Overview

Chapter 11
Public health informatics
Test Bank

Multiple Choice

1. Which is not an activity of public health?
a. Direct clinical services
b. Disease outbreak management
c. Bariatric surgery because obesity is a national public health problem
d. Rat and mosquito abatement

ANS: C
Although obesity is a national public health problem, public health does not provide surgical services. Surgical services are typically provided in the acute care or outpatient care settings. The other responses are activities of public health.

DIF: Cognitive Level: Understand REF: pp. 179-180

2. Public health differs from clinical practice in important ways. Which statement reflects the differences?
a. Public health is focused on the prevention and health of populations before they are ill.
b. Public health is focused on one individual at a time to ensure the best possible outcome.
c. The health of a community is measured by the use of sophisticated technologies like MRIs.
d. Public health is focused on one family at a time to ensure the best possible outcome.

ANS: A
Public health is concerned with the health of populations and communities rather than the individual, and therefore, its focus is on the health and prevention of illness of populations.

DIF: Cognitive Level: Analyze REF: pp. 180-181

3. You are asked to justify the creation of the first public health informatics (PHI) program in your jurisdiction. You will emphasize this likely benefit by ensuring:
a. current PHI can enhance public health surveillance such as identifying clusters of diseases.
b. privacy and security issues are avoided because public health informatics data are de-identified at the community level.
c. interoperability already exists for public health IT.
d. standards already exist for PHI.

ANS: A
Emphasizing the likely benefit of a PHI program (e.g. identifying clusters of diseases) will ensure that current PHI can enhance public health surveillance. The others are still issues in public health informatics, but they do not ensure benefit.

DIF: Cognitive Level: Analyze REF: pp. 185-187

4. Despite the challenges, public health systems are now available. Good examples of these systems have implemented vocabulary and messaging standards, are used to make public health decisions in a clinical setting, and provide data for public health policy. One of the best examples is:
a. the linkage of local electronic health records in the 50 states to public health reporting databases.
b. immunization information systems.
c. geographical informatics systems for reporting environmental issues.
d. direct lab reporting of conditions and diseases such as lead poisoning.

ANS: B
Immunization information systems exemplify public health systems that implement vocabulary and messaging standards, that are used to make public health decisions in a clinical setting, and that provide data for public health policy. The others lack one or more of the stated elements.

DIF: Cognitive Level: Understand REF: pp. 187-189

5. The public health supply chain needs to evolve to an information ecology approach for the future direction. This would involve:
a. standardizing public health supplies and suppliers.
b. being partners with others to receive, reuse, and republish data.
c. allowing public health departments to exclude data sharing to protect patient privacy.
d. allowing public health departments to include data sharing to protect patient privacy.

ANS: B
Information ecology involves the reuse and sharing of data.

DIF: Cognitive Level: Apply REF: pp. 192-193

6. Public health could benefit from improved technical architectures in the future. Which of these is not a likely technology for the future?
a. Service-oriented architecture (SOA)
b. Software as a service (SaaS)
c. Open source methods such as OpenELS or OpenMRS
d. Mobile devices such as the iPhone

ANS: D
While mobile devices are popular, they are not considered infrastructure and they do not allow sharing between device manufacturers, the very function that public health would require.

DIF: Cognitive Level: Remember REF: pp. 193-194

Multiple Response

7. Which social and political challenges impact public health informatics? (Select all that apply.)
a. The limits of federal authority
b. The evolution of public health primarily as state and local functions
c. The lack of resources to implement health IT
d. The presence of standards to implement health IT

ANS: A, B
Social and political challenges impacting public health informatics include the limits of federal authority and the evolution of public health primarily as state and local functions. Public health is not nationally organized and monitored.

DIF: Cognitive Level: Apply REF: p. 183

8. Blueprint Version 2.0 updates public health surveillance activities for the 21st century. Which methods exemplify these activities? (Select all that apply.)
a. Analysis of population data to describe disease characteristics and risk factors
b. Analysis of electronic health record data
c. Biomonitoring and environmental monitoring
d. Analysis of individual data to describe disease characteristics and risk factors

ANS: A, B, C
Methods that exemplify Blueprint Version 2.0 updates for public health surveillance activities for the 21st century include analysis of population data to describe disease characteristics and risk factors, analysis of electronic health record data, and biomonitoring and environmental monitoring.

DIF: Cognitive Level: Apply REF: p. 186

9. Informatics opportunities for reportable conditions include: (Select all that apply.)
a. the use of computable logic to define where and how reports should be sent.
b. automation of patient education from electronic health records.
c. automation of information extraction from electronic health records.
d. standardization of message structure and content for reporting.

ANS: A, C, D
Informatics opportunities for reportable conditions include the use of computable logic to define where and how reports should be sent, automation of information extraction from electronic health record, and standardization of message structure and content for reporting.

DIF: Cognitive Level: Remember REF: p. 191

10. Immunization information systems are used to record at least some of the immunizations for about 75% of children in the U.S. Which benefits are provided by the use of these systems? (Select all that apply.)
a. A high return on investment
b. The ability to provide consolidated immunization histories to avoid over- or under-vaccinating
c. The ability to improve vaccination rates by integrating data across the country
d. Integration across nations

ANS: A, B, C
Immunization information systems provide the following benefits: a high return on investment, the ability to provide consolidated immunization histories to avoid over- or under-vaccinating, and the ability to improve vaccination rates by integrating data across the country. Integration across nations is not available as yet.

DIF: Cognitive Level: Remember REF: pp. 187-189