CAHIMS Health Information Exchange and Interoperability 2 — Questions and Answers
Question 1: Which messaging standard, predating FHIR, has been the traditional backbone of hospital-to-hospital clinical data exchange since the 1980s?
- HL7 v2 (Correct answer)
- DICOM
- X12 EDI
- SNOMED CT
Correct answer: HL7 v2
HL7 version 2 (v2) has been the dominant clinical messaging standard since the late 1980s, used for ADT notifications, lab results, and order messages between systems.
Question 2: What is a patient consent directive in the context of HIE?
- A legal document authorizing a physician to perform surgery
- A patient's authorization governing how their health information can be shared in an HIE (Correct answer)
- An insurance pre-authorization form
- A provider agreement to participate in a regional HIE network
Correct answer: A patient's authorization governing how their health information can be shared in an HIE
A patient consent directive in HIE specifies the patient's preferences for how, when, and with whom their health information may be shared across participating organizations.
Question 3: A Continuity of Care Document (CCD) is most closely associated with which standard?
- HL7 FHIR
- C-CDA (Consolidated Clinical Document Architecture) (Correct answer)
- DICOM
- ICD-10-CM
Correct answer: C-CDA (Consolidated Clinical Document Architecture)
The CCD (Continuity of Care Document) is an implementation guide based on HL7's C-CDA standard, used to summarize patient health information for care transitions.
Question 4: In an HIE, 'record locator service' (RLS) is used primarily to:
- Translate clinical codes between different terminologies
- Identify which organizations hold data for a specific patient (Correct answer)
- Authenticate provider credentials before data access
- Compress and encrypt data for secure transmission
Correct answer: Identify which organizations hold data for a specific patient
A Record Locator Service (RLS) maintains an index of where patient records exist across participating HIE organizations, enabling efficient retrieval without storing the data itself.
Question 5: Which of the following is an example of an 'information blocking' practice prohibited under the 21st Century Cures Act?
- Charging a reasonable fee for paper copies of records
- Intentionally delaying the release of electronic health information to a competitor EHR (Correct answer)
- Requiring identity verification before releasing records
- Restricting access to records under a valid court order
Correct answer: Intentionally delaying the release of electronic health information to a competitor EHR
Intentionally delaying or obstructing the access, exchange, or use of electronic health information for competitive reasons constitutes information blocking under the 21st Century Cures Act.
Question 6: DICOM is a standard primarily used for exchanging:
- Laboratory test results and reference ranges
- Medical imaging data such as X-rays and MRI scans (Correct answer)
- Insurance eligibility and claims information
- Pharmacy prescription and dispensing records
Correct answer: Medical imaging data such as X-rays and MRI scans
DICOM (Digital Imaging and Communications in Medicine) is the international standard for storing, transmitting, and sharing medical imaging data including radiology and cardiology images.
Question 7: Which nationally recognized patient matching strategy helps link records in an HIE when a universal patient identifier does not exist?
- Deterministic and probabilistic matching algorithms (Correct answer)
- Social Security Number cross-referencing
- ICD-10 diagnosis code matching
- Medication reconciliation comparison
Correct answer: Deterministic and probabilistic matching algorithms
Deterministic matching uses exact demographic fields to link records, while probabilistic matching scores the likelihood of a match based on weighted data elements — both are used in HIE patient matching without a national ID.
CAHIMS Health Information Exchange and Interoperability 2
Which messaging standard, predating FHIR, has been the traditional backbone of hospital-to-hospital clinical data exchange since the 1980s?