Chapter 19
Question 1
Which of the following laws, signed by President Clinton in 2000, gives electronic signatures
the same legal status as handwritten signatures?
1. The Health Insurance Portability and Accountability Act (HIPAA)
2. The American Recovery and Reinvestment Act of 2009 (ARRA)
3. Medicare Improvements for Patients and Providers Act (MIPPA)
4. The Electronic Signatures in Global and National Commerce Act
Correct Answer: 4
Rationale 1:
The Electronic Signatures in Global and National Commerce Act ("E-Sign or ESIGN") was
signed into law by President Clinton on June 30, 2000. E-Sign gives electronic signatures the
same legal status as handwritten signatures. From a legal perspective, this means that any
contract signed electronically cannot be declared invalid on the basis of an electronic
signature (Freeman, 2004).
Rationale 2:
The Electronic Signatures in Global and National Commerce Act ("E-Sign or ESIGN") was
signed into law by President Clinton on June 30, 2000. E-Sign gives electronic signatures the
same legal status as handwritten signatures. From a legal perspective, this means that any
contract signed electronically cannot be declared invalid on the basis of an electronic
signature (Freeman, 2004).
Rationale 3:
The Electronic Signatures in Global and National Commerce Act ("E-Sign or ESIGN") was
signed into law by President Clinton on June 30, 2000. E-Sign gives electronic signatures the
same legal status as handwritten signatures. From a legal perspective, this means that any
contract signed electronically cannot be declared invalid on the basis of an electronic
signature (Freeman, 2004).
Rationale 4:
From a legal perspective, this act means that any contract signed electronically cannot be
declared invalid on the basis of an electronic signature. The Electronic Signatures in Global
and National Commerce Act ("E-Sign or ESIGN") was signed into law by President Clinton
on June 30, 2000. E-Sign gives electronic signatures the same legal status as handwritten
signatures. From a legal perspective, this means that any contract signed electronically cannot
be declared invalid on the basis of an electronic signature (Freeman, 2004).
Question 2
MIPPA is an acronym for ___________________.
Correct Answer: Medicare Improvements for Patients and Providers Act
Rationale:
MIPPA: Medicare Improvements for Patients and Providers Act
Question 3
Which act makes several significant changes to the current HIPAA Security and Privacy
Rules and provides funds and incentives to increase the use of electronic health records
(EHRs) by physicians and hospitals who meet eligibility criteria?
1. Health Information Technology for Economic and Clinical Health Act (HITECH)
2. The American Recovery and Reinvestment Act of 2009
3. Medicare Improvements for Patients and Providers Act (MIPPA)
4. The Health Insurance Portability and Accountability Act
Correct Answer: 1
Rationale 1:
The Health Information Technology for Economic and Clinical Health Act (HITECH) is the
correct answer. HITECH, which was enacted as part of the American Recovery and
Reinvestment Act of 2009, made significant changes to the HIPAA Security and Privacy
Rules and provided funds and incentives to promote the adoption and meaningful use of
electronic health records (EHRs) by healthcare providers. These incentives were designed to
encourage the adoption of health information technology and improve the quality, safety, and
efficiency of healthcare delivery.
Rationale 2:
While The American Recovery and Reinvestment Act of 2009 (ARRA) includes provisions
related to healthcare and health information technology, the specific act that made significant
changes to the HIPAA Security and Privacy Rules and provided funds for EHR adoption is
the HITECH Act, which is part of ARRA.
Rationale 3:
The Medicare Improvements for Patients and Providers Act (MIPPA) primarily focuses on
Medicare payment policies and benefits, including provisions related to Medicare Advantage,
Medicare Part D, and Medicare payments to healthcare providers. It does not specifically
address changes to HIPAA rules or provide incentives for EHR adoption.
Rationale 4:
The Health Insurance Portability and Accountability Act (HIPAA) is a foundational
legislation for protecting the privacy and security of health information. While HIPAA
establishes regulations for safeguarding health data, it does not provide funds or incentives
for EHR adoption. The act that introduced such provisions is the Health Information
Technology for Economic and Clinical Health Act (HITECH), which is part of the broader
framework of HIPAA regulations.
