CEHRS CEHRS Interoperability and Health Information Exchange 4 — Questions and Answers
Question 1: Which federal program created the framework for a nationwide network of Health Information Exchanges (HIEs)?
- HITECH Act (Correct answer)
- The Affordable Care Act
- MACRA
- The Stark Law
Correct answer: HITECH Act
The HITECH Act of 2009 established the legal and financial framework for HIE development and incentivized adoption of interoperable EHR systems.
Question 2: A patient moves from one state to another and their new provider cannot access prior records. Which HIE model would BEST address this gap?
- Directed exchange
- Query-based exchange (Correct answer)
- Consumer-mediated exchange
- Consolidated-CDA only sharing
Correct answer: Query-based exchange
Query-based exchange allows providers to search and retrieve patient records from other providers on demand, ideal for accessing records across geographic boundaries.
Question 3: What is the primary purpose of a Master Patient Index (MPI) in health information exchange?
- Encrypt patient data during transmission
- Uniquely identify and match patient records across different systems (Correct answer)
- Standardize medication codes
- Generate Consolidated-CDAs automatically
Correct answer: Uniquely identify and match patient records across different systems
An MPI assigns unique identifiers and uses matching algorithms to link records belonging to the same patient across disparate systems.
Question 4: Under the 21st Century Cures Act, which practice is prohibited when health IT vendors or providers restrict access, exchange, or use of EHR data?
- Data minimization
- Information blocking (Correct answer)
- Selective disclosure
- Consent revocation
Correct answer: Information blocking
The 21st Century Cures Act explicitly prohibits 'information blocking'—practices that interfere with the access, exchange, or use of electronic health information.
Question 5: Which standard message format is most commonly used to transmit lab results, ADT notifications, and order information between hospital systems?
- HL7 v2.x (Correct answer)
- DICOM
- FHIR R4
- X12 EDI 837
Correct answer: HL7 v2.x
HL7 v2.x remains the most widely deployed standard for real-time clinical messaging including ADT, ORM, ORU, and other transaction types.
Question 6: A health records specialist receives a Direct message containing a patient's care summary. What document standard is most likely used in this attachment?
- CDA (Clinical Document Architecture) (Correct answer)
- DICOM SR
- X12 270/271
- NCPDP SCRIPT
Correct answer: CDA (Clinical Document Architecture)
Direct messaging typically carries Consolidated-CDA documents, which are based on the HL7 CDA standard for structured clinical documents.
Question 7: Which type of HIE governance model is characterized by a central organization that stores and manages all participating members' patient data?
- Federated model
- Hybrid model
- Centralized model (Correct answer)
- Peer-to-peer model
Correct answer: Centralized model
In a centralized HIE model, a single repository stores data from all participants, enabling fast queries but requiring strong governance and data stewardship.
CEHRS CEHRS Interoperability and Health Information Exchange 4
Which federal program created the framework for a nationwide network of Health Information Exchanges (HIEs)?