
Nursing can benefit from integration and data exchange such as trends in client care data and
cost analysis that can be used to justify nursing staffing levels in the hospital setting. In
addition, integration provides a tool to build nursing knowledge. Nursing should be sure that
data will be collected in only one system; nurses must be involved in identifying and defining
data elements that an interface may be able to supply; and the use of the data dictionary and
interface engine actually facilitates integration and allows for the collection of aggregate data.
Rationale 4:
Nursing can benefit from integration and data exchange such as trends in client care data and
cost analysis that can be used to justify nursing staffing levels in the hospital setting. In
addition, integration provides a tool to build nursing knowledge. Nursing should be sure that
data will be collected in only one system; nurses must be involved in identifying and defining
data elements that an interface may be able to supply; and the use of the data dictionary and
interface engine actually facilitates integration and allows for the collection of aggregate data.
Question 17
The clinical data repository provides data definition consistency through which of the
following?
1. Mapping
2. Interface engine
3. Point-to-point interface
4. Clinical data warehouse
Correct Answer: 1
Rationale 1:
The clinical data repository provides data definition consistency through mapping. Mapping
is the process in which terms defined in one system are associated with comparable terms in
another system. The clinical data repository may also be referred to as the clinical data
warehouse.
Rationale 2:
The clinical data repository provides data definition consistency through mapping. Mapping
is the process in which terms defined in one system are associated with comparable terms in
another system. The clinical data repository may also be referred to as the clinical data
warehouse.
Rationale 3:
The clinical data repository provides data definition consistency through mapping. Mapping
is the process in which terms defined in one system are associated with comparable terms in
another system. The clinical data repository may also be referred to as the clinical data
warehouse.
Rationale 4:
The clinical data repository provides data definition consistency through mapping. Mapping
is the process in which terms defined in one system are associated with comparable terms in
another system. The clinical data repository may also be referred to as the clinical data
warehouse.
Question 18
_______________________ uses XML (Extensible Markup Language) for storage and
movement of clinical documents between systems.
Correct Answer: HL7
Rationale:
HL7 relies upon XML markup language for the storage and movement of clinical documents
between systems.
Question 19
______________________________ interoperability is the ability to exchange the structure
of the data, but not necessarily the meaning of the data. It is also referred to as functional
interoperability. Web pages built with HTML illustrate this type of interoperability.
Correct Answer: Syntactic
Rationale:
Syntactic interoperability is the ability to exchange the structure of the data, but not
necessarily the meaning of the data. It is also referred to as functional interoperability. Web
pages built with HTML illustrate this type of interoperability.
Semantic interoperability guarantees that the meaning of the exchanged data remains the
same on both ends of the transaction. This is critical for clinical data. There have been several
standardization efforts to achieve interoperability for EHRs, including HL7.
Question 20
Which of the following supports the development of an EHR by classifying and categorizing
nursing data?
1. North American Nursing Diagnosis Association (NANDA)
2. HL7
3. Service oriented architecture (SOA)
4. SNOMED
Correct Answer: 1
Rationale 1:
North American Nursing Diagnosis Association (NANDA), Nursing Interventions
Classification (NIC), and Nursing Outcomes Classification (NOC) support of the
development of an EHR by classifying and categorizing nursing data. They are designed to
be used together as one large system for classifying nursing care.
Rationale 2:
North American Nursing Diagnosis Association (NANDA), Nursing Interventions
Classification (NIC), and Nursing Outcomes Classification (NOC) support of the
development of an EHR by classifying and categorizing nursing data. They are designed to
be used together as one large system for classifying nursing care.
Rationale 3:
North American Nursing Diagnosis Association (NANDA), Nursing Interventions
Classification (NIC), and Nursing Outcomes Classification (NOC) support of the
development of an EHR by classifying and categorizing nursing data. They are designed to
be used together as one large system for classifying nursing care.
Rationale 4:
North American Nursing Diagnosis Association (NANDA), Nursing Interventions
Classification (NIC), and Nursing Outcomes Classification (NOC) support of the
development of an EHR by classifying and categorizing nursing data. They are designed to
be used together as one large system for classifying nursing care.
Question 21
The use of HL7 standards in individual applications can improve the integration of
applications with other applications or systems through the use of which of the following?
1. Digital imaging and communications in medicine (DICOM)
2. Interface engine
3. Radiology information system (RIS)
4. Current procedural terminology (CPT) codes
Correct Answer: 2
Rationale 1:
Use of HL7 standards in individual applications improves the integration of these
applications with other applications or systems using an interface engine. Benefits include
easier and less costly integration within an organization and more accurate and useful data
integration nationally and globally. Integration efforts and the development and use of
integration standards, including HL7, are taking place at many levels.
Rationale 2:
Use of HL7 standards in individual applications improves the integration of these
applications with other applications or systems using an interface engine. Benefits include
easier and less costly integration within an organization and more accurate and useful data
integration nationally and globally. Integration efforts and the development and use of
integration standards, including HL7, are taking place at many levels.
Rationale 3:
Use of HL7 standards in individual applications improves the integration of these
applications with other applications or systems using an interface engine. Benefits include
easier and less costly integration within an organization and more accurate and useful data
integration nationally and globally. Integration efforts and the development and use of
integration standards, including HL7, are taking place at many levels.
Rationale 4:
Use of HL7 standards in individual applications improves the integration of these
applications with other applications or systems using an interface engine. Benefits include
easier and less costly integration within an organization and more accurate and useful data
integration nationally and globally. Integration efforts and the development and use of
integration standards, including HL7, are taking place at many levels.
