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RHIA Domain Three
| Question | Answer |
|---|---|
| What is strategic plan? | is a long term,covering a period of at least three to five years and focus on the direction needed to accomplish the organization mission |
| What is a tactical plan? | is a short term, focused on one component or project rather than a strategic plan, tactical plan often do not fully address the SDLC ( System develop life cycle)result may be one where the short term project focus on one component. |
| What is the difference a strategic and tactical plan? | Strategic plan is long term three to five, whereas, tactical plan is focused on one component or shorter term ,one to two years |
| What is system development life cycle? | refers to the steps taken from an initial point of recognizing the need for a desire result, the steps taken to ensure all components needed for the system achieve desired result are addressed,example failure of system to produce w/federal coding system |
| What are the elements of a system development life cycle? | They're variations in how steps in the SDLC are described depending on the context in which its used. SDLC steps are 1)identify need,2) specify requirements,3) Design or acquire,4)Develop/implement,5)maintain,6)monitor results |
| What is CPOE and BCMAR? | BCMAR-used for med tracking,supply requisiting or chart,data input error rates are 0,remedy for med errors.COPE-enables ordering everything from admit to various depts,identifies PT health plan,fewer call to pharm,med list. |
| What is MPI identity management? master patient index | Breakdown in PT identification cause record errors,failing to locate PT in MPI causing dup record,reg PT under another PT causing overlay result merging two different PTs |
| What is enterprise master patient indices (EMPIs) | involves services to identity management through an indexing scheme to all unique PT identification numbers /databases,test 2 c if PT is identified in all systems,reg to send data,capability to merg records using match algorithms, linking PT EOC. |
| What is a project manager? | is responsible for developing a detailed project plan for ensuring that all tasks are successfully performed on time and on budget |
| What is requirement analysis? | step that identifies in detail,the precise requirements needed for both health information technology(that is,hardware/software) and operational components (people,policy and process) of health information system to meet goals specified in the plan |
| What is the implementation? | is the process in which the system is configured to meet a specific organization needs.Implementation follows acquisition. Implementation includes number of steps,install of hardware/software,data conversion,chart conversion,workflow/process improvement |
| What is RFP ,request for proposal? | When all requirements are determined for functionality a vendor is next,RFP is a solicitation to vendors,includes basic info about organization,how many users,timeline for implementation,RFP is set to 4/6 vendors, include information about other vendors |
| What is the evaluating responses to RFP and the steps your would take ? | Evaluating responses to an REP for a major health information system acquisition generally follows several steps. |
| What is step one of RFP? | An internal analysis of proposal against the requirements specification and other components of the RFP should be conducted by the steering committee and analysis the proposal timeless implementation,ongoing maintenance,upgrades |
| What is the second step of RFP? | Once the internal review is completed,the steering committee should narrow the field of vendors where any vendors whose bids are deficient are dropped from consideration. |
| What is the third step of RFP? | Remaining vendors are invited to come back to conduct a system demonstration ,this will view any gaps the organization may have or other challenges that vendors identify that may narrow or broaden their scope of response. |
| What is the fourth step of RFP? | following demonstration,the organization may asked the vendor to return a revised proposal. The next step is to narrow the field of vendors whose product did not demonstrate well. |
| What is the fifth step of RFP? | Remaining vendors from second cut are analyzed by conducting due diligence, this includes reference check ,frequent site visits to see product works in real life. |
| What is the sixth step of RFP? | All info is accumulated, the steering committee and financial/officer should consider all findings to date in the light of the price/contract terms.Contract issue list should be started,contract list should be reviewed by legal team. |
| What is EHR systems? | Electronic health record system is a concept that consists of a host of integrated component information systems and technologies, capture clinical data from multiple sources for POC,support users by complete and accurate data,keeps track of PT care |
| How is electronic medical record defined?EMR | is a electronic record of health related info on an individual that can be created,gathered,managed and consulted by authorized clinicians and staff within one healthcare organization. |
| What is electronic health record ? EHR | is defined as an electronic record of health related information on an individual that conforms to nationally recognize interoperability standards that can be created,managed ,staff across more than one healthcare organization. |
| What should a EHR be able to do? | EHR should assist clinicians/other healthcare professional provider safer ,more efficient ,cost effective care by providing info and decision support to end users,example,improve quality healthcare,enhance patient safety,revenue enhancement,confidentially |
| What are core clinical EHR applications? | EHR applications are those used directly by clinicians at the point of care, There are five major categories of applications, these applications are results management,POC documentation,medication management,clinical decision support and reporting. |
