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1. COO(Chief Operating Officer): handles day-to-day operations
2. CMIO: Chief Medical Information/Informatics Officer: Liaison between CIO and
CMO
3. CMO: chief medical officer, usually a physician serving as a liaison between upper
management and the medical staff at a HCO. Responsible for clinical care, quality improvement, and sometimes graduate medical education
4. CIO: Chief Information Officer: oversees all uses of IT and ensures the strategic
alignment of IT with business goals and objectives
5. Joint Commission accredits both: medicare and medicaid
6. Insurance paid for by govenment: Single payer
7. HOPD(Hospital Outpatient Department): medicare parts
8. PPO (Preferred Provider Organization): Choose your own specialist
A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if you use providers that belong to the plan's network.
9. Bundles payments: a single funding amount to a healthcare provider specific to a
certain patient's treatment and recovery; episodes of care
10. URAC: An acronym for Utilization Review Accreditation Commission. One of the
accrediting bodies of health plans.;
11. American Health Information Management Association (AHIMA): a profes- sional
association for health professionals involved in the health information man- agement needed to deliver quality health care to the public
12. IMIA: International Medical Interpreters Association
13. Both AMIA and IMIA place privacy in: the number one position on their lists of
ethical duties for health informatics professionals
14. Culture refers to: the beliefs and customs of a single group of society
15. diversity means: composed of different elements or types
16. Internal diversity: what humans are born with and is out of their control, such as
gender, race, ethnicity, age, physical ability, and sexual orientation
17. External diversity: religion, education, marital status, and income
18. ethnocentrism: superiority
19. ethnorelativism: the opposite; all are equal though dissimilar
20. High-context: nonverbal cues are improtant
21. low-context: words are more important(help desks)
22. Strategic planning: long-term, assumption, alignment, upper management; need
input from all stakeholders
23. technical planning: short-term, detailed, lower management
24. IT strategic planning: how to best help the business goals of the organization
25. What best explains the need and purpose for having an IT governance structure:
It estabilshed a framework for the leadership and organizational struc- tures, as well as clarification of the roles and responsibilities at every level of the organization, to ensure that the IT strategic plan provides maximum facilitation toward achieving the goals of its BUSINESS strategic plan
26. IT governing bodies: regulatory oversight, procurement, lower managers
27. Governance council: ASSESS alignment, initiate evaluation/approval PRO-
PORSALS, LEAD GOVERNANCE, business division heads, IT senior management
28. IT Executive steering committee: confirm alignment, approve resources, in-
vestments, top management
29. IT governance structure: should be driven by all stakeholders
30. MIPS need to submit data on four performance categories: Cost, Quality,
Improvement Activities, and Promoting Interoperability
31. ACOs: Accountable Care Organizations
Established by Affordable Care Act as a pilot payment models for Medicare
32. ACOs are charged with: reducing the cost of healthcare
33. IOM: Institute of Medicine; "Crossing the quality chasm"
34. "Crossing the quality chasm" has six principles: safe, effective, patient-cen- tered,
timely, efficient and equitable
35. AHRQ (Agency for Healthcare Research and Quality): a federal agency established
to improve the quality, safety, efficiency, and effectiveness of health care for Americans
36. AHRQ provides: evidence
37. AHRQ: works with HHS to produce annual health reports for current state
38. NCQA (National Committee for Quality Assurance): not for profit organization
dedicated to assessing and reporting on quality and performance of health care plans; accredits HMO's
Quality key measures and PMCHs and ACOs
39. Process measures: examine steps in providing care process
-adherence to professional standards or practice guidelines -determine if they are sufficient; these improve before outcomes do
40. Outcome measures: data describing the results of healthcare services
impact of changes (views from the patients and other stakeholders)
41. Balancing measures: see if the process works as a whole; looks at costs and the
patient
42. Aims: what, how much, when
43. clinical decision support: provides clinicians, staff, patients or other individuals with
knowledge and person-specific information, intelligently filtered or presented at
57. Ishikawa/Fishbone Diagram: Helps establish cause-and-effect by identifying factors
that contribute to outcomes or problems; the factors are categories as Peo- ple, Machines, Methods, Measurements, Materials, and Environment and include intentional and unintentional consequences and influence quality performance.
