.
You decide to interview all the key stakeholders involved in an informatics
intervention as part of the planning process. Together you identify the resources
available, the likely barriers, and the short-term and long-term objectives. Which
kind of theoretical model are you using?
Selected
Answer:
Response
Feedback:
a.
Logic model
Program theory models consist of the implicit ideas and beliefs of key
stakeholders. A logic model is a representation of components and
mechanisms of the program. Basically, a logic model is a systematic
and visual way to present and share your understanding of the
relationship among the resources you have to operate your program,
the activities you plan, and the changes or results you hope to achieve.
•
Question 2
1 out of 1 points
A method for exchanging patient data among healthcare organizations that is
endorsed by the federal government is:
Selected
Answer:
Response
Feedback:
d.
implementing a secure internet connection using components of the
eHealth Exchange.
The eHealth Exchange (formerly the Nationwide Health Information
Network) is a method for exchanging data endorsed by the federal
government and used by organizations from all 50 states as well as
four federal agencies. The other methods listed are not considered
safe and confidential, and the federal government does endorse health
information sharing.
•
Question 3
1 out of 1 points
Your organization hires you to conduct a formative evaluation of a new informatics
intervention. Which areas would you focus on in a formative evaluation?
Selected
Answer:
Response
Feedback:
d.
Intervention fidelity, implementation quality, and types of personnel
A formative evaluation is an assessment of how well a program is
being implemented. Intervention fidelity, implementation quality, and
types of personnel are areas that would be focused on in formative
evaluation. Results of the formative evaluation are used as feedback to
the program for continuous improvement.
•
Question 4
1 out of 1 points
If you choose to evaluate an informatics intervention by examining the impact on a
clinician’s ability to think ahead about future events, which level of situation
•
Question 1
1 out of 1 points
awareness would you be measuring?
Selected
Answer:
Response
Feedback:
c.
Projection
Projections are expectations of outcomes in the future. Projections
are driven by implicit theories and knowledge about the causal
mechanisms underlying events.
•
Question 5
1 out of 1 points
A facility calls in experts to review evidence developed in research and develop
guidelines for clinical practice. Which stage of EBP is represented?
Selected
Answer:
Response
Feedback:
c.
Translation to guidelines
In the third stage of EBP, translation, experts are called on to consider
the evidence summary, fill in gaps with consensus expert opinion, and
merge research knowledge with expertise to produce clinical practice
guidelines (CPGs).
•
Question 6
1 out of 1 points
When data are passed between two systems, the receiving system must
understand the content of the message. The infrastructure that guides the
comprehensible model and terminology in the receiving system is called:
Selected
Answer:
Response
Feedback:
d.
semantic interoperability.
Semantic interoperability ensures that the data passed between two
systems are understandable by the receiving system. This is
accomplished by mapping the content of the message to a comparable
and comprehensible model and terminology in the receiving system.
Semantic interoperability supports understandable communication
between users among multiple systems. Syntactic interoperability is a
common exchange mechanism and message format. System
interoperability is the ability to integrate data within an organization.
Interface engines are intersystem communication methodologies using
point-to-point connections to allow different systems to share data and
information.
REF: Pages 81-82
•
Question 7
1 out of 1 points
Select the option that best describes the current major challenges for informatics
infrastructure.
Selected d.
Answer: Storage architectures, lack of implemented standards, and
applications match clinical workflow
Response
Feedback:
Challenges exist with all of the answers, but the major challenges for
healthcare IT are the ability for clinical applications to integrate well
with clinical workflow, data integration and interoperability due to lack
of standards, and the robustness of storage architectures. Data
respositories have limited storage and are not able to retain processing
information for clinical decision support transactions. The time to
export all patient data, medical data, pharmacy data, and the volumes
of nursing documentation to repositories for business intelligent data
analysis is limited. Nursing decision making data are not consistently
exported to business intelligent application for data analysis because
healthcare systems limit the volume of data to complete the daily
exporting function within a 24-hour period of time. Current clinical
applications lack the usability for clinical workflow and at times result in
users having to duplicate documentation, cause errors of omission of
care, use dual screens to accomplish decisions, or result in additional
work to click open multiple screens to complete a task about care
processes. Ongoing challenges include upgrades, customization,
multiple applications, inflexible application programming interfaces that
require effort in order to add new components, the ability to handle
new information that was not anticipated in the original design, the
ability of databases to scale in size to accommodate large amounts of
online data, patient data with a lifetime measured in decades when the
technology will be enhanced or replaced in 5 or 10 years (or less), and
transitioning the data in the repository to new technology without loss
of information.
