Q&A Hero

Q: The importance of billing codes and reimbursement for services cannot be overstated. Which of the following responses are true regarding accurate code input and claims processing? Standard Text: Select all that apply. 1. CPT codes were grouped into services by the first digit followed by four more digits that further described the procedure. 2. The number 9 is reserved for visits related to evaluation and management procedures. 3. The CPT code 99211 is an office visit and used for injections. 4. Two digit modifiers are used to further distinguish services and procedures altering the billing process. 5. Inaccurate code input will delay claims processing.

Q: The __________________________ was developed by Medicare in an effort to control quality and cost and minimize preventable complications. Standard Text:

Q: Which of the following statements is true about the do-not-pay list? 1. If a patient develops a complication, Medicare will reimburse for all services. 2. If a patient develops complications, Medicaid will reimburse for all services. 3. If a patient has certain complications during the hospital stay, Medicare will not reimburse the hospital at the higher rate for the treatment. 4. If a patient develops a preventable complication, Medicare will demand the immediate transfer of the patient to a different health care setting.

Q: Which act makes several significant changes to the current HIPAA Security and Privacy Rules and provides funds and incentives to increase the use of electronic health records (EHRs) by physicians and hospitals who meet eligibility criteria? 1. Health Information Technology for Economic and Clinical Health Act (HITECH) 2. The American Recovery and Reinvestment Act of 2009 3. Medicare Improvements for Patients and Providers Act (MIPPA) 4. The Health Insurance Portability and Accountability Act

Q: What is the rationale the AMA is using to oppose the do-not-pay list? 1. Physicians assert each patient's circumstances are unique and complications cannot always be prevented or explained. 2. The physicians assert this reimbursement ruling is unjust. 3. The physicians assert the do-not-pay list is punitive to health care providers. 4. The physicians assert do-not-pay list minimizes complications.

Q: The _________________________________________ oversees information- technology standards, implementation strategies, and impact assessment. Standard Text:

Q: Which of the following statements is true about the projected results of the increase in federal and state mandated health care cost reform legislation? 1. The increase in governmental regulations provides for a higher quality of care. 2. Governmental oversight is something that has been lacking in health care over the past several years. 3. The burden of proof is placed on the health care community. 4. The increase in governmental oversight allows for improved outcomes with decreased FTEs.

Q: To comply with the mandate to use EHRs by 2014, physicians and hospitals must have the EHR prepared and ready for implementation. Which of the following methods are available to entities that will assist in the funding of the EHR? 1. Medicare and Medicaid 2. HIPAA 3. Consumer Digest Guidelines 4. American Recovery and Reinvestment Act of 2009

Q: There has been an impact of the Health Insurance Reform Act, also known as The Patient Protection and Affordable Care Act, on system use and design. Which of the following actions was enacted upon the president's signature? 1. Young people can remain on their parents insurance until 24 years old. 2. Children with preexisting conditions are no longer covered. 3. New plans must offer free preventive care. 4. There are lifetime limits on benefits.

Q: To receive financial incentives, hospitals and physician offices must meet designated criteria established by which organization? 1. Centers for Medicare and Medicaid 2. The Joint Commission 3. American Nurses Association 4. TIGER Initiative

Q: The effects of the new regulatory and reimbursement laws instigated subtle changes which will have an impact on the physician office as well as outpatient facilities, ancillary services, and hospitals. In order to become, or perhaps soon remain, a Medicare/Medicaid provider, a medical compliance program must be in place. According to the Fox Group's website (n.d., p. 1) that includes which of the following measures? Standard Text: Select all that apply. 1. Compliance with health and safety laws and regulations 2. Compliance with fraud complaints 3. Compliance with environmental laws and regulations 4. Compliance with human resources laws and regulations 5. Compliance with HIPAA laws and regulations

Q: Healthcare entities, as well as their business associates, must notify individuals whose health information is breached within 60 days of that breach. In which of the following cases does the entity not have to notify the individual whose information has been breached? 1. If data are anonymous 2. If data are encrypted 3. If data are misplaced in setting 4. If data are lab results

Q: Implementing an electronic health record in a small primary care practice can be cost prohibitive. To assist in the cost of the endeavor, the government has done which of the following? 1. Provided loans to physicians to purchase technology 2. Offered physicians stipends if they use the equipment correctly 3. Has given financial aid to larger practices to purchase equipment 4. Has given physicians the equipment to convert to electronic health records

Q: Which act eases the budgetary impact of EHR thereby facilitating implementation? 1. HIPAA 2. ARRA 3. ESIGN 4. HITECH

