RHIT 9th Edition Practice Questions_ Domain 6@@@
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Information Systems
Date
Dec 6, 2023
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14
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RHIT 9th Edition Practice Questions: Domain 6
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The HIM department is developing a system to track coding productivity. The director wants the
system to track the productivity of each coding professional by productive hours worked per
day, health record ID, and type of records coded; as well as provide weekly productivity reports
and analyses. Which of the following tools would be best to use for this purpose?
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Question 2
0 / 1 point
An HIM department is planning to implement virtual teams for the coding and data analytics
areas. Some in the facility are skeptical of this arrangement, believing that off-site employees
cannot be managed. Given this work format, how can the supervisor best gauge productivity of
the virtual staff?
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Question 3
0 / 1 point
When reviewing the monthly performance report, a manager noticed the coding accuracy rate
was below standard. She considered whether this difference might be related to a recent change
in systems or attributed to another factor. This manager is performing which of the following?
Word-processing documents
Paper log book
Spreadsheet
Database management system
The database management system is the best option to collect, store, manipulate, and retrieve data for this
situation. Paper and word-processing documents cannot sort and store the data in a meaningful way for this
purpose. Spreadsheets should be used for accounting-type functions and not for data storage (Sayles and
Kavanaugh-Burke 2021, 39).
Require staff to call in to the office every morning.
Require a daily conference call with all staff.
Set clear goals and productivity standards and see that these are met.
Install camcorders on each team member's computer to ensure that they are at their workstations.
It is not necessarily more difficult to manage remote staff; rather, it presents different challenges. In the remote
environment, managers may need to rely on productivity and coding accuracy reports to determine the success of
remote employees. When allowing coding professionals to work from home or contracting with remote coding
professionals, work expectations must be established in advance (Prater 2020, 626–627).
Performance measurement
Workforce planning
Work observation study
Variance analysis
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RHIT 9th Edition Practice Questions: Domain 6
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Question 4
1 / 1 point
The RHIT supervisor for the scanning and quality control section of Community Clinic is
developing a staffing schedule for the year. The clinic is open 260 days per year and has an
average of 500 clinic visits per day. The standard for scanning records is 50 records per hour.
The standard for quality control of scanning of records is 40 records per hour. Given these
standards, how many productive hours will be required daily to scan and quality control records
for each clinic day?
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Question 5
0 / 1 point
Which of the following strategies would be best to ensure that all stakeholders are engaged in
the planning and development of an organization EHR system?
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Question 6
0 / 1 point
Based on a productivity log, a coding professional completed 23 charts during a 7.5-hour
workday. The performance standard is four charts per hour. How many charts did he code per
hour? Round to the nearest whole number.
Reported performance data are regularly analyzed for variance. Variance—where actual performance does not
meet, varies, or is significantly different from the standard—should be further assessed (Prater 2020, 630).
10 hours per day
11.11 hours per day
12.5 hours per day
22.5 hours per day
Timeliness of the scanning and quality control processes should be monitored. In this situation, each clinic visit
represents a patient record that will need to be scanned and quality control completed. The calculation is: (500 /
50) + (500 / 40) = 22.5 hours per day (White 2020, 156; Prater 2020, 628–629).
Form an EHR steering committee.
Put out a press release.
Distribute an organization-wide memorandum from the CEO.
Put out a notice on the organization's intranet.
Most organizations create an electronic health records (EHR) steering committee to engage all the various
stakeholders in EHR planning and development. This ensures that the EHR planning is comprehensive and also
starts the process of introducing change and gaining buy-in (Amatayakul 2020, 351).
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RHIT 9th Edition Practice Questions: Domain 6
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Question 7
1 / 1 point
The cardiologist group wants to add some terms and abbreviations that have been developed in
their clinic. Their IT coordinator comes to you and asks to put these into the EHR system. You
inform him that these must be recognized and meet standard requirements of the most widely
recognized nomenclature in healthcare, which is:
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Question 8
1 / 1 point
Which phase in the project life cycle is where the project shifts to become an integrated part of
organizational operations?
