Cheat Sheet Questions

Front 1

What are the desirable characteristics that make clinical terminologies more useful?

Back 1

1. Content broad/narrow
a) Narrow useful for specific purpose but limited value ow
b) Broad must have gaps filled as needed (formal process)

2. Concept orientation
a) Each term should correspond to a single concept which has a single meaning
b) Given concept may be interpreted differently when used in diff contexts(FH<PH)

3. Concept Permanence
a) Meaning cannot change nor be deleted
4. Nonsemantic Concept Identifier
a) Identifier does not carry any meaning in itself
b) Identifier does not indicate the hierarchical position of the term it represents
5. Polyhierarchy
a) Support diff users and uses of the same terminology (SNOMED uses is-a relationship)
6. Formal Definitions
a) Definitions represented in a form that can be manipulated by a computer (is-a)
7. Reject “Not Elsewhere Classified”
8. Multiple granularities
a) Supports more user than those with a single level of granularity
9. Multiple consistent views
a) Polyhierarchical terminologies with multiple levels of granularity must not permit inconsistent views of the same concept
10. Context representation
a) A “grammar” that can be used to manipulate data with appropriate content
11. Graceful evolution
a) Adding content to describe current medical practice
12. Recognized redundancy
a) Terms with the same meaning are treated as synonyms and are represented by the same identifying code, ideally map to the same concept. If synonymous terms are not recognized within the terminology, data aggregation is incomplete and inconsistent
13. Copyrighted and licensed
a) Prevents local modifications
14. CIS vendor neutral
15. Scientifically valid
16. Well-maintained
17. Self-sustaining, either through public or endowment funding or by license fees
18. Scalable infrastructure and process control

Front 2

What are the Joint Commission (JCAHO) standards relating to the acquisition, analysis, and reporting of information?

Back 2

JCAHO standards relating to the acquisition, analysis and reporting of info: (6):

1. Institution-wide planning and design of info mgmt processes
2. Confidentiality security and integrity of info
3. Uniform data definitions and methods of data capture
4. Ed and training in principles of info mgmt by Csuite and those who generate, collect, and analyze info
5. Timely accurate transmission of data in standardized formats
6. Integration and reporting of data with linkages of pt care and nonpt care data across depts. And care modes over tine

Front 3

What segments make up the Uniform Ambulatory Care Data Set?

Back 3

1. Segment 1: Patient Data Items
2. Segment 2: Provider Data Items
3. Segment 3: Encounter Data Items
14. What are the characteristics of data quality?
Characteristics of Data Quality (#11):
1. Accuracy
2. Accessibility
3. Comprehensiveness
4. Consistency
5. Currency
6. Data Definition
7. Granularity
8. Integrity
9. Precision
10. Relevance
11. Timeliness

Front 4

What are the major segments in the ASTM E1384 standard?

Back 4

1. Demographics – pt id unrelated to health status or services
2. Legal elements – living will etc
3. Financials
4. Provider data
5. Problem list
6. Immunization record
7. Hazardous exposures
8. History – family/cumulative/med/dental
9. PE and assessments - all
10. Orders and treatment plans
11. Diagnostic tests
12. Medication profile
13. Scheduled appointments
14. Encounter or episode

Front 5

What are the main parts of an encounter record?

Back 5

a) administrative and diagnostic summary
b) HPI
c) Progress notes and clinical course
d) therapies
e) procedures
f) disposition
g) charges

Front 6

What are the benefits of integration?

Back 6

The benefits of integration are as follows (5):
1. Allows instant access to applications and data
2. Improves data integrity with single entry of data
3. Decreases labor costs with single entry of data
4. Facilitates the formulation of a more accurate, complete client record
5. Facilitates information tracking for accurate cost determinations

Front 7

What are the benefits of an interface engine?

Back 7

The benefits of an interface engine are as follows (9):
1. Improves timeliness and availability of critical administrative and clinical data
2. Improved data quality because of data mapping and consistent use of terms
3. Decreases integration costs by providing an alternative to customized p to p interface app programming
4. Allows clients to select the best system for their needs
5. Preserves institutional investment in existing systems
6. Simplifies the administration of healthcare data processing
7. Simplifies systems integration efforts
8. Improves management of care, financial tracking of care rendered, and efficacy of treatment
9. Shortens the time required for integration

Front 8

What factors slow integration?