Q: HIPAA and HITECH have designated some technical standards as mandatory. Which of the following are associated with the implementation of standards? Standard Text: Select all that apply. 1. The standards are insufficient to enable collection, management, and exchange of the mandated data. 2. Technical standards are needed to assure that structured and codified terminologies 3. Technical standards are needed to sufficiently capture all of health care 4. Standards must be widely available 5. Technical standards should be easily exchanged within and across organizations

Q: Which of the following skills are needed by nurse informaticists? Standard Text: Select all that apply. 1. Communication 2. Mining data 3. Analyze data aggregates 4. Design in-case process 5. Design functional and clinically valid decision support

Q: The need for informaticians who understand health care has grown. Which of the following best represents the future of nursing informatics? 1. The role of the nurse informatician will decrease in the future with an emphasis on medical informatics. 2. The need for nurse informaticians will increase in the future. 3. The need for nurses to specialize in informatics is unnecessary. 4. Nurses need advanced education to participate in the design and implementation of the information system.

Q: ____________________________ is a specialty in nursing that focuses on the technology aspect of patient care. Standard Text:

Q: One of the biggest pitfalls and concerns to health care providers to the transition to the ICD-10 by 2013 is which of the following? 1. Training staff to use the new system efficiently 2. Having enough qualified personnel available to troubleshoot impending issues 3. The need to overcome resistance to change in the health care setting 4. The cost to convert the current systems to accommodate the changes

Q: Despite the negative responses by health care providers toward the transition from ICD-9 to ICD-10, which of the following statements is a clear benefit of the transition? 1. Over 100 countries have already adopted the ICD-10 coding system. 2. Coding solutions will be clearly understood by all health professionals. 3. The impact on small physician's practices will be negligible. 4. More nurses will be hired to maintain the systems.

Q: Which type of billing codes is used by Medicare to determine the level of severity and per diem rate? 1. POA 2. MS-DRG 3. ICD 4. PPAC

Q: According to Peters (2002), which of the following are considered stages of policy development? Standard Text: Select all that apply. 1. Recognition of a problem or issue 2. Agenda setting 3. Policy formation 4. Brain storming 5. Budgeting

Q: What do the TIGER initiative and nursing have in common? 1. One of the top goals of the TIGER Initiative is to have more nurses play an active role in the development of a national health care information technology infrastructure. 2. One of the top goals of the TIGER Initiative is to have more nurses create standards of approval. 3. One of the top goals of the TIGER Initiative is to move toward medical informatics. 4. One of the top TIGER initiative goals is to add supportive personnel at the bedside.

Q: Health policy may at times contribute to negative trends. Certain aspects of U.S. health policy have been blamed for creating or contributing to some of the health problems. Which of the following are associated with wayward policies? Standard Text: Select all that apply. 1. Lack of clinical and administrative standardization 2. Fragmented care 3. Unequal access to care 4. Turning health problems into marketing opportunities 5. Failure to curtail costs for services

Q: Which of the following laws, signed by President Clinton in 2000, gives electronic signatures the same legal status as handwritten signatures? 1. The Health Insurance Portability and Accountability Act (HIPAA) 2. The American Recovery and Reinvestment Act of 2009 (ARRA) 3. Medicare Improvements for Patients and Providers Act (MIPPA) 4. The Electronic Signatures in Global and National Commerce Act

Q: The need for health care reform has been obvious for some time but the implications of the broken U.S. health care delivery system were largely brought to the attention of the public through which famous report? 1. Learning What Works: Infrastructure Required for Comparative Research - Workshop Summary 2. From Public Health: Revitalizing Law and Policies to Meet New Challenges 3. To Err is Human: Building A Safer Health System 4. Leading Health Indicators for Healthy People 2020

Q: MIPPA is an acronym for ___________________. Standard Text:

Q: Health information technology can be seen as a tool to aid the health care reform process through which of the following? 1. Limited engagement 2. Sharing information with interested parties 3. Recognition of its potential to improve the safety and efficiency of health care delivery 4. Denying care to individuals who cannot pay

Q: President George W. Bush signed a law that mandated the development of an EHR for every American by which year? 1. 2013 2. 2014 3. 2015 4. 2020

Q: Widespread adoption of HIT (Health Information Technology) requires _______________ and policies that make quality improvement and cost reduction essential to providers in order to accomplish their financial and professional goals. Standard Text:

Q: Health care technology has multiple benefits and can be instrumental in continuing the health care reform process. Which of the following would be considered a benefit? Standard Text: Select all that apply. 1. Immediate electronic access to all records 2. The development of best practice models 3. A larger portion of the operating budget used to purchase and maintain electronic equipment 4. Improves the safety and efficiency of health care delivery 5. Facilitates the sharing of information needed to improve the quality of care

Q: The Health Information Technology (HIT) Committee was created under the auspices of the Federal Advisory Committee Act (FACA). The committee is composed of several workgroups designated by the National Coordinator for Health IT. Which of the following are individual working groups are associated with the HIT Committee? Standard Text: Select all that apply. 1. Governance 2. Privacy and Security Tiger Team 3. Strategic Plan Privacy and Security Policy 4. National Health Information Network (NHIN) 5. Meaningful Use Certification/Adoption Information Exchange

Q: Which of the following serve as a guide in the development of the policies and technologies used to support quality reporting and other uses of health data? 1. Budget 2. Regulations 3. Issues 4. Values

Q: The development of HIT policy advisory boards should reflect the needs of all citizens. To gather data needed to create appropriate policies, special interest groups become part of the assessment and planning process. To that end, which of the following groups support or impact health care policy? Standard Text: Select all that apply. 1. Agency for Healthcare Research and Policy 2. Alliance for Health Reform 3. American Federation of Labor and Congress of Industrial Organizations 4. American Hospital Association 5. Henry J. Kaiser Family Foundation

Q: With the increased use of HIT in health care settings, nurses are asked to participate in the development of national, state, and local policy. How can nurses gain practical experience in policy shaping and development? 1. Internships 2. Continuing education programs 3. Online legal courses 4. Volunteer in a homeless shelter

Q: TIGER Leadership Collaborative Report has called for transformation of the health care delivery system through the development of a national health information infrastructure that requires nurse leaders "understand, promote, own, and measure the success of health IT." To do so, which of the following strategies cannot be incorporated? 1. Education programs for nurse executives and faculty that stress the value of information technology and empower them to use HIT appropriately 2. The expansion/integration of informatics competencies into nursing leadership development programs 3. Exchange best practice models with physician groups 4. Sharing of best practices using HIT effectively to improve the delivery of nursing care

Q: Nurse executives are asked to play important roles in the shaping of HIT policy. Which of the following apply to ways in which they can be actively involved? Standard Text: Select all that apply. 1. Overcome financial and cultural barriers related to HIT 2. Support and provide leadership development on HIT-related topics 3. Incrementally decrease the information technology budget line for support services 4. Contribute to research that substantiates the business case for nursing 5. Improve patient safety through the use of decision-support tools at the point of care

Q: Nurses can be leaders in the development and implementation of HITs by which of the following? 1. Guiding the process 2. Attending graduate school 3. Resisting change and innovation 4. Researching best practice models

Q: What are some of the HIT benefits that can be actualized in the health care setting? 1. Decreased point of care contact 2. Increased revenue 3. Personalized health care 4. Increased need to upgrade technology

Q: The health information exchange requires exchange of health-related information according to nationally recognized standards to link into which of the following as it can provide a standardized, secure, and confidential way to link information systems together for authorized users to share reliable health-related information? 1. Office of National Coordinator (ONC) 2. Health information exchange (HIE) 3. National health information network (NHIN) 4. Health Information Security and Privacy Collaborative (HISPC)

Q: The future of HIT in the health care system is reliant on a number of individuals dedicated to the creation and success of the initiative. Which of the following are some of the key figures in the positive launch of a system? Standard Text: Select all that apply. 1. Nurse informaticians 2. Information technologists 3. Physicians 4. Vice presidents 5. Staff nurses

Q: To accomplish exchanges, an HIE infrastructure requires not only technology but an organizing structure for processes. The organizing structure establishes which of the following? 1. Nontechnical standardization 2. Secure application and rules of operation 3. Transoperational exchanges 4. Standardized workflow to obtain nonessential information

Q: According to Iowa e-Health, which of the following are key factors that are indispensable prerequisites to consider for the HIE organizing infrastructure? Standard Text: Select all that apply. 1. Master person index 2. Record locator service used to access and find health information that matches the identified individual 3. Methods of authentication 4. Provide authorization for users 5. Scope of services provided

Q: The preparations for an HIE include organizing a governing body and establishing financial sustainability. Which of the following is considered a conceptual and sustainable public governance model? 1. Public utility HIE with government oversight 2. Public utility HIE with no government oversight 3. Private sector-led HIE with local collaboration 4. Private sector-led HIE with corporation collaboration

Q: _________________ and health systems with nursing homes, hospice, homecare, and clinics integrated with hospitals are able to exchange with standard content and identifiers adopted across settings. Standard Text:

Q: Which of the following are considered barriers to the implementation of the HIE? Standard Text: Select all that apply. 1. Equipment 2. Financial 3. Local 4. Personnel 5. Legal procedures

Q: Which of the following is true about the sustainability of the HIE? 1. Sustainability discussions occur after the implementation phase. 2. Sustainability is no longer an issue in HIE. 3. A system that is not sustainable is not an effective one. 4. Sustainable technology is not cost effective.

