Certified Midwife Exam Prep Technology & Digital Applications 5 — Questions and Answers
Question 1: A midwife practicing in a rural state wants to provide telehealth prenatal care to a patient temporarily visiting another state. What must be verified first?
- Whether the midwife holds licensure or a telehealth exception in the patient's current state (Correct answer)
- Whether the patient has a smartphone with video capability
- Whether the practice accepts the patient's insurance
- Whether the patient can travel to the midwife's state for delivery
Correct answer: Whether the midwife holds licensure or a telehealth exception in the patient's current state
Telehealth licensure is governed by the patient's physical location at the time of service; practicing without a valid license is illegal.
Question 2: An EHR system generates a drug interaction alert when a midwife prescribes iron supplements with a calcium antacid. The midwife knows this is a minor interaction. What is best practice?
- Document the clinical rationale for overriding the alert and proceed with the prescription (Correct answer)
- Ignore all drug interaction alerts to improve workflow efficiency
- Cancel the prescription without explaining to the patient
- Escalate to a physician to override any alert
Correct answer: Document the clinical rationale for overriding the alert and proceed with the prescription
Alert overrides require documented clinical rationale to maintain an audit trail and demonstrate that the decision was informed and intentional.
Question 3: What is the purpose of a 'break-the-glass' function in an EHR system?
- It allows emergency access to a restricted patient record with automatic logging and subsequent review (Correct answer)
- It deletes a patient record in case of data breach
- It enables mass export of all records for auditing
- It locks the system during a security incident
Correct answer: It allows emergency access to a restricted patient record with automatic logging and subsequent review
Break-the-glass permits emergency access to restricted records while creating an audit log for mandatory post-hoc review.
Question 4: A midwife receives a secure Direct Message referral from an OB/GYN with a CCD (Continuity of Care Document) attached. What information does the CCD contain?
- Structured clinical summary including problems, medications, allergies, procedures, and results (Correct answer)
- Only the patient's insurance billing codes
- A scanned PDF of handwritten notes only
- Appointment scheduling preferences
Correct answer: Structured clinical summary including problems, medications, allergies, procedures, and results
A CCD is a structured HL7 CDA document that provides a standardized patient summary covering diagnoses, medications, allergies, and clinical history.
Question 5: Which metric from an electronic fetal monitor requires the most immediate clinical response if identified by digital surveillance software?
- Prolonged deceleration lasting more than 2 minutes with absent variability (Correct answer)
- Early decelerations with moderate variability
- Mild tachycardia of 165 bpm with accelerations present
- Occasional variable decelerations with quick recovery
Correct answer: Prolonged deceleration lasting more than 2 minutes with absent variability
Prolonged deceleration with absent variability is a Category III pattern indicating fetal compromise requiring immediate evaluation and intervention.
Question 6: A midwifery practice wants to send appointment reminders via automated text messages. What is required for HIPAA compliance?
- Patient written authorization and opt-in consent for SMS communication containing PHI (Correct answer)
- Only a verbal agreement from the patient
- No special requirements since text messages are not covered by HIPAA
- Physician co-signature on all automated messages
Correct answer: Patient written authorization and opt-in consent for SMS communication containing PHI
SMS messages containing PHI require written patient authorization and opt-in consent, as standard SMS lacks required encryption safeguards.
Question 7: A birth center is adopting a cloud-based EHR. Which contractual document must be executed with the cloud vendor to ensure HIPAA compliance?
- Business Associate Agreement (BAA) (Correct answer)
- Non-Disclosure Agreement (NDA) only
- Service Level Agreement (SLA) only
- End User License Agreement (EULA)
Correct answer: Business Associate Agreement (BAA)
A Business Associate Agreement is legally required under HIPAA whenever a vendor handles PHI on behalf of a covered entity.
Certified Midwife Exam Prep Technology & Digital Applications 5
A midwife practicing in a rural state wants to provide telehealth prenatal care to a patient temporarily visiting another state.
What must be verified first?