Back 8

Factors that slow integration (7):
1. Unrealistic vendor promises
2. Unrealistic institutional timetable
3. Changing user specs
4. Lack of vendor support
5. Insufficient documentation
6. Lack of agreement among merged institutions
7. All components of a vendor’s products may not work together

Front 9

How does standardization affect the economy?

Back 9

Standardization affects the economy in the FOLLOWING ways:
1. Constrains activities to reduce undesirable outcomes
2. Enhances innovation within the standard
3. Companies benefit from participating thru ^quality, < cost
4. Consumer benefits from competition
5. May reduce companies’ profitability

Front 10

What are the benefits of having information architecture?

Back 10

The benefits of information architecture are as follows: (6)
1. a guiding plan across development projects
2. a component orientation to the development process, so that larger pieces of the system are built out of smaller units
3. decreases redundancy of data entry and storage, provides coherent approach to crosscutting systems like security and backup
4. incorporates standards to promote efficiency and interoperability; solves common challenges once instead of many times in many ways
5. promotes planning and clarifies business processes
6. returns locus of control and decision making to the executive level

Front 11

How was the MOHSAIC Information Strategy Plan developed?

Back 11

1. identify the functions performed by the dept and data needed to perform these functions
2.Define data elements and process
3. develop software/design sessions
4. long term plan

The MOHSAIC ISP was developed by two teams. One team assessed all the information systems in the MDOH and identified all the functions performed and the data needed to perform these functions. This team created a long-range plan for IS development that transcended org boundaries and units. The second team consisted of reps from a rural area, a city, a large metro health dept and one manager from the original team. They reviewed the functions performed by local public health agencies and data needed to perform these functions. This team also developed a plan that was identical to the first with the expansion of a few activity definitions.
The two teams’ plans were then consolidated to create a single plan that addressed the info needs for public health in Minn.

Front 12

What requirements were identified for the integrated MOHSAIC system?

Back 12

1) Same standards would be used to capture the data
2) All data would be included in one integrated system
3) One technical platform would be used
4) Records would be client-centered to allow a holistic view of client vs. episodic info
5) Staff would support data sharing among public health agencies and staff
6) System would support the capture of demographic and other client info one time to eliminate redundant info entry
7) System would be designed for the MDOH and the local public health agencies that are independent of the MDOH

Front 13

What factors add risk of failure when developing integrated systems?

Back 13

1) Large systems projects typically fail
2) Coordination across programs is typically difficult
3) Categorical programs don’t support integrated systems
4) Large health agencies already have an info system
5) Pooling of funds is difficult (program-specific funding)
6) Enterprise-level systems are expensive to develop
7) Integrated systems compound confidentiality issues
8) Legacy data conversion is difficult
9) Resistance to business reengineering

Front 14

What problems were encountered when converting legacy data?

Back 14

1) Different formats
2) Lack of data entry standards for fields
3) Legacy system design failed to include critical data and user worked around the design flaw by free texting
4) Older systems had insufficient edits to ensure only allowable codes were entered
5) Older systems did not provide sufficient identification data to permit unique identification

Front 15

What order do the five stages of the telehealth technology innovation continuum occur in?

Back 15

Telehealth technology continuum occurs in the following 5 stages:
1) Need is identified
2) Applications are developed
3) Devices are developed
4) Integration with clinical protocols
5) Program development

Front 16

What are examples of telehealth technology?

Back 16

1) Remote monitoring
2) Diagnostics
3) Video conferencing
4) Digital imaging
5) Information technologies
6) Networking/interfaces
7) Robotics/remote controls
8) Store and forward
9) Simulation and training

Front 17

What level of interoperability is needed to improve productivity, increase quality, and reduce costs?

Back 17

the following 3 levels of interoperability are needed:

1) Interactions among stations or apps developed by independent vendors
2) Connectivity among medical devices and other peripherals developed by independent vendors
3) “Plug and play” components developed by multiple vendors for independent vendors

Front 18

Which priority areas and related challenges have been identified to benefit most from the recommendations outlined in the SemanticHEALTH January 2009 report?

