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business
principles information systems
Health Information Exchange Navigating And Managing A Network Of Health Information Systems 2nd Edition Brian Dixon - Solutions
2. What are the strengths and weakness of a centralized versus a decentralized approach to health information exchange organization within a state?
1. Is the assertion “all health care is local” valid?
9. How could health information exchanges such as HEALTHeLINK be used to support public healthrelated activities to manage a pandemic?
8. If you were a public health official involved in HEALTHeLINK, what would your next steps be?
7. What are other ways in which health information exchange can be used for public health beyond what HEALTHeLINK is doing?
6. How would involving public health stakeholders from the outset have changed uses of HEALTHeLINK for public health?
5. Is the use of HEALTHeLINK synchronous or asynchronous? Why?
4. Describe the efficiencies achieved by using HEALTHeLINK.
3. What are ways in which the use of HEALTHeLINK could be improved to maximize public health benefit?
2. What would be necessary in other communities to use their health information exchange or Regional Health Information Organizations to support public health?
1. What are some other ways in which HEALTHeLINK could be used to support public health activities?
5. Computing infrastructure, networking technology, software, and clinical information standards will continue to evolve rapidly, and investments in the technology will depreciate relatively rapidly. What are the core assets of an HIE, if not these things?
4. Establishing and operating a HIE network requires various investments, including computing and network infrastructure, software systems of multiple types, and legal and operational costs. Would you agree that data capture and normalization is the most significant investment required?
3. The INPC originated as a research project, was initially funded by grants, and one of the ongoing value propositions is the research use of the data. Is research necessarily critical to the success of a health information exchange?
2. Vendor-based HIE networks seem to be growing faster than community-based HIE networks. Community-based HIE networks should arguably offer more value to patients and lower costs to provider organizations.Why the discrepancy?
1. Interoperability can only be achieved when provider organizations do the work necessary to participate. Do provider organizations have the incentives required to do that work?
5. If there is a new pandemic in the future, based on initiatives described in this chapter, in what ways should our HIE infrastructure be more prepared to respond and meet information sharing needs?
4. Are there ways in which the future directions described in this chapter complement each other? Are there ways in which they may come into conflict with each other?
3. Are there key challenges that emerging efforts are not addressing? How might these challenges be addressed?
2. What are the key ways in which emerging efforts are addressing these challenges?
1. What are the primary challenges that emerging efforts to improve HIE are tackling?
4. What steps did Brazil and French Guiana take to address the need for malaria surveillance for their mobile populations in their cross-border region?
3. How is Europe addressing the challenges of cross-border health exchange? What regulation and project are driving forward an EU collaboration towards cross-border health information exchange?
2. What was the role of the Cross-Border Health Integrated Partnership Project (CB-HIPP) to address the needs of mobile populations in Africa? Which of the open software and technologies have helped to address crossborder health issues?
1. Describe some of the projects in the United States that have led to the growth of crossborder health information exchange?
4. What are the facilitators and barriers to capturing SDOH data in the clinical setting?How might HIE be deployed to address these?
3. How might a community-based HIE network incorporate SDOH to support healthcare systems in population health management?
2. What are the differences between individual-level and population-level SDOH? How might these differences influence management of these data in an HIE network?
1. What are SDOH and how might they influence the health outcomes of an individual? Of a population?
4. What are three types of Analytical Approaches? Provide an example of each.
3. When should an HIE consider the analytical maturity of their organization?
2. What are two types of organizational barriers an HIE may face when trying to implement analytics?
1. How is the role of HIE as an Enabler of Analytics different than an HIE who provides Analytics-as-a-Service?
6. Why should health systems or accountable care organizations fund evaluation of HIE? Isn’t research funding best left to government?
5. Who are potential funders of HIE evaluation in the United States? Internationally?
4. How might the evaluation plan for a low-tomiddle income country differ from an evaluation plan in the United States?
3. What are the ethical implications of conducting an evaluation of HIE in a community setting?
2. Which study designs and methods lend themselves best to evaluations on a“shoestring budget?”
1. Under what circumstances might summative evaluation be considered research? How about vice versa? Is one better than the other?
5. How do you anticipate the landscape of HIE will change with the proliferation of interoperability initiatives such as FHIR?
4. If HIE conditions were completely interoperable, what kind of studies would you propose?
3. With the expansion of interoperability initiatives, what kind of health outcomes would you expect to be impacted by HIE in the future?
2. What are some barriers to studying the effect of HIE?a. Why is there a lack of quasiexperimental studies and randomized controlled trials in the field of HIE?b. What are the barriers to stronger study designs?c. How can the barriers to stronger study designs in this field be overcome?
1. How have the benefits to health outcomes from HIE use changed over time? Which health outcomes have received the most benefits from HIE? Which health outcomes are the benefits yet to be realized?
3. Where is your nation in its pursuit of universal healthcare? Are claims processed using health information technologies? If so, are HIE networks leveraged to submit and/or process claims?
2. Currently US HIE networks are not clearinghouses for insurance claims processes. Why do you think this is the case?
1. What benefits do HIE networks offer to healthcare financing schemes?
5) How might future changes in health care influence the usefulness of HWRs?
