Electronic Health Records.docx

Electronic Health Records Multiple Choice Questions   1. What is the catalyst that created the need of electronic health records (EHRs)?  A. Improvement of the health insurance industry. B. Improvement of patient medical care. C. Improvement of the work place for healthcare professionals. D. The advancement of computer technology.   2. In what decade were some of the first electronic medical record systems developed?  A. 1960s B. 1970s C. 1980s D. 1990s   3. What information is more available to doctors because of the inception of EHRs?  A. Drug dosages B. Side effects C. Allergies D. All of these   4. What is one advanced method used to input data into an EHR?  A. Typing with a keyboard. B. Use an iPod. C. Use a voice recognition system. D. Use of a transcriptionist.   5. What are the large bodies of preset text known as?  A. Cut and paste B. Templates C. Text messages D. Tap and Go™   6. Which of the following features is not a positive attribute of EHRs?  A. Enhanced accessibility to clinical information B. Improved patient safety C. Increased quality of patient care D. Decreased efficiency and savings   7. Which advancement in technology has brought greater mobility to healthcare providers?  A. Handheld computers B. Wireless connectivity C. PDAs D. All of these   8. What is the definition of EHR?  A. Software with a full range of functionalities to store, access, and use patient medical information. B. The time and place of care being given to the patient from the health-care provider. C. A portable, handheld computer, with the ability to document directly on the screen with a stylus pen. D. Software capable of voice recognition systems to document patient health insurance information.   9. Which of the following is a barrier to the implementation of EHR?  A. Lack of standards B. E-prescribing options C. Identified ROI D. Increased patient safety   10. President Obama's 2009 stimulus package to fund EHR is known as:  A. American Reimbursement and Recovery Act B. American Reinvestment and Recosting Act C. American Recovery and Reinvestment Act D. American Reinvestment and Reimbursement Act   11. In what way does the use of EHR affect the practice of transcription?  A. Transcription needs increase because providers do not have time to enter data into EHRs. B. Transcription needs decrease because data entry at the point of care eliminated dictated records. C. There is no change in the practice of transcription as a result of implementation of EHR. D. None of these.   12. Which technologies have increased the availability of medical databases that can be accessed across large distances?  A. Internet B. LANs C. Smart phones D. None of these   13. When might internet technologies benefit a health-care provider?  A. When accessing their EHR from a hospital. B. When accessing their EHR from a nursing home. C. When accessing their EHR from a home office. D. All of these   14. Computer programs focused on fiscal management are known as:  A. CMS B. FICA C. PMS D. HIE   15. When computer data is changed from its original form to be transmitted securely it is:  A. coded B. encrypted C. disguised D. changed   16. Which of the following is not a benefit of EHR?  A. Little or no training necessary B. Enhanced access to clinical information C. Improved patient safety D. Decreased medical errors   17. EMR is an abbreviation for which of the following?  A. Electronic Medical Record B. Emergency Medical Record C. Electronic Medical Resource D. Electronic Method of Recording   18. What was one of the first terms used to conceptualize the idea of an EHR?  A. Computer-Based Medical Record B. Electronic Medical Computer C. Medical-Based Computer D. Computer-Based Patient Record   19. Which term refers to the ability of a software program to accept, send, or communicate data from its database to other software programs from multiple vendors?  A. Continuity of health-care records B. Interprobability C. Interoperability D. Operational continuity   20. What is the difference between an electronic medical record and a computerized patient record?  A. An electronic medical record does not necessarily contain a patient's lifetime record and does not include dental, behavioral, or alternative care. B. There is no difference. C. A computerized patient record does not necessarily contain a patient's lifetime record and does not include dental, behavioral, or alternative care. D. A computerized patient record contains patient data on allergies and drug interactions; an electronic patient record does not.   21. Which of the following is a feature of the EHR?  A. Personal Health Record B. Continuity of Care Record C. Application Server Provider D. Personal Care Record   22. The CCR is designed to be neutral concerning which parties?  A. vendor, intranet B. technology, patient C. vendor, technology D. technology, internet   23. Which of the following is considered a subset of the EHR?  A. CCR B. CCD C. Both CCR and CCD D. Neither CCR nor CCD   24. PHR is an acronym for which term?  A. Personnel Health Record B. Public Health Record C. Personal Health Review D. Personal Health Record   25. CCR is an acronym for which term?  A. Credence Clearwater Revival B. Continuity of Care Record C. Continuity of Clinical Records D. Computer Care Record   26. The PHR allows patients to do all of the following except:  A. schedule appointments B. request medication refills C. access other patient records D. access their lab or radiology results   27. Which of the following allows a patient to make inquiries to their health-care provider?  A. PHRs B. LANs C. Touch and Go D. Voice recognition systems   28. Which president outlined a 10- year plan that would ensure most Americans to have electronic health records?  A. Barack Obama B. George W. Bush C. Bill Clinton D. Ronald Reagan   29. Which of the following could have been a reason for the lack of EHR implementation in the 1990s?  A. Doctors perceived EHRs were difficult to operate. B. Programs offered different features therefore data exchange was difficult. C. Unknown cost and ROI. D. All of these.   30. The cost of an EHR includes:  A. The software purchase price, additional computer hardware, and training of staff B. Customization of the system, ongoing technical support, system maintenance, and future program upgrades C. All of these D. None of these   31. ROI is an acronym for which term?  A. Return on Income B. Return on Investment C. Record of Income D. Record of Investment   32. In an address to Congress, which of the following is credited with stating, "Our recovery plan will invest in electronic health records and new technology that will reduce errors, bring down costs, ensure privacy, and save lives?"  A. Barack Obama B. George W. Bush C. Bill Clinton D. Ronald Reagan   33. What percentage of patients in the United States receives medications because of e-prescribing?  A. 26% B. 46% C. 66% D. 100%   34. Why did health-care providers perceive EHR systems to lack safety?  A. The electronic medical record could be altered without his or her knowledge. B. Because of possible power outages. C. Because of possible computer "crashes". D. All of these.   