Clinical Informatics Certification Clinical Informatics Health Systems 3 — Questions and Answers
Question 1: Which component of the FHIR specification defines the data elements, constraints, and extensions for a specific resource use case?
- Implementation Guide
- Capability Statement
- StructureDefinition (Correct answer)
- SearchParameter
Correct answer: StructureDefinition
A FHIR StructureDefinition formally describes the structure, constraints, and extensions applied to a base FHIR resource for a specific use case.
Question 2: A health system is selecting an EHR. Which procurement step involves vendors demonstrating their system meets specified functional requirements in a controlled scenario?
- Request for Information (RFI)
- Request for Proposal (RFP)
- Scripted demonstration (Correct answer)
- Contract negotiation
Correct answer: Scripted demonstration
Scripted demonstrations require vendors to show specific workflows using predefined scripts, allowing direct comparison against functional requirements.
Question 3: In population health management, a registry most directly supports care by:
- Automating billing for chronic disease management codes
- Identifying patients due for preventive services or follow-up (Correct answer)
- Replacing the EHR problem list for chronic conditions
- Generating real-time alerts during clinical encounters
Correct answer: Identifying patients due for preventive services or follow-up
Disease registries aggregate patient data to proactively identify care gaps and trigger outreach for patients needing preventive or follow-up care.
Question 4: Which security control best addresses the risk of an employee accessing PHI unrelated to their job duties?
- Data encryption at rest
- Role-based access control (RBAC) (Correct answer)
- Multi-factor authentication
- Audit log review
Correct answer: Role-based access control (RBAC)
RBAC limits PHI access based on a user's organizational role, ensuring employees can only view information relevant to their job functions.
Question 5: The ONC's 21st Century Cures Act final rule primarily targets:
- Mandating structured data entry for all clinical notes
- Prohibiting information blocking and advancing interoperability (Correct answer)
- Requiring EHR vendors to support ICD-11 coding
- Establishing federal CDS algorithm review boards
Correct answer: Prohibiting information blocking and advancing interoperability
The ONC 21st Century Cures Act final rule defines information blocking prohibitions and requires standardized FHIR-based API access to patient data.
Question 6: When calculating the positive predictive value (PPV) of a screening test, which variables are required?
- Sensitivity and prevalence only
- True positives and false positives (Correct answer)
- Specificity and false negative rate
- Likelihood ratio and prior probability
Correct answer: True positives and false positives
PPV = True Positives / (True Positives + False Positives), representing the probability that a positive test result is a true case.
Question 7: A health system implements a sepsis early warning algorithm. To evaluate its real-world performance, which method compares algorithm predictions against actual patient outcomes in production?
- Prospective clinical trial with randomization
- Retrospective validation using historical EHR data
- Prospective surveillance with post-hoc outcome linkage (Correct answer)
- A/B testing with control and intervention units
Correct answer: Prospective surveillance with post-hoc outcome linkage
Prospective surveillance with outcome linkage monitors algorithm alerts in real time and links them to confirmed sepsis diagnoses to assess production performance.
Clinical Informatics Certification Clinical Informatics Health Systems 3
Which component of the FHIR specification defines the data elements, constraints, and extensions for a specific resource use case?