Q: Which of the following are considered obstacles to sustainability? Standard Text: Select all that apply. 1. Underestimating the size and scope of the project 2. Identifying critical mass of data to exchange 3. Identifying critical mass of participants 4. The collaboration between common competitors in communities 5. The resistance to changes in workflow

Q: Which of the following statements is most accurate about the relationship between the national health information network (NHIN) and the health information exchanges (HIE) in the United States? 1. The success of the NHIN is dependent on the state-wide HIEs. 2. The success of the NHIN is not dependent on the state-wide HIEs. 3. The success of the state-wide HIEs is dependent on the NHIN. 4. The success of the state-wide HIEs is not dependent on the NHIN.

Q: Which of the following are considered disadvantages of the PHR? Standard Text: Select all that apply. 1. E-literacy 2. Lack of access in poor and rural regions 3. Patient satisfaction 4. Cost 5. Enhanced therapeutic alliances

Q: The overall role of the state-level HIE initiatives can be loosely grouped into three broad categories. Which of the following is not considered a category? 1. HIE enabler/readiness 2. HIE sustainability 3. HIE outsourcing/technical partnership 4. HIE operator

Q: Which of the following is a barrier associated with patient use of PHRs in rural regions? 1. Access 2. Awareness 3. Usability 4. eHealth literacy

Q: The HIE initiatives are often started by which of the following? 1. Research teams, advisory councils, and executive committees 2. Informaticians 3. LeapFrog Group 4. TIGER

Q: Patients bring a wide variation in their capacity to use information technology. Which of the following does not increase the usability of PHRs? 1. Easy navigation 2. Simple functionality 3. Decreased e-literacy 4. Readability

Q: As national standards for interoperability are developed, the future of HIEs seems to be in the hands of which of the following? 1. Nationwide health information network 2. The Department of Homeland Security 3. HIPAA 4. HIMMS

Q: As PHRs become the established norm, health care providers are aware of issues that can emerge from patient self-disclosure. Which of the following is a key concern associated with the patient-self entered data? 1. Electronic medication refills 2. Automated appointment schedules 3. Data review responsibility 4. Downloading accurate data

Q: A volunteer federal _________________________ develops interoperable standards. Standard Text:

Q: Which of the following is not a PHR concern? 1. Insurance claims 2. Privacy 3. Portability 4. Accuracy of data

Q: As standards are developed for interoperability, there will be an increased number of vendors seeking which of the following? 1. Funding 2. Contracts 3. Certification 4. Revenue increases

Q: _______________________________ is defined as the electronic movement of health-related information among organizations according to nationally recognized standards. Standard Text:

Q: Which of the following are considered obstacles to the HIE? Standard Text: Select all that apply. 1. Policy 2. Organizational 3. Structure 4. Financial sustainability 5. Technology design

Q: Which of the following answers best describes the relationship between the health information exchange (HIE) and regional health information organization (RHIO)? 1. The HIE provides oversight to authorize the location of health information and the secure transfer and reuse of that health information electronically. 2. RHIO provides oversight to authorize the location of health information and the unsecured transfer and reuse of that health information electronically. 3. RHIO provides oversight to authorize the location of health information and the secure transfer and reuse of that health information electronically. 4. RHIO provides analysis of health information and the secure transfer and reuse of that health information electronically.