| What are results management systems? | are applications that enable diagnostic studies to be processed according to the needs of the users. Clinicians can review lab result.LOINC-data standard for laboratory data used codes placed into clinical data.results management enables lab results |
| What is POC Documentation system? | POC documentation applications guide user through the necessary data to collect in the context of specific patient,templates are reacted to the nature of the data being entered,Hospitals use POC charting such as nursing documentation,care plans,vitals |
| What are medical management system? | applications that support the closed loop medication management process,where patient safety is ensure through proper drug ordering,dispensing,administering/monitoring reactions through POC documentation. |
| What is E-Prescribing? | special type of CPOE application used to write prescriptions/ transmit them to retail pharmacies, the national council for prescription drug programs (NCPDP) SCRIPT standard is sent through pharmacy information exchange, E-RX system includes med alerts. |
| What is electronic medication administration record, EMAR? | EMAR systems were simply electronic generated paper list of medication from the pharmacy info system after it processed physician orders,nurses were expected to date/time ,exceptions,hospital are now moving to BCMAR system. |
| What is automated drug dispensing? | machines available for secure and make drugs specific to patient orders readily available to nursing staff., machines are filled by pharmacy based on physician orders. |
| What is systematic oval? | graphical technique displays stacked ovals with the height of the stack corresponding to the maximum of the scale, ovals are separated into discrete units , each oval corresponding to a specific unit of measue,veritical bars results accurate/rapid proces |
| What is random oval? | displays is similar to systematic ovals but it is not as uniform, the ovals are randomly filled in. |
| How important is a experience user when displaying visual data? | improve accuracy of interpreting data with less experienced health professionals. Experience considered when designing a visual of data,discuss impact visual display on users,whether visual display improves /hinders performance w/professional experience |
| What is information over load? and why is it important not to present information overload? | defined as difficulty in making decisions due to the presence of excessive amounts of information.Presentation methods should maximize information retrieval while not causing information overload. Chart advantage is to limit cognitive process |
| What is a histogram? | displays a frequency or density distribution of single numeric variable, categorizing or sorting these numeric variables together is called binning, the numeric variables is broken down into groups based on specific range of values, width of each bar. |
| What is a normal and positive right distributions in a histogram? | Normal distributions in a histogram when the pattern follows a bell shaped pattern,if histogram has highest point to the left side of the graph and a right trailing tail, its referred to as right skewed or positively skewed. |
| What is a negatively left distributions in a histogram? | Negatively distributions have the highest point to the right side of the graph and a left leading tail,it referred to as a left skewed or negatively skewed. |
| What is a bimodal distribution in a histogram? | A bimodal distribution in a histogram occurs when there is more than one peak in the data. |
| What is a bar plot? | Two main purposes,1) plotting the frequency for one or more groups where height of each bar represents count/frequency 2)plotting the mean for one or more groups where the height of each bar represents average,can be vertical/horizontally. |
| What is a dot plot? | presents the frequency or means to compare many groups using dots.Dots offer less cluttered view of data when there are many groups to compare. |
| What is a pie chart? | use to present the count or proportion of subgroups to the whole,represent the subgroups of a single factor,each proportion |
| What is a line plot? | main purposes,1) present trends/patterns in the number of occurrences between groups 2)presents trends/patterns in the mean of a variable between groups,change of variable over time is compared,more than one group is compared a separate line is drawn. |
| What is a boxplot? | Displays the descriptive statistic of a variable including the minimum,first quartile,medium,third quartile.maximum and potential outlier values |
| What is scatterplot? | relationship between two quantitative variables. line is drawn in the middle of the points/represents trend of data known as the best fit line. Slope in the line determines relationship between variables,simple linear regression statistical scatterplot |
| What is complexity of data? | data complexity as it visualization of healthcare data usually arises when there are multiple parameters need to be viewed simultaneously, when it is necessary to view multiple parameters on one graphic display. |
| What is dashboard? | method developed for presenting a variety of data on a single display in a easy to read format,used for different purposes includes viewing organization performance data,financial data and clinical data,meant for high level of understanding. |
| What is graphic perception? | referring to visual interpretation process and was originally described as the ability to unconsciously extract information from graphics. |
| Why is it important to know graphical techniques? | When data is presented as a position along a common scale,the info can be extracted faster with greater accuracy than other methods.by choosing graphical methods it enhance accuracy/efficiency of interpreting data. |
| What are the various types of charts that can be used to present data across the graphical techniques? | Bar is for data as a position along a common scale.line chart is for data position along a common scale.Stacked bar is for data using length.Pie chart is to present data by comparing area.3D bar is for comparing volume.Heat map is data use shading/color |