Back 18

• Patient care: patient safety; dissemination of good practice, integration of education and care; connecting multiple locations for collaborative care delivery (at local, regional, national and international levels); empowerment of citizens (patient centered healthcare)
• Public health: international statistics; comparative outcome assessment; harmacovigilance; coordination of risk assessment, management and surveillance of large-scale adverse health events, population health research
• Research and translational medicine: multi-centre studies and trials, health data repositories, bio- and tissue-banks, development of personalised medicine based on genetic and genomic analyses
• Support for diverse markets: identification of solutions with superior benefit/cost ratios; enabling plug-and play best of breed, encouraging industry involvement, especially SMEs; stimulating innovations by health service providers and involving clinicians, harmonizing legal and regulatory frameworks.

Front 19

What are major desiderata for semantically interoperable systems?

Back 19

• Consistancy means that the receiving system must be able to recognise what has been sent, so it is a prime requirement for machine-machine communications and dictates the need for unambiguous identifiers.
• Understandability is essential for human communication. Humans can tolerate considerable ambiguity, but tend to focus too narrowly, so that the requirements are almost the reverse as for automated support. It is limited by the trust that the information is valid, especially with aggregated population data where the aggregation process may result in loss of information.
• Reproducibility addresses the question of inter-individual reliability when data are collected or encoded. This holds both for individual and aggregated data.

Front 20

What three layers do current attempts to standardize the capture, representation, and communication of clinical data rely on?

Back 20

• Generic reference models for representing clinical (EHR) data, e.g. ISO/EN 13606 Part 18, HL7 CDA Release 29, the openEHR Reference Model0
• Agreed clinical data structure definitions, e.g. openEHR archetypes, ISO/EN 13606 Part 22, HL7 templates3, generic templates and data sets
• Clinical terminology systems, e.g., LOINC4 and SNOMED CT5

Front 21

What are the top data integration issues according to the TDWI report on data integration by Colin White?

Back 21

Data quality and security issues
Lack of business case and funding
Poor data integration infrastructure
Metadata management issues
Lack of IT data integration skills
Data transformation and aggregation
Software and support costs
Batch window
Scalability and performance
Product functionality and maturity
Other

Front 22

What are distinguishing features to look for when evaluating enterprise information
integration products?

Back 22

Data sources and targets supported (including web services and unstructured data)
Transformation capabilities
Metadata management
Source data update capabilities
Authentication and security options
Performance
Caching

Front 23

What are the main types of source data used in integration projects according to the TDWI report on data integration by Colin White?

Back 23

Structured data files
Spreadsheets
Unstructured data files
Xml
Web pages
Ecm data stores
Web logs
multimedia

Front 24

What is the sequence of the phases that make up the master data management lifecycle?

Back 24

Data assessment
Data harmonization
Loading the mdm systems
Creating operational processes that deliver data integrity
Putting in place data governance for ongoing assessment and evaluation

Front 25

What are the data integration application variables that affect the choice of techniques and technologies for doing data integration?

Back 25

• Source data type
– Structured
– Semi-structured (e.g., XML)
– Unstructured
– Packaged application
– EAI
– Web service
– Metadata
• Source data organization
– Homogeneous or heterogeneous
– Centralized or distributed (integrated data and metadata)
– Federated (integrated metadata) or dispersed (no integrated metadata)
• Source data transformation requirements
– Data restructuring
– Data cleansing
– Data reconciliation
– Data aggregation
• Target data currency (latency) and access
– Real time
– Near real time
– Point in time
– Read-only or read-write
• Data integration technique and mode
– consolidation, federation, propagation, changed data capture
– event push or on-demand pull
– synchronous or asynchronous
• Data integration technology
– ETL, EII, EAI, EDR, ECM
• Data scale
– Number of data sources
– Data store size
– Data store volatility

Front 26

What benefits are sought through healthcare data warehousing? (p.9 HCDW)

Back 26

• Improved access to clinical information at the point of care
• Evidence based clinical decision making
• Evidence based health care policy decision making
• Management of chronic diseases – higher quality of life and lower cost of treatment?
• More consistent patient behavior change, via more informed and directed counseling, support and feedback
• Cost savings, through the ability to identify and manage cost trends more rapidly and precisely
• Better risk management, through the ability to quantify risks more precisely, for providers, payers and patients
• Elimination of redundant medical testing and reporting
• More timely response to legislative and regulatory mandates
• Reduction of fraud, waste and abuse
• More effective use of research funds

Front 27

What are the critical success factors in healthcare data warehousing?