Question 4
The _________________________________________ oversees information- technology
standards, implementation strategies, and impact assessment.
Correct Answer: Office of the National Coordinator for Health Information Technology
(ONCHIT)
Rationale:
The Office of the National Coordinator for Health Information Technology (ONCHIT)
oversees information- technology standards, implementation strategies, and impact
assessment. To receive the positive incentives and physicians and hospitals must use EHRs
certified by ONCHIT (Tomes, 2010).
Question 5
To comply with the mandate to use EHRs by 2014, physicians and hospitals must have the
EHR prepared and ready for implementation. Which of the following methods are available
to entities that will assist in the funding of the EHR?
1. Medicare and Medicaid
2. HIPAA
3. Consumer Digest Guidelines
4. American Recovery and Reinvestment Act of 2009
Correct Answer: 1
Rationale 1:
Medicare and Medicaid provide financial incentives for eligible healthcare providers who
adopt and meaningfully use electronic health records (EHRs). These incentives are part of the
Health Information Technology for Economic and Clinical Health (HITECH) Act, which is a
component of the American Recovery and Reinvestment Act of 2009 (ARRA). Through
Medicare and Medicaid EHR Incentive Programs, eligible professionals and hospitals can
receive incentive payments for implementing and effectively utilizing certified EHR
technology to improve patient care and health outcomes.
Rationale 2:
HIPAA (Health Insurance Portability and Accountability Act) primarily focuses on protecting
the privacy and security of health information and does not provide funding for EHR
adoption. While HIPAA regulations may influence the implementation and use of EHRs by
specifying security and privacy requirements, it does not offer financial assistance for EHR
implementation.
Rationale 3:
Consumer Digest Guidelines do not typically provide funding or incentives for EHR
adoption. Consumer Digest Guidelines may offer recommendations or criteria for selecting
EHR systems, but they are not a source of financial assistance for healthcare providers
seeking to implement EHR technology.
Rationale 4:
The American Recovery and Reinvestment Act of 2009 (ARRA) includes the Health
Information Technology for Economic and Clinical Health (HITECH) Act, which provides
funding and incentives for EHR adoption through Medicare and Medicaid EHR Incentive
Programs. However, the ARRA itself is not a direct method for funding EHR implementation;
rather, it establishes the framework for the HITECH Act, which offers financial incentives for
eligible healthcare providers.
Question 6
To receive financial incentives, hospitals and physician offices must meet designated criteria
established by which organization?
1. Centers for Medicare and Medicaid
2. The Joint Commission
3. American Nurses Association
4. TIGER Initiative
Correct Answer: 1
Rationale 1:
The Centers for Medicare and Medicaid Services (CMS) administer the Medicare and
Medicaid Electronic Health Record (EHR) Incentive Programs, which provide financial
incentives to eligible healthcare professionals, hospitals, and critical access hospitals that
demonstrate meaningful use of certified EHR technology. CMS establishes the criteria and
requirements for meaningful use, as well as the specific measures that healthcare providers
must meet to qualify for incentive payments. Compliance with CMS criteria is necessary for
hospitals and physician offices to receive financial incentives under the Medicare and
Medicaid EHR Incentive Programs.
Rationale 2:
The Joint Commission is a healthcare accreditation organization that sets standards for
healthcare organizations and evaluates their compliance through accreditation surveys. While
The Joint Commission may assess the use of electronic health records (EHRs) as part of its
accreditation process, it does not administer financial incentive programs related to EHR
adoption.
Rationale 3:
The American Nurses Association (ANA) is a professional organization representing nurses
in the United States. While the ANA may advocate for policies related to electronic health
records (EHRs) and informatics, it does not administer financial incentive programs or
establish criteria for EHR adoption.