35. When did Congress enact the Medicare Improvements for Patients and Providers Act (MIPPA)?  A. July 15, 2007 B. July 15, 2008 C. July 15, 2009 D. July 15, 2010   36. What percentage of private practice physicians are in the small- to medium-sized market group?  A. 60% B. 70% C. 80% D. 90%   37. What institute recognized the benefits of the EHR and in 1991 summoned their implementation?  A. Institute of Medicine B. Institute of Scientific Medicine C. Institute of Biomedicine D. The Medical Institute   38. In what year will Medicare begin payments to providers for implementation of EHR?  A. 2001 B. 2011 C. 2015 D. 2010   39. In 2004 President George W. Bush commented:  A. "By computerizing health records, we may create a dangerous threat to the healthcare industry." B. "By computerizing health records, our country will increase our national debt." C. "By computerizing health records, we can avoid dangerous medical mistakes, reduce costs, and improve care." D. President Bush did not comment on EHRs.   40. In 2004, President Bush outlined a plan to ensure most Americans would have EHRs within how many years?  A. 20 B. 15 C. 12 D. 10   41. All of the following are benefits of implementing EHRs except:  A. Access to a patient's medical information is available at the patient's point of care. B. The health-care provider can easily be informed of past medical history and family medical history. C. EHRs are more time-consuming than paper charts. D. The health-care provider can easily be informed and access immunization records.   42. Which of the following can be eliminated with the use of EHRs?  A. Doctors B. Clerical and clinical staff C. Handwritten notes, orders, and prescriptions D. All of these   43. What is one benefit of an EHR over paper charts?  A. EHR is centralized. B. EHR can become cluttered. C. Paper charts are always more accessible than EHR charts. D. EHR cannot be accessed off site.   44. Who will provide incentive payments to doctors for using a certified EHR product and demonstrating meaningful use?  A. HIPPA B. CMS C. AMA D. IOM   45. With the use of EHRs, drug recalls are handled efficiently because  A. The EHR sends automated notices to patients using recalled prescription medications. B. They can document which patients currently use specific medications. C. The EHR sends automated notices to patients using recalled prescription medications and can document which patients currently use specific medications. D. None of these are correct.   46. A paper chart environment is less efficient and likely to produce errors because  A. Illegible handwriting leads to misinterpretations of orders and prescriptions B. Paper records are often mislaid resulting in backtracking and searching C. Misfiled records cost time and money D. All of these are reasons that paper charts are less efficient and likely to produce errors.   47. In which of the following ways does the implementation of EHRs affect the repetition of labs and tests?  A. Increases B. Decreases C. No net effect D. None of these   48. What is the cost trend associated with chart pull when hospitals utilize EHR technology?  A. More expensive than paper chart pulls B. Less expensive than paper chart pulls C. No change in cost noticed between paper and EHR chart requests D. None of these.   49. Which of the following describes a method in which EHRs enhance communication between providers and their staff?  A. Instant messaging B. Text messaging C. Digital dictation D. Voice recognition   50. With the use of EHR, how much can providers save with the elimination of transcription needs?  A. $300-$1000/day B. $300-$1000/week C. $300-$1000/month D. $300-$1000/year   51. Which of the following identifies a reason why smaller practices demonstrate reluctance in the adoption and use of EHRs?  A. Cost of software and hardware B. Task of data entry C. Change resistance D. All of these   52. Which of the following errors potentially are eliminated with the implementation of EHR technology?  A. Medication B. Transcription C. Both of these D. None of these   53. Which of the following describes a person admitted to a healthcare facility to stay overnight for an indeterminate amount of time?  A. Inpatient B. Impatient C. Outpatient D. Discharge   54. Software content created in a language common and accessible by all EHR is referred to as:  A. Positive B. Negative C. Neutral D. Expensive   55. Which of the following Internet companies launched patient portals to enable the general public to store and update their own medical records?  A. WebMD B. Yahoo! C. Microsoft D. All of these   56. What is the estimated percentage of the population that has accessed a Web-based Model of the EHR?  A. 3% B. 5% C. 7% D. 9%   57. In what way does the use of a stylus affect the process of data entry in an EHR?  A. Increases the time needed for data entry because using a stylus is similar to writing with a pen in a paper chart. B. Decreases the time needed for data entry because the stylus is used to tap entries in a template, increasing the efficiency of documentation. C. All of these D. None of these   58. Enacted by Congress in 2008, this legislation increases benefits to low-income beneficiaries and other vulnerable areas of the population.  A. HIPAA B. MIPPA C. HITECH D. ONC   59. Which of the following is defined as handheld mobile device that functions as a personal information manager?  A. EHR B. PDF C. EMR D. PDA   60. Which of the following represents the measure, expressed as a percentage, which a company earns as the result of investing money to make a purchase?  A. Profit B. Loss C. Gain D. Return on investment   61. What is the name of a set of standards, services, and policies that enable secure health information exchange over the Internet?  A. National Health Information Network B. Health Information Exchange C. Health Information Portability and Accountability Act D. HITECH Act   62. Which is a part of the federally funded insurance program that covers medical providers' supervision, outpatient hospital care, diagnostic tests, and other ambulatory services?  A. Medicaid B. Medicare Part A C. Medicare Part B D. Medigap   63. Which is a part of the federally funded insurance program that covers hospitals, skilled nursing facilities, home health agencies, and other non-ambulatory services?  A. Medicaid B. Medicare Part A C. Medicare Part B D. Medigap   64. What is the term used to describe the use of computerized tools to create and sign prescriptions?  A. point of care prescribing B. E-prescribing C. DUR D. None of these   65. Which of the following processes will not change as a result of implementation of EHR?  A. Documenting the physical exam B. Verifying insurance coverage C. Examining the patient D. Distributing patient education materials   66. The use of EHR results in a significant timesaving for clinicians because  A. Typing documentation is faster than writing B. Streamlined job processes increase efficiency C. Voice recognition software records dictation as the physician interacts with patients D. Preset templates allow the physician to document patient encounters with the use of yes or no questions   67. Which error results in decreased reimbursement for providers?  