Healthcare Information Technology (D516)

Correct Answer

A. Comprehensive Digital Repository

Explanation

The Electronic Health Record (EHR) primarily functions as a comprehensive digital repository, storing a wide variety of patient data, including medical history, test results, medication orders, and clinical notes. It enables healthcare providers to access and update patient information in real-time, ensuring that patient data is complete, up-to-date, and accessible at all times. This centralization improves healthcare quality and efficiency by facilitating communication and decision-making.

Why other options are wrong

B. Static Paper Record

A static paper record is outdated in comparison to the dynamic and real-time functionality of an EHR. While paper records are fixed and require manual updating, EHRs are electronic, allowing for continuous updates and easy access by multiple healthcare providers. Therefore, the EHR does not function as a static paper record.

C. Set of Components

Although an EHR is made up of multiple components (such as clinical documentation, order entry, and results management), describing it merely as a "set of components" does not capture its full functionality as a comprehensive digital repository that integrates patient information from various sources.

D. Limited Data Entry Tool

While data entry is a part of the EHR's function, limiting its description to just a data entry tool overlooks its broader role as a comprehensive record-keeping system that consolidates and manages all aspects of patient care.

Correct Answer

C. Create a request for proposal (RFP)

Explanation

Creating a Request for Proposal (RFP) is the next critical step after completing a feasibility study. The RFP allows the healthcare team to outline their specific needs and requirements for the telehealth service, helping potential technology providers submit proposals tailored to these needs. This structured approach ensures that the team can compare and evaluate the offers based on factors like cost, service capabilities, and compliance with industry standards.

Why other options are wrong

A. Conduct a market analysis of existing telehealth solutions

While conducting a market analysis is helpful in understanding the landscape of telehealth solutions, the RFP is the direct tool for selecting a technology provider. A market analysis does not provide the detailed, actionable insights that an RFP allows providers to address in a targeted way.

B. Develop a detailed project timeline

Developing a detailed project timeline is an essential part of project management but is not the immediate next step after a feasibility study. It can be created after selecting the provider, as the timeline will depend on the chosen technology and its integration into the healthcare system.

D. Establish a budget for the telehealth service

Establishing a budget is crucial but should be done in conjunction with other steps, such as the RFP process. The RFP itself will help clarify costs and ensure the selected provider is within the organization’s budget, making it more effective to establish a precise budget after assessing available providers.

Correct Answer

A. A healthcare worker accesses a friend's medical record

Explanation

Accessing a friend's medical record without a legitimate work-related reason constitutes a privacy violation. Healthcare workers are expected to access patient information only when necessary for their job responsibilities, and personal relationships should never influence access to medical data. Violations of this kind breach patient confidentiality and privacy regulations such as HIPAA.

Why other options are wrong

B. A healthcare worker accesses the medical history of a patient

This is not necessarily a privacy violation. Accessing a patient's medical history is appropriate if the healthcare worker is involved in the patient's care. However, it would be a violation if the worker accessed it without a legitimate work-related reason.

C. A medical record is released to another clinic after the patient signs a release

This is not a privacy violation. If the patient has given consent through a signed release form, it is legally permissible to share the medical record with another clinic. The release form ensures that the patient’s rights are respected.

D. A list of diagnoses is reviewed in a staff meeting in order to plan future services

This is not a privacy violation if done in accordance with privacy regulations. If the meeting is appropriate and the discussion involves de-identified information or is conducted in a manner that ensures confidentiality, it would not be a violation.

Correct Answer

A. Patient data analysis

Explanation

Without the use of EHRs, patient data analysis is significantly hindered. EHR systems allow for the rapid collection, aggregation, and analysis of large volumes of patient data, facilitating better decision-making, trend identification, and population health management. Without EHRs, these processes are more cumbersome, time-consuming, and error-prone.

Why other options are wrong

B. Manual billing processes

Manual billing processes are indeed hindered without EHR systems, but this is a more operational challenge than a fundamental healthcare function. While EHRs streamline billing, other systems can be used to manage manual billing. The overall impact is less significant compared to the inability to analyze patient data.

C. Knowledge management

Knowledge management can be hindered by the absence of EHR systems, but it is not as directly impacted as patient data analysis. Knowledge management refers to organizing and sharing information and resources, which can still occur through alternative means, though EHRs provide a more integrated solution.

D. Paper-based record keeping

Paper-based record keeping is indeed hindered without EHRs, but it is a more outdated and transitional challenge. While switching from paper to electronic records is crucial for efficiency and accessibility, the major hindrance lies in the lack of data analysis capabilities, which is a core function that EHR systems enable.

Correct Answer

B. Disgruntled Employees

Explanation

Disgruntled employees are often the primary source of internal security threats because they have direct access to sensitive information and systems. If they are dissatisfied with their job or employer, they may use their knowledge and access to cause harm, intentionally or unintentionally. Such incidents are typically more damaging than external attacks, as insiders often have a deeper understanding of the organization’s network and security vulnerabilities.

Why other options are wrong

A. External Hackers

While external hackers pose significant threats, they are not typically the primary source of internal network security incidents. External hackers generally target vulnerable networks from outside the organization, but internal threats from employees account for a larger percentage of incidents.