Back 27

1. Enterprise approach – integrate the data across the enterprise with consistent, sustained focus on moving towards enterprise integration and that it occur on a foundation that is sound and able to be supported over a period of years.
2. Support for complex data structures among patients, providers, diagnoses, medications, tests, treatments, events, claims, etc.
3. Support for complex queries (large non-colocated joins on multiple large tables)
4. Large data volumes that are already large and continuously growing.
5. Concurrent and timely use; support many users running interactive and complex queries at one time and receiving responses in seconds, support many creating report or analyses, and making large demands on the resources of the system, and handle new data arriving constantly (some that goes right into the db when it arrives).
6. Flexibility – ability to adapt to the changing face of healthcare (changing data, data types, processes, type of data, etc)
7. High Performance – data entry and retrieval must be timely
8. High Availability – must be highly and reliably available. Database server and database itself must always be up to date and available for use
9. Privacy and Security - data must be secure and only authorized by the correct party.
10. Support and Education – support for the db, education for the users
11. Data Quality and Standards – HC data is a different ball game. HC policy decision can affect the healthcare. Medical data is remarkably complex, created for a specific purpose, and evolves. Medical standards differ.

Front 28

What are the performance objectives for the healthcare industry?

Back 28

• Effective treatment of patients.
• Reimbursement for treatments.
• Reduction of administrative costs.
• Effectively record and track patients’ medical history
• Efficient management of health care delivery schedules for practitioners as well as patients

Front 29

What are some sample key performance indicators for the healthcare industry?

Back 29

• Average length of stay
• Maintained bed occupancy
• FTEs per adjusted occupied bed
• Case-mix index
• Monthly surgical cases (outpatient and inpatient)
• Inpatient and outpatient revenues
• Cost per adjusted patient day (outpatient and inpatient)
• Percentage of revenue from charitable sources
• Revenue and expense per physician
• Margin per department
• Admitting-process performance

Front 30

What are some performance metrics for the emergency room?

Back 30

• Door to Provider Time
• Admission to Provider Time
• Length of Stay
• Wait Time for Ambulances
• Throughput (Urgent/Non-Urgent)
• Triage to Initial Assessment
• Bed Turnover
• Staff Applied To Each Type of Patient
• Type of Cases

Front 31

What are some performance metrics for the customer satisfaction?

Back 31

• Wait Times
• Quality of Physician
• Cleanliness
• Food Taste

Front 32

What data should be tracked to populate trending reports related to the relationships of the different parties involved in healthcare?

Back 32

• People and Organizations
o Patients, health care provider organizations, individual practitioners, insurance companies
• Relationships between:
o Patient / Practitioners
o Provider / Health care networks
o Practitioners / Health care provider organizations
• Services and products provided by the healthcare providers
• Agreements
o Patient / Practitioner
o Provider / Network
o Provider / Supplier
• Records of health care services performed as it relates to various health care incidents, visits and episodes
• Claims submitted and the status of claims
• Other data needed to track financial statement and personnel data

Front 33

What dimensions can be included in a star schema for an episode?

Back 33

o Diagnosis type
o Episode type
o Incident type
o Individual healthcare practitioner
o Outcome type
o Provider organization
o Time by week

Front 34

Describe a general project methodology to initiate a data warehouse.

Back 34

1. Current State Assessment
a. Allows data warehousing team to analyze the healthcare provider’s current data situation
2. Future State Requirements
a. DW team meets with key healthcare provider personnel to assess the healthcare provider’s missions and goals and exactly what the healthcare provider is looking to achieve through data warehousing.
3. Gap Analysis and Roadmap Development
a. Most important phase. Determines which changes need to occur in order for the current and future states to be the same.
4. From Project Plan to Release Phase
a. Project plan and implementation.

Front 35

What are the components of a framework used to assess the informational value of data?

Back 35

• Data dimensions
• Aligning data quality with business practices
• Identify authoritative sources and integration keys
• Merging models
• Uniting updates of frequency
• overlapping or gapped data sets

Front 36

What layers does integration occur at?

Back 36

Integration occurs at four layers:
1. data sources – database, website, publication or any other collection of data constructed on a set of concepts and models
2. Data elements – atomic unit of data collection that is unambiguously defined in the controlled vocab of a project
3. Data sets – collection of data produced from a data source at a moment of time
4. Data values – specific value of a DE (body temp of101, etc)

Front 37

What categories can data elements be split into for the purposes of integration?