Rationale 4:
The TIGER Initiative (Technology Informatics Guiding Education Reform) is a collaborative
effort focused on advancing nursing informatics competencies and the integration of health
information technology (HIT) into nursing education and practice. While the TIGER
Initiative aims to promote the meaningful use of electronic health records (EHRs) among
nurses, it does not administer financial incentive programs or set criteria for EHR adoption.
Question 7
Healthcare entities, as well as their business associates, must notify individuals whose health
information is breached within 60 days of that breach. In which of the following cases does
the entity not have to notify the individual whose information has been breached?
1. If data are anonymous
2. If data are encrypted
3. If data are misplaced in setting
4. If data are lab results
Correct Answer: 2
Rationale 1:
If data are anonymous, meaning they cannot be linked to an individual, there is typically no
requirement to notify individuals in the event of a breach because the data do not pose a risk
to individuals' privacy or security.
Rationale 2:
If data are encrypted, and the encryption meets specified standards outlined in the Health
Insurance Portability and Accountability Act (HIPAA) Breach Notification Rule, the entity
may be exempt from the notification requirement. Encrypted data are considered secure
because they are rendered unreadable without the appropriate decryption key, reducing the
risk of unauthorized access to protected health information (PHI).
Rationale 3:
If data are misplaced in a setting where they are not accessible to unauthorized individuals
and there is no indication that the data have been accessed or compromised, the entity may
not be required to notify individuals of the breach. However, if there is a risk that the data
could be accessed or compromised, notification may still be necessary.
Rationale 4:
If data are lab results and they contain identifiable health information, such as a patient's
name or medical record number, and the breach poses a risk to the privacy or security of the
individual, notification may be required under HIPAA regulations. Lab results are considered
protected health information (PHI), and breaches involving PHI are subject to notification
requirements under HIPAA.
Question 8
Which act eases the budgetary impact of EHR thereby facilitating implementation?
1. HIPAA
2. ARRA
3. ESIGN
4. HITECH
Correct Answer: 4
Rationale 1:
HIPAA (Health Insurance Portability and Accountability Act) primarily focuses on protecting
the privacy and security of health information and does not specifically address the budgetary
impact of EHR implementation.
Rationale 2:
The American Recovery and Reinvestment Act of 2009 (ARRA) includes provisions related
to healthcare and health information technology, but it is the Health Information Technology
for Economic and Clinical Health (HITECH) Act, which is part of ARRA, that specifically
addresses the budgetary impact of EHR implementation. Therefore, while ARRA is related to
healthcare funding, it is the HITECH Act that directly facilitates EHR implementation by
providing incentives and support.
Rationale 3:
The Electronic Signatures in Global and National Commerce (ESIGN) Act is legislation that
facilitates the use of electronic signatures and records in interstate and foreign commerce.
While ESIGN promotes the use of electronic records, it does not specifically address the
budgetary impact of EHR implementation in healthcare settings.
Rationale 4:
The Health Information Technology for Economic and Clinical Health (HITECH) Act, which
is part of the American Recovery and Reinvestment Act of 2009 (ARRA), eases the
budgetary impact of EHR implementation by providing financial incentives, grants, and
support for eligible healthcare providers to adopt and meaningfully use certified EHR
technology. HITECH encourages the widespread adoption of EHRs to improve healthcare
quality, safety, and efficiency while also addressing the financial challenges associated with
implementation.
Question 9
HIPAA and HITECH have designated some technical standards as mandatory. Which of the
following are associated with the implementation of standards?
1. The standards are insufficient to enable collection, management, and exchange of the
mandated data.
2. Technical standards are needed to assure that structured and codified terminologies
3. Technical standards are needed to sufficiently capture all of health care
4. Standards must be widely available
5. Technical standards should be easily exchanged within and across organizations
Correct Answer: 1, 2, 3, 4, 5
Rationale 1:
The implementation of technical standards may face challenges if the standards are
insufficient to enable the collection, management, and exchange of the mandated data. In
such cases, additional development or refinement of standards may be necessary to ensure
interoperability and data exchange.