58. ISO 9000: subset of TQM
59. Flat Organizational Structure: An organizational structure that has only a few levels
of management and emphasizes decentralization(most start up)
60. managers: more on floor; familiar with the work practices and processes
61. Managing=: administration
62. Some people have power without authority being given to them: Ghandi
63. Functional structure: hierarchical hospitals, schools, assembly plants, govern- ment
agencies
64. Projectized structure: project manager and team have power; organized by
project, not department
65. matrix structure: an organization combines functional and divisional chains of
command in a grid so that there are two command structures-vertical and horizontal
is mixed; both functional and project managers
66. Weak matrix: functional has more authority than project manager (may not even have
one)
67. Strong matrix: project takes on authority
68. balanced matrix: both have power
69. agile method: completely iterative, analysis code and testing does with stake-
holders until perfect (applies to software); basically incremental
70. Extreme programming: users involved throughout who process
71. work groups: individualistic, short-term, defined, leader plans assigned work
72. NIST(National Institute of Standards and Technology): NIST is a part of the U.S.
Department of Commerce, and it includes an Information Technology Laboratory (ITL). The ITL publishes special publications related to security that are freely available for download here: http:// csrc.nist.gov/ publications/ PubsSPs.html.
73. NIST: special publication 800-30 is timely, relevant and provides good best
practice
74. Hackers discover information about the: target, plan ways to attack, then attempt
to try
75. Defense of depth: A defense that uses multiple types of security devices to
protect a network. Also called layered security.
76. OS system: firewall should always be on; do not run two at once
77. Antivirus software: detect viruses throughout their signatures
78. access: active directory for GROUPS, user accounts for individuals
79. Data must be encrypted when deemed appropriate from the results of a risk
assessment. Often will be done on: mobile devices
80. HCOs: may use MDMs which are given to employees by the organization that have
the required security on it
81. Electronic Protected Health Information (ePHI): should be provided only on an
encrypted USB device provided by the practice
82. Nonrepudiation: is when a security process can prove a user or application
performed a specific action beyond any reasonable doubt
83. SSID: Service Set Identifier. Identifies the name of a wireless network. Disabling SSID
broadcast can hide the network from casual users but an attacker can easily discover it with a wireless sniffer. It's recommended to change the SSID from the default name.
84. WLAN (Wireless Local Area Network): A self-contained network of two or more
computers connected using a wireless connection.
85. WPA3: LARGE BUSINESSES WiFi protected access 3
Next gen of WiFi security, uses latest security protocols, disallows outdated legacy protocols and requires use of protected management frames.
86. WPA2: Wireless Protected Access 2. Wireless network encryption system.
(homes, small business, guest networks)