| What are the ranking techniques from most to least accurate? | 1)Position along a common scale 2)Position along nonaligned scales 3)Length,direction,angle 4)Area 5)Volume,curvature 6)shading,color saturation. |
| What's the difference between charts and tables? | Most common type of data displayed graphically is quantitative data.Weight is quantitative data element. When presenting weight over a period of childhood data can be presented in a table where numeric values for weigh displayed. |
| What's the difference between charts and tables? continue | if a task was to identify the trend in weight over time the simplest way to complete is a chart |
| What is spatial representations? | allows information to be view at a glance utilizing perceptual processes without needing to address the individual elements of infor separately/analytically.More dimensional interpretation/limits discrete data points,great for large data,task depended. |
| What is symbolic representations? | require analytical processes where infor is extracted from specific data values.Precise numeric values are more easily discerned when reading a table,holistic interpretation discrete data points may be determined.accurate values/tublar presentation |
| What type of chart or table would you used when conveying a message from several sets of data on a common subject and presenting subsets of data? | Both table and chart |
| What are the several factors can have an impact on the effectiveness of a visual display? | Context of the situation, experience of the user, type of chart, complexity of the data. |
| What is latency, accuracy, compactness and user preference? | latency decribes amount of time it takes to answer a question, accuracy measures correctness, compectness of the display and user preference is preference. Accuracy and latency of interpreting a visual display tend to be most common measures to consider |
| What is context of the situation? | certain situations where it may be necessary to present data using numerical values and other situations where a graphical display is ideal. whether numbers,charts,both are best presenting quantitative data.highly dependent on the type /complexity task |
| What is data mining? What is it used for? | the process of extracting and analyzing large volumes of data from a data base for the purpose of identifying hidden patterns. Used for secondary analysis to find trends,data use for purpose not primary reason collections. |
| What is predictive modeling? | form of mining applies statistic techniques to determine history likelihood of certain events occurring together. Statistical methods are applied to historical data to learn the pattern of data these patterns create models of most likely to occur. |
| What is logistical regression? | Statistical technique used to create data model to assess the probability. Example logistical regression use determine likelihood that a claim is fraudulent is estimated based on a series of historical data. |
| What is cluster analysis? and how is it used? | Historical data used to build a model to will measure the distance of a claim from the typical claim submitted by the provider or for the type of service. |
| What is decision trees used for? | Series of screens or yes or no questions to determine the probability that a claim is valid. |
| What is primary source data? | Source that contains information about a patient documented by staff who provide care / services to PT. Patient records tends to be most commonly use source statistical info, Its the first place data was recorded. |
| What is secondary source data? | Created using the information from primary data source. Examples of secondary data sources are indices, registries and reports created within the healthcare organization to manage data and decision making. |
| What is descriptive statistics? | Describe a large amount of data by illustrating the data with charts, graphs and tables in a way that data is summarized and organized.Descriptive is not used to draw a conclusion about the population data is describing. |
| What is inferential statistics? | is used to test hypothesis and draw conclusion to the population, the conclusions are used to infer the conclusions about the sample are reflective of the whole population from which the sample was taken. |
| What is length of stay? and how is it calculated? LOS/ALOS | is the number of days a patient is occupied a hospital bed.When counting LOS the day of discharge is not counted. For ALOS a period of time all number of PT are added up, the LOS of each PT including deaths is total, than divided |
| What is case-mix index (CMI) and why is it important and how is it calculated? | CMI is a weighted average of the sum of the relative weights of all patients treated during a specified time period.Relative weights can be stated as compared values. CMI gives details about how complex the PT cases are at each hospital. |
| What is case-mix index (CMI) and why is it important and how is it calculated? continue example 1 | CMI gives a picture of the severity of illness typical at each hospital.This information is important because the complexity of the hospital's PT reflects on cost of treating those PTs. If CMI is greater than 1.00 adj cost per PT will be lower, |
| What is case-mix index (CMI) and why is it important and how is it calculated? continue example 2 | used to adjust average cost per patient/per day for a given hospital relative to adjusted average cost for other hospitals by dividing average cost per day,adjusted average cost per PT would reflect charges reported for these types of cases treated year |
| What is DRG and why is it used for hospital reimbursement? | Diagnosis related groups are used for the hospital reimbursement because it measure the resources consumed for clinically similar patients. The DRG assigns numeric value to acute/inpat EOC that serves as relative weighting factor and resource intensity. |
| How is DRG used for hospital reimbursement? and how is it calculated with CMI? | DRG as a reimbursement system uses the DRG assignment determines the payment level the hospital will receive. CMI index is calculated by adding the DRG weights for all MCR PT discharges and dividing the number discharges example on PG 502. |
