Term
| How does interoperability benefit the patient? |
|
Definition
1. Reduce repeat tests
2. Info follow patient |
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Term
| 3 goals of interoperability? |
|
Definition
1. Pay for performance
2. Embedded architecture of everything
3. Accountable care organization |
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Term
| Which executive order established EHRs in 2004? |
|
Definition
|
|
Term
| What did executive order #13410 establish in 2006? |
|
Definition
|
|
Term
| What is the Medicaid transformation grant? |
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Definition
| $150M of debt forgiveness for states when implementing HIT |
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Term
| How did MIPPA in 2008 advance ePrescribing? |
|
Definition
incentives from 2009-2013
penalties from 2012-present |
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Term
| Describe the 2009 American Recovery Reinvestment Act IRT to HIT |
|
Definition
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Term
| 4 benefits of ePrescribing |
|
Definition
1. reduce med errors
2. improve outcomes
3. increase compliance
4. increase efficiency |
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Term
| Two parts of the HITECH Act |
|
Definition
through 2014 HIE + EHR adoption
through 2021 EHR Meaningful Use (MU) incentives |
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Term
| Two govt agencies involved in the HITECH ACT |
|
Definition
Medicare (CMS|Federal)
Medicaid (State) |
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Term
|
Definition
Using certified EHR Technology for:
1. ePrescribing
2. information exchange
3. submitting Clinical Quality Meas. (CQM) |
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Term
| Describe the hypothesized MU concept |
|
Definition
| data sharing --> advanced clinical processes --> improved outcomes |
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Term
| What are 3 aims of the Affordable Care Act of 2010? |
|
Definition
1. Better care
2. Affordable care
3. Healthy people and healthy communities |
|
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Term
| 6 priorities of the Affordable Care Act of 2010 |
|
Definition
1. safer
2. getting patients/caregivers engaged
3. effective communication/coordination
4. effective prevention/treatment
5. best practice promotion
6. affordable |
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Term
| What 3 things can patients share using the Blue Button Initiative |
|
Definition
1. Medications
2. Vaccinations
3. Test results |
|
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Term
| Pharmacist weak-sauce role in the Blue Button Initiative |
|
Definition
1. Assist with download
2. Medication reconciliation
3. Share + protect data |
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Term
|
Definition
| $22B for adoption and MU of EHRs by physicians and hospitals |
|
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Term
| Pharmacy Informatics (PI) relationships |
|
Definition
| people, information, technology |
|
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Term
|
Definition
| Pharmacy Information System |
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Term
|
Definition
| Computerized provider order entry |
|
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Term
|
Definition
| automatic dispensing machine |
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Term
|
Definition
| Barcode Medication Administration |
|
|
Term
|
Definition
|
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Term
| Five step of the Medication Use Process |
|
Definition
1. Prescribe
2. Transcribe
3. Dispense
4. Administration
5. Monitor |
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Term
| List PI components of the prescribing step in the Medication Use Process |
|
Definition
|
|
Term
| List PI components of the transcribing step in the Medication Use Process |
|
Definition
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|
Term
| List PI components of the dispensing step in the Medication Use Process |
|
Definition
| barcoding, robotics, auto dispensing machines, syringe filling machines |
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|
Term
| List PI components of the administration step in the Medication Use Process |
|
Definition
| smart pumps, POC barcoding, eMAR |
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Term
| List PI components of the monitoring step in the Medication Use Process |
|
Definition
| wearable tech, ADE/drug surveillance, data anylytics |
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Term
| Two Legislative ACTS that advanced PI |
|
Definition
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|
Term
| Describe the stages of meaningful use providers are required to reach for incentives under the HITEH act |
|
Definition
Stage I - Data capture and sharing (15 core + 5 meu objective)
Stage II- Advance clinical processes (17 core +3 menu objectives)
Stage III - Improved outcome (objectives not yet released) |
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Term
|
Definition
| Personal healthcare record; maintained by the patient |
|
|
Term
|
Definition
-Less than 10% of patients maintain
-Accuracy
-unstructured data (interoperability problems) |
|
|
Term
| Patient portals are often tethered to |
|
Definition
|
|
Term
| 6 things patients can do on Patient portals |
|
Definition
1. complete forms
2. Communicate
3. Schedule
4. View lab values
5. Request refills
6. Access med hist. |
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Term
| What are 3 integrated healthcare tools available on patient portals. |
|
Definition
1. Secure comms