87. WEP: Wired Equivalence Protocol. Wireless network encryption system.
88. MAC: Media Access Control- the physical address
89. WIPS: Wireless intrusion prevention system. An IPS used for wireless networks.
90. WIDS: Wireless intrusion detection system. An IDS used for wireless networks.
91. WIPS and WIDS: catch unauthorized WAPS
92. WAPs: wireless access points; the bridge
93. HIPPAA enforced Rule: provides for the enforcement of the HIPAA Privacy and
Security Rules by the OCR
94. data provenance: keeping "detailed records about the data"
95. HITECH: Health Information Technology for Economic and Clinical Health Act
96. HITECH includes: business associated of covered entities
97. If the patient presents his or her own device: an unencrypted cope of the
information can be given directly to the patient
98. Hybrid entity: "An entity that performs both covered and noncovered functions under
the Privacy Rule; provides immunizations/direct care and educates/monitors diseases; must implement measures that cover both
99. superusers are part of the: tier 1 but can be asked deeper questions about the
workflow than the helpdesk
100. second tier: proficient with the systems and applications
-network specialists, physical installation of equipment
125. Synthetic backup: the process of generating a file from a complete copy of a file
created at some past time and one or more incremental copies created at later times
126. Decommissioning: PER- plan, execute, review
127. Learning Objectives: Spells out specifically what information or ability the learner
is expected to know or demonstrate after an instructional activity; focus on a singly concept or principle
128. Properly written learning objectives are: written from the perspective of the learner
129. Goal is a generally: long-term
130. Objective has measurable/outcomes generally: short-term
131. behavioral(the skill or knowledge): calculate, administer, locate
132. condition: environment, 'using the EHR system'
133. standard: time/or rate measurement, 'in 5 minutes', 'in three tries'
134. The term KSA in bloomberg's taxonomy, it is often seen in: government training
documentation
135. KSA: knowledge, skills, and abilities
136. in Bloomberg's Taxonomy a superuser: engages whenever EHR and health- care
technology support is needed ; SHOULD NOT be assigned any clinical duties during go- live
137. ADDIE phases: FORMATIVE; used to test and initiate in Bloomburg's taxono- my
138. The first component in bloomburg's taxonomy states that it must be: com- pleted
when developing a lesson plan is determining the topic and related content
139. The functional verbs in a learning objective can: help to determine the depth
and sophistication of a learner's knowledge
140. Training is usually: very specific and immediate and is designed to improve
performance on the PRESENT jobs
141. WIIFM: An acronym that stands for "What's in it for me?" This is the question that
listeners ask themselves when they begin to listen to a speech. Listeners want to know; What does this speech have to do with my life? Is this information useful to me? Is the speaker talking about something I already know? Is the subject interesting? Why should I pay attention?
142. Single vendor: easier to manage capital and costs, decreased complexity of
maintenance, difficult to change
143. Best of breed: integrates legacy, government incentive program compliance risks,
more technical skills needed to manage
144. Best of suite: less need for redesign; one vendor; complexity increased
145. Three T's for successful EHR implementation: team, tech, tactics
146. The SDLC provides a standard development model that project managers can: use
to maintain order in the chaotic implementation process; controls the development environment
147. SDLC (Systems Development Life Cycle): The overall process for develop- ing
information systems from planning and analysis through implementation and maintenance
148. SDLC Phase One: planning; identify need, approval, SWOT/feasibility done, which
staff
149. SDLC Phase 2: Analysis: system, its function, COTS or MOTS, stakeholders
150. COTS: Commercial off the shelf software
151. SDLC Phase Three: Analysis and design; detailed blueprint; reveals flaws in
original design, everything is coded and assembled, program documents started
152. SDLC Phase Four: integration and testing, piloting
153. SDLC Phase Five: implementation; user training takes place, old data migrat- ed,
system online
154. SDLC Phase Six: evaluation; debriefing, patching, updates
155. SLDC DOES NOT: have to be 6 phases
156. iterative: requirements might change a lot
157. Incremental: Software developed in parts; initial to development, can continue after;
large development projects that need considerable feedback from users
158. spiral: mixes iterative and incremental together; develops a prototype, often used
in IT, does not work for smaller projects; can be costly
159. HOC testing: is performed without planning and documentation to check quick- ly for
defects
160. Exploratory testing: is used to find out how the software will handle difficult and
easy cases
161. formal testing: positive test and negative test
162. credible: likely or could happen
163. complex: multiple relationships between products
164. motivational: what the user wants, what could happen if it does not happen
165. system testing and UAT both include: processes for documenting defects found
during testing
166. (UAT) user acceptance testing: testing involving end users of a system, ensuring
that the system meets the requirements laid out in the scope statement.
167. The vendor's testers will make sure the issues are resolved, but the client's
testers and test team will: make the final determination about whether issues are resolved satifactorily
168. Work practices are: part of the departmental context
169. UAT can be: automated
192. MAUDE uses MDRs for: medical device monitoring
193. The MAUDE database is an FDA database that: catalogs injuries and deaths possibly
caused by medical devices
194. Not all medical devices are tested. Simple devices and devices unlikely to fail or
be misused: might not be tested
195. The interface engine serves as a centralized hub or connecting point from each
system to: every other system; more reliable that point-to-point
196. ADE: adverse drug event , related to pharmacy
197. Problems with sharing info across systems: some devices are standalone, no plug
and play, no incentive, data has to be merged into the medical record
198. One approach to interfacing devices with proprietary protocols is to
implement a: middleware solution
199. Open standards: XML, HTML, TCP/TCP IP/IP, ethernet(LAN, Fiber optic
(EIA/TIA 568B), wireless (IEEE 802.11)
200. XML: Extensible Markup Language
201. HTML: Hypertext Markup Language
202. TCP: Transmission Control Protocol - provides reliable, ordered, and er-
ror-checked delivery of a stream of packets on the internet. TCP is tightly linked with IP and usually seen as TCP/IP in writing.