REF: Pages 84-85
•
Question 8
1 out of 1 points
The use of opinion leaders and real-time feedback about patient outcomes are
examples of which type of intervention?
Selected
Answer:
Response
Feedback
:
d.
Offer mechanisms to diffuse and adopt new knowledge and include
innovation
The interventions are describing diffusion of innovations. These
interventions offer an understanding of the mechanisms by which
individual, small group, and organizational contexts affect the diffusion,
uptake, and adoption of new knowledge and include innovation as an
essential step with the design of EBP initiatives. The use of opinion
leaders, champions, and real-time feedback is a specific intervention
that serves to accelerate the adoption of best evidence in practices
among healthcare professionals. The remaining options involve
identifying a question/topic/problem in healthcare, retrieving relevant
evidence to address the identified issue, creating opportunities for
regular working relationships between scientists and clinicians who
intervene to put new discoveries into practice, and legislating policies
to diffuse the practice. Process analysis and engineering workflows are
interventions to incorporate practice changes into daily care activities.
REF: Pages 40-41
•
Question 9
1 out of 1 points
Health informatics is both a as well as a(n) .
Selected
Answer:
Response
Feedback:
b.
profession; discipline
Health informatics is a discipline, or field of study, in the same sense
that “medicine,” “sociology,” and “pharmacy” are fields of study. It is
also a profession, practiced by thousands of informaticians in a
number of varied roles within the healthcare industry.
•
Question 10
1 out of 1 points
Which two hurdles does the STAR Model address in employing evidence-based
practice?
Selected
Answer:
Response
Feedback:
a.
The volume and form of
knowledge
The STAR Model addresses two major hurdles in employing evidence-
based practice (EBP). These two hurdles are the volume of current
professional knowledge and the form of knowledge that healthcare
professionals attempt to apply in practice.
•
Question 11
1 out of 1 points
The definition of healthcare informatics is defined by several organizations. Which
of these statements would best define healthcare informatics in the understanding
of clinicians such as nurses and other professional caregivers?
Selecte
d
Answer:
c.
An interdisciplinary professional specialty and scientific discipline that
integrates the health sciences, computer science, and information
science as well as other analytic sciences with the goal of managing and
communicating data, information, knowledge, and wisdom in providing
care for individuals, families, groups, and communities.
Response The answer C best describes the definition for caregivers who are
Feedback: required to use best evidence-based practices (health sciences for
nursing, medicine, rehabilitation, etc.); this answer includes the need to
have knowledge resources (nursing, medical, and pharmaceutical
databases) and methods to analyze this data/information over time to
support and guide care. Answer A focuses on IT professionals and
lacks the factors for clinical knowledge and decision making
processes. Answer B is central to professionals managing the
requirements of the legal record and tasks that are occurring with the
information in research, education, and practice and so limits the
scope of needs for clinicians. Answer D is focused on many aspects of
clinical data with a focus to improve the science of health services.
REF: Pages 2-3
•
Question 12
Differences between formative and summative evaluation include:
1 out of 1 points
Selected
Answer:
Response
Feedback:
a.
assessments.
Formative evaluation refers to an assessment of how well the program
is being implemented and describes the experience of participants. It
includes the fidelity of the intervention, the quality of implementation,
the characteristics of the organizational context, and the types of
personnel. Needs assessments and feasibility analyses are included in
this formative evaluation. Summative evaluation, however, refers to an
assessment of the outcomes and impact of the program. Cost-
effectiveness and adverse events analyses would be included in a
summation evaluation. The methods and the terms of the content of
the information collected are often the same for both.