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2
3
4
23
Work measurement is based on assessment of internal data collected on actual work performed within the
organization and the calculation of time it takes to do the work. Employees log what they do and the time spent
on tasks in units of work received and processed each day. 23 charts / 7.5 hours = 3.06, which is rounded to
three charts per hour (Prater 2020, 629).
ICD-10
ICD-9
SNOMED-CT
ANSI
The education provided to the IT coordinator of the cardiology department was in regards to SNOWMED CT. The
current version, Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT), is the most comprehensive,
multilingual clinical healthcare terminology in the world (Sayles and Kavanaugh-Burke 2021, 44).
Closure
Execution
Initiation
Planning
In closure, the new system or process is used by the customer. This is the phase in which the project shifts to
become an integrated part of organizational operations. During the operational phase, management must
continually monitor performance and determine whether the new system or process meets established
performance criteria (Shaw and Carter 2019, 371).
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RHIT 9th Edition Practice Questions: Domain 6
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Question 9
1 / 1 point
An HIM supervisor is revising job descriptions for record scanning positions. These positions
have been in existence for just over one year. Which of the following would be the most
appropriate action to take to ensure all tasks being performed are included in the new job
descriptions?
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Question 10
0 / 1 point
Which of the following is a positive aspect of using employee self-appraisal as a source of data
for performance appraisal?
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Question 11
0 / 1 point
Which of the following can assist managers with the tasks of monitoring productivity and
forecasting budgets?
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Ask current staff members to keep a diary for a certain period of time on how they spend their time.
Review job descriptions from other hospitals.
Make random observations of job tasks.
Refer the matter to the human resources department.
Collecting data on current performance and tasks allows the HIM supervisor to include all tasks that are being
performed in the new job descriptions. When more than one person is performing a task, the data could be
collected over time and averaged. One method of doing this is to keep a diary for a period of time on how they
spend their time. The HIM supervisor may then use this data to revise the job description to accurately reflect the
work performed (Prater 2020, 629–630).
Employees are in the best position to provide objective review without overstatement.
The supervisor is kept informed of the employee's accomplishments.
Appraiser and employee training on the purpose and procedures of this process is essential.
Peer pressure of evaluation can motivate team members to be more productive.
Employee self-appraisal provides the opportunity for the employee to keep the supervisor informed of
accomplishments and issues (Prater 2020, 632).
Intermediary bulletins
Mapping errors
Revenue codes
Workload statistics
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RHIT 9th Edition Practice Questions: Domain 6
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Question 12
0 / 1 point
This planning technique provides a structure that requires the project team to identify the order
and projected duration of activities needed to complete a project:
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Question 13
0 / 1 point
An HIM department has set productivity standards for each task associated with scanning
records of discharged patients. The standard for the scanning process is 1,500 images per hour
worked. Twelve weeks after implementation, the standard is reassessed because of errors made
by some employees. Given this data, what action might the HIM manager or director want to
take regarding quality of production?
Employee Scanning Productivity
Employee
Actual Production
Hours
Worked
Percentage
Errors
Chad
1,325 images/hour
242
1%
Barbara
1,500 images/hour
240
2%
Leslie
1,450 images/hour
232
1%
Maria
1,700 image/hour
240
7%
Mike
1,675 images/hour
220
6%
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Question 14
0 / 1 point
Workload statistics can assist managers with the tasks of monitoring productivity and provide data regarding
resources used, such as equipment, personnel, services, and supplies (Schraffenberger and Kuehn 2011, 223).
Gantt chart
Flowchart
Pie chart
PERT chart
The PERT technique provides a structure that requires the project team to identify the order and projected
duration of activities needed to complete a project. The most helpful element of PERT is that it identifies those
critical activities that must be completed on time in order for the entire project to meet its final deadline (Shaw
and Carter 2019, 370).
Talk with Chad and put him on probation for not meeting the productivity standard.
Complement Maria and Mike for exceeding the productivity standard.
Incorporate quality expectations into the standard.