203. IP: Internet Protocol
204. LAN: Local Area Network; a geographic network that covers a relatively small
geographic area such as a building or a small campus - no more than a mile distance between computers
205. EIA- fiber optic: a test that screens for the presence of HIV antibodies in the blood
206. EDI: eCommerce- business done over the internet-Electronic Data Interchange
207. Naming standards are often: very structured
208. HCPCS(informally refered to as 'hicks picks': is required for Medicare billing
209. CDRH (Center for Devices and Radiological Health) classifies medical devices
into three categories: simple, medium risk, and high risk
210. Data dictionary: comprehensive list of names, definitions, and attributes for data
elements that are recorded in an information system or database
211. Standards abound in health IT commonly have standards that: NEED TO BE
ADOPTED
212. The information management and reporting requirements of anatomic
pathology are: managed by LIS
213. Functional requirements: what the system does what it is intended to and how it
does it
214. nonfunctional requriements: attributes, organization and environment; plan to
relocate, expand, and potentially build
215. should=: recommended
216. may=: optional
217. uability: ease of use effectively, efferently, and satisfactorily perform all tasks for
all users
218. performance: how well it works in different degrees
219. a use case is a scenario that: explains a system interaction with end users or
explains how system component interact with each other
220. when all requirements are document: the use case scenarios are construct- ed and
applied, and the requirements are ranked, the RFP can be written
221. RFP (Request for Proposal): A document that is sent out to potential vendors
requesting them to provide a proposal on a product or service.
222. vendor demonstrations: stakeholders from the selection team
223. fewer site visits than demonstrations will occur, and the team is: very close to
a decision when the site visits occur
224. Select finalist companies: rally buy-in, negotiate contract
225. CCR: Continuity of Care Record; is the current design of EHR interoperability for
exchange PHI
226. PHI: Protected Health Information
227. Greatest barrier for EHR system installation and implementation: COST
228. greatest barrier to EHR system adoption: usability
229. most expensive EHR: traditional in house
230. cheapest EHR: Cloud based
231. When a project is not completed it is: terminated
232. In a project you first need to initiate: project charter, statement of work, identify
stakeholders; support scope
233. In a project the second thing you need is to: execute and implement
234. In a project the fourth thing you need is to: monitor and control
235. Lastly the fifth thing you need to do in your project is: close and finalize the
project
236. The functional (most common): traditional hierarchy, managers report up, PT project
manager little interaction with the team
237. A project may have a weak matrix if: a project manager was not as involved
238. A project is balanced when a: PM is a bit more involved
239. A project is strong when: it is full of PMs and has a project management office;
great authority
240. A project has the least amount of stress during closeout of a: weak matrix
265. UEL has two phases: begins and ends with user considerations and provides
opportunities for improvement throughout
266. UEL's main focus is: usability and iterativeness
267. Life cycle is: the stages of development of a product
268. SMART goals: Specific
Measurable Attainable Relevant Time-bound
269. SMART is for: readiness assessment
270. cognitive ease: operates automatically with little sense of voluntary control
271. cognitive strain: takes effort just to navigate user interface
272. Usability is the: ease of use
273. Utility: works how the user expects it to
274. user-centered design(UCD): is an iterative process; study of the user
275. Engineering and cognitive psychology are: two principles that guide human factors
276. organizational ergonomics: changing work schedule to prevent burnout, cre- ating
solid work teams
277. cognitive ergonomics: individual's mental workload, interruptions, poor hu- man-