Back 37

Integration keys – chose from focal DE
Informative Des – chosen from focal DE
Auxiliary DE – provide add’ info that might be associated with the business rules, allow us to decide whether to include or exclude some records. From either peripheral or focal DE

Front 38

What harmonization issues do implementation guides help address?

Back 38

• Reduction/elimination of optionality in current standards
• Reduction/elimination of need for point-to-point
• Improved consistency of information/terminologies
• Improved security and privacy of information exchange

Front 39

Who benefits from IHE’s work?

Back 39

• Patients
o Enhance care’s quality, safety, efficiency & effectiveness
• Clinicians
o Improve workflow & information reporting
o Fewer error opportunities; Less repeated work
• Vendors & Consultants
o Satisfy customers’ interoperability demands
o Decreased cost & complexity of installation & better ROI
• SDOs
o Rapid feedback to address real-world issues
o Establishment of critical mass and widespread adoption
• Government
o Reduced costs of implementing EHR systems
o Increased patient information interoperability

Front 40

What is the sequence of steps in the in the HITSP harmonization process?

Back 40

I. Harmonization Request
II. Requirements Analysis
III. Identification of Candidate Standards
IV. Gaps, Duplications, & Overlap Resolution
V. Standards Selection
VI. Construction of Interoperability Specifications
VII. Inspection Test
VIII. Interoperability Spec Release & Dissemination
IX. Program Management

Front 41

What federal organizations are members of HITSP?

Back 41

• Agency for Healthcare Research
• Center for Mental Health Services/SAMHSA
• Centers for Disease Control & Prevention
• Centers for Medicare & Medicaid Services
• Department of Defense
• Department of Health & Human Services
• Department of Veterans Affairs
• Food & Drug Administration
• General Services Administration
• HHS/NIH/ National Library of Medicine
• National Committee for Vital Health Statistics
• National Library of Medicine
• NIST US Department of Commerce
• Office of Management & Budget
• Social Security Administration

Front 42

What technical committees does HITSP have?

Back 42

• Care Delivery
• Consumer Empowerment
• Population Health
• CrossTechnical Committee Coordination
• Security and Privacy
• 6. Emergency Responder – EHR Coordination

Front 43

What is an archetype?

Back 43

Archetypes are high-quality, reusable clinical models of content and process that are defined by clinicians.

Front 44

What are the estimated implementation and operating costs for the national healthcare information network?

Back 44

The estimated costs of implementation and operation of the NHIN are $103B initially and $27B annually thereafter.

Front 45

What items are included in the Uniform Hospital Discharge Data Set?

Back 45

1. Personal identification
2. . DOB
3. Sex
4. Race and ethnicity
5. Address inc zip
6. Hosp ID # (preferred Medicare provider number)
7. Date of admit
8. Type of admit (sch or unsch)
9. Date of DC
10. 10.Att physician id (UPIN)
11. Operatin physician id (UPIN)
12. Principal dx
13. Addl dxs
14. Qualifier for dx
15. External cause of injury code (inc AE)
16. BW of neonate
17. Procedures and dates inc UPIN of person performing the principal procedure
18. Disposition of pt
19. 19.Expected source of payment
20. Total charges ex professional charges

Front 46

What must be in place to achieve health information exchange?

Back 46

1. Patient identifier
2. Technology infrastructure
3. A business model
4. Participants (hospitals, physicians, pharmacies and independent labs)
5. Funding
6. Policies including access restrictions
7. Consent management
8. Community buy-in
9. Scalability

Front 47

What information is typically available to participants of a health information exchange?

Back 47

1. E-prescribing
2. Lab results
3. Path results
4. Radiology results
5. Diagnostic images
6. Physicians’ dictations inc H&P, Progress Notes and DS
7. Inpt medication treatments
8. Nursing care documentation
9. Client demographic info
10. Client health ins info
11. Names of primary and consulting physicians
12. Long-term health records
13. Amb care/clinic visits
14. Public health records
15. Home health info
16. Decision support
17. Quality measurement and reporting services
18. Telehealth consults
19. Immunization records
20. Prescribed meds, vits, supps, homeopathic remedies

Front 48

What benefits are associated with a health information exchange?

Back 48

1. Saves money
2. Improves outcomes
3. Improves provider-patient relationships
4. Streamlines workflow
5. Provides positive perception

Front 49

What are the different models for a health information exchange?