2. Embedded glucose trackers
3. Reduce unnecessary appointments |
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Term
|
Definition
| Electronic record kept within ONE healthcare organization |
|
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Term
| What do healthcare organizations gain by using EMRs |
|
Definition
| The ability to maintain and index a vast amount of information |
|
|
Term
|
Definition
| Conforms to nationally recognized interoperability standards. Can be created, managed, and consulted by MORE than one healthcare organization |
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Term
| How does electronic media differ from paper record keeping? |
|
Definition
| Performed at the point-of-care in real-time |
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|
Term
| Two advantages of note templates |
|
Definition
1. Consistency
2. Data retrieval |
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|
Term
| 3 disadvantages of Note templates |
|
Definition
1. Large volume of free-text data
2. Takes more time
3. Not enough detail |
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Term
| Define document by exception IRT Note templates |
|
Definition
| Normal values pre-populated; provider must select abnomalties |
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|
Term
| One problem with Voice recognition? |
|
Definition
|
|
Term
| 4 barriers of EMR adoption |
|
Definition
1. Cost
2. Workflow impact
3. Provider resistance
4. Divided market |
|
|
Term
| T/F EMR adoption has many hidden costs like: acquisition, operation, training, support... |
|
Definition
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|
Term
| What are some disadvantages of incorporating paper records into electronic? |
|
Definition
1. Cost
2. Labor
3. Must be indexed |
|
|
Term
| Define hybrid EMR; where might they be used? |
|
Definition
| Provider uses paper; pharmacist enters information. Oncology b/c of inability to easily create standardized note templates |
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Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Define "best-of-breed" models IRT HIT |
|
Definition
| Each department chooses the best system for their specialty |
|
|
Term
| Advantage of Best-of-breed? |
|
Definition
|
|
Term
| 4 Disadvantage of Best-of-breed? |
|
Definition
1. Inconsistent GUI across enterprise
2. Interoperability issues
3. Limited Report + Data sharing
4. Cost |
|
|
Term
|
Definition
| Enterprise marketplace (applications) |
|
|
Term
| Advantages of E-MAR over best-of-breed |
|
Definition
1. Consistent GUI
2. Integration
3. One database
4. Single vendor |
|
|
Term
|
Definition
-It is a compromise, and not all departmental needs will be met.
-Upgrades are complex |
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|
Term
| Why are providers eRx-ing? |
|
Definition
1. Financial incentives (HITECH)
2. Financial penalties (MIPPA) |
|
|
Term
| Which company is leading the way in eRx services? |
|
Definition
|
|
Term
| What eRx queries gets sent to PBMs before pharmacy? |
|
Definition
|
|
Term
| Provider queries to pharmacist IRT eRx |
|
Definition
1. NewRX - new prescription
2. CanRx - cancel prescription |
|
|
Term
| Pharmacist queries to provider IRT eRx |
|
Definition
1. ChngRx - alternate drug suggestions
2. Refreq - refill request |
|
|
Term
|
Definition
1. Interoperability
2. Process/Workflow
3. Culture
4. Skills
5. Lack of resources |
|
|
Term
| Can electronic prescriptions of controlled substance (EPCS) be converted to other forms? i.e. fax... |
|
Definition
|
|
Term
|
Definition
1. Fraud
2. Diversion
3. Forgery |
|
|
Term
| T/F Participation in EPCS is voluntary? |
|
Definition
| True -phone is still authorized |
|
|
Term
| T/F if an prescription is sent electronically from a provider, but received as a fax at the pharmacy it is still considered a eRx |
|
Definition
|
|
Term
| T/F eRx requires fundamental changes in workflow to be implemented fully and effectively |
|
Definition
|
|
Term
| Providers must meet what DEA reqs to use EPCS? |
|
Definition
1. EPCS certified
2. Identity proofing
3. Logical access controls
4. Two factor authentication |
|
|
Term
| Describe two factor authentication |
|
Definition
Must have 2/3 of the following:
-something you know (password)
-something you have (token card)
-something you are (retina, fingerprint) |
|
|
Term
| Describe logical access IRT EPCS |
|
Definition
TPI on software permissions
Person 1 - is DEA register prescriber
Person 2 - Verifies person 1's DEA registration |
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|
Term
|
Definition
| preventable event that may cause or lead to inappropriate medication use or patient harm |
|
|
Term
| How many med errors occur during prescribing phase of the medication use system? |
|
Definition
|
|
Term
| What IT solution can reduce med errors during the prescribing phase |
|
Definition
|
|
Term
| How does CPOE reduce med errors to zero in the transcribing phase? |
|
Definition
|
|
Term
| T/F 2/3 of reported dispensing errors reach patient; relatively few cause harm |
|
Definition
|
|
Term
| 38% of med errors occur during administration what are some of these errors? |
|
Definition
Wrong:
-dose
-time
-rate
-route
-patient
-med
-never given |
|
|
Term
| What IT solution can resolve med errors during the admin phase? |
|
Definition
|
|
Term
| What are 3 types of hazardous workarounds IRT BCMA? |
|
Definition
1. omission of process steps
2. out of sequence process steps
3. unauthorized process steps |
|
|
Term
| What are some causes of BCMA workarounds? |
|
Definition
1. Technology-related
2. Task-related
3. Patient related
4. environmental
5. Organizational |
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