to-machine interfaces
278. cognitive capacity: leads to selective attention: three factors
279. Salience: grabs an individual's attention
280. exectancy and value: filers out what is not important to them
281. effort is the: task it takes to the higher change or a workaround
282. the effect of an active error is: experienced immediately and requires a
prompt response
283. Slip: correct route of action followed but executed the wrong way (when routine
performance is misplaced or missapplied)
284. Mistake: an incorrect action is performed because of incorrect judement/per-
ception
285. hindsight bias: errors are usually studied only after they occur; collected data is
measured against a known outcome
286. SWISS CHEESE has defense barriers: slices of cheese; holes= vulnerabili- ties in
the slices of cheese (the system's defenses have weaknesses)
287. The swiss cheese model states that failure often occurs because: of multiple
interconnected/overlapping errors and is usually not attributable to one cause
288. the holes align in the swiss cheese model: momentary hazard where failure and
damage can occur
289. knowledge-rule mistakes: human bias, faulty heuristics
290. Rule-based mistakes: someone incorrectly interprets a rule, are ignored in part
or in whole
291. mental/temporal/physical demand on workload index: also own perfor- mance,
effort, and frustrations
292. mental demands tell: whether a task is simple or complex
293. CTA: tasks, mental models, optimizing the user experience
294. Exiting one sequence and entering another to: complete required entries
describes a nonlinear and cognitively more difficult process
295. preservation of context: when the program shifts the users attention from where
they are working
296. the output of the requirements phase is the creation of technical speci- fications
that: the systems designers and developers can use to turn the require- ments into systems realities
297. the individuals who have an interest in, oversee, manage, or perform the current
process are a primary source: they must be asked to participate as project stakeholders
298. systems analyst: sometimes called the HIT analyst or workflow redesign
specialist
299. documentation analysis is the method best suited for: eliciting and under- standing
regulations and guidelines
300. contextual inquires is not quick: helps show key stakeholders and social
structures in workplace
301. affinity diagrams sort and display throughts, ideas, and data from multiple sources:
puts certain ideas into groups with common themes
302. both affinity diagrams and process flow diagrams should be: reviewed with
stakeholders and signed-off before final documents are drawn
303. functional requirements system: CPOE allows user to input first and last name
of patient and then displays the patient
304. nonfunctional requirements: everything else; user characteristics, environ- ment,
docs not happy about new CPOE etc.
305. once workflow documentation has been reviewed and approved: systems and
technical requirements are moved to the primary focus
306. data requirements=: standards or accuracy
307. technical requirements=: hardware, software, network, security, and training
308. environmental requirements: lighting, noise temperature control
309. process and workflow are used: interchangably
336. UML: software design and development (UML class diagrams); can be contex- tual
also
337. UML is: useful for diagramming the order in which data or other elements move
through a process and the logic that controls that flow
338. ERDs: relational databases like SQL; shows interrelationships among data in a
process
339. Metadata is a: reference used with standardized data made up of definitions,
principles, guidelines, values, formats, and synonyms for each data element
340. NDC: prescription and over-the-counter(OTC) drugs have their own standard-
ization scheme: the National Drug Codes
341. HCPCS: outpatient procedures and medical supplies (wheelchair); largely used
for medical/billing; IT IS A CODING STANDARD FOR PATIENT DATA
342. NANDA: North American Nursing Diagnosis Association, purpose is to define,
refine, and promote a taxonomy of nursing diagnostic terminology of general use to professional nurses.