A. Unbundling B. Under-coding C. Bundling D. Up-coding   68. Which of the following is a way that EHR contributes to patient safety?  A. Allergy alert systems B. Drug utilization review C. Elimination of illegible handwriting D. All of these   69. This EHR model stores patient data on the health information system at a particular healthcare facility or with a third-party hosting company.  A. Distribution-based model B. Facility-based model C. Web-based model D. Insurance-based model   70. EHR is an acronym for  A. Emergency Health Record B. Electronic Health Record C. Emergency Health Repository D. Electronic Health Repository   71. One of the first terms used to conceptualize the idea of an EHR was  A. Telemedicine B. WebMD C. CPR D. CCR   72. How much funding did the HITECH Act contribute to the establishment of the Health Information Technology Extension program?  A. $677 thousand B. $677 million C. $677 billion D. $677 trillion   73. Which of the following represents methods that have consistently shown superior results and are used as a benchmark or standard until improvements are discovered or developed?  A. Best practice guidelines B. Continuity of Care C. Evidenced-based medicine D. None of these   74. Failure to implement EHR could result in financial penalty to the provider beginning in what year?  A. 2013 B. 2014 C. 2015 D. 2016   75. Which of the following does not represent a manner in which the Regional Extension Centers were mandated to assist with implementation of EHR?  A. Provide technical assistance as needed. B. Offer guidance to assist with achieving standards of meaningful use. C. Recommend training and support services. D. Subsidize the expense of new hardware and software.   76. Which of the following terms can be defined as the time and place the healthcare provider gives the patient medical care?  A. Scheduled appointment B. Routine office visit C. Point of care D. Patient portal   77. In which year did the federal government develop the financial incentive program to support the implementation of EHR?  A. 2008 B. 2009 C. 2010 D. 2011   78. In which EHR model is selected healthcare data transmitted to a centralized electronic record?  A. Distribution-based model B. Facility-based model C. Web-based model D. Center-based model   79. Which of the following allows the patient to become an interactive source of health information and health management through an Internet-based connection to the practice website?  A. WebMD B. PHR C. CCR D. PMS   80. Dependent upon the date of implementation, meaningful use of EHR could result in incentive payments of how much (over five years)?  A. $18,000 B. $12,000 C. $44,000 D. $2,000   81. What is contained in the definition of the term ambulatory?  A. Inpatient B. Outpatient C. All of these D. None of these   82. Which of the following is not a benefit to patient care through the use of evidence-based medicine?  A. Protocols and recommendations ensure optimal patient care. B. Electronic reminders generate revenue for the office. C. Clinical decision support systems assist with diagnosing. D. Electronic reminders may be personalized to meet specific patient needs.   83. Which of the following may increase the price of EHR implementation?  A. Computer hardware B. Staff training C. System maintenance D. All of these   84. In 1991, which of the following organizations first called for the implementation of EHRs and the elimination of paper-based patient records?  A. ONC B. IOM C. CMS D. HIE   85. Which of the following describes factors of the twenty-first century that influenced the transition to EHR?  A. Increased instant communication B. Demand for immediate availability of information C. Highly mobile society D. All of these   86. The acronym TPO refers to which of the following?  A. Third Party Operator B. Treatment, Payment, or Operations C. Treatment Provider Organization D. Third Party Organization   87. Computers and practice management systems were used in independent medical offices for insurance claims and financial accounting during which decade?  A. 1960s B. 1970s C. 1980s D. 1990s   88. Which of the following is not available in a paper chart environment?  A. Office visit documentation B. Automated drug interaction review C. Patient insurance information D. All of these are available in a paper chart environment   89. Which of the following provides practitioners and healthcare facilities who adopt EHR with financial incentives paid over a five year period through the Medicaid and Medicare programs?  A. MIPPA B. HIPAA C. HIE D. HITECH   90. In what ways do EHR provide meaningful improvements with the use of e-prescribing?  A. Cost B. Quality C. Patient safety D. All of these   91. Which of the following was passed as part of ARRA to aid in the development of a national healthcare infrastructure?  A. MIPPA B. HIPPA C. HITECH D. NHIN   92. The purpose of which of the following organizations is to create a sophisticated network of healthcare information accessible by hospitals, insurers, doctors, pharmacies, and other stakeholders nationwide?  A. National Health Information Network B. Health Information Technology Extension Program C. Health Information Technology Research Center D. Beacon Community Cooperative   93. With the adoption of an EHR program physicians are able to see how many more patients daily?  A. None-they see the same amount of patients. B. 2 to 4 C. 4 to 6 D. 6 to 8   94. National attention to patient safety is driving the healthcare industry toward drastically reducing errors with the use of which of the following?  A. Electronic prescriptions B. Electronic provider orders C. Electronic prescriptions and electronic provider orders D. None of these   95. Which of the following have reduced costs and increased reimbursements because of EHR implementation?  A. Rapid documentation B. Accurate Coding C. Both rapid documentation and accurate coding D. Neither rapid documentation nor accurate coding   96. Providers did not fully utilize EHR technology until recently because  A. Lack of standards B. Unknown ROI C. Difficulty in operating EHR D. All of these   97. Which of the following allows the patient access via the Internet to store and update personal medical information and ask questions about prescriptions, appointments, or other medical concerns?  A. WebMD B. PHR C. EMR D. EHR   98. Which of the following indicates the primary difference between EMR and EHR programs?  A. EHR costs exceed that of EMR B. EHR presents a full range of higher-end functionalities not available with EMR. C. EHR is compatible with both Microsoft and MacIntosh, EMR is not. D. EHR is no different than EMR.   99. Which of the following parties will have access to clinical data via the Internet and use of EHR?  A. Patients B. Medical Personnel C. Third-party entities D. All of these   100. Which of the following information would not be included in a patient's EHR?  