Back 49

1. Community-based – multiple unrelated stakeholders
2. Proprietary – stakeholders are owned by or affil with a single corporate entity
3. Federation – Multiple independent enterprises agree to allow access to info they maintain, often developing a system to index or locate data
4. Coop – Multiple enterprises agree to share tech, CDR, and admin overhead to create a central utility
5. Hybrid –

Front 50

What are the primary features of a community health information network?

Back 50

1. Open communications – interface engine connects EHR, CDR’s, and payer info
2. CDR – Clinical Data Warehouse
3. Mechanisms for cost, outcome, and utilization analysis

Front 51

What are the obstacles to the long-term success of a health information exchange?

Back 51

1. Governance- strong leadership is needed to set balanced attainable goals
2. Funding – life after grants and startup funds
3. Competition- stakeholders are often competing for the same patients
4. Internal policies
5. Consumer privacy concerns
6. Trust
7. Legal and regulatory issues
8. Technology
9. Scarce human resources

Front 52

What groups will receive the largest annual dollar savings from Level 4 interoperability?

Back 52

1. Providers and hospitals
2. Payers
3. Pharmacies
4. Independent laboratories
5. Radiology centers
6. Public health depts.
7. Nation as a whole

Front 53

Who is involved in IHE?

Back 53

• Users (clinicians, staff, administrators, CIOs, Gov’t agencies)
• Professional societies representing 270,000 individual members (HIMSS, RSNA, ACC, ACP, AAO, ACCE, ASTRO )
• Standards Development Orgs (SDOs) (HL7, DICOM, ISO, CDISC, ASTM, W3C, IEEE, IETF)
• Vendors & Consultants (imaging, EHRs, cardiology, medical devices)

Front 54

How do the CDA levels differ from one another?

Back 54

Level 1 – unconstrained. Allows for free text. Facilitates the transfer of unstructured clinical notes.
Level 2 – adds a spec for section constraints within the CDA doc; provides structure while allowing for unconstrained elements within the headings; one could define the section headings of subjective, objective, assessment and plan for SOAP notes.
Level 3 – fully structured “entry level templates”; most granular; maximum machine readability.

Each level up adds more machine readability, though clinical content should be the same on all three.

Front 55

What benefits do each of the CDA levels provide?

Back 55

Level 1 – maximum compatability with older systems; simplifies the implementation process from a technical standpoint
Level 2 – more structure while allowing unconstrained elements
Level 3 – best machine readability

Front 56

What are the components of the information pipeline architecture?

Back 56

The Operational Data Store (ODS) collects all required data which are merged, cleansed and validated in Extract-Transfer-Load (ETL) process. The Core Database (Core DB) contains a reliable non-redundant collection of data, parts of which are made available for queries through data

Front 57

The big benefits of data warehousing are dependent on which two aspects of an enterprise
approach?

Back 57

• Enterprise level data integration
• Support of multiple different views and uses of the data

Front 58

What does high performance mean in data warehousing today?

Back 58

• Complete simple queries quickly
• Complete large complex queries efficiently and scalably
• Load new data into the data warehouse in a timely way

Front 59

Explain the simple idea of the data warehouse concept.

Back 59

Create a single repository of data – separate from the operational systems of the enterprise – strictly to support decision making, reporting and analysis. Keeping but one high quality copy of all the data – cleansed, standardized, and integrated in the dw both eliminates costs and helps to synchronize the data.

Front 60

What levels in an information technology system can enterprise business integration occur at?

Back 60

Data
Application
Business Process
User Interaction

Front 61

What are the main techniques used for integrating data?

Back 61

Physical view of data that has been captures from multiple disparate sources and consolidated into an integrated data store (data warehouse)
Federated view of disparate data that is assembled dynamically at data run time
Propagating data from one database to another

Front 62

What technologies support the data consolidation technique?

Back 62

ETL – extract transform and load
ECM – enterprise content management

Front 63

What are the advantages of using a federated approach?

Back 63

Provides access to current data
Removes the need to consolidate source data into another data source

Front 64

What are the disadvantages of using a federated approach?

Back 64

Not well suited for retrieving and reconciling large amounts of data
Not well suited for applications where there are significant data quality problems in the source data
Performance impact and overhead of accessing multiple data sources at one time

Front 65

What technologies support the data propagation technique?

Back 65

EAI – enterprise application integration
EDR – enterprise data replication

Front 66

What two aspects of data quality need to be considered in a data integration project?

