Clinical Informatics Certification Clinical Decision Support Systems 2 — Questions and Answers
Question 1: Which CDS intervention type is MOST likely to be ignored due to 'alert fatigue'?
- Interruptive pop-up alerts (Correct answer)
- Order sets
- Passive reference information
- Dashboards
Correct answer: Interruptive pop-up alerts
Interruptive alerts that fire frequently for low-severity issues are the primary driver of alert fatigue and override behavior.
Question 2: A hospital wants to reduce duplicate laboratory orders. Which CDS approach is MOST appropriate?
- Medication dosing calculator
- Redundant order checking alert (Correct answer)
- Clinical pathway display
- Diagnostic imaging decision support
Correct answer: Redundant order checking alert
Redundant order checking alerts notify clinicians when a test has recently been ordered or resulted, directly targeting duplicate orders.
Question 3: In the Five Rights of CDS, 'right channel' refers to:
- Delivering the alert at the correct point in workflow
- Using the EHR versus a standalone system
- Sending the alert to the appropriate clinician role (Correct answer)
- Choosing email over in-system notification
Correct answer: Sending the alert to the appropriate clinician role
The 'right channel' means the CDS information reaches the correct person (e.g., pharmacist vs. physician) who can act on it.
Question 4: Which standard is MOST commonly used to represent clinical knowledge in shareable CDS artifacts?
- HL7 FHIR Clinical Quality Language (CQL) (Correct answer)
- SNOMED CT
- ICD-10-CM
- LOINC
Correct answer: HL7 FHIR Clinical Quality Language (CQL)
CQL is the HL7-endorsed expression language for representing logic in shareable CDS and quality measure artifacts.
Question 5: A CDS rule fires an alert every time a beta-blocker is ordered for a patient with COPD, regardless of severity. This BEST illustrates a failure in:
- Alert specificity (Correct answer)
- Alert sensitivity
- Integration architecture
- Knowledge base currency
Correct answer: Alert specificity
Low specificity means the rule fires too broadly, including cases where it is not clinically warranted, contributing to alert fatigue.
Question 6: Which metric BEST evaluates the clinical impact of a CDS drug-drug interaction alert?
- Override rate (Correct answer)
- Number of alerts fired per day
- System uptime during alert delivery
- Time from alert creation to deployment
Correct answer: Override rate
Override rate measures how often clinicians bypass an alert; high override rates indicate the alert may lack clinical relevance or specificity.
Question 7: Which CDS governance activity ensures that knowledge artifacts remain clinically valid over time?
- Periodic knowledge base review and sunset process (Correct answer)
- One-time clinical expert sign-off at build time
- Vendor SLA monitoring
- End-user satisfaction surveys
Correct answer: Periodic knowledge base review and sunset process
A formal review and sunset process identifies outdated rules, retiring or updating them as clinical evidence evolves.
Clinical Informatics Certification Clinical Decision Support Systems 2
Which CDS intervention type is MOST likely to be ignored due to 'alert fatigue'?