A. Allergies B. Demographics C. Family history D. All of these are found in the EHR     Multiple Choice Questions   1. What is the catalyst that created the need of electronic health records (EHRs)?  A. Improvement of the health insurance industry. B. Improvement of patient medical care. C. Improvement of the work place for healthcare professionals. D. The advancement of computer technology. Improvement of patient medical care was and is the catalyst for the need of electronic health records.   2. In what decade were some of the first electronic medical record systems developed?  A. 1960s B. 1970s C. 1980s D. 1990s The Mayo Clinic in Rochester, Minnesota; the University Hospital in Burlington, Vermont; and the Latter Day Saints Hospital in Salt Lake City, Utah, were some of the first medical facilities to use electronic health record systems. Their systems were developed in the early 1960s.   3. What information is more available to doctors because of the inception of EHRs?  A. Drug dosages B. Side effects C. Allergies D. All of these Drug dosages, side effects, and allergies are some of the information more available to doctors because of the inception of EHRs.   4. What is one advanced method used to input data into an EHR?  A. Typing with a keyboard. B. Use an iPod. C. Use a voice recognition system. D. Use of a transcriptionist. The use of a voice recognition system is one advanced method used to input data into an EHR.   5. What are the large bodies of preset text known as?  A. Cut and paste B. Templates C. Text messages D. Tap and Go™ Templates are large bodies of preset text in an EHR.   6. Which of the following features is not a positive attribute of EHRs?  A. Enhanced accessibility to clinical information B. Improved patient safety C. Increased quality of patient care D. Decreased efficiency and savings EHRs are noted as increasing efficiency and savings in healthcare delivery.   7. Which advancement in technology has brought greater mobility to healthcare providers?  A. Handheld computers B. Wireless connectivity C. PDAs D. All of these Laptops, wireless connectivity, and Tablet PCs are some of the advancements in technology that has brought greater mobility to health-care providers.   8. What is the definition of EHR?  A. Software with a full range of functionalities to store, access, and use patient medical information. B. The time and place of care being given to the patient from the health-care provider. C. A portable, handheld computer, with the ability to document directly on the screen with a stylus pen. D. Software capable of voice recognition systems to document patient health insurance information. An EHR is defined as software with a full range of functionalities to store, access, and use patient medical information.   9. Which of the following is a barrier to the implementation of EHR?  A. Lack of standards B. E-prescribing options C. Identified ROI D. Increased patient safety Lack of standards within EHR has many providers concerned with compatibility and interoperability of the product.   10. President Obama's 2009 stimulus package to fund EHR is known as:  A. American Reimbursement and Recovery Act B. American Reinvestment and Recosting Act C. American Recovery and Reinvestment Act D. American Reinvestment and Reimbursement Act ARRA was introduced in 2009 by President Obama to stimulate the move toward EHR.   11. In what way does the use of EHR affect the practice of transcription?  A. Transcription needs increase because providers do not have time to enter data into EHRs. B. Transcription needs decrease because data entry at the point of care eliminated dictated records. C. There is no change in the practice of transcription as a result of implementation of EHR. D. None of these. When healthcare providers complete documentation in an EHR, the need for transcription services is often eliminated.   12. Which technologies have increased the availability of medical databases that can be accessed across large distances?  A. Internet B. LANs C. Smart phones D. None of these The internet is a technology that has increased the availability of medical databases that can be accessed across large distances.   13. When might internet technologies benefit a health-care provider?  A. When accessing their EHR from a hospital. B. When accessing their EHR from a nursing home. C. When accessing their EHR from a home office. D. All of these Internet technology gives health-care providers access to their EHR from remote locations such as a hospital, nursing home, or home office.   14. Computer programs focused on fiscal management are known as:  A. CMS B. FICA C. PMS D. HIE Practice management systems (PMS) facilitate the processing of insurance claims and patient statements.   15. When computer data is changed from its original form to be transmitted securely it is:  A. coded B. encrypted C. disguised D. changed Encrypting computer data means to change the data from its original form to be transmitted securely.   16. Which of the following is not a benefit of EHR?  A. Little or no training necessary B. Enhanced access to clinical information C. Improved patient safety D. Decreased medical errors Training is necessary for the proper implementation and use of EHR to experience the benefits associated with EHR use.   17. EMR is an abbreviation for which of the following?  A. Electronic Medical Record B. Emergency Medical Record C. Electronic Medical Resource D. Electronic Method of Recording The abbreviation for Electronic Medical Record is EMR.   18. What was one of the first terms used to conceptualize the idea of an EHR?  A. Computer-Based Medical Record B. Electronic Medical Computer C. Medical-Based Computer D. Computer-Based Patient Record Computer-Based Patient Record was one of the first terms used to conceptualize the idea of an EHR.   19. Which term refers to the ability of a software program to accept, send, or communicate data from its database to other software programs from multiple vendors?  A. Continuity of health-care records B. Interprobability C. Interoperability D. Operational continuity Interoperability refers to the ability of a software program to accept, send, or communicate data from its database to other software programs from multiple vendors.   20. What is the difference between an electronic medical record and a computerized patient record?  A. An electronic medical record does not necessarily contain a patient's lifetime record and does not include dental, behavioral, or alternative care. B. There is no difference. C. A computerized patient record does not necessarily contain a patient's lifetime record and does not include dental, behavioral, or alternative care. D. A computerized patient record contains patient data on allergies and drug interactions; an electronic patient record does not. An electronic medical record focuses on the patient's relevant medical information, and does not necessarily contain a patient's lifetime record. A computerized patient record contains the patient's lifetime record including dental, behavioral, or alternative care.   21. Which of the following is a feature of the EHR?  