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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Systems Management | 27% | - Systems Analysis and Design
|
| Topic 2: Healthcare Environment | 26% | - Healthcare Data and Information
|
| Topic 3: Technology Environment | 27% | - Applications and Software
|
| Topic 4: Related Topics | 20% | - Management and Leadership
|
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質問 # 19
Which of the following is the primary function of a project steering committee?
正解：C
解説：
A project steering committee's primary function is to provide oversight of the project . In healthcare information systems initiatives, the steering committee serves as the governance body that ensures the project remains aligned with organizational strategy, clinical priorities, patient safety, regulatory needs, and available resources. Oversight includes setting or approving major direction, validating scope and success criteria, reviewing progress against milestones, monitoring risk, and making high-impact decisions when tradeoffs are required (e.g., timeline vs. scope, workflow standardization vs. local variation). It also establishes accountability across stakeholders-clinical, operational, financial, and IT-and provides executive sponsorship and escalation pathways.
While steering committees often help remove barriers, troubleshooting (A) is a secondary outcome of oversight and escalation rather than the core purpose. Executing milestones (B) is the responsibility of the project team-project manager, analysts, builders, trainers, and operational owners-who perform the day-to- day work. "Meet according to the project plan" (C) describes a procedural detail, not a primary function.
Effective oversight is especially critical in health IT projects because decisions can affect care delivery, clinician workload, data integrity, privacy/security, and operational continuity. Therefore, the best answer is Provide oversight of the project .
質問 # 20
An emergency department requested a study of laboratory turn-around times. A review shows peak patient arrivals during weekend evening hours. When should sampling of turn-around occur to obtain the MOST reliable data?
正解：B
解説：
To obtain the most reliable laboratory turnaround time (TAT) data for an emergency department, sampling must be representative of the full operating reality , not concentrated only in one high-volume window.
Although the review shows peak arrivals during weekend evenings , TAT performance is influenced by multiple time-dependent factors: staffing levels in the ED and lab, specimen transport coverage, analyzer workload, competing inpatient priorities, courier schedules, and shifts/hand-offs. If sampling occurs only on weekend evenings (or only on weekends), the study risks systematic bias by over-representing peak congestion conditions and under-representing baseline performance during non-peak periods.
Therefore, sampling across varied weekday and weekend hours produces the most reliable dataset because it captures both peak and non-peak operations, different staffing patterns (day/evening/night), and weekday- versus-weekend workflow differences. This broader sampling supports stronger conclusions about true average performance, variability, and whether delays are isolated to peak demand periods or occur across the week. It also enables better root-cause analysis (e.g., shift-related bottlenecks, transport gaps, batching behavior) and more credible improvement recommendations. Random weekend-only sampling or intermittent peak-only sampling may be easier, but it is less representative and therefore less reliable for organization- wide decisions.
質問 # 21
A department has provided a list of suggested enhancements to its primary system. Which of the following is the BEST method to prioritize these enhancements?
正解：C
解説：
The best method to prioritize enhancement requests is to conduct a cost/benefit analysis because it provides an objective, decision-oriented way to compare competing options using consistent criteria. In healthcare information systems management, enhancements compete for limited analyst time, testing capacity, training bandwidth, and change windows-so prioritization must consider not only effort but also measurable value .
A cost/benefit analysis evaluates expected benefits such as improved patient safety, reduced clinical risk, compliance impact, productivity gains, reduced turnaround time, better charge capture, lower support burden, and improved user satisfaction, then weighs them against costs such as implementation effort, licensing, interface work, workflow redesign, training time, downtime risk, and ongoing maintenance. This approach supports governance transparency and aligns investment with organizational strategy and outcomes.
The other options can inform prioritization but are not sufficient alone. Organizing by IT resource requirements (A) risks prioritizing what is easiest rather than what delivers the greatest value or risk reduction. Service desk frequency (B) highlights pain points, but high-frequency issues may be low impact, while low-frequency issues can be high severity (e.g., safety or regulatory). Grouping into categories (C) helps organize discussion but does not rank options. Therefore, cost/benefit analysis is the strongest method for rational, defensible prioritization.
質問 # 22
A data breach has occurred and personally identifiable information has become exposed. The security officer has been notified and has started an investigation. The most appropriate NEXT action is to notify
正解：D
解説：
The most appropriate next action is to notify senior management immediately because an incident involving exposed personally identifiable information requires rapid organizational escalation for governance, legal, operational, and communications decisions. Once the security officer initiates the investigation, executive leadership must be engaged right away to activate the incident response structure, allocate resources, approve containment actions that may affect clinical operations (e.g., taking systems offline), and ensure required stakeholders are involved (legal counsel, privacy officer, compliance, risk management, public relations, and clinical leadership). Early senior leadership notification supports timely decision-making and preserves evidence, while ensuring consistent internal and external messaging.
Waiting until the investigation is completed (option B) risks delays in containment, reporting decisions, and organizational coordination. Options C and D focus on notifying affected individuals within a specific timeframe; however, individual notification requirements vary by jurisdiction and circumstance, and generally depend on confirming the scope, impacted individuals, and whether the incident meets the definition of a reportable breach. Those steps come after leadership is engaged and the response process is coordinated.
Therefore, immediate senior management notification is the best next step to manage risk, compliance, and patient trust effectively.
質問 # 23
Vendor A provides a major clinical system for an organization. Vendor B has an interface from the clinical system to a billing system. Over the weekend, vendor A upgraded the clinical system and vendor B upgraded the interface to the billing system. On Monday morning, the billing system has errors. After failing to adequately resolve the issue in-house, the IT manager should contact
正解：A
解説：
Because two interdependent components changed at the same time -the core clinical system (Vendor A) and the interface engine/interface build (Vendor B)-the most appropriate escalation is to engage both vendors .
Interface failures after concurrent upgrades commonly stem from version compatibility issues (e.g., updated message formats, changed field mappings, new code sets, modified API endpoints, altered authentication, or stricter validation rules). Even if the error appears "in billing," the root cause may originate upstream in the clinical system's outbound messages or in the interface transformation logic that sits between systems.
Best practice in healthcare systems management is coordinated vendor triage: confirm upgrade versions, review release notes for breaking changes, validate interface specifications, and compare pre-/post-upgrade message samples. Involving both vendors speeds resolution because each controls different layers of the transaction path-Vendor A for source data creation/export and Vendor B for interface routing, translation, acknowledgments, and delivery to billing. Contacting only one vendor risks slow back-and-forth and "fault isolation" disputes. Legal/contracting is typically reserved for unresolved service-level or contractual disputes, not initial technical remediation. By escalating to both vendors, the IT manager enables joint troubleshooting, faster restoration of revenue-cycle workflows, and reduced operational risk.
質問 # 24
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