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| Section | Objectives |
|---|---|
| Health Cloud Fundamentals | - Core Health Cloud features and capabilities - Healthcare industry concepts and use cases for Health Cloud |
| Data Model and Patient / Member Management | - Patient / member data organization and relationships - Person accounts, contacts, and care team structures |
| Security, Compliance, and Privacy | - HIPAA-related considerations in Salesforce Health Cloud - Data access controls, sharing models, and consent management |
| Reporting and Analytics | - Tracking outcomes and operational insights - Healthcare reporting and dashboards |
| Integration and Interoperability | - Use of APIs and healthcare data exchange standards (e.g., HL7/FHIR concepts) - Integration with EHR systems and external healthcare systems |
| Care Coordination and Care Plans | - Care plan creation and lifecycle management - Care team collaboration and task management |
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118. Frage
Bloomington Caregivers needs to monitor care plan adherence for the patients at various facilities within its network.
What is available to extend the reporting capability of Health Cloud?
Antwort: D
Begründung:
Step-by-Step
CRM Analytics for Health Cloud:
Exact Extract:
"CRM Analytics for Health Cloud delivers prebuilt dashboards and extended analytics for monitoring care plans, outcomes, and adherence across networks and facilities." Reference:
Why Not Other Options?
Insights for Health Cloud: Not a standard reporting/analytics product for care plan adherence.
Reporting unmanaged package: Not mentioned in the latest Health Cloud documentation.
Care Management Extension: Refers to process automation, not analytics.
119. Frage
A consultant is working with an insurance provider to set up prior authorizations in Health Cloud. The provider requires a display of preauthorization outcomes from its external system which manages the end-to- end prior authorization process.
Which solution is appropriate to meet this use case?
Antwort: A
Begründung:
In Salesforce Health Cloud, managing prior authorizations involves utilizing specific objects designed to handle the complexities of authorization requests and their associated details. For an insurance provider aiming to display preauthorization outcomes from an external system that manages the end-to-end prior authorization process, the appropriate solution involves the Service Preauth and Preauth Detail objects.
* Service Preauth Object:
* Purpose: The Service Preauth object represents a preauthorization request within Health Cloud.
It serves as a container for all relevant information pertaining to a specific authorization, including patient details, requested services, and status updates.
* Integration Capability: This object is designed to integrate with external systems, allowing for the seamless import and display of preauthorization outcomes managed outside of Salesforce. By mapping external authorization data to the Service Preauth object, users can view and manage authorization statuses directly within Health Cloud.
* Preauth Detail Object:
* Purpose: The Preauth Detail object stores detailed information related to each preauthorization request captured in the Service Preauth object. This includes specifics about the services or procedures being authorized, such as service codes, descriptions, quantities, and any other pertinent details.
* Integration Capability: By populating the Preauth Detail object with data from external systems, Health Cloud users gain comprehensive visibility into the components of each authorization request, facilitating informed decision-making and efficient care coordination.
Integration Process:
To effectively display preauthorization outcomes from an external system within Health Cloud, consider the following steps:
* Data Mapping: Establish a data mapping strategy to align fields from the external system with the corresponding fields in the Service Preauth and Preauth Detail objects. This ensures that all relevant information is accurately captured and displayed within Health Cloud.
* Data Import: Utilize Salesforce's data import tools or integration middleware (such as MuleSoft) to import preauthorization data into the Service Preauth and Preauth Detail objects. This process can be automated to ensure real-time or near-real-time updates, providing users with the most current information.
* User Access and Permissions: Configure user permissions to ensure that appropriate personnel have access to view and manage preauthorization information. This includes setting up profiles and permission sets that grant access to the Service Preauth and Preauth Detail objects.
References:
Authorization Request Overview: This Salesforce Help article provides an overview of managing authorization requests within Health Cloud, detailing the objects and processes involved.
Salesforce
Built-In MuleSoft Integration to Manage Authorization Requests: This resource outlines how to integrate Health Cloud with external Electronic Health Record (EHR) and payer systems using MuleSoft, facilitating seamless data exchange for authorization requests.
Salesforce
Care Services Review and Response: This developer guide section discusses RESTful APIs that support data elements required for ANSI X12 278 format Health Care Services Review and Response, enabling electronic receipt of prior authorization requests from providers.
Salesforce Developers
By leveraging the Service Preauth and Preauth Detail objects, along with appropriate integration strategies, insurance providers can effectively display and manage preauthorization outcomes from external systems within Salesforce Health Cloud, enhancing operational efficiency and improving patient care coordination.
