Certified Specialist Business
Intelligence Exam question with answers
Define the phenomenon big data - -understanding and using combinations of large
data sets, both clinical and non-clinical, which are generated by healthcare industry
organizations in the course of doing business
-Define and illustrate the applicability of and need to engage and use small data - -
-Recognize the internal components of healthcare service delivery - --Medical Care
Services
-Types of Health Services
-Providers and Locations
-ACA providers
-Provider Organization Ownership Status
-Supplier and Supply Chain
-Payers
-Insurers
-Education and Research
-Government
-Recognize the key external influencers of the healthcare delivery environment - --
Economic Factors: economy, elasticity
-Social Values: diversity, religion
-Global Influences: immigration, epidemics
-Population Characteristics: SDOH
-Political Climate: elected officials, interest groups
-Technology Development
-Physical Environment
-Identify three areas where misalignment between hospital components and
healthcare users may occur - --lack of coordination
-healthcare users on their own
-service coordination
-Identify the services performed at various points on the health continuum - --
preventative
-curative treatment
-chronic treatment
-restorative
-palliative
-facility hierarchy - --preventative care
-primary care
-acute care
-specialty care
-sub-acute care
, -rehab care
-chronic care
-long term care
-end of life care
-Recognize what strongly influence medical care decisions in regards to supply
sensitive care - -Decisions surrounding medical necessity are strongly influenced by
capacity rather than medical evidence of severity of illness
-Identify foundational drivers for change taking place in the industry - --
Transparency
-Understanding costs
-Community based services
-IHI Triple Aim
-Define HIPAA - -Health Insurance Portability and Accountability Act; organizations
that are a CE and, now, directly to business associates as well
-privacy rule
-accountability rule
-Define HITECH - -Health Information Technology for Economic and Clinical Health
Act
-both CE and individuals
-business associate contractors
Breach notification requirements: Accounting of PHI disclosures; allows for sanctions
for non-compliance including fines of up to 1.75M and 10 years imprisonment
-Identify fundamental purpose of engaging in analytics - -understand what is
happening and finding a path forward
-recognize the basic business functions of finance, marketing and operations - --
operations is the function that meets the demand for a service or product by
marketplace entities
-finance ensures monetary resources are in place to conduct operations
-marketing provides the market interface function that is focused on understanding
what the marketplace overtly seeks, specifically needs, anticipating shifts and
ensuring a strong marketplace presence
-recognize the dimensions of changes in the work and relationships of players in
the business of providing healthcare services - --role of nurses: integrated role
within team-based model of care; focus on standardization and improving outcomes
-role of case managers: minimizing 30-day re-admissions
-quality and performance improvement: work will be performed in direct
collaboration with clinicians, clinical informaticists, decision support professionals
and patient access team members
-operational management decision: increased focus on procurement sourcing and
management of suppliers and supply lines rather than on managing inventory and
processing orders
-decision support becomes a BI/Analytics function
-Internal Financial and Payer Experts
Intelligence Exam question with answers
Define the phenomenon big data - -understanding and using combinations of large
data sets, both clinical and non-clinical, which are generated by healthcare industry
organizations in the course of doing business
-Define and illustrate the applicability of and need to engage and use small data - -
-Recognize the internal components of healthcare service delivery - --Medical Care
Services
-Types