Continue to benchmark another six weeks to see if there is any difference.
Productivity standards should be based on both accuracy and volume (Prater 2020, 628–629)
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RHIT 9th Edition Practice Questions: Domain 6
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An HIM department is projecting workforce needs for its document scanning process. The intent
of the department is to scan patient records at the time of discharge, providing a 24-hour
turnaround time. The hospital has an average daily discharge of 120 patients, and each patient
record has an average of 200 pages. Given the benchmarks listed here, what is the least amount
of work hours needed each day to meet a 24-hour turnaround time?
National Benchmarks for Document Scanning Processes
Function
Expectations per Worked Hour
Prepping
340–500 images
Scanning
1,200–2,400 images
Quality Control
1,600–2,000 images
Indexing
600–800 images
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Question 15
1 / 1 point
Zachary is the new EHR coordinator. He has written all the EHR training material for employees.
During the initial training, he stresses he has worked with various departments to ensure that
different systems communicate and exchange information without corrupting the data. The
ability of these different information systems and software applications to communicate and
exchange data is referred to as:
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100 hours
146 hours
1,000 hours
3,740 hours
The question is asking for the least amount of hours needed to meet the 24-hour turnaround time. The average
discharge in a 24-hour period is 120 patients, and the average number of pages for each patient chart is 200. So,
120 × 200 = 24,000 pages in a 24-hour period. Each chart must be prepped, scanned, checked for quality, and
indexed. The highest number of pages that can go through all these processes in an hour would be: 500 images
in prepping; 2,400 images in scanning; 2,000 images in quality control; and 800 images in indexing.
• 24,000 / 500 = 48 hours needed for prepping
• 24,000 / 2,400 = 10 hours for scanning
• 24,000 / 2,000 = 12 hours for quality control
• 24,000 / 800 = 30 hours for indexing
• 48 + 10 + 12 + 30 = 100 hours, at least, needed each day to meet a 24-hour turnaround time (Prater 2020,
628–629).
Interoperability
Certification
NLP
Meaningful Use
Interoperability is the ability of different information systems and software applications to communicate and
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RHIT 9th Edition Practice Questions: Domain 6
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Question 16
0 / 1 point
Dr. Smith wants to use a lot of free text in his EHR. What should be your response?
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Question 17
1 / 1 point
City Hospital's HIPAA committee is considering a change in policy to allow hospital employees
who are also hospital patients to access their own patient information in the hospital's EHR
system. A committee member notes that HIPAA provides rights to patients to view their own
health information. However, another member wonders if this action might present other
problems. In this situation, what information should the HIM director provide?
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Question 18
0 / 1 point
City Hospital has implemented a procedure that allows inpatients to decide whether they want
to be listed in the hospital's directory. The directory information includes the patient's name,
exchange data (Sayles and Kavanaugh-Burke 2021, 198).
Good idea, Dr. Smith. This allows you to customize the documentation for each patient.
Dr. Smith, we recommend that you do not use any free text in the EHR.
Dr. Smith, we recommend that you should use free text only in your more complex cases.
Dr. Smith, we recommend that you use little, if any, free text in the EHR.
Free-text data is the unstructured narrative data that is the result of a person typing data into an information
system. It is undefined, unlimited, and unstructured, meaning that the typist can type anything into the field or
document. The amount of free-text in the EHR should be limited as the ability to manipulate data is diminished
with its use (Sayles 2020b, 82).
HIPAA requires that employees have access to their own information, so grant privileges to the employees
to perform this function.
HIPAA does not allow employees to have access to their own information, so the procedure should not be
implemented.
Allowing employees to access their own records using their job-based access rights appears to violate
HIPAA's minimum necessary requirement; therefore, allow employees to access their records through
normal procedures.
Employees are considered a special class of people under HIPAA and the procedure should be
implemented.
Allowing employees of a covered entity to access their own protected health information electronically results in a
situation in which the covered entity may be in compliance with parts of the HIPAA Privacy Rule but in violation of
other sections of the Privacy Rule. An ideal situation would be to establish a patient portal through which all
patients may view their own records in a secure manner and for which an employee has neither more or less
rights than any other patient (Thomason 2013, 109).
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RHIT 9th Edition Practice Questions: Domain 6
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location in the hospital, and general condition. If a patient elects to be in the directory, this
information is used to inform callers who know the patient's name. Some patients have
requested that they be listed in the directory, but information is to be released to only a list of
specific people the patient provides. A hospital committee is considering changing the policy to
accommodate these types of patients. In this case, what type of advice should the HIM director
provide?
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Question 19
1 / 1 point
The HIM director has put together a group of department employees to develop coding
benchmarks for the number and types of charts to be coded per work hour. The group includes
seven employees from the analysis, transcription, release of information, and coding sections.
No managers are included on the team because the HIM director wants a bottom-up approach
to benchmark development. What fundamental team leadership mistake is the HIM director
making with composition of the team?
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Approve the requests because this is a patient right under HIPAA regulations.
Deny these requests because screening of calls is difficult to manage and if information is given in error,
this would be considered a violation of HIPAA.
Develop two different types of directories—one directory for provision of all information and one directory
for provision of information to selected friends and family of the patient.
Deny these requests and seek approval from the Office for Civil Rights.
The HIPAA Privacy Rule allows individuals to decide whether they want to be listed in a facility directory when they
are admitted to a facility. If the patient decides to be listed in the facility directory, the patient should be
informed that only callers who know his or her name will be given any of this limited information. Covered
entities generally do not, however, have to provide screening of visitors or calls for patients because such an
activity is too difficult to manage with the number of employees and volunteers involved in the process of
forwarding calls and directing visitors. If the covered entity agreed to the screening and could not meet the
agreement, it could be considered a violation of this standard of the Privacy Rule (Thomason 2013, 105).
Insufficient knowledge of team members
Too many team members
Unspecific team charge
Too few team members
Whether selecting a permanent staff team or members of a team for a short-term project, making the right
choice is fundamental to the team's success. Putting together a team involves understanding the challenges to be
faced and considering all of the perspectives, experience, and knowledge that will be needed. The members of
the team should be selected for what they can contribute to the team. Member selection should not be based
purely on job title; rather, team members should be selected for the tasks that they actually can perform and the
responsibilities they can carry out (Gordon, L. L. 2020b, 596–597).
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RHIT 9th Edition Practice Questions: Domain 6
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Question 20
0 / 1 point
Performance monitoring is data driven and the HIM department needs access to data in order to
make important decisions. One way to provide real-time data and important information that
can be monitored at a glance is to use which of the following?
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Question 21
1 / 1 point
The HIM director is part of the revenue cycle management team. The discharged not final billed
days are increasing because discharges are increasing. The number of coding staff is five. In an
effort to increase productivity, the HIM director is researching staffing alternatives. With the
implementation of an electronic document storage system, telecommuting has been suggested
as an alternative. Studies report that coding productivity can increase as much as 20 percent
with telecommuting. Given that discharges have increased from 100 per day to 144, how many
more full-time equivalents (FTE) would need to be hired if the department went to
telecommuting?
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Question 22
0 / 1 point
To develop performance standards for release of information turnaround time, the manager
conducted a literature search and contacted peer institutions. Which method did she use?
Benchmark
Dashboards
Pareto chart
Time ladder
Performance monitoring is data driven. The organization's leadership uses the information displayed on the
dashboard to guide operations and determine improvement projects. Having real-time data in an easily
assessable format like a dashboard allows leaders to keep track of high-impact, high-risk, or high-value
processes and make adjustments on a daily basis if needed (Carter and Palmer 2020, 552).
0.5 FTE
0.75 FTE
1 FTE
2 FTEs
The productivity increase with telecommuting is 20 percent. The facility has five coding professionals who are
currently coding a total of 100 charts a day. With this 20 percent increase, each of the existing five coding
professionals can code four records more per day each (a 20 percent increase). This amounts to 120 charts: 24 ×
5 = 120. If the discharges increase by 44 charts, the facility would need one more FTE in the telecommuting
staffing model, since each coding professional can code 24 records per day (White 2020, 157–158).
Benchmarking
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RHIT 9th Edition Practice Questions: Domain 6
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10/14
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Question 23
1 / 1 point
Which phase in the project life cycle is where installation of equipment or construction begins,
and any policy or procedure manuals should be prepared for distribution?
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Question 24
1 / 1 point
Dr. Wesson is looking for a new EHR system for her practice. Since you are the HIM director, she
asks you what is absolutely essential in an EHR system? You tell her EHRs must prove they have
been tested to perform up to national standards. Which of the following is used to describe
health information technologies that have been tested and certified to perform up to national
standards?
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Question 25
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Workflow analysis
Productivity analysis
Work measurement
Comparing an organization's performance to the performance of other organizations that provide the same types
of service is known as benchmarking. Internal benchmarking is also important to establish a baseline for the
organization to find ways to improve effectiveness (Shaw and Carter 2019, 42).
Closure
Execution
Initiation
Planning
Once project planning is completed, execution (or implementation) begins. This is where installation of
equipment or construction begins, and any policy or procedure manuals should be prepared for distribution
(Shaw and Carter 2019, 370).
CEHRT
CERT
CPOE
ONC
Certified EHR technology (CEHRT) is a complete EHR that meets the requirements included in the definition of a
qualified EHR and has been tested and certified in accordance with the certification program established by the
ONC (Sayles and Kavanaugh-Burke 2021, 203).
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RHIT 9th Edition Practice Questions: Domain 6
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11/14
The manager calculated a unit and time productivity statistic based on employee self-reported
data. Which method did he use to develop this performance standard?
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Question 26
0 / 1 point
The HIM and IT departments are working together to justify additional employee password
training. The additional training would cost approximately $100,000 with the expectation that
password calls to the IT help desk will be reduced by 20 percent. The IT department has done a
cost analysis of help desk calls solving password issues. Given this data and approximately 40
password calls per day, can the cost of the additional training be justified?
Costs Associated with Each IT Help Desk Call to Resolve Password Issues
Personnel
Cost
User's time—30 minutes
$15
Telephone cost—30 minutes
$2
Call Desk time—30 minutes
$16
Call Desk IS facilities time
$17
Total
$50
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Question 27
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An audit of the document imaging process reveals that the HIM department staff is scanning
250 pages per hour and indexing 114 pages per hour. If the department is meeting its
performance standard for scanning, but is only meeting 60 percent of the indexing standard,
how many more pages per hour must be indexed to meet the indexing standard?
Benchmarking
Work distribution analysis
Work measurement
Workflow analysis
Work measurement is based on assessment of internal data collected on actual work performed within the
organization and the calculation of time it takes to do the work (Prater 2020, 629).
Training will provide $146,000 savings in help desk support and can be justified.
The results of training will provide $365,000 savings in help desk support and can be justified.
The cost of training will be recouped in less than half a year and can be justified.
The cost of training is not justified because qualitative results cannot be measured to calculate a return on
investment.
Current cost: $50 × 40 calls per day = $2,000 per day × 365 days = $730,000. Cost with reduced number of
help desk calls: $50 × (40 × 0.80) calls per day = $1,600 per day × 365 days = $584,000, or a savings of
$146,000. Training costs of $100,000 will be recouped and a savings of $46,000 realized (Gordon, L. L. 2020a,
541–542).
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RHIT 9th Edition Practice Questions: Domain 6
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Question 28
0 / 1 point
In designing input by clinicians for an EHR system, which of the following would be effective for
a clinician when the data are repetitive and the vocabulary used is fairly limited?
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Question 29
0 / 1 point
Dr. Wilson asks you, the EHR manager, to explain the difference between an alert and a
reminder. You explain that reminders are typically used for things that can be scheduled or that
occur on a regular basis. An example of a reminder that would be given to Dr. Wilson would be:
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Question 30
1 / 1 point
45.6 pages
68.4 pages
76 pages
190 pages
Performance standards should be based on both accuracy and volume. In this situation, 114 / 0.60 = 190; 190 –
114 = 76 more pages will need to be indexed to meet the productivity standard (Kelly and Greenstone 2020,
183).
Drop-down menus
Point and click fields
Speech recognition
Structured templates
Speech recognition can be very effective in certain situations when data entry is fairly repetitive and the
vocabulary used is fairly limited. As speech recognition improves, it is becoming a replacement for other forms of
dictation. In some cases, the user reviews the speech as it is being converted to type and makes any needed
corrections; in other cases, the speech is sent to a special device where it generates type for another individual to
review and edit (Sayles and Kavanaugh-Burke 2021, 20).
Use of anticoagulant is contraindicated.
Patient is due for MMR immunization.
Patient is allergic to sulfa drugs.
Drug does not come in this format.
Reminders can notify physicians of screenings that should be performed based on the patient's age and gender.
The other options are all alerts (Sayles 2020b, 83–84; Bowe and Williamson 2020, 370).
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RHIT 9th Edition Practice Questions: Domain 6
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As part of Community Hospital's organization-wide quality improvement initiative, the HIM
director is establishing benchmarks for all the divisions within the HIM department. The
following table shows sample productivity benchmarks for record analysis the director found
through a literature search. Given this information, how should the director proceed in
establishing benchmarks for the department?
Sample Productivity Benchmarks
Productivity Benchmarks
Per Hour
Function
Low
Average
High
Analysis (charts per hour)
Inpatient
8
20
Observation/outpatient
surgery/newborn/maternity
5
14
60
Other outpatient
20
120
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Question 31
0 / 1 point
If steps in a revenue cycle process are handled separately in sequence by individual workers, the
method of organizing work is called which of the following?
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Question 32
1 / 1 point
One release of information (ROI) specialist handles requests from insurance and managed care
companies. Another handles requests from attorneys and courts. Each completes all steps in the
business process from beginning to end. This is an example of which of the following?
Determine whether the source of the benchmark data is from a comparable institution.
Use the low benchmark example as a beginning point for implementation.
Contact the hospital statistician to determine whether the data are relevant.
Use the average benchmark example as a beginning point for implementation.
Comparing an organization's performance to the performance of other organizations that provide the same types
of services is known as external benchmarking. The other organizations need not be in the same region of the
country, but they should be comparable organizations in terms of patient mix and size (Shaw and Carter 2019,
70).
Serial work division
Parallel work division
Processing
Benchmarking
One of two major ways to organize process work is serial work division, assembly line fashion, where tasks or
steps are handled separately in sequence by multiple individuals (Prater 2020, 625).
11/21/23, 4:17 PM
RHIT 9th Edition Practice Questions: Domain 6
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Question 33
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At which stage in project management process would the status of the project be assessed
regularly in reference to planned activities and their timeline, and if the project is off target, a
project manager would take action to bring it back on track?
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Question 34
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A hospital currently uses the patient's Social Security number as their patient identifier. The
hospital risk manager has identified this as a potential identity fraud risk and wants the
information removed. The risk manager is not getting cooperation from the physicians and
others in the hospital who say they need the information for identification and other purposes.
Given this situation, what should the HIM director suggest?
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Serial work division
Job sharing
Job rotation
Parallel work division
In parallel work division, the same tasks are handled simultaneously by several workers; each completes all steps
in the process from beginning to end, working independently of the other employees (Prater 2020, 625).
Controlling and monitoring
Execution
Initiation
Planning
The monitoring activity is performed to determine the current status of the project, enabling the project to be
controlled. The control activity is performed to assess project status in reference to planned activities and their
timeline. If the project is off target, a project manager would take action to bring it back on track (Shaw and
Carter 2019, 371).
Avoid displaying the number on any document, screen, or data collection field.
Allow the information in both electronic and paper forms since a variety of people need this data.
Require employees to sign confidentiality agreements if they have access to Social Security numbers.
Contact legal counsel for advice.