AHIC Clinical Informatics and Patient Care 2 — Questions and Answers
Question 1: A hospitalized patient's EHR shows conflicting medication allergy entries from two different encounters. Which informatics principle should guide resolution?
- Delete the older entry automatically
- Reconcile using a single source of truth with clinical review (Correct answer)
- Keep both entries to preserve history
- Flag for pharmacy review only
Correct answer: Reconcile using a single source of truth with clinical review
Allergy reconciliation requires clinical review to establish a single authoritative record, preventing both under- and over-documentation of allergies.
Question 2: Which standard is primarily used to encode clinical diagnoses in US ambulatory care settings for billing and reporting purposes?
- SNOMED CT
- ICD-10-CM (Correct answer)
- LOINC
- RxNorm
Correct answer: ICD-10-CM
ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) is the US standard for diagnosis coding in clinical and billing documentation.
Question 3: A CDS alert fires every time a provider orders acetaminophen, regardless of dose or patient context. This is an example of:
- Effective hard stop usage
- Alert fatigue from low specificity (Correct answer)
- Appropriate medication safety monitoring
- A pharmacy benefit management tool
Correct answer: Alert fatigue from low specificity
Indiscriminate alerts with low specificity cause alert fatigue, leading providers to override even important warnings.
Question 4: Which clinical informatics approach best supports care coordination for patients with multiple chronic conditions?
- Problem-oriented medical records
- Longitudinal care plans with shared access (Correct answer)
- Episodic encounter notes only
- Separate siloed EHRs per specialty
Correct answer: Longitudinal care plans with shared access
Longitudinal care plans with shared access across providers enable coordinated management of complex patients over time.
Question 5: In the context of clinical decision support, what does 'specificity' refer to?
- The proportion of true positives correctly identified
- The proportion of true negatives correctly identified (Correct answer)
- The number of alerts generated per patient
- The complexity of the clinical rule logic
Correct answer: The proportion of true negatives correctly identified
Specificity measures how well a CDS tool correctly identifies patients who do NOT have the condition, minimizing false-positive alerts.
Question 6: A nurse documents a patient fall in a structured incident report system linked to the EHR. What is the PRIMARY informatics benefit of this integration?
- Faster billing submission
- Automated adverse event analysis and safety reporting (Correct answer)
- Reduced documentation burden for physicians
- Improved lab result routing
Correct answer: Automated adverse event analysis and safety reporting
EHR-integrated incident reporting enables systematic adverse event tracking, root cause analysis, and quality improvement workflows.
Question 7: Which workflow change most effectively reduces wrong-patient medication errors in a hospital EHR?
- Mandatory paper cosign for all orders
- Positive patient identification before order entry (Correct answer)
- Restricting medication orders to pharmacists
- Removing patient photos from EHR to reduce bias
Correct answer: Positive patient identification before order entry
Positive patient identification (e.g., scanning wristband barcode) before order entry is the leading informatics intervention to prevent wrong-patient errors.
AHIC Clinical Informatics and Patient Care 2
A hospitalized patient's EHR shows conflicting medication allergy entries from two different encounters.
Which informatics principle should guide resolution?