4) What considerations must be taken into account when developing a MDS? Who should participate? What data fields should be included?
3) Who are some of the potential users of a HWR? Who may provide the data?
2) Describe some of the benefits of implementing a health worker registry.Provide examples of situations where an HWR might improve workforce efficiency.
1) What are some of the major challenges in creating an HWR for an HIE? How do these vary by country?
3. Discuss why it is important to go beyond facility identification and collect facility services and infrastructure or resources.
2. How can facility registries achieve true interoperability? What are some barriers to interoperability of facility-related data?
1. Compare and contrast the different protocols for developing unique facility identifiers. Which method would be preferable for a rapidly developing and changing healthcare environment? Which would be preferable for a well-established environment?
5. What are the major barriers to a national patient ID in the United States? Do you think the United States might ever change its approach given the success of national IDs used in other nations?
4. What are the differences between deterministic and probabilistic matching algorithms? Is one preferred to the other?
3. How do client registries limit the number of potential matches before deploying matching algorithms? Describe how this is achieved.
2. Discuss the impact data quality has on CR patient matching. Is it preferable to have a sophisticated algorithm or high-quality data?
1. Compare and contrast SSN, biometric identifiers, and voluntary universal health identifiers in terms of the seven ideal unique patient identifier attributes discussed in this chapter.
7. How might the SHR and HMIS components evolve following the COVID-19 pandemic?
6. Why is data quality critical to both the SHR and HMIS components of an HIE network?
5. Under what conditions would an SHR not make sense for an HIE network to implement?
4. What are some of the benefits of NoSQL DBMS in comparison to a RDBMS for managing clinical data?
3. What advantages does a HMIS component offer over traditional sources of health indicator data such as population-based surveys?
2. How would the implementation of a SHR system in the United States differ from an implementation in other countries around the world?
1. Which organizations and roles benefit from shared, longitudinal health records in a health system? What benefits do these stakeholders receive from access to SHRs?
5. Terminology Services require ongoing, iterative support and assessment. Explain why continuous evaluation and updates are necessary.
4. What is the purpose of a Terminology Service? What considerations must be taken into account when selecting the appropriate software and hardware of the Terminology Service?
3. Describe some types of equivalence that may be observed when mapping. What might cause a source code to go unmapped?
2. What considerations must be taken into account when selecting an HIE terminology standard? Should the entire standard be utilized or only a subset?
1. Reference terminologies are the foundation of semantic interoperability in an HIE network. Describe some of the potential beneficial outcomes that result from having comparable, structured language among the differing systems participating in the HIE network.
5. Why do we need implementation guides?Shouldn’t standards be sufficient for achieving interoperability?
4. Why are there so many syntactic standards for HIE? What precludes universal development and adoption of a single standard?
3. What is the process by which an individual or organization can get involved in developing standards with HL7 or integration profiles with IHE?
2. What are key differences between the three commonly used HL7 standards?
1. Syntactic standards provide a solution for the combinatorial explosion of interfaces.Describe what steps would be necessary to facilitate exchange of data between two systems without syntactic standards.
5. What function provided by the interoperability layer is the most important to HIE endeavors? Why?
4. Why is a flexible HIE architecture so important in a country like the United States with multiple, heterogeneous health information systems?
3. Which type of interoperability is most important to architectural design of an HIE?
2. Compare and contrast the HIE architectural styles and patterns. Which approach might be the most effective on a national scale?
1. What characteristics of the health system support the argument that a health information infrastructure can be classified as an ULS system?
12. How do the OCTAVE frameworks handle organizational perceptions of risk at multiple levels?
11. Is FIPS 140-3 based off of international standards? If so, which ones?
10. Does GDPR mandate specific types of encryption? How is its application different than the Breach Notification Rule?
9. Do any current frameworks cover MITRE ATT&CK or D3FEND? If not, what frameworks would it best work in conjunction with?
8. Does the NIST Cybersecurity Framework cover penetration testing? What category does it fall under in the framework, and why?
7. True or False? The NIST Cybersecurity Framework is a skeleton that organizations can use to build their own frameworks.
6. Why are data ransomed in a ransomware attack considered breached?
5. Since the HIPAA Security Rule indicates that encryption is addressable, it means that my organization does not have to do it and can claim it is too much effort. Why or why not is not this the case?
4. Does the GDPR Right To Be Forgotten applies to public health data?
3. Is it recommended, if your organization wants an ISO/IEC 27001 certification, to use an independent auditor? Why or why not? Where would there be a potential conflict of interest?
2. Does the GDPR require security by design?How does this compare and contract with the NIST Cybersecurity Framework in how they approach application of security?
1. The HITECH Act requires the use of NISTApproved encryption. Can encryption algorithms have their approvals revoked because of age or weakness even if previously approved? Provide an example of how NIST Special Publications have evolved since the initial Breach Notification Rule
9. What type of contracting structure are most HIE initiatives trending toward?
8. What are the three categories of security controls under the HIPAA Security Rule?
7. What benefits does encryption provide under the Breach Notification Rule?
6. Is encryption a required or addressable control under the HIPAA Security Rule?
5. May states enact legislation that is more stringent than HIPAA?
4. What uses and disclosures of protected information are permitted under HIPAA without patient consent or authorization?
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