Back 66

Analysis of the source data stores to ascertain their contents and data quality (use data profiling tools)
Cleansing of poor quality data. Insert a data transformation process in the integration workflow.

Front 67

What circumstances make it more appropriate to using extract, transfer, and load technology as opposed to enterprise information integration technology?

Back 67

Read only access to reasonably stable data is required
Users need historical or trend data
Data access performance and availability are key requirements
Users needs are repeatable and can be predicted in advance
Data transformation is complex

Front 68

What are the advantages of using the data consolidation technique?

Back 68

allows large volumes of data to be transformed (restructured, reconciled, cleansed, and/or aggregated) as it flows from source systems to the target data store.

Front 69

What are the disadvantages of using the data consolidation technique?

Back 69

The computing resources required to support the data consolidation process and the amount of disk space required to support the target data store.

Front 70

What are the advantages of using the data propagation technique?

Back 70

Real or near real time movement of data
Guaranteed data deliver and two way data propagation (varies by product)
Workload balancing, backup and recovery and disaster recovery

Front 71

What are the major levels that states are encouraged to undertake action on to develop overall interoperability by the SemanticHEALTH project in the January 2009 report?

Back 71

These are the political, organizational, technical and semantic levels, with educational and awareness raising mechanisms to underpin initiatives in those main domains.

Front 72

What are the semantic interoperability facets relevant to individual patients?

Back 72

SIOp relevant tasks comprise assisted clinical data capture and quick access to the patient record as well as to pertinent background knowledge. It also includes quality assurance, clinical decision support, monitoring and alerts, as well as feedback regarding quality and costs.

Front 73

What does the National Institute of Standards and Technology work towards regarding emerging telehealth technologies?

Back 73

The National Institute of Standards and Technology (NIST) works towards making emerging information technologies, including telehealth technologies, more usable, more secure, more scalable, and more interoperable. They are also working on the development of standards.

Front 74

What are the sequence of steps typically involved in standard setting process?

Back 74

Identify areas requiring standardization,Determine whether standards exist for the area of interest,Submit proposal,Discussion/Debate, Review process/Incorporate changes,Consensus/Final vote

Front 75

What is a benefit of improved interoperability between outpatient providers and pharmacies?

Back 75

1. Reducing duplicate therapy, drug interactions and ADEs, and med abuse
2. Automated refill alerts and info to clinicians re compliance
3. Complete insurance forms reqd for some meds
4. ID affected patients in drug recalls or discovery of new side effects
5. Improve formulary management
6. Promote adherence to formulary guidelines

Front 76

How will clinical care be improved by improving interoperability between providers and laboratories?

Back 76

Interoperability between outpatient providers and independent labs will improve care by giving clinicians better access to patients’ longitudinal test results, eliminate errors associated with verbal reporting, optimize ordering patterns by making costs readily available, and make testing more convenient for patients.

Front 77

What is a benefit of improved interoperability between outpatient providers and radiology centers?

Back 77

giving radiologists access to relevant clinical info,
enabling them to recommend optimal testing,
improving patient safety by alerts re test contraindications,
improving coordination of care,
and helping prevent errors of omission by automated reminders to both clinicians and patients when FU studies are indicated. It also reduces redundant tests and saves time and cost assoc with processing of film.

Front 78

What are the managerial-related aspects of an interface engine that should be considered?

Back 78

The managerial-related aspects of an interface engine that should be considered are the ff: time to install, cost to install, ease of use and training of key personnel, and support after installation. The engine should be vendor neutral, HL7 standard, there should be integrity of data, there should be a monitoring system with message logging and acknowledgements.

Front 79

What are the steps involved in information resource management planning?

Back 79

understanding the business

simplifying the business

integrating the business

Front 80

What do middleware standards provide?

Back 80

Middleware standards provide a common infrastructure for interconnecting distributed software components. They are primarily intended to provide programming abstractions which help a programmer easily bridge different hardware, os, and programming languages. (Ex: CORBA, .net, EJB, or Web Services)

Front 81

What does an application framework provide?

Back 81

clear specifications of interfaces and interaction protocols which are needed for embedding a software component into a system of cooperating components. (Ex: IHE initiative)

Front 82

Under what conditions does semantic heterogeneity occur?

Back 82

Semantic heterogeneity occurs when there is disagreement about the meaning, interpretation or intended use of the same or related data.