A. Personal Health Record B. Continuity of Care Record C. Application Server Provider D. Personal Care Record A continuity of care record is one feature of an EHR.   22. The CCR is designed to be neutral concerning which parties?  A. vendor, intranet B. technology, patient C. vendor, technology D. technology, internet The CCR is designed to be vendor and technology neutral; that is, accessible and readable by other electronic systems   23. Which of the following is considered a subset of the EHR?  A. CCR B. CCD C. Both CCR and CCD D. Neither CCR nor CCD The CCD/CCR is a healthcare provider-oriented record comprising a core set of data considered to be the most relevant summary of a patient's medical healthcare. The CCD/CCR would be considered a subset of the EHR.   24. PHR is an acronym for which term?  A. Personnel Health Record B. Public Health Record C. Personal Health Review D. Personal Health Record The acronym for Personal Health Record is PHR.   25. CCR is an acronym for which term?  A. Credence Clearwater Revival B. Continuity of Care Record C. Continuity of Clinical Records D. Computer Care Record The acronym for Continuity of Care Record is CCR.   26. The PHR allows patients to do all of the following except:  A. schedule appointments B. request medication refills C. access other patient records D. access their lab or radiology results The PHR allows patients to schedule appointments, request medication refills, and access their lab or radiology results, but does not allow a patient to access other patient records.   27. Which of the following allows a patient to make inquiries to their health-care provider?  A. PHRs B. LANs C. Touch and Go D. Voice recognition systems PHRs allow patients to make inquiries to their health-care provider.   28. Which president outlined a 10- year plan that would ensure most Americans to have electronic health records?  A. Barack Obama B. George W. Bush C. Bill Clinton D. Ronald Reagan George W. Bush outlined a 10- year plan that would ensure most Americans to have EHRs.   29. Which of the following could have been a reason for the lack of EHR implementation in the 1990s?  A. Doctors perceived EHRs were difficult to operate. B. Programs offered different features therefore data exchange was difficult. C. Unknown cost and ROI. D. All of these. Some reasons for the lack of EHR implementation in the 1990s include: doctors perceived EHRs were difficult to operate, EHR programs offered different features therefore data exchange was difficult, and the cost and ROI were unknown.   30. The cost of an EHR includes:  A. The software purchase price, additional computer hardware, and training of staff B. Customization of the system, ongoing technical support, system maintenance, and future program upgrades C. All of these D. None of these The cost of an EHR can include, the software purchase price, additional computer hardware, training of staff, customization of the system, ongoing technical support, system maintenance, and future program upgrades.   31. ROI is an acronym for which term?  A. Return on Income B. Return on Investment C. Record of Income D. Record of Investment The acronym for Return on Investment is ROI.   32. In an address to Congress, which of the following is credited with stating, "Our recovery plan will invest in electronic health records and new technology that will reduce errors, bring down costs, ensure privacy, and save lives?"  A. Barack Obama B. George W. Bush C. Bill Clinton D. Ronald Reagan Barack Obama, in his speech to Congress in February 2009 stated, "Our recovery plan will invest in electronic health records and new technology that will reduce errors, bring down costs, ensure privacy, and save lives."   33. What percentage of patients in the United States receives medications because of e-prescribing?  A. 26% B. 46% C. 66% D. 100% It is estimated more than 66 percent of patients in the United States are now receiving medications through e-prescribing.   34. Why did health-care providers perceive EHR systems to lack safety?  A. The electronic medical record could be altered without his or her knowledge. B. Because of possible power outages. C. Because of possible computer "crashes". D. All of these. Health-care providers perceived EHR systems to lack safety because of possible power outages, computer "crashes", and because an electronic medical record could be altered without the provider's knowledge.   35. When did Congress enact the Medicare Improvements for Patients and Providers Act (MIPPA)?  A. July 15, 2007 B. July 15, 2008 C. July 15, 2009 D. July 15, 2010 On July 15, 2008, Congress enacted the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).   36. What percentage of private practice physicians are in the small- to medium-sized market group?  A. 60% B. 70% C. 80% D. 90% 90% of private practice physicians are in the small- to medium-sized market with five or fewer physicians practicing in the group.   37. What institute recognized the benefits of the EHR and in 1991 summoned their implementation?  A. Institute of Medicine B. Institute of Scientific Medicine C. Institute of Biomedicine D. The Medical Institute The Institute of Medicine recognized the benefits of the EHR and in 1991 called for their implementation.   38. In what year will Medicare begin payments to providers for implementation of EHR?  A. 2001 B. 2011 C. 2015 D. 2010 Medicare offered the first incentive payment to providers in 2011 for implementation of EHR.   39. In 2004 President George W. Bush commented:  A. "By computerizing health records, we may create a dangerous threat to the healthcare industry." B. "By computerizing health records, our country will increase our national debt." C. "By computerizing health records, we can avoid dangerous medical mistakes, reduce costs, and improve care." D. President Bush did not comment on EHRs. In 2004 President George W. Bush stated, "By computerizing health records, we can avoid dangerous medical mistakes, reduce costs, and improve care."   40. In 2004, President Bush outlined a plan to ensure most Americans would have EHRs within how many years?  A. 20 B. 15 C. 12 D. 10 In 2004 President Bush outlined a plan to ensure most Americans would have EHRs within the next 10 years.   41. All of the following are benefits of implementing EHRs except:  A. Access to a patient's medical information is available at the patient's point of care. B. The health-care provider can easily be informed of past medical history and family medical history. C. EHRs are more time-consuming than paper charts. D. The health-care provider can easily be informed and access immunization records. EHRs, when used properly, are not more time-consuming than paper charts. Industry studies show that with the use of an EHR, a medical office will perform more efficiently.   42. Which of the following can be eliminated with the use of EHRs?  A. Doctors B. Clerical and clinical staff C. Handwritten notes, orders, and prescriptions D. All of these Handwritten notes, orders, and prescriptions can be eliminated with the use of EHRs.   43. What is one benefit of an EHR over paper charts?  A. EHR is centralized. B. EHR can become cluttered. C. Paper charts are always more accessible than EHR charts. D. EHR cannot be accessed off site. One benefit of an EHR chart over a paper chart is that EHR charts are centralized, and can be found in the same place. EHR charts are less likely to be lost or misplaced.   44. Who will provide incentive payments to doctors for using a certified EHR product and demonstrating meaningful use?  A. HIPPA B. CMS C. AMA D. IOM Doctors may receive an incentive from CMS for using a "certified" EHR. The doctors must comply with CMS standards to receive benefits associated with meaningful use.   45. With the use of EHRs, drug recalls are handled efficiently because  A. The EHR sends automated notices to patients using recalled prescription medications. B. They can document which patients currently use specific medications. C. The EHR sends automated notices to patients using recalled prescription medications and can document which patients currently use specific medications. D. None of these are correct. Drug recalls are handled quickly because reports generated through an EHR can document which patients are currently taking specific medications. Form letters can be quickly generated, alerting patients to the recall and requesting an office visit appointment to discuss future plans.   46. A paper chart environment is less efficient and likely to produce errors because  A. Illegible handwriting leads to misinterpretations of orders and prescriptions B. Paper records are often mislaid resulting in backtracking and searching C. Misfiled records cost time and money D. All of these are reasons that paper charts are less efficient and likely to produce errors. An EHR environment is more efficient and less likely to produce errors, because handwritten mistakes and lost paperwork/notes can be eliminated. Also, reporting and communication between providers or lab companies is more efficient.   47. In which of the following ways does the implementation of EHRs affect the repetition of labs and tests?  A. Increases B. Decreases C. No net effect D. None of these EHRs reduce the repetition of labs and tests because all medical test information is clearly displayed and readily accessed. Lost or delayed test and/or lab results are not as common with EHR programs, resulting in a quicker diagnosis and treatment plan for the patient.   48. What is the cost trend associated with chart pull when hospitals utilize EHR technology?  A. More expensive than paper chart pulls B. Less expensive than paper chart pulls C. No change in cost noticed between paper and EHR chart requests D. None of these. One study indicated that use of EHR decreased chart pull costs from $20 to less than $1, because of the decreased cost of storage and retrieval.   49. Which of the following describes a method in which EHRs enhance communication between providers and their staff?  A. Instant messaging B. Text messaging C. Digital dictation D. Voice recognition The use of simple electronic messaging systems built into an EHR enable faster communication between staff members.   50. With the use of EHR, how much can providers save with the elimination of transcription needs?  A. $300-$1000/day B. $300-$1000/week C. $300-$1000/month D. $300-$1000/year When health-care providers complete their documentation on an EHR the need to have it transcribed can be eliminated, resulting in a $300 to $1000 per month per physician savings.   51. Which of the following identifies a reason why smaller practices demonstrate reluctance in the adoption and use of EHRs?  A. Cost of software and hardware B. Task of data entry C. Change resistance D. All of these Smaller practices were slow to implement EHR programs because of the high cost of computer hardware and software, the huge task of data entry, and the resulting need to change office processes and procedures.   52. Which of the following errors potentially are eliminated with the implementation of EHR technology?  A. Medication B. Transcription C. Both of these D. None of these Entire categories of medication errors and potential errors have been eliminated with the use of EHR.   53. Which of the following describes a person admitted to a healthcare facility to stay overnight for an indeterminate amount of time?  A. Inpatient B. Impatient C. Outpatient D. Discharge An inpatient is a person who is admitted to the hospital and stays overnight or for an indeterminate amount of time, usually several days or weeks.   54. Software content created in a language common and accessible by all EHR is referred to as:  A. Positive B. Negative C. Neutral D. Expensive Software content created in a language common and accessible by all EHR software and vendors is considered neutral.   55. Which of the following Internet companies launched patient portals to enable the general public to store and update their own medical records?  A. WebMD B. Yahoo! C. Microsoft D. All of these Large Internet companies like Yahoo!, Microsoft, and WebMD have launched healthcare patient portals that enable the general public to store and update their own medical records.   56. What is the estimated percentage of the population that has accessed a Web-based Model of the EHR?  A. 3% B. 5% C. 7% D. 9% The fact remains that a relatively small proportion of the population, perhaps 7 percent, have utilized the Web-based model, due to concerns about Internet security and identity fraud.   57. In what way does the use of a stylus affect the process of data entry in an EHR?  A. Increases the time needed for data entry because using a stylus is similar to writing with a pen in a paper chart. B. Decreases the time needed for data entry because the stylus is used to tap entries in a template, increasing the efficiency of documentation. C. All of these D. None of these Touch screens and use of a stylus are features used with the EHR system, to speed data input and minimize the need for typing.   58. Enacted by Congress in 2008, this legislation increases benefits to low-income beneficiaries and other vulnerable areas of the population.  A. HIPAA B. MIPPA C. HITECH D. ONC The Medicare Improvements for Patients and Providers Act of 2008 increases benefits to low-income beneficiaries and helps deter cuts in Medicare's payments to physicians.   59. Which of the following is defined as handheld mobile device that functions as a personal information manager?  A. EHR B. PDF C. EMR D. PDA A PDA is defined as a handheld mobile device that functions as a personal information manager.   60. Which of the following represents the measure, expressed as a percentage, which a company earns as the result of investing money to make a purchase?  A. Profit B. Loss C. Gain D. Return on investment ROI represents the measure, expressed as a percentage, which a company earns as a result of investing money in a purchase.   61. What is the name of a set of standards, services, and policies that enable secure health information exchange over the Internet?  A. National Health Information Network B. Health Information Exchange C. Health Information Portability and Accountability Act D. HITECH Act NHIN is the name of the set of standards, services, and policies that enable secure health information exchange over the Internet.   62. Which is a part of the federally funded insurance program that covers medical providers' supervision, outpatient hospital care, diagnostic tests, and other ambulatory services?  A. Medicaid B. Medicare Part A C. Medicare Part B D. Medigap Medicare Part B is federally funded and covers outpatient services and diagnostic procedures.   63. Which is a part of the federally funded insurance program that covers hospitals, skilled nursing facilities, home health agencies, and other non-ambulatory services?  A. Medicaid B. Medicare Part A C. Medicare Part B D. Medigap Medicare Part A is federally funded and covers inpatient (non-ambulatory) services.   64. What is the term used to describe the use of computerized tools to create and sign prescriptions?  A. point of care prescribing B. E-prescribing C. DUR D. None of these E-prescribing replaces the handwritten prescription with the use of computerized tools to create and sign prescriptions.   65. Which of the following processes will not change as a result of implementation of EHR?  A. Documenting the physical exam B. Verifying insurance coverage C. Examining the patient D. Distributing patient education materials Though documentation and billing processes will become streamlined with the use of EHR, patient examinations by the physician will not change; the human element of medicine will not be removed.   66. The use of EHR results in a significant timesaving for clinicians because  A. Typing documentation is faster than writing B. Streamlined job processes increase efficiency C. Voice recognition software records dictation as the physician interacts with patients D. Preset templates allow the physician to document patient encounters with the use of yes or no questions The use of EHR results in time saving for clinicians through streamlined job processes.   67. Which error results in decreased reimbursement for providers?  A. Unbundling B. Under-coding C. Bundling D. Up-coding EHR's automated level-of-care coding prevents the under-coding that often prevents providers from maximizing reimbursement.   68. Which of the following is a way that EHR contributes to patient safety?  A. Allergy alert systems B. Drug utilization review C. Elimination of illegible handwriting D. All of these EHR contributes to patient safety by eliminating illegible handwriting and through the use of allergy alert systems and drug utilization review.   69. This EHR model stores patient data on the health information system at a particular healthcare facility or with a third-party hosting company.  A. Distribution-based model B. Facility-based model C. Web-based model D. Insurance-based model Facility-based models store patient date on the health information system at a particular healthcare facility or with a third-party hosting company.   70. EHR is an acronym for  A. Emergency Health Record B. Electronic Health Record C. Emergency Health Repository D. Electronic Health Repository EHR is an acronym for Electronic Health Record.   71. One of the first terms used to conceptualize the idea of an EHR was  A. Telemedicine B. WebMD C. CPR D. CCR Computer-Based Patient Record (CPR) was one of the first terms used to conceptualize the idea of an EHR.   72. How much funding did the HITECH Act contribute to the establishment of the Health Information Technology Extension program?  A. $677 thousand B. $677 million C. $677 billion D. $677 trillion The HITECH Act also allocated $677 million to authorize the establishment of the Health Information Technology Extension Program.   73. Which of the following represents methods that have consistently shown superior results and are used as a benchmark or standard until improvements are discovered or developed?  A. Best practice guidelines B. Continuity of Care C. Evidenced-based medicine D. None of these Best practice guidelines represent methods that have consistently shown superior results and are used as a benchmark or standard until improvements are discovered or developed.   74. Failure to implement EHR could result in financial penalty to the provider beginning in what year?  A. 2013 B. 2014 C. 2015 D. 2016 During the initial years of implementation providers demonstrating meaningful use of EHR were eligible to receive incentives to defray the cost of EHR implementation; penalties may apply to those not using EHR by 2016.   75. Which of the following does not represent a manner in which the Regional Extension Centers were mandated to assist with implementation of EHR?  A. Provide technical assistance as needed. B. Offer guidance to assist with achieving standards of meaningful use. C. Recommend training and support services. D. Subsidize the expense of new hardware and software. The Regional Extension Centers were in no way involved in the financing of EHR, only the support needed for implementation.   76. Which of the following terms can be defined as the time and place the healthcare provider gives the patient medical care?  A. Scheduled appointment B. Routine office visit C. Point of care D. Patient portal The point-of-care is the time and place the healthcare provider gives the patient medical care   77. In which year did the federal government develop the financial incentive program to support the implementation of EHR?  A. 2008 B. 2009 C. 2010 D. 2011 The federal government established a financial incentive program in 2009, providers' concerns regarding cost and estimating ROI substantially decreased.   78. In which EHR model is selected healthcare data transmitted to a centralized electronic record?  A. Distribution-based model B. Facility-based model C. Web-based model D. Center-based model In a distribution-based model, healthcare data is transmitted to a centralized electronic record.   79. Which of the following allows the patient to become an interactive source of health information and health management through an Internet-based connection to the practice website?  A. WebMD B. PHR C. CCR D. PMS The PHR allows the patient to become an interactive source of health information and health management through an Internet-based connection to the practice website.   80. Dependent upon the date of implementation, meaningful use of EHR could result in incentive payments of how much (over five years)?  A. $18,000 B. $12,000 C. $44,000 D. $2,000 Payments can accumulate to $44,000 over the life of the five year program through Medicare.   81. What is contained in the definition of the term ambulatory?  A. Inpatient B. Outpatient C. All of these D. None of these Ambulatory patients are considered to have the capability to move and are most likely to be outpatients (versus inpatients confined to beds).   82. Which of the following is not a benefit to patient care through the use of evidence-based medicine?  A. Protocols and recommendations ensure optimal patient care. B. Electronic reminders generate revenue for the office. C. Clinical decision support systems assist with diagnosing. D. Electronic reminders may be personalized to meet specific patient needs. Though true that electronic reminders can enhance revenue by suggesting routine and preventative screenings that are often overlooked by the patient and provider, office revenue is not a direct benefit to the patient.   