C. Malicious Software

Malicious software is indeed a major security concern, but it typically comes from external sources and is not an internal threat. While internal employees may inadvertently introduce malware into the system, it is external actors or malicious software programs, not employees, that are the primary threat.

D. Untrained Staff

Untrained staff members can be a security risk, but they are not typically the primary source of internal threats. While they may accidentally mishandle sensitive data or fall for phishing scams, the most serious internal security breaches usually result from intentional actions taken by disgruntled employees with knowledge of the system.

Correct Answer

B. Return or destroy all protected health information unless it is not feasible or must be retained for a legal reason.

Explanation

Under HIPAA regulations, when a business associate's services are terminated, they are required to either return or destroy the protected health information (PHI) they have been entrusted with, unless it is not feasible or must be retained for legal reasons, such as compliance with other laws. This ensures that PHI is not misused or improperly disclosed after the termination of services.

Why other options are wrong

A. Safeguard and not use the protected health information for 6 years, after which it becomes the property of the business associate.

This option is incorrect because it is not the business associate's property. PHI must be returned or destroyed at the termination of services. There is no provision for it to become the property of the business associate after six years.

C. Create a limited data set with the original protected health information, destroy the balance of the identifiers, and retain the limited data set for business associate use.

This is incorrect because a limited data set is generally used under specific circumstances, not as a default procedure when business associate services are terminated. The business associate must either return or destroy the PHI.

D. Retain the protected health information if the business associate agreement transfers ownership of the data set at the termination of the services.

HIPAA does not permit the transfer of ownership of PHI at the termination of services. The business associate must return or destroy the information, not retain it.

Correct Answer

C. Software update frequency

Explanation

While software updates are important for system security and performance, evaluating the performance of a healthcare information system typically focuses on factors that directly impact daily operations, such as user training, interoperability, and network performance. The frequency of software updates, although important, doesn't directly impact the system’s performance in real-time usage.

Why other options are wrong

A. User training effectiveness

User training is a crucial aspect of system performance. If healthcare staff are not adequately trained, it can result in errors or inefficient use of the system, leading to performance issues.

B. Data interoperability challenges

Interoperability is a key concern when evaluating a healthcare information system. If the system is not compatible with other systems or cannot share data efficiently, it will result in performance issues, making interoperability a vital factor in performance evaluation.

D. Network bandwidth specifications

Network bandwidth is directly tied to the system’s ability to function smoothly. Low bandwidth can cause slowdowns, errors, or delays in accessing data, which are significant performance issues in healthcare environments.

Correct Answer

E. To replace traditional healthcare services with electronic procedures such as providing a diagnosis or other treatment

Explanation

The objective of meaningful use is not to replace traditional healthcare services with electronic procedures but rather to improve the overall quality, safety, and efficiency of healthcare delivery by using electronic health record (EHR) systems. While EHRs enable the electronic exchange of health data, they do not aim to replace face-to-face healthcare or the necessary in-person diagnostic procedures and treatments.

Why other options are wrong

A. To improve quality, safety, and efficiency and reduce health disparities

This is a valid objective of meaningful use. It aims to improve healthcare quality by using EHR technology to reduce errors, streamline workflows, and address disparities in care delivery.

B. To engage patients and family to become involved in their own health care

This is another key goal of meaningful use. It encourages healthcare providers to make patients more active participants in their healthcare by providing them with access to their own health data and other resources.

C. To improve care coordination and public health and safety

This is also an objective of meaningful use. By using EHR systems, healthcare providers can share patient information more easily, improving care coordination and supporting public health initiatives.

D. To maintain privacy and security of patient health information

This is a core objective of meaningful use, as it ensures that EHRs are used in compliance with privacy laws, such as HIPAA, to protect sensitive patient data from unauthorized access or breaches.

Correct Answer

D. Installing a privacy screen to prevent viewing from the side or above, preventing a workstation from being installed facing into a busy corridor.

Explanation

Physical safeguards, such as installing a privacy screen to prevent unauthorized viewing and ensuring the workstation is not placed in a high-traffic area, are important to protect sensitive information in healthcare settings. These safeguards reduce the risk of inadvertent access to protected health information (PHI) by unauthorized individuals, which helps maintain patient confidentiality.

Why other options are wrong

A. Video surveillance of the area surrounding the workstation, and role-based access control programs installed on the machine.

While video surveillance is useful for monitoring activity, it does not directly protect the physical security of the workstation itself. Role-based access control (RBAC) is an IT safeguard rather than a physical safeguard, making this option less relevant to the question.

B. Configuring the server to deny access to the machine after several failed attempts to log on with a username, and preventing a workstation from being installed facing into a busy corridor.

The server configuration for login attempts is an IT safeguard, not a physical one. Preventing the workstation from being installed in a busy corridor is a valid physical safeguard, but this answer combines it with a non-physical security measure.

C. Installing a privacy screen to prevent viewing from the side or above and user-based access control programs installed on the machine.

While the privacy screen is a valid safeguard, user-based access control programs are more of a logical safeguard than a physical one, as they focus on limiting access based on user identity rather than protecting the physical environment around the workstation.