| What's the appropriate way to use descriptive statistic? | is used to describe the distribution of the variable interest.Is determined by the type of data analyzed.Rates and proportions often used. Rate is used to measure subjects died compare to total. Proportion use describing CC breakout. |
| What is the appropriate way to used inferential statistics? | used to test hypotheses or make decisions. Is determined by hypothesis to be tested or a question to be answered.Analyst maybe asked to compare LOS to state standard,DRG change rate from value observed at facility,questions maybe answered with inferential |
| What is sample? | a portion of a target population,it's a set units.Researchers often use samples because studies involving entire populations can be impractical or unfeasible. |
| What are the two types of sampling and what do they do? | Random sampling is a method selecting a sample from target population in which all it's members have an equal and independent chance of being selected for the research.HIM most encounters,use either a spreadsheet or select cases from table of populations |
| How many types of random sampling and what do they do? | 4,Simple sample is units from a population so that every unit has the exactly same change of being included in the sample.Stratified sampling is population that divide them sucha s male/female therefore sample should be 50%. |
| How many types of random sampling? continue 1 | Systematic sample uses sample are selected from a list by drawing every _unit example HIM choose every fourth surgery for case review.Cluster sample is cluster of units example family,school,community. |
| What are the two types of sampling and what do they do? | Nonrandom sampling does not use statistical methods of probability to select samples and all members of the population do not have to be equal and independent chance of being selected for the research study. |
| How many types of nonrandom sampling and what do they do? | 3,Convenience sampling use any unit handy also known as accidental sampling.Purposive sampling researcher use their expertise to select both representative units and unrepresentative units of population. |
| How many types of nonrandom sampling and what do they do? continue 1 | Snow ball sampling intial contacts units suggest additional contacts who also could be informative. |
| What is structured data and examples? | data that is comprise of values that can be stored as either numbers or finite number of categories healthcare data such as height,weight,age,gender and MSDRG. |
| What is unstructured data and examples? | Data cannot be expressed by numbers/categories.Example clinician notes recorded in EHR,notes are valuable data regarding treatment protocols /documentation but they are recorded as freeform text and therefore difficult to analyses.NLP engines use 4 coding |
| How is structure data broken down? | broken down in levels of measurement, discrete and nominal data,discrete data take on values that cannot be added together/divided.Nominal categories represent names of items but do not have a natural order such as gender,color,ICD/CPT codes. |
| What are the basic data levels of measurement? | Nominal-categories mutually exclusive but do not have natural order example gender,dept. Ordinal-categories mutually exclusive but do have natural order example PT satisfaction scores,surveys,likert scale. |
| What are the basic data levels of measurement? continue | Interval-numeric data where distance between two values has meaning sucha s temperature,PH levels,dates.Rato numeric data values may be doubles or multipied such as charges,LOS or age. |
| What is rates and proportions? | are actually summary statistics based on either sample or population. A rate is the number of times an event of interest occurs divided by the number of times the event could have occurred, event and number carefully defined calculations rates are valid. |
| What are tools are sampling and design? | The sample size for a study is determined by the amount of precision desired for the study. There are number of tools available such as SAS offers module for sample calculation,G-Power is a public domain software application used to calculate samples,OIG. |
| What is the sample tool OIG offers? | The office of the inspector general OIG offers a statistical package called RAT-STATs can be used for both sample size determination and the generation of random numbers required for sampling. |
| Why did OIG develop the RAT-STATS program? | to help providers select samples for audits required for those under corporate integrity agreements to resolve compliance issues. OIG also requires random sample audits to support estimation of amounts subject to repayment under self disclosure agreements |
| What is descriptive statistic for rates and proportions? | Rates may be reported as percentages ,counts per 1.000, or as a fraction as in X out of Y. |
| What is inferential statistic for rates and proportions? | The most common types of inferential statistical techniques used with rates and proportions are hypothesis used with rates and proportions are hypothesis tests to compare rates to a standards or confidence intervals.First step is define the null quo |
| What is the mean, median and mode? | The center of distribution of continuous variable is typically describe by the mean.mean is found by adding up all values and dividing by number of samples. Median is the middle value in sample,found by sorting smallest to largest value,center is median. |
| What is the mean, median and mode? continue | The mode is the value with the highest frequency of occurrence. There may not be a mode for some variables such as charges since each value may be different in the sample |
| Who is in charged with performing prepayment reviews to ensure services provided to Medicare beneficiaries are covered and medically necessary? | Medicare administrative contractors (MACs) who are charged with performing prepayment reviews to ensure services provided to Medicare beneficiaries are covered and medically necessary. Source: LaTour |
| What is implementation? | process in which system is configured to meet a specific organizations needs. |
Created by:
Lclarey