The name of the government agency that has led the development of basic data sets for health records and computer databases is the:
Centers for Medicare and Medicaid Services
John Hopkins University
American National Standards Institute
National Committee on Vital and Health Statistics
Minimum data set in healthcare are developed to:
Recommend common data elements to be collected in health records
Mandate all data that must be contained in a health record
Define reportable data for federally funded programs
Standardize medical vocabulary
Data that are collected from individual records and then combined are referred to as:
Statistics
Information
Aggregate data
Standards
The inpatient data set that has been incorporated into federal law and is required for Medicare reporting is the:
Ambulatory Care Data Set
Uniform Hospital Discharge Data Set
Minimum Data Set for Long-term Care
Health Plan Employer Data and Information Set
Both HEDIS and the Joint Commission's ORYX program are designed to collect data to be used for:
Performance improvement programs
Billing and claims data processing
Developing hospital discharge abstracting systems
Developing individual care plans for residents
Critique this statement: The continutity care record contains only current clincial information:
This is a true statement.
This is a false statement as the CCR contains both current and future plans
This is a false statement as the CCR contains both past information
This is a false statement as the CCR contains both future and past clinical information.
Standardizing medical terminology to avoid differences in naming various medical conditions and procedures (such as the synonyms bunionectomy, McBride procedure, and repair of hallus valgus) is one purpose of:
Transaction standards
Content and structure standards
Vocabulary standards
Security standards
The federal law that directed the Secretary of Health and Human Services to develop healthcare standards governing electronic data interchange and data security is the:
Medicare Act
Prospective Payment Act
Health Insurance Portability and Accountability Act of 1996
American Recovery and Reinvestment Act
A key technology tool for enabling data is:
Content standard
Vocabulary standard
Extensible markup language
Metadata standards
Most healthcare informatics standards have been implemented by:
Federal mandate
Consensus
State regulation
Trade association requirement
A critical early step in designing an EHR is to developed a ____ in which the characteristics of each data element are defined
Accrediation manual
Core content
Continuity of care record
Data dictionary
According to the UHDDS definiton, ethnicity should be recorded on a patient record as:
Race of mother
Race of father
Hispanic, non-hispanic, unknown
Free text descriptor as reported by patient
Mary Smith, RHIA has been asked to work on the develpment of a hospital trauma data registry. Which of the following data sets would be most helpful in developing this registry?
DEEDS
UACDS
MDS Version 3.0
OASIS
While the focus of inpatient data collection is on the principal diagnosis, the focus of ______ outpatient data collection is on:
Reason for admission
Reason for encounter
Discharge diagnosis
Activities of daily living
In long term care, the resident's care plan is based on data collected in the:
UHDDS
HEDIS
Reinbursement for home health services in dependent of data collected from:
A consumer interested in comparing the performance of health plans should review data from:
ORYX
Administrative data
Claims data
Health record review data
Administrative, claims, and health record review data
Each of the three dimensions (personal, provider, community) of information defined by the National Health Information Infrastructure (NHII) contains specific recommendations for:
government regulations
core data elements
privacy controls
technology requirements
A statewide cancer surveillance system is an example of which of the NHII dimensions?
Personal
Provider
Community
Payer
Providers and health plans need to share information. What standard must they use?
X12N
LOINC
IEE 1073
DICOM
A radiology department is planning to develop a remote clinic and plans to transmit images for diagnostic purposes. The most important standards to implement in order to transmit images is:
IEEE 1073
I work for outpatient surgery center. What data set should I use?
Continuity of Care Record
Minimum data set
Uniform Ambulatory Care data set
Uniform Hospital Discarge data set
Laboratory data is succnessfully transmitted back and forth from Community Hospital to three local physician clinics. This successful transmission is dependent on which of the following standards?
RxNorm
As many private and public standards groups promulgate health informatics standards, the Office of the National Coordinator of Health Information Technology has been given resposibility for:
Developing unique provider indentifiers
Finalizing the extensible markup language
Harmonization of standards from multiple sources
Building software systems to support EHR development