343. NANDA has: 13 domains
344. NIC: what the nurse did
345. NOC: what the OUTCOME was
346. SNOMED CT: Systemized Nomenclature of Medicine Clinical Terms; GLOBAL
347. LOINC: lab results and physiological data
348. HL and FHIR: exchange between system no matter how stored; administrative,
clinical
349. HL and FHIR are not: a security protocol; but it does define exchange protocols that
need to be used
350. Codified data is data that has been formatted according to specific stan- dards:
However, not all standards result in codified data
351. Current Procedural Terminology (CPT): a medical code set maintained and
copyrighted by the American Medical Association that has been selected for use under HIPAA for non-institutional and non-dental professional transactions
352. Some information is: lost during data mapping
353. True or Flase
There are currently no unique, global patient identifiers to attach to patient health data: TRUE
354. CHINS: try to reduce costs through the sharing of patient data but failed because
ROI was not clear, stakeholders, were not on the same page and they were profit driven
355. RHIOs: benefitted from the modern tech that had arisen also focused more on
quality rather than costs
356. eHealth Exchange spans: over all 50 states
357. EHRs with meaningful use were: tested by ATLs (accredited testing labora- tories)
but certified by ONC-ACBs (ONC-authorized certifying bodies)
358. Cures Act of 2016: promotes more interoperability
359. Consumers and patients CANNOT: easily get electronic access to (or copies of)
their medical records and information from healthcare providers
360. ALU: does arithmetic not the CPU
361. every piece of data in the CPU has a: physical address
362. OS is the layer between: hardware and software applciations
363. Utility programs do: file back up/search/ compression, system diagnostics, font
size/screen adjusts
364. An intranet does not require an internet connection: even if the supported
locations are physically separate locations
365. Private IPs are for intranet networks;: same IP address may be used for many
different PRIVATE networks
366. Public are for: internet
367. Point of care (POC) examples: BG tests, nerve conduction, home test kits
368. Wired POC testing device=: IP bedside vital sign monitors
369. Cloud services: Saas, aaS,
370. Saas: least amount of control
371. Platform aaS: have the hardware
372. infrasrtucture (aaS): lease and build and maintain your own cloud
373. Virtualization allows: computer resource consolidation
374. Hypervisor: inserts between the hardware and OS (decouples)
375. Mobile devices do not typically: have an impact on appointment times
376. Knowledge management systems: enable an organization to create a knowl- edge
repository, improve knowledge resources, improve the knowledge environ- ment, and manage knowledge as a resource
377. the MPI offers multiple ways to: find a patient through data fields that record
patient-specific information, such as admission/discharge dates, name, date of birth, and other fields. but not insurance info
378. inference engine=: rules
379. drug to laboratory checks are considered advanced for CPOE: such as
contraindications on basis of labs
380. CPOE must be integrated with other systems to be: fully effective (like a CDSS)
but can do ordering on its own
381. Voided: the clinician cancels the order before signing
382. image-guided surgery: generally describes any surgical procedure for which a
surgeon uses surgical tools that interface with displayed images
408. Universal Safety Protocols: surgical safety (wrong site etc)
409. Also Speak Up program for: patients to speak out
410. URAC by itself does: policy/procedure followed for websites and HIPAA; ac-
creditation for IT professionals
411. AMA: educating doctors
412. AHA: healthcare advocacy with hospitals
413. ABMS: gold standard certs
414. OCR: protects against discrimination from certain HCOs and social service
programs
415. ACA: wants to make more opportunities for Medicaid to be
416. AHRQ watched for deviation of care: most lawsuit cases are about negli- gence
417. The Err is Human: found that the wrong medicine was given to the right patient
418. HIPAA Admin: IAM, security and training
419. HIPAA physical: theft, facility access and workstation
420. HIPAA technical: access, audit, integrity, transmission, person/audit IT; HHS and
OCF
421. HITECH Act: transparency and efficiency
422. Barrier of adoption of EHR: COST; less efficient workflow at first, less patients seen =
less revenue
423. So RECs were invented: ONC funded expertise in tech and on the ground
assistance (helps workforce training)
424. Meaningful use: better clinical outcomes, improved pop. Health outcomes,
increased transparency/efficiency, empowered individuals
425. MIPS and APM: programs both include measures that promote interoperability
426. outpatient=: ambulatory, nursing process ADCIE
427. Mobile adoption support positions: requires 6 months of training
support the INITIAL implementation of HIT: implementation manager/support spe- cialist, workflow/info management redesign specialist
428. AFTER: trainer, technical/software support staff
429. HIM professionals DO NOT: create the standards, but they can inform and
facilitate discussion; they play a key role in managing the national health info infrastructure
430. MCO=: HMO
431. physician serves as gatekeeper=: preventative care
432. MSOc help physicians with: billing etc,
433. IPA=: contracts; managed care is not flexible
434. POS: you do not choose (referrals only given for in-network)
435. EPOs: have no gatekeepers
