Chapter 17: Implementing and Upgrading an Information System Solution

Chapter 17: Implementing and Upgrading an Information System Solution

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. Upon entering an order for two units of packed red blood cells into a computerized physician order entry system, a dialog box is displayed stating that the patient is designated as “Bloodless,” meaning that the patient will refuse all blood products. This is an example of:

ANS:  A

Evidence-based medicine is defined as best practices or the application of the results from the best research-based studies in clinical care in order to obtain the best results. The Heisenberg Principle is defined as the difficulty involved in explaining an existing phenomenon and predicting future phenomena when the domain being studied is always changing. A minimal data set is the state-approved resident assessment instrument, which contains a minimum set of data elements with uniform definitions and categories concerning the cost and quality of nursing care.

DIF:    Cognitive Level: Apply                   REF:   pp. 273-274

2. A large medical practice that specializes in cancer care is weighing the advantages and disadvantages of implementing the most recent version of a commercial EHR or building its own homegrown system for its office. The staff selects a commercial EHR from a major vendor. Which factor best supports this decision?

ANS:  C

Commercial electronic health systems are more expensive than homegrown systems but also considered one of the “Best of Breed” products. A homegrown system can be certified through a Certification Commission for Healthcare Information Technology (CCHIT) program called EACH. Homegrown systems are usually fully integrated using a common database and not interfaced with other dissimilar applications.

DIF:    Cognitive Level: Apply                   REF:   p. 277

3. A large medical center that specializes in high-risk pregnancies is implementing an entire suite of clinical applications such as CPOE, barcode medication administration (BCMA), nursing documentation, data acquisition system to collect clinical data from cardiac and fetal monitors and ventilators, laboratory system, radiology system, PACS, and cardiology. It has a large, highly skilled, experienced IT team. The project team decided to go with a Big Bang go-live versus an incremental or phased approach. Which factor best supports this decision?

ANS:  A

Big Bang decreases the possibility of errors because physicians do not have to use different workflows in different departments or units. Users also have high levels of support in the initial days. Big Bang will have a major impact on productivity initially with a gradual return to baseline. The incremental approach is best suited for organizations with small IT departments and minimal support personnel. It also typically will increase the overall costs of the project.

DIF:    Cognitive Level: Apply                   REF:   pp. 284-285

4. An unintended consequence associated with the use of an electronic health system occurs when:

ANS:  B

The physician entering orders on a patient who was incorrectly selected from a drop-down list of the physician’s personal patient list would be an example of an unintended consequence. The other responses are examples of behaviors that are not unique to orders placed in an EHR and can occur in a paper system as well.

DIF:    Cognitive Level: Apply                   REF:   pp. 275-276