Health Informatics an Inter professional Approach 1st Edition By Nelson Staggers, Test Bank

Health Informatics an Inter professional Approach 1st Edition By Nelson Staggers, Test Bank

Chapter 10: Clinical Decision Support Systems in Healthcare
Test Bank

MULTIPLE CHOICE

1. Why have most CDS systems not shown to significantly impact patient outcomes in clinical trials, despite the fact that a majority of systems have been shown to significantly improve care processes?
a. CDS systems have not been evaluated in clinical trials.
b. Very few studies have assessed the impact of CDS systems on patient outcomes.
c. Many CDS system evaluation trials are underpowered to detect changes in care outcomes.
d. CDS systems have been implemented and evaluated in too many diverse institutions.

ANS: C
The sample sizes of many CDS system evaluation studies were too small or conducted with too short of a time period to detect changes in care outcomes.

DIF: Cognitive Level: Analyze REF: p. 170

2. Which group would have a financial incentive to implement CDS?
a. A community hospital
b. An inner-city clinic
c. A national insurer
d. Depends on CDS and healthcare payment model

ANS: D
Whether a particular stakeholder group has a financial incentive to implement CDS depends on the specific CDS under consideration and the governing healthcare payment model in place.

DIF: Cognitive Level: Apply REF: p. 171

3. A healthcare system has implemented a functionality where patients who are overdue or almost due for a mammogram are sent letters notifying them to schedule a mammogram based on available data and current clinical care guidelines. Which type of CDS system is this?
a. This is not a CDS.
b. A personal health record system
c. A reminder system
d. An alerting system

ANS: C
This is a classic example of a reminder system. Patients are also potential targets of CDS interventions.

DIF: Cognitive Level: Apply REF: pp. 166-167 | p. 173

4. Which statement is not part of the Ten Commandments of CDS?
a. Speed is everything.
b. Fit into the user’s workflow.
c. Alerting is the most effective approach to CDS.
d. Ask for additional information only when you really need it.

ANS: C
The Ten Commandments of CDS include speed is everything, fit into the user’s workflow, and ask for additional information only when you really need it. Alerting may not be the most effective approach to CDS as it may cause alert fatigue, so it is not one of the Ten Commandments of CDS.

DIF: Cognitive Level: Remember REF: p. 172

5. Which incentive has the strongest potential to spur the nationwide adoption of advanced CDS?
a. Freely available CDS knowledge in a machine-executable form
b. Significant government funding for research efforts to share CDS
c. Shift of healthcare payment from a fee-for-service model to approaches rewarding the delivery of better quality and outcomes at lower cost
d. Meaningful Use Stage 1 requirements related to CDS

ANS: C
All of these are important elements encouraging nationwide adoption of advanced CDS. However, as discussed in the chapter, the shift of healthcare payment from a fee-for-service model to approaches rewarding the delivery of better quality and outcomes at lower cost appears to have the strongest potential for change.

DIF: Cognitive Level: Apply REF: p. 173

MULTIPLE RESPONSE

6. Which tools are examples of CDS? (Select all that apply.)
a. An order set
b. A reminder
c. A phone call
d. An infobutton

ANS: A, B, D
Despite CDS often being limited to alerts and reminders, an order set, a reminder, and an infobutton are also examples that represent CDS types. A phone call is not a type of CDS.

DIF: Cognitive Level: Apply REF: pp. 166-170

7. Why is CDS important for healthcare institutions? (Select all that apply).
a. It can reduce the need for registered nurses.
b. It can help reduce medical errors.
c. It is a required element of Meaningful Use regulations.
d. It can help improve care value.

ANS: B, C, D
CDS is important on multiple levels. CDS has been found to reduce medical errors, is required as part of Meaningful Use, and has the potential to improve the value of care. CDS have not been found to reduce the need for registered nurses.

DIF: Cognitive Level: Apply REF: pp. 164-167