Q: A ______________________ model enables the access and exchange of data stored in existing provider networks and also through a central data repository maintained for smaller providers who would not be able to maintain 24x7 services for HIE access. Standard Text:

Q: Health information exchanges can be useful for more than patient care and the uses are described at levels. Which of the following are considered levels? Standard Text: Select all that apply. 1. Public health 2. National 3. Individual 4. Agency/organization 5. Professional

Q: The use of SNOMED CT within electronic health records has multiple benefits. Which of the following are considered benefits of SNOMED CT? Standard Text: Select all that apply. 1. Provides interoperable data collection that can be analyzed and used for evidence-based practice models 2. Provides interoperable data collection that can be analyzed and used for decision support rules 3. Provides interoperable data collection that can be analyzed and used in reporting quality measures 4. Provides interoperable data collection that can be analyzed and used for medication renewals 5. Provides interoperable data collection that can be analyzed and used for administrative billing

Q: Some functionalities require integration between the PHR and a scheduling application. Which of the following is a benefit of this communication? 1. Integration between a scheduling application and the PHR allows the patient to locate a physician's practice in a new region. 2. Integration between a scheduling application and the PHR allows the patient to have instant access with a health care provider's staff. 3. Integration between a scheduling application and the PHR allows the patient to schedule an appointment without making a telephone call. 4. Integration between a scheduling application and the PHR allows the patient to send notes and updates to the health care provider's office.

Q: Standard terminologies have been scientifically investigated for their effectiveness and impact on patient care. The use of standard terminologies can, therefore, facilitate the use of which of the following? 1. Multiple support languages 2. Consumer informatics 3. Computer literacy 4. Evidence-based practice and decision support rules

Q: In its simplest form, the PHR is a stand alone system where the _______________enters data. Standard Text:

Q: The impact of standardized terminology throughout the U.S. health care system has grown exponentially. Medicare and Medicaid have begun to offer financial incentives to health care providers to promote adoption and meaningful use of interoperable health information systems and a qualified health record. Which of the following statements best describes meaningful use? 1. The goal of meaningful use is to input data in a manner that creates evidence-based practice models. 2. The goal of meaningful use is to exchange clinical structured data in a manner that is accurate and complete to improve patient care in a cost-efficient way. 3. The goal of meaningful use is to provide a warehouse of data that supports medication renewal and patient teaching plans. 4. The goal of meaningful use is to offer the clinician patient care tools for improved outcomes.

Q: PHRs and their functions are becoming more important in health care delivery systems. There are a multitude of benefits associated with the PHR. Which of the following is not a potential benefit associated with the PHR and laboratory tests? 1. May confuse and worry patients 2. Avoids letters and phone calls 3. Reduces patient waiting time 4. All data are confidential

Q: Meaningful use requirements mandate the use of _________________________ for data collection and reporting of established quality measures. Standard Text:

Q: PHRs can enhance a health care provider's clinical practice in a number of ways. Which of the following are associated with the benefits of the PHR and medication management? Standard Text: Select all that apply. 1. Allows patients to check and improve quality of medication list (medication reconciliation) 2. Encourages discussion with doctor to improve adherence 3. Patient can share medication information with other providers 4. Health care provider can access information on prescription refills 5. Allows the health care provider and patient immediate communication with pharmacy

Q: In the last decade, and with the requirement to build EHRs that meet the 2009 meaningful use criteria, the use of which type of data has expanded to include pay-for-performance initiatives, care coordination, patient safety monitoring, and public health surveillance? 1. Patient 2. Coded 3. Embedded 4. Qualitative

Q: Which of the following are considered patient benefits of EHR personal health information? Standard Text: Select all that apply. 1. Self-entered data 2. Appointment request 3. Medication management 4. Appointment views 5. Access to test results

Q: Implementing standardized terminology has many benefits to multiple beneficiaries. Which of the following are benefits of standardized terminology? Standard Text: Select all that apply. 1. Patients 2. Providers 3. Health care organizations 4. Health care industry 5. Informational technicians

Q: Which of the following health systems was an early pioneer adopting the PHR? 1. Tenet Health System 2. Jefferson Medical System 3. Nationwide Health Care System 4. Palo Alto Medical Foundation

Q: Multiple benefits have emerged from the use of structured terminologies within health care records. Which of the following are considered benefits of the health information technology (HIT)? Standard Text: Select all that apply. 1. Accurate, consistent meaning of data is collected and shared across the health care system. 2. A plethora of data can be entered into the system manually. 3. Clinical terminology enables the capture of data at the level of detail necessary for patient care documentation. 4. Standardization in nursing documentation supports research across settings on patient outcomes and interoperability. 5. Patient identification and outcomes are clearly shared throughout the systems.

Q: Beth Israel Deaconess Medical Center was one of the early adopters of PHRs. Which type of PHRs are used throughout the system? 1. Stand alone 2. Tethered 3. Integrated 4. Integrated alone

Q: ___________________________ facilitates the monitoring of trends and problems of the health of populations, developing clinical decision support, and expanding our knowledge of diseases and treatments and outcomes through research and clinical data mining. Standard Text:

Q: The largest health system to deploy a PHR in the United States is __________________: Standard Text: