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RHIA DOMAIN 3 EXAM PREP QUESTIONS AND ANSWERS
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RHIA DOMAIN 3 EXAM PREP QUESTIONS AND ANSWERS
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RHIA DOMAIN 3 EXAM PREPA hospital is undergoing a major reconstruction project and a new director of nursing
has been hired. At the same time, the nursing documentation component of the EHR
has been implemented. The fact that nursing staff satisfaction scores have risen is:
a. A result of anecdotal benefits of EHR
b. A result of qualitative benefits of EHR
c. A result of reconfiguration of the nursing units
d. Uncertain due to existence of confounding variables - Answers -d. Uncertain due to
existence of confounding variables
In this situation there are too many changes occurring at the same time to determine
what is improving the nursing staffing satisfaction scores. Any one item could be the
reason for the improvement. To evaluate the impact of the electronic health record
(EHR) nursing documentation component, a benefits realization study should have been
utilized. This would have studied the impact of the EHR component before and after
implementation (Amatayakul 2017, 106).
If a health plan analyst wanted to determine if the readmission rates for two hospitals
were statistically different, what is the null hypothesis?
a. The readmission rates are not equal.
b. The readmission rates are equal.
c. The readmission rate for one hospital is larger than the other.
d. The readmission rate for one hospital is smaller than the other. - Answers -b. The
readmission rates are equal.
The first step in statistical hypothesis testing is defining the null and alternative
hypotheses. The null hypothesis is the status quo. In this example the readmission rates
are equal would be the null hypothesis showing no relationship between the two
hospitals (White 2016a, 65).
Consumer health informatics is a field devoted to informatics from multiple consumer or
patient views and includes patient-focused informatics, health literacy, and consumer
education, with a focus on information structures and processes that empower
consumers to manage their own health (AMIA 2015; Sandefer 2016b, 425).
Community Memorial Hospital had 25 inpatient deaths, including newborns, during the
month of June. The hospital had a total of 500 discharges for the same period, including
deaths of adults, children, and newborns. The hospital's gross death rate for the month
of June was:
,a. 0.05%
b. 2%
c. 5%
d. 20% - Answers -c. 5%
The gross death rate is the proportion of all hospital discharges that ended in death. It is
the basic indicator of mortality in a healthcare facility.
The gross death rate is calculated by dividing the total number of deaths occurring in a
given time period by the total number of discharges, including deaths, for the same time
period: 25/500 = 0.05 × 100 = 5% (Palkie 2016b, 296).
For an EHR to provide robust clinical decision support, what critical element must be
present?
a. Structured data
b. Internet connection
c. Physician portal
d. Standard vocabulary - Answers -a. Structured data
If an EHR is to provide clinical decision support it requires two things: structured data
and a clinical data repository (Sandefer 2016a, 364).
Assume you are the manager of a 10-physician group primary care practice. The
physicians are interested in contracting with an application service provider to develop
and manage patient records electronically. Which of the following statements is an
indication that an application service provider (ASP) may be a good idea for this
practice?
a. The practice does not have the up-front capital or IT staff needed to purchase and
implement a system from a health information systems vendor.
b. The practice wants an electronic medical record system and wants to get into the IT
management business as well.
c. The practice would like to have the system up and running in a relatively short period
of time (less than four months).
d. The practice is not looking to purchase any additional hardware needed for an
electronic medical record system. - Answers -a. The practice does not have the up-front
capital or IT staff needed to purchase and implement a system from a health information
systems vendor.
In an application service provider (ASP) model, there is much less upfront capital outlay
and fewer IT staff required in-house. In fact, the ASP acquisition strategy may be
considered essentially a financing model (Amatayakul 2016, 402).
, In addition to bar codes on health record documents, what other forms of recognition
characteristics enhance the accuracy of form indexing features?
a. Access controls
b. COLD
c. OCR
d. Workflow - Answers -c. OCR
The capability to retrieve documents from an electronic document management system
(EDMS) is determined by the underlying technology used to store the documents. In
addition to bar codes on medical record documents, optical character recognition (OCR)
may be available to enhance the accuracy of indexing features on forms (Sandefer
2016a, 352).
To reduce the effect of a server crash in an EHR environment, it is advisable to:
a. Set up redundant systems
b. Have a storage area network
c. Store data in RAID
d. Have an inventory of all systems - Answers -a. Set up redundant systems
To achieve availability, an EHR must have full redundancy as well as backup and
network redundancy. This means that there is a duplication of all data, hardware,
cables, or other components of the system. Should the primary server crash, the system
switches over to the second server and can continue processing (Sayles and
Kavanaugh-Burke 2018, 228).
A possible justification for building an information system in-house rather than
purchasing one from a vendor is that:
a. It is cheaper to buy than to build
b. The facility has development teams they do not want to give up
c. Integration of systems will be easier
d. Vendor products are not comprehensive enough - Answers -b. The facility has
development teams they do not want to give up
Most organizations recognize that commercial products can meet their needs and that
most of these products will far surpass the functionality that could be self-developed.
Still, some organizations want to at least consider the build option. Some physicians are
intrigued with developing their own perfect system, and some hospitals have
development teams they do not want to give up. An organization's decision to build or
buy should be based on a careful review of the marketplace. Currently, it is more
expensive to undertake self-development. Unless self-development is coupled with a
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