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| Section | Objectives |
|---|---|
| Healthcare Environment | - Healthcare policy, regulations, and standards - Healthcare delivery systems and stakeholders |
| Health Information Systems | - System lifecycle and implementation - System selection and evaluation |
| Privacy, Security, and Data Governance | - Data privacy and confidentiality - Cybersecurity principles in healthcare systems |
| Information Technology | - Data management and interoperability - IT infrastructure and architecture |
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質問 # 30
What coding system is used to identify a patient's diagnosis in an electronic health record?
正解:D
解説:
The International Classification of Diseases (ICD) is the standardized coding system used to identify and classify patient diagnoses in an electronic health record (EHR). ICD codes are applied to document diseases, conditions, signs, symptoms, abnormal findings, and external causes of injury or illness. Within healthcare information systems, ICD coding ensures uniform clinical documentation, supports data analytics, enables population health reporting, and drives reimbursement processes.
By contrast, LOINC (Logical Observation Identifiers Names and Codes) is used to standardize laboratory tests and clinical observations, not diagnoses. CPT (Current Procedural Terminology) codes describe medical, surgical, and diagnostic procedures performed by providers. DRGs (Diagnosis-Related Groups) are reimbursement categories used primarily for inpatient hospital payment classification, grouping cases based on diagnoses and procedures rather than serving as the primary diagnosis coding system itself.
In healthcare information and systems management, accurate ICD coding is critical for regulatory reporting, quality measurement, epidemiological tracking, and claims submission. It also supports interoperability by allowing consistent diagnostic data exchange between organizations. Therefore, ICD is the correct system specifically designed to identify and classify patient diagnoses within the electronic health record environment.
質問 # 31
Which of the following ensures enhanced health care for the individual, improved health for the community population, and reduced per-capita cost?
正解:A
解説:
The Triple Aim is the recognized strategic framework that explicitly targets three linked goals: (1) improving the individual experience of care (quality, safety, and satisfaction), (2) improving the health of populations , and (3) reducing the per-capita cost of healthcare . These three aims are designed to be pursued together because progress in one area can be undermined if the others are ignored-for example, improving patient experience without controlling cost may be unsustainable, while cost cutting that harms outcomes or experience fails the overall purpose of healthcare.
"Population health" (option B) is one component of the Triple Aim, but by itself it does not inherently ensure the other two aims (experience and per-capita cost). "Home health care" (option C) is a care setting/service model that may contribute to better outcomes and lower cost for certain groups, but it is not a comprehensive system-wide framework. "Tertiary care" (option D) refers to specialized, high-complexity services and likewise does not define a three-part improvement strategy.
Therefore, the option that best matches the combined goals in the question is Triple Aim .
質問 # 32
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:A
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 # 33
The planning, execution, and controlling of the switch from an existing manual or automated system to a new system is called
正解:C
解説:
The coordinated planning, execution, and control of transitioning from an old system to a new one is known as Cutover Management . In healthcare IT implementations-such as EHR go-lives-cutover represents the structured set of activities that occur during the final transition period when the organization switches operational use from the legacy system to the new solution. This includes detailed scheduling, data migration validation, downtime procedures, system activation timing, communication plans, command center setup, contingency planning, rollback strategies, and stabilization support.
Cutover management ensures continuity of clinical operations and patient safety during the transition. It often involves mock cutovers, dress rehearsals, checklist-driven execution, role assignments, and real-time issue tracking. The goal is to minimize disruption, prevent data loss, ensure accurate patient information transfer, and maintain clinical workflow integrity.
Option C (Change Management) refers more broadly to organizational readiness, training, stakeholder engagement, and behavioral adoption-not the technical switch itself. Option A (Command Center Management) relates to post-go-live support coordination. Option D (Support Management) focuses on ongoing operational support after implementation.
Therefore, the specific discipline governing the actual transition from old to new system operations is Cutover Management , making option B correct.
質問 # 34
A consulting firm was hired to discover causes of medication errors for a healthcare facility. Data was collected and analyzed within a 3-month period. Which of the following is the BEST way to display the results of the analysis?
正解:D
解説:
A Pareto chart is the best way to display results when the goal is to communicate the most common causes of medication errors and prioritize improvement actions. In medication safety and quality management, error causes are usually categorized (e.g., wrong dose, wrong patient, transcription issues, look-alike/sound-alike drugs, override of alerts, labeling problems). A Pareto chart sorts these categories from highest to lowest frequency and typically includes a cumulative percentage line, making it easy to see which "vital few" causes account for the majority of errors. This aligns with the Pareto principle (often described as 80/20), supporting leadership decisions about where interventions will yield the greatest impact (training, workflow redesign, decision support tuning, barcode scanning compliance, etc.).
A control chart is designed to monitor a process over time and distinguish common-cause from special- cause variation; it is excellent for tracking monthly error rates but not for ranking causes. A flowchart maps steps in a process and helps identify where errors might occur, but it does not summarize analyzed frequency results. A histogram shows the distribution of numeric data (e.g., time-to-administer), not categorical root- cause frequencies. Therefore, the Pareto chart best displays the analysis of error causes.
質問 # 35
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