Question 22
The lack of which of the following has long been a barrier to effective data reporting and
analysis?
1. Knowledge
2. Interoperability
3. Resources
4. Information technology
Correct Answer: 2
Rationale 1:
The lack of interoperability has long been a barrier to effective data reporting and analysis.
Rationale 2:
The lack of interoperability has long been a barrier to effective data reporting and analysis.
Rationale 3:
The lack of interoperability has long been a barrier to effective data reporting and analysis.
Rationale 4:
The lack of interoperability has long been a barrier to effective data reporting and analysis.
Question 23
Using what kind of strategy will permit data exchange within each hospital and across health
care networks or enterprises?
1. Integration
2. Syntactic interoperability
3. Semantic interoperability
4. Using a clinical data repository
Correct Answer: 1
Rationale 1:
Using integration strategies will permit data exchange within each hospital and across health
care networks or enterprises. This will open up a realm of possibilities for new ways to chart
data trends, such as by provider, by diagnosis, or by cost. It will also allow hospitals to find
trends in financial and clinical data. Health care providers will be able to obtain improved
information, making them better able to react to market changes and maintain a competitive
edge.
Rationale 2:
Syntactic interoperability is the ability to exchange the structure of the data but not
necessarily the meaning of the data. It is also referred to as functional interoperability. Web
pages built with HTML illustrate this type of interoperability.
Rationale 3:
Semantic interoperability guarantees that the meaning of the exchanged data remains the
same on both ends of the transaction.
Rationale 4:
The clinical data repository provides data definition consistency through mapping. Mapping
is the process in which terms defined in one system are associated with comparable terms in
another system.
Question 24
What is a computer program that tells two different systems how to exchange data?
1. An interface
2. Request for proposal
3. Syntactic operability
4. HL7
Correct Answer: 1
Rationale 1:
An interface is a computer program that tells two different systems how to exchange data.
Traditionally, communication between and among most disparate systems has been the result
of costly, time-consuming efforts to build interfaces. In other words, interface programs are
the tools used to achieve integration.
Rationale 2:
An interface is a computer program that tells two different systems how to exchange data.
Traditionally, communication between and among most disparate systems has been the result
of costly, time-consuming efforts to build interfaces. In other words, interface programs are
the tools used to achieve integration.
Rationale 3:
An interface is a computer program that tells two different systems how to exchange data.
Traditionally, communication between and among most disparate systems has been the result
of costly, time-consuming efforts to build interfaces. In other words, interface programs are
the tools used to achieve integration.
Rationale 4:
An interface is a computer program that tells two different systems how to exchange data.
Traditionally, communication between and among most disparate systems has been the result
of costly, time-consuming efforts to build interfaces. In other words, interface programs are
the tools used to achieve integration.
Question 25
What uses archetypes (clinical models of content and process) as a means of exchanging
clinical documents between systems?
1. Service oriented architecture
2. HL7
3. Open EHR
4. Semantic interoperability
Correct Answer: 2
Rationale 1:
HL7 uses archetypes (clinical models of content and process) as a means of exchanging
clinical documents between systems. Integration efforts and the development and use of
integration standards, including HL7, are taking place at many levels. Although efforts are
under way to develop both national and international health data networks, competition has
not yet facilitated this type of information sharing.
Rationale 2:
HL7 uses archetypes (clinical models of content and process) as a means of exchanging
clinical documents between systems. Integration efforts and the development and use of
integration standards, including HL7, are taking place at many levels. Although efforts are
under way to develop both national and international health data networks, competition has
not yet facilitated this type of information sharing.
Rationale 3:
HL7 uses archetypes (clinical models of content and process) as a means of exchanging
clinical documents between systems. Integration efforts and the development and use of
integration standards, including HL7, are taking place at many levels. Although efforts are
under way to develop both national and international health data networks, competition has
not yet facilitated this type of information sharing.
Rationale 4:
HL7 uses archetypes (clinical models of content and process) as a means of exchanging
clinical documents between systems. Integration efforts and the development and use of
integration standards, including HL7, are taking place at many levels. Although efforts are
under way to develop both national and international health data networks, competition has
not yet facilitated this type of information sharing.
Question 26
Nurses must be involved in identifying and defining data elements that an interface may be
able to supply. One way to ensure participation is to recruit staff nurses to do which of the
following?
1. Provide input during the interface design.
2. Be a member of the technology committee
3. Participate in the creation of a RFP.
4. Define language needed for interoperability.
Correct Answer: 1
Rationale 1:
Nursing plays an important role in the system integration efforts. The unique body of
knowledge pertaining to patient care and clinical practice offers an expert in system and
information usage.
Rationale 2:
Technology committee membership is an important role for all stakeholders; however, this is
a decision making and advisory body.
Rationale 3:
Request for proposal (RFP) documents are part of the vendor selection process.
Rationale 4:
The uniform language initiative continues to be debated at all levels of health care.
Question 27
____________________ and Internet technology were seen as a means to provide access to
data from disparate information systems.
Correct Answer: Web based tools
Rationale:
Web-based tools and Internet technology were seen as a means to provide access to data from
disparate information systems. This was largely a local solution that improved access to
clinical information for the providers at a single hospital or health care system, but did
nothing to advance exchange of data on a larger scale or ensure that data could be used in the
same manner in both sending and receiving systems.
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