REF: Page 61
•
Question 13
The options for cloud computing are best described as:
0
out of 1 points
Selected
Answer:
Response
Feedback:
c.
public-resource computing .
Cloud computing can be best described using three models: software
as a service (SaaS), where service providers operate applications at
web locations for healthcare providers or users; infrastructure as a
service (IaaS), where local healthcare staff members are responsible
for deploying the operating system, applications, databases, and tools
and supporting those installed assets while the users connect to the
assets deployed on the IaaS resources through the internet or via a
virtual private network; and platform as a service (PaaS), where the
entire platform for running the healthcare computing includes the
operating system, application server, web server, and database, and
the healthcare provider installs or develops software on the resources
provided. Application service providers (ASP) are companies that host
an EHR or departmental system solution for a healthcare enterprise
and provide access to an application via a secure network. An ASP
model relieves the healthcare enterprise from having to host and
support the technical components of the EHR, which may lead to lower
capital infrastructure costs. Public-resources computing is known as
global computing or peer-to-peer computing to do scientific
supercomputing to encourage awareness and interests of current
scientific research and gives the public a measure of control over the
directions of scientific progress. Web-accessible decision support
database applications are increasingly complex healthcare service
solutions using electronic audiovisual tools or mobile applications to
educate patients, caregivers, or clinicians about diabetes management
and assess a psychological, behavioral, or clinical outcome.
REF: Page 84
•
Question 14
1 out of 1 points
Computer applications are grouped according to the objects (data, information,
and/or knowledge) they processed. Several models illustrated the types of objects
processed. Wisdom was added to what model to manage and solve human
problems?
Selected
Answer:
Response
Feedback:
c.
Nelson’s model
Shannon and Weaver were concerned about the message moving
between sender and receiver and the amount of information in a
message and how to manage simple parts of a message. In 1989,
Nelson extended the Blum (medical) and Graves and Corcoran
(nursing) data, information, and types of knowledge continuum to
include wisdom. Effective use of wisdom to manage a patient problem
requires a combination of values, experience, and the four types of
knowledge identified by Graves and Corcoran. The concepts of data,
information, knowledge, and wisdom overlap and interrelate as
demonstrated by the overlapping circles and arrows in Nelson’s model.
What is information in one context may be data in another.
REF: Pages 22-25
•
Question 15
1
out of 1 points
When managing the interrelationships among the stakeholders to further develop
EHR systems, health information technology (HIT) professionals need to facilitate
life-cycle change. Select the foundational health informatics knowledge HIT
professionals need to consider?
Selected
Answer:
Response
Feedback:
c.
Healthcare providers advocate for their involvement in selecting
systems that directly and indirectly impact patient care.
The best statement is D where clinicians and healthcare providers are
to advocate for being involved in selecting systems that both directly
impact them and indirectly impact their practice. Healthcare providers
do not need to change their practice to add extra daily workflow steps
to work around issues caused by another department’s software
system. The steps to acquire software need to include all stakeholders
to avoid work arounds and maximize functions of the EHR
applications. Clinical informaticians cannot advocate for clinical
providers because informaticians do not fully understand the care
practices of the various disciplines.
REF: Pages 4-5
•
Question 16
The primary characteristics used to analyze an open system include:
1 out of 1 points
Selected
Answer:
Response
Feedback:
c.
structure, purpose, and functions.
Using these three characteristics, one can determine why the system
exists, what functions it performs to achieve its purpose, and how it is
structured to achieve its purpose.
•
Question 17
1 out of 1 points
You are leading an effort to implement a clinical decision support system. In order to
improve the patient specificity of your CDS rules, you would:
Selected
Answer:
Response
Feedback:
b.
store rules in a knowledge base and allow clinician experts to review
and update the rules.
