AHIMA Health Information Exchange 2 — Questions and Answers
Question 1: Which interoperability framework published by the Office of the National Coordinator (ONC) defines the four domains of interoperability—foundational, structural, semantic, and organizational?
- FHIR Implementation Guide
- Interoperability Standards Advisory (ISA)
- TEFCA (Trusted Exchange Framework and Common Agreement) (Correct answer)
- CommonWell Health Alliance Charter
Correct answer: TEFCA (Trusted Exchange Framework and Common Agreement)
TEFCA establishes the Trusted Exchange Framework defining governance, technical, and legal requirements, and references the four interoperability domains across its structure.
Question 2: HL7 FHIR (Fast Healthcare Interoperability Resources) uses which application programming paradigm to enable data exchange?
- SOAP-based web services
- RESTful API (Correct answer)
- File Transfer Protocol (FTP)
- EDI batch transactions
Correct answer: RESTful API
FHIR uses RESTful APIs, enabling lightweight, web-based queries and updates to discrete clinical resources using standard HTTP methods.
Question 3: Which FHIR resource type is used to represent a patient's longitudinal clinical record summary, including problems, medications, and allergies?
- Encounter
- Composition (used in CCD/C-CDA) (Correct answer)
- DocumentReference
- CarePlan
Correct answer: Composition (used in CCD/C-CDA)
The FHIR Composition resource assembles a set of clinical resources into a coherent document, and is the basis for the Consolidated CDA (C-CDA) mapped in FHIR, representing a summary record.
Question 4: When an HIE sends an Admit, Discharge, and Transfer (ADT) notification to a primary care provider, which event type signals a patient's hospital discharge?
- ADT A01 (Admit)
- ADT A03 (Discharge) (Correct answer)
- ADT A08 (Update Patient Information)
- ADT A28 (Add Person Information)
Correct answer: ADT A03 (Discharge)
The HL7 ADT A03 event type is the standard message used to notify care team members that a patient has been discharged from a facility.
Question 5: Which challenge in HIE specifically refers to the difficulty of correctly linking records belonging to the same patient across different systems?
- Semantic interoperability
- Patient identity matching / record linkage (Correct answer)
- Data normalization
- Consent management
Correct answer: Patient identity matching / record linkage
Patient identity matching (record linkage) is the process of determining whether records from different systems refer to the same individual, a core challenge in HIE due to inconsistent identifiers.
Question 6: A Qualified Health Information Network (QHIN) under TEFCA is best described as:
- A state-designated entity that operates a regional HIE
- A nationally recognized network that connects to other QHINs to enable nationwide exchange (Correct answer)
- A vendor that sells EHR software certified for interoperability
- A federal agency that regulates health data exchange
Correct answer: A nationally recognized network that connects to other QHINs to enable nationwide exchange
QHINs are designated entities under TEFCA that connect to each other and to the Recognized Coordinating Entity (RCE) to enable trusted, nationwide health information exchange.
Question 7: Which approach to data normalization in HIE ensures that clinical concepts from different code systems (e.g., SNOMED CT, ICD-10, LOINC) are correctly translated to a common meaning?
- Syntactic interoperability
- Semantic interoperability through terminology mapping (Correct answer)
- Organizational interoperability
- Foundational interoperability
Correct answer: Semantic interoperability through terminology mapping
Semantic interoperability achieved through terminology mapping (e.g., mapping SNOMED CT to ICD-10) ensures that concepts shared between systems carry the same meaning.
AHIMA Health Information Exchange 2
Which interoperability framework published by the Office of the National Coordinator (ONC) defines the four domains of interoperability—foundational, structural, semantic, and organizational?