Rationale 2:
Technical standards are needed to assure that structured and codified terminologies are used
consistently across healthcare systems. This ensures that healthcare data are accurately
recorded, encoded, and exchanged, supporting interoperability and the meaningful use of
health information.
Rationale 3:
Technical standards are needed to sufficiently capture all of health care by providing
guidelines and requirements for data collection, storage, transmission, and retrieval.
Comprehensive standards help ensure that healthcare information is captured in a
standardized format, facilitating interoperability and the exchange of health information
across different systems and settings.
Rationale 4:
Standards must be widely available to ensure their adoption and implementation across
healthcare organizations and technology vendors. Widely available standards promote
interoperability and consistency in health information exchange, allowing different systems
and stakeholders to communicate and share data effectively.
Rationale 5:
Technical standards should be easily exchanged within and across organizations to facilitate
interoperability and seamless data exchange. Standards that are easily accessible and
implementable support the integration of diverse healthcare systems and promote
collaboration among healthcare stakeholders, ultimately improving patient care and health
outcomes.
Question 10
Which of the following skills are needed by nurse informaticists?
1. Communication
2. Mining data
3. Analyze data aggregates
4. Design in-case process
5. Design functional and clinically valid decision support
Correct Answer: 1, 2, 3, 4, 5
Rationale 1:
Communication skills are essential for nurse informaticists to effectively convey information,
collaborate with interdisciplinary teams, and facilitate the implementation and optimization
of health information technology (HIT) systems. Strong communication skills enable nurse
informaticists to bridge the gap between clinical practice and technology, engage
stakeholders, and advocate for patient-centered care.
Rationale 2:
Nurse informaticists need to possess skills in data mining to extract meaningful insights and
patterns from large datasets. Data mining techniques allow them to identify trends, patterns,
and associations within clinical data, which can inform decision-making, quality
improvement initiatives, and evidence-based practice.
Rationale 3:
Analyzing data aggregates involves the ability to synthesize and interpret large volumes of
data to derive actionable insights and inform strategic decision-making. Nurse informaticists
must be proficient in analyzing data aggregates to identify trends, outcomes, and performance
metrics, which can guide process improvement efforts and support evidence-based practice.
Rationale 4:
Designing in-case processes involves developing workflows, protocols, and procedures that
optimize the use of health information technology (HIT) systems within clinical practice
settings. Nurse informaticists need to have the skills to design efficient and user-friendly
processes that align with clinical workflows, enhance patient care delivery, and promote the
adoption of HIT solutions.
Rationale 5:
Designing functional and clinically valid decision support involves developing and
implementing clinical decision support tools and systems that assist healthcare providers in
making informed and evidence-based decisions at the point of care. Nurse informaticists must
have the skills to design decision support interventions that are clinically relevant,
contextually appropriate, and aligned with best practices, guidelines, and standards of care.
Question 11
The need for informaticians who understand health care has grown. Which of the following
best represents the future of nursing informatics?
1. The role of the nurse informatician will decrease in the future with an emphasis on medical
informatics.
2. The need for nurse informaticians will increase in the future.
3. The need for nurses to specialize in informatics is unnecessary.
4. Nurses need advanced education to participate in the design and implementation of the
information system.
Correct Answer: 2
Rationale 1:
A nurse can specialize in informatics in graduate school. Baccalaureate education prepares a
nurse generalist. The growth of the specialty is expected to grow in the future.
Rationale 2:
A nurse can specialize in informatics in graduate school. The need for nurse informaticians
will increase as the EHR and the 2014 deadline looms for organizations.
Rationale 3:
The need for nurse informaticians will grow with the resultant increase in technology.
Rationale 4:
Advanced education prepares the nurse informatician for leadership and research. However, a
graduate degree is not necessary for participation in the development of the information
system initiative.
Question 12
____________________________ is a specialty in nursing that focuses on the technology
aspect of patient care.
Correct Answer: Nurse Informatics Specialist
Rationale:
Nurse Informatics Specialist is a considered a specialty in nursing that focuses on the
technology aspect of patient care. A nurse can become a specialist through completion of a
graduate degree.
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
