EHR Clinical Decision Support Systems 3 — Questions and Answers
Question 1: Which federal regulation requires EHR systems to include specific CDS functionality to qualify for Promoting Interoperability incentives?
- ONC Health IT Certification Program (Correct answer)
- HIPAA Privacy Rule
- Stark Law
- DEA Controlled Substance Act
Correct answer: ONC Health IT Certification Program
The ONC Health IT Certification Program defines certification criteria, including CDS capabilities required for Promoting Interoperability (formerly Meaningful Use) incentive eligibility.
Question 2: A hospital wants to reduce unnecessary lab ordering. Which CDS approach is most directly applicable?
- Order entry guidance with evidence-based indications (Correct answer)
- Medication reconciliation alert
- Problem list reminder
- Discharge summary template
Correct answer: Order entry guidance with evidence-based indications
Order entry guidance that presents evidence-based indications prompts clinicians to evaluate whether a test is truly necessary before ordering.
Question 3: What does 'passive CDS' refer to in clinical informatics?
- Information available on demand without an unsolicited alert (Correct answer)
- Alerts that fire automatically at order entry
- Rules that block contraindicated orders
- Population health dashboards
Correct answer: Information available on demand without an unsolicited alert
Passive CDS provides knowledge or references that clinicians can access when they choose, without an automatic system-generated alert.
Question 4: Which data element is most critical for a CDS rule designed to recommend age-appropriate cancer screening?
- Patient date of birth (Correct answer)
- Insurance payer type
- Attending physician NPI
- Facility bed count
Correct answer: Patient date of birth
Patient date of birth is essential for calculating age, which drives age-based screening recommendations such as mammography or colonoscopy guidelines.
Question 5: A CDS alert recommending an alternative antibiotic fires when a culture shows resistance. At what point in the workflow should this alert ideally trigger?
- When the culture result is resulted and the antibiotic is still active (Correct answer)
- At the time of initial order entry
- At patient discharge
- During billing code assignment
Correct answer: When the culture result is resulted and the antibiotic is still active
Antibiotic stewardship CDS is most effective when it fires upon receipt of susceptibility results while the patient is still receiving the original antibiotic.
Question 6: What is a 'knowledge artifact' in the context of CDS?
- A structured, computable representation of clinical knowledge used to drive CDS rules (Correct answer)
- A scanned paper protocol stored in the EHR
- A physician's handwritten order
- An interface engine message
Correct answer: A structured, computable representation of clinical knowledge used to drive CDS rules
A knowledge artifact is a structured, computable representation of clinical knowledge (e.g., CQL or FHIR-based rules) that EHR systems use to execute CDS logic.
Question 7: Which standard is commonly used to represent CDS logic in a computable, interoperable format?
- Clinical Quality Language (CQL) (Correct answer)
- HL7 v2 ADT
- DICOM
- X12 837
Correct answer: Clinical Quality Language (CQL)
Clinical Quality Language (CQL) is the HL7 standard used to express clinical logic for CDS rules and quality measures in a computable format.
EHR Clinical Decision Support Systems 3
Which federal regulation requires EHR systems to include specific CDS functionality to qualify for Promoting Interoperability incentives?