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Special Topics in Vendor-Specific Systems: System and Database

Architectures Used in Commercial EHRs

Self-assessment Key

1. Which of the following is/are component(s) of the architecture of an Electronic


Health Record (EHR)?
a. Users of EHR
b. Pharmacy
c. Clinical data repository
d. a and c only
*e. All of the above

Answer: e
Objective: 1. Demonstrate concept knowledge of system and database
architectures used in commercial EHRs
Lecture/Slide: 4

2. Which of the following is an example of front end hardware platforms for


EHRs?
a. Database server
b. Application server
*c. Mobile device
d. a and c only
e. All of the above

Answer: c
Objective: 1. Demonstrate concept knowledge of system and database
architectures used in commercial EHRs
Lecture/Slide: 6

3. Which type of EHR hardware platform exists independent of a central server?


*a. Thick client
b. Thin client
Health IT Workforce Curriculum Special Topics in Vendor-Specific Systems
Version 3.0 / Spring 2012 System and Database Architectures Used in Commercial EHRs

This material (Comp14_Unit5) was developed by Columbia University, funded by the Department of Health and Human Services,
Office of the National Coordinator for Health Information Technology under Award Number 1U24OC000003.
c. Web based
d. Citrix

Answer: a
Objective: 3. Identify the differences between EHR hardware platform
Lecture/Slide: 7

4. Which type of EHR hardware platform requires that most of its business logic
take place on a desktop PC?
*a. Thick client
b. Thin client
c. Web based
d. Citrix

Answer: a
Objective: 3. Identify the differences between EHR hardware platforms
Lecture/Slide: 7

5. Which type of EHR hardware platform may use online document processors
as opposed to the traditional software?
a. Thick client
b. Thin client
*c. Web based
d. Citrix

Answer: c
Objective: 3. Identify the differences between EHR hardware platforms
Lecture/Slide: 7

6. Which of the following is/are example(s) of a health information system that


may be included in EHRs?
a. Pharmacy
b. Radiology
Health IT Workforce Curriculum Special Topics in Vendor-Specific Systems
Version 3.0 / Spring 2012 System and Database Architectures Used in Commercial EHRs

This material (Comp14_Unit5) was developed by Columbia University, funded by the Department of Health and Human Services,
Office of the National Coordinator for Health Information Technology under Award Number 1U24OC000003.
c. Laboratory
d. a and b only
*e. All of the above

Answer: e
Objective: 2. Describe the health information systems landscape, including
CPOE, Pharmacy, Lab, etc.
Lecture/Slide: 4

7. Which of the following is/are example(s) of operating systems for EHRs?


a. MacOS
b. Linux
c. Oracle
*d. a and b only
e. All of the above

Answer: d
Objective: 4. Compare different EHR operating systems and databases
Lecture/Slide: 9

8. For items i-vi, match the type of database with its component using either
response a or B.
a. Relational database
b. Hierarchical database
i. SQL Server:
ii. PureXML
iii. Structured as formally-described tables:
iv. Structured tree-like with branching:
v. Oracle:
vi. Intersystems-Cache:

Answer:

Health IT Workforce Curriculum Special Topics in Vendor-Specific Systems


Version 3.0 / Spring 2012 System and Database Architectures Used in Commercial EHRs

This material (Comp14_Unit5) was developed by Columbia University, funded by the Department of Health and Human Services,
Office of the National Coordinator for Health Information Technology under Award Number 1U24OC000003.
i. a
ii. b
iii. q
iv. b
v. q
vi. b

Objective: 4. Compare different EHR operating systems and databases


Lecture/Slides: 9-14

9. Based upon the EHR system reviews in unit 5, which EHR system uses
software that is centered around the MUMPS/Cache database?
*a. Epic
b. Eclipsys
c. Quadramed
d. NextGen
e. eClinicalWorks

Answer: a
Objective: 4. Compare different EHR operating systems and databases
Lecture/Slide: 18

10. Based upon the EHR system reviews in unit 5, which EHR system uses
software that is centered around SQL Server database?
a. Epic
*b. Eclipsys
c. Quadramed
d. NextGen
e. eClinicalWorks

Answer: b
Objective: 4. Compare different EHR operating systems and databases

Health IT Workforce Curriculum Special Topics in Vendor-Specific Systems


Version 3.0 / Spring 2012 System and Database Architectures Used in Commercial EHRs

This material (Comp14_Unit5) was developed by Columbia University, funded by the Department of Health and Human Services,
Office of the National Coordinator for Health Information Technology under Award Number 1U24OC000003.
Lecture/Slide: 21

11. Identify FOUR (4) recommended EHR security measures according to the
AHIMA e-HIM work group on Security of Personal Health Information.

Answer:
a. Ability to assign an alias to a patient
b. Ability to restrict patients from physicians who are not the physician of record
c. Ability to block access to specific progress note or lab result
d. Ability to track versioning or mask sensitive entries for release of information
e. Role-based security that restricts access to predefined categories of patients,
encounters, and documents based on the access a user needs to perform his or
her job.
F. VIP status indicators that restrict especially identified patients and encounters
to those individuals with permission for VIP encounters and patients.

Objective: 5. Articulate how system and database architectures impact security,


auditing, and performance monitoring
Lecture/Slide: 29

12. Which of the following is/are benefit(s) of audit logs of an EHR system?
a. Allows the client to know when the system is used most.
b. Allows the client to know who uses the system and how often.
c. Allows the client to access audit logs to enhance information security.
d. a and b only
*e. All of the above

Answer: e
Objective: 5. Articulate how system and database architectures impact security,
auditing, and performance monitoring
Lecture/Slide: 30

Health IT Workforce Curriculum Special Topics in Vendor-Specific Systems


Version 3.0 / Spring 2012 System and Database Architectures Used in Commercial EHRs

This material (Comp14_Unit5) was developed by Columbia University, funded by the Department of Health and Human Services,
Office of the National Coordinator for Health Information Technology under Award Number 1U24OC000003.