In order to improve CDS rules, you would store rules in a knowledge
base and allow clinician experts to review and update the rules. The
other choices do not address patient specificity; allowing experts to
update rules and make the rules immediately available to the CDS can
improve patient specificity.
•
Question 18
1 out of 1 points
All data instances within patient clinical records are collected and stored in what
component of the electronic health record?
Selected
Answer:
Response
Feedback:
d.
Clinical data
repository
The clinical data repository (CDR) is the storage component for all
instances of data within patient clinical records. An instance of data
can be described as an actual piece of information collected by data
entry or automated means for a specific patient at a point in time.
Examples include lab results, medication orders, vital signs, and
clinical documentation.
REF: Pages 75-77
•
Question 19
What is the primary difference between an open and closed system?
1 out of 1 points
Selected
Answer:
Response
Feedback:
d.
An open system has a semipermeable boundary and therefore will
filter both inputs and outputs when interacting with the environment.
With an open system the boundary is semipermeable, thereby
controlling what will be accepted as input and what will be permitted
to leave the system.
•
Question 20
1 out of 1 points
Which statement describes a repository with central storage of a longitudinal
record?
Selected
Answer:
Response
Feedback:
b.
The information collected by the organization is stored in a single
database no matter when or where the patient was seen.
The information collected by an organization that is stored in a single
database no matter when or where the patient was seen is an example
of a repository with central storage of a longitudinal record. The other
items describe aspects of distributed and/or encounter-based records.
•
Question 21
UTAUT is a theory of:
1 out of 1 points
Selected
Answer:
Response
Feedback:
c.
acceptance and use of technology.
The unified theory of acceptance and use of technology (UTAUT)
assesses factors associated with effective use.
•
Question 22
1 out of 1 points
A(n) is considered the gold standard research design for answering
questions about the efficacy of treatments.
Selected
Answer:
Response
Feedback:
a.
RCT
An experimental design, often called a “randomized controlled trial
(RCT),” has emerged as the gold standard research design for
answering questions about the efficacy of treatments.
•
Question 23
1 out of 1 points
An emerging approach to knowledge building includes measuring the effectiveness
of EBP guidelines. This approach requires steps to obtain clinical data through the
application of PBE research design techniques. These techniques include:
Selected
Answer:
Response
Feedback:
d.
using collected electronic data with cohort samples of patients with
identified characteristics to detect subtle patterns within comprehensive
standardized data about practice interventions and treatments.
The techniques include accessing very large samples of
comprehensive standardized data on large cohorts of patients with
specified characteristics to detect subtle patterns in the documented
data, even with missing or less than optimal data quality available from
EHRs. Standardized valid data and patient characteristics compensate
for the lack of randomization in the practice setting. Observational
studies use prospective research designs to record valuable
information under naturalistic conditions to characterize disease risk
and generate hypotheses about potentially effective treatments or how
well treatments work in actual practice. Chart reviews are
observational studies using retrospective data to determine
effectiveness of treatments. Randomized control trials use the gold
standard experimental research design involving randomized
assignment of patients with tightly controlled inclusion criteria.
REF: Pages 49-50
•
Question 24
1 out of 1 points
What is the main idea of the subsection titled “Why Informatics Is Needed in
Healthcare: An Example”?
Selected
Answer:
b.
An interoperable healthcare system that provides clear, concise patient
data and information among institutions is lacking in many facilities, and
its presence would greatly facilitate things such as patient transfers.
Response This subsection takes the specific case of the transfer of geriatric
Feedback: patients from a hospital setting to a long-term skilled nursing facility
(SNF) and uses it to illustrate the great need for an interoperable
healthcare system that allows patient data to be transferred quickly,
clearly, and concisely among facilities.
•
Question 25
1 out of 1 points
The STEEEP recommendations and redesign principles reflected in health
professional education programs to improve the quality of care are best described
as:
Selected
Answer:
Response
Feedback:
c.
safe, timely, effective, efficient, equitable, and patient-centered.