83. Which of the following may increase the price of EHR implementation?  A. Computer hardware B. Staff training C. System maintenance D. All of these The cost of an EHR may include additional computer hardware, as well as the software purchase price, implementation including the training of staff, customization of the system, ongoing technical support, system maintenance, and future program upgrades.   84. In 1991, which of the following organizations first called for the implementation of EHRs and the elimination of paper-based patient records?  A. ONC B. IOM C. CMS D. HIE Realizing the benefits EHR could provide to healthcare, in 1991 the Institute of Medicine (IOM) called for the implementation of electronic health records and the elimination of paper-based patient records.   85. Which of the following describes factors of the twenty-first century that influenced the transition to EHR?  A. Increased instant communication B. Demand for immediate availability of information C. Highly mobile society D. All of these Entry into the twenty-first century witnessed an upsurge in electronic social networking, instant communication, and demand for the immediate availability of information. Because of our mobile society, patients are more likely to change doctors or to be seen by a number of practitioners, which makes the efficient transfer of medical records a necessity.   86. The acronym TPO refers to which of the following?  A. Third Party Operator B. Treatment, Payment, or Operations C. Treatment Provider Organization D. Third Party Organization TPO refers to normal business practices (treatment, payment, or operations) which do not require patients to provide authorization to release medical information.   87. Computers and practice management systems were used in independent medical offices for insurance claims and financial accounting during which decade?  A. 1960s B. 1970s C. 1980s D. 1990s In the 1990s computers and practice management systems were used in independent medical offices for insurance claims and financial accounting.   88. Which of the following is not available in a paper chart environment?  A. Office visit documentation B. Automated drug interaction review C. Patient insurance information D. All of these are available in a paper chart environment In contrast, in a paper chart environment, information such as drug interaction is not present.   89. Which of the following provides practitioners and healthcare facilities who adopt EHR with financial incentives paid over a five year period through the Medicaid and Medicare programs?  A. MIPPA B. HIPAA C. HIE D. HITECH The HITECH Act provides practitioners and healthcare facilities large financial incentives, paid over a five year period through the Medicaid and Medicare programs.   90. In what ways do EHR provide meaningful improvements with the use of e-prescribing?  A. Cost B. Quality C. Patient safety D. All of these Through e-prescribing, EHRs are providing meaningful improvements in cost, quality, and patient safety.   91. Which of the following was passed as part of ARRA to aid in the development of a national healthcare infrastructure?  A. MIPPA B. HIPPA C. HITECH D. NHIN The Health Information Technology for Economic and Clinical Health (HITECH) Act was passed as a part of ARRA to aid in the development of a national healthcare infrastructure.   92. The purpose of which of the following organizations is to create a sophisticated network of healthcare information accessible by hospitals, insurers, doctors, pharmacies, and other stakeholders nationwide?  A. National Health Information Network B. Health Information Technology Extension Program C. Health Information Technology Research Center D. Beacon Community Cooperative The purpose of NHIN is to create a sophisticated network of healthcare information accessible by hospitals, insurers, doctors, pharmacies, and other stakeholders nationwide.   93. With the adoption of an EHR program physicians are able to see how many more patients daily?  A. None-they see the same amount of patients. B. 2 to 4 C. 4 to 6 D. 6 to 8 With the adoption of an EHR program, physicians are able to see 4 to 6 more patients per day than previously reported with the use of paper patient records.   94. National attention to patient safety is driving the healthcare industry toward drastically reducing errors with the use of which of the following?  A. Electronic prescriptions B. Electronic provider orders C. Electronic prescriptions and electronic provider orders D. None of these National attention to patient safety is driving the healthcare industry toward drastically reducing errors through the use of e-prescription and electronic provider orders.   95. Which of the following have reduced costs and increased reimbursements because of EHR implementation?  A. Rapid documentation B. Accurate Coding C. Both rapid documentation and accurate coding D. Neither rapid documentation nor accurate coding Rapid documentation and accurate coding have reduced costs and increased reimbursements because of EHR implementation.   96. Providers did not fully utilize EHR technology until recently because  A. Lack of standards B. Unknown ROI C. Difficulty in operating EHR D. All of these Because of concerns about the lack of standards, return on investment, and perceived difficulty in operating the EHR, providers did not fully utilize the technology.   97. Which of the following allows the patient access via the Internet to store and update personal medical information and ask questions about prescriptions, appointments, or other medical concerns?  A. WebMD B. PHR C. EMR D. EHR Personal Health Records (PHRs) allow the patient access via the Internet to store and update personal medical information and ask questions about prescriptions, appointments, or other medical concerns.   98. Which of the following indicates the primary difference between EMR and EHR programs?  A. EHR costs exceed that of EMR B. EHR presents a full range of higher-end functionalities not available with EMR. C. EHR is compatible with both Microsoft and MacIntosh, EMR is not. D. EHR is no different than EMR. The term EMR replaced computer-based patient record, a term that references electronic medical record software that lacks a full range of higher-end functionalities to store, access, and use patient medical information.   99. Which of the following parties will have access to clinical data via the Internet and use of EHR?  A. Patients B. Medical Personnel C. Third-party entities D. All of these Clinical data will no longer reside exclusively in a physician's office but be available to the patient, medical personnel, and third-party entities wherever the Internet is available.   100. Which of the following information would not be included in a patient's EHR?  A. Allergies B. Demographics C. Family history D. All of these are found in the EHR EHRs contain all of the information previously assembled in the paper chart, including patient demographics, insurance information, allergies, and family health history.