120. Frage
Bloomington Caregivers has created and tested its first care plan template In a sandbox, which Includes problems, goals, and tasks. The company has deployed this template to its final environment using Data Loader.
Which two steps should a consultant recommend, following this deployment, to enable users to successfully leverage this new template?
Choose 2 answers
Antwort: C,D
Begründung:
After deploying a care plan template to the final environment, it is crucial to perform the following steps to ensure users can successfully leverage it:
* Activate the New Care Plan Template (A):
* After deployment via Data Loader, the care plan template remains inactive by default. You must activate it in the final environment to make it available for users to apply to patient cases.
* Activation ensures that care providers can use the template to assign care plans that include problems, goals, and tasks to their patients.
* Confirm User Access to Care Plan Objects (B):
* Users need the appropriate permissions to access care plan objects (e.g., Problems, Goals, and Tasks). Verify and assign the correct profiles or permission sets to ensure users can view, edit, and apply these components within the care plan template.
Why Other Options Are Incorrect:
* C. Conduct end-user training on the use of the care plan template:While beneficial for user adoption, training is not a technical or mandatory step to enable users to leverage the template post- deployment.
* D. Activate the problems, goals, and tasks associated with the template:Individual components like problems, goals, and tasks are activated as part of the template. Activating the template itself (Option A) suffices.
References:
Administer Health Cloud
Salesforce Documentation on Care Plan Template Management
121. Frage
A hospital system wants to track patient relationships to its cardiologist, primary care physician, and oncologist. Which object should a consultant recommend to implement?
Antwort: A
Begründung:
In Salesforce Health Cloud, to track a patient's relationships with multiple healthcare providers such as a cardiologist, primary care physician, and oncologist, the Patient Provider Relationship object is the appropriate choice.
Understanding the Patient Provider Relationship Object:
* Purpose:
* The Patient Provider Relationship object is designed to represent and manage the associations between patients (contacts) and their healthcare providers (practitioners).
* It facilitates the documentation of various roles that providers play in a patient's care, enabling a comprehensive view of the patient's healthcare network.
* Functionality:
* This object allows healthcare organizations to record and monitor the specific relationships between patients and providers, including details such as the type of care provided, duration of the relationship, and any relevant notes.
* By utilizing this object, organizations can ensure accurate and up-to-date records of all healthcare professionals involved in a patient's care, supporting coordinated and efficient care delivery.
Implementing Patient Provider Relationships:
* Configuration Steps:
* Define Relationship Types:
* Customize the relationship types to reflect various provider roles, such as cardiologist, primary care physician, and oncologist.
* Establish Relationships:
* For each patient, create records in the Patient Provider Relationship object to link them with their respective providers, specifying the role and any pertinent details.
* Maintain and Update Records:
* Regularly update these relationships to reflect any changes in the patient's care team, ensuring that the information remains current and accurate.
By leveraging the Patient Provider Relationship object, healthcare organizations can effectively manage and visualize the network of providers associated with each patient, enhancing care coordination and patient outcomes.
References:
Provider Relationship Management | Salesforce Health Cloud Developer Guide Track Complex Household Roles and Relationships in Health Cloud
122. Frage
A payer is looking to optimize the workflow for its call center, which focuses primarily on members calling to check on the status of their prior authorization requests.
How should a consultant conduct discovery to define a workflow for these call center users?
Antwort: C
Begründung:
To optimize workflows for a payer's call center, conducting a discovery phase requires identifying key pain points, inefficiencies, and opportunities.
Identify Personas and Walk Through a Day in Their Life:
Engage call center agents and supervisors who handle prior authorization requests and ask them to describe their daily processes, challenges, and tools used.
Take detailed notes to map out existing workflows and pinpoint inefficiencies. This approach provides insights into real-world challenges, helping to design tailored workflows that address bottlenecks.
Why Other Options Are Incorrect:
B . Build a proof of concept to present to the client and ask them for feedback:
Building a proof of concept comes later, after completing discovery and requirements gathering.
C . Research industry trends and develop a point of view, then present it to the customer for validation:
While understanding industry trends is useful, presenting pre-determined workflows without first understanding the customer's specific needs risks misalignment.
D . Use work from another project to inform the discovery, then review it with the IT department:
Reusing workflows from another project may not address the unique needs of this customer's call center processes.
Reference:
Salesforce Health Cloud Use Case Discovery Best Practices
Administer Health Cloud
123. Frage
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