EHR Interoperability & Health Information Exchange 4 — Questions and Answers
Question 1: A care coordinator wants to automatically receive a notification when a patient is admitted to any hospital in the region. Which HIE capability supports this use case?
- Event notification / subscription service (Correct answer)
- Query-based document retrieval
- Direct secure messaging
- Patient portal integration
Correct answer: Event notification / subscription service
Event notification services (ADT feeds or FHIR Subscriptions) proactively alert providers to patient care events without requiring manual queries.
Question 2: Which standard defines the minimum dataset for electronic prescribing and medication history exchange between prescribers, pharmacies, and PBMs?
- NCPDP SCRIPT (Correct answer)
- HL7 v2 ORU
- X12 837
- FHIR MedicationRequest
Correct answer: NCPDP SCRIPT
NCPDP SCRIPT is the industry standard for electronic prescribing transactions between providers, pharmacies, and benefit managers.
Question 3: What is a 'federated' model of health information exchange, as opposed to a centralized model?
- Data stays at the source organization and is queried on demand (Correct answer)
- All data is copied to a central repository
- Data is stored in the cloud by a vendor
- Data is printed and faxed between facilities
Correct answer: Data stays at the source organization and is queried on demand
In a federated model, each organization retains its own data, which is retrieved directly when needed rather than pre-loaded into a central store.
Question 4: Which FHIR capability statement element advertises what resources and interactions an EHR server supports, enabling clients to discover exchange capabilities?
- CapabilityStatement (Correct answer)
- StructureDefinition
- ImplementationGuide
- OperationDefinition
Correct answer: CapabilityStatement
A FHIR CapabilityStatement describes a server's supported resources, operations, and interactions, acting as a machine-readable API contract.
Question 5: When reconciling medication lists received from an external source during a care transition, what is the clinician's primary responsibility?
- Review and verify the accuracy of the received list before updating the patient's record (Correct answer)
- Automatically accept all external medications without review
- Delete the current medication list and replace it with the received list
- Forward the list to the pharmacy without clinical review
Correct answer: Review and verify the accuracy of the received list before updating the patient's record
Medication reconciliation requires a clinician to actively compare, verify, and resolve discrepancies between medication lists.
Question 6: Which transport standard is required by ONC for secure Direct messaging to exchange health information between providers?
- SMTP with S/MIME encryption (Correct answer)
- FTP with password protection
- HTTP without encryption
- SOAP over HTTP
Correct answer: SMTP with S/MIME encryption
Direct messaging uses SMTP secured with S/MIME certificates to ensure encrypted, authenticated transmission of clinical data.
Question 7: A patient requests that their records not be shared with other providers through the HIE. What is this practice called?
- Opt-out from HIE participation (Correct answer)
- Minimum necessary disclosure
- Treatment restriction
- Data segmentation for privacy
Correct answer: Opt-out from HIE participation
Patients may opt out of HIE data sharing, instructing the network not to release their records to querying providers.
EHR Interoperability & Health Information Exchange 4
A care coordinator wants to automatically receive a notification when a patient is admitted to any hospital in the region.
Which HIE capability supports this use case?