The recommendations to redesign healthcare were to avoid injuries,
reduce harmful delays or waiting time, provide services based on
scientific knowledge, avoid waste, equalize quality, and respond to
patient preferences. C best describes the principles used in education
to ensure all professions are focused on evidence-based quality
improvement in care delivery.
REF: Pages 39-40; Table 3-1
•
Question 26
In a social network analysis, each node is usually a(n):
1 out of 1 points
Selected
Answer:
Response
Feedback:
a.
individual or unit of analysis.
The patterns of connection between people in a social network
analysis (SNA) are displayed as a visual network of nodes and lines.
Nodes are individuals, and lines are interactions between them.
•
Question 27
Which are the three general types of learned behaviors?
1 out of 1 points
Selected
Answer:
Response
Feedback:
a.
Cognitive, affective, and psychomotor
Learning is defined as an increase in knowledge, a change in attitude
or values, or the development of new skills. Learned behaviors can be
cognitive (intellectual skills), affective (values and attitudes), or
psychomotor (the integration of cognitive and motor skills).
•
Question 28
Knowing when and how to use knowledge is referred to as:
Selected c.
1 out of 1 points
Answer:
wisdom.
Response
Feedback:
Wisdom is defined as the appropriate use of knowledge in managing
or solving human problems. It is knowing when and how to use
knowledge in managing patient need(s) or problem(s).
•
Question 29
1 out of 1 points
Data and information within the EHR systems provide opportunities to generate
knowledge. Healthcare providers must have an understanding of health informatics.
Which of the following statements best describes their role in knowledge
generation?
Selected
Answer:
Response
Feedback:
b.
The clinician supports the use of standardized languages to document
patient care to allow others such as patients and other clinicians to
search the terms to understand the assessments, diagnoses, treatment
procedures, therapy, or intervention.
The correct answer is A. When clinicians use standard languages with
definitions this supports the correct documentation by clinicians into
the EHR and when all healthcare systems use this common standard
in their EHR this generates alike terms being available within data
warehouses for researchers to integrate the data and query many EHR
data warehouses in order to generate new knowledge about what
treatments resulted in best outcomes for specific diagnosis for patient
demographics. Healthcare providers could also query a local data
warehouse to see how others are treated with a defined diagnosis to
know what treatments worked for best outcomes and what did not
work within the local environment. The other three answers are
examples of how existing knowledge is used in clinical decision
support interventions.
REF: Page 5
•
Question 30
Knowledge is the point of convergence across the areas of:
1 out of 1 points
Selected
Answer:
Response
Feedback:
c.
evidence-based practice, improvement, and
informatics.
Knowledge is the point of convergence across the areas of evidence-
based practice, informatics, and improvement. None of the other
answers include all of these aspects.
•
Question 31
1 out of 1 points
The chapter makes the argument for increased automation for such things as
managing supplies, because studies have shown that .
Selected
Answer:
Response
Feedback:
a.
nurses waste “an hour a shift” finding
equipment
The chapter focused on using health informatics and technology
solutions to free up nurses’ days so they can spend more time at
patients’ bedsides and less on extraneous duties. A 2011 study by the
Robert Wood Johnson Foundation found that nurses do use an hour
per shift of their time simply hunting down equipment.
•
Question 32
1 out of 1 points
Which factor would strongly influence the reliability of an EHR’s repository?
Selected
Answer:
Response
Feedback:
a.
The redundancy of storage
hardware
Architectural and procedural models such as the redundancy of
storage hardware and access routes, contribute to the reliability of an
EHR’s data repository. The other items affect application use,
accessibility, and security.
•
Question 33
Which type of review is considered the most rigorous?
1 out of 1 points
Selected
Answer:
Response
Feedback:
d.
Systematic reviews
Evidence summaries include evidence synthesis, systematic reviews,
integrative reviews, and reviews of the literature, with systematic
reviews being the most rigorous approach to evidence summary.
•
Question 34
1 out of 1 points
You decide to base the evaluation plan of your informatics project on the theory of
planned behavior. Which constructs will you use to develop your measurements?
Selected
Answer:
Response
Feedback:
a.
Values, expectations of others, behaviors, and perceived self-
efficacy
The theory of planned behavior focuses on the ability to predict
intentions and behavior as a function of beliefs about the value of an
outcome, the likelihood that the outcome will occur given the behavior,
beliefs about the expectations of others, and self-efficacy beliefs about
the personal ability to engage in the activity.
•
Question 35
1 out of 1 points
The “butterfly effect” describes a situation in which a minor change in input (eg, a
butterfly flapping its wings in one part of the world) can have a major effect on
output (eg, a windstorm developing in another part of the world). This aspect of
chaotic systems illustrates their property of:
Selected
Answer:
Response
Feedback:
c.
the reiterative feedback loop.
Chaotic systems are dynamic systems with reiterative feedback loops.
A minor change in input can create a major change in output. This is
often described as the butterfly effect. A butterfly’s flapping wings in
California can over time become a hurricane in New York.
•
Question 36
1 out of 1 points
A commonly used model for healthcare system change is the systems life cycle
(SLC). This model describes stages or phases of an informatics project and it
guides system implementation from initial feasibility through a more completed
stage of maintenance and evaluation of the products. The Staggers and Nelson
Systems Life Cycle Model (SLCM) includes:
Selected
Answer:
Response
Feedback:
b.
Analyze, plan, develop/purchase, test, implement/go-live/maintenance
and evolve, and evaluate and return to analyze.
The Staggers and Nelson SLCM specifies and emphasizes additional
phases to develop or purchase information technology and to test what
was developed or purchased, as well as the return to analyzing the
care processes to identify problems with workflow. The phases of
large-scale HIT change have been described for technology
professionals as planning with analysis, implementation, stabilization,
optimization, and transformation. Often project managers may
organize by the 3 phases of implementation with detailed tasks
included within the phases or may use the systems development life
cycle model used in project management to describe stages or phases
of an informatics project and guide system implementation from initial
feasibility through a more completed stage of maintenance and
evaluation of the products.
REF: Pages 32-33
•
Question 37
0
out of 1 points
Which group will test out new technology but are not usually seen as leaders within
an organization?
Selected a.
Answer:
Response
Feedback:
Early majority
Innovators will test out a new technology; however, they are too far
ahead of the social group to be seen as leaders by other members of
the social system. Early adopters are seen as much more discreet in
their selection of new technology and are therefore better at selling a
new technology to a group of potential users.
•
Question 38
1
out of 1 points
The is one of the oldest—and still widely used—methods for building and
implementing software applications in IT arena.
Selected
Answer:
Response
Feedback:
b.
SDLC
Though it’s been through a number of iterations and adjustments, the
software development life cycle remains the tested and tried-and-true
method for studying, building, implementing, and maintaining a health
information system.
•
Question 39
1 out of 1 points
The visual representation that illustrates what is occurring and how one
understands the intervention to solve a problem is called a:
Selected
Answer:
Response
Feedback:
d.
model.
A model is a visual representation of a theoretical framework. A theory
explains the “what” and “how” of a phenomenon (heartbeat) and a
theory can provide direction for planning interventions and
understanding and managing a problem. Initial observation of a
phenomenon stimulates the need to develop a theory to explain that
phenomenon. Many of the models in healthcare and health informatics
use a combination of theories in explaining phenomena of interest in a
discipline, and this model may fit the definition of a theoretical
framework. The building blocks of a theory are concepts. Concepts
may be abstract or concrete and provide structure to a theory.
REF: Pages 13-14
•
Question 40
1 out of 1 points
The top three uses of the U.S. Army’s telehealth network include all of the following
EXCEPT .
Selected
Answer:
a.
otolaryngology
Response
Feedback:
The biggest use of the U.S. Army’s telehealth network is for behavioral
telehealth, followed by cardiology and dermatology. While
telemedicine is making inroads in otolaryngology, it is not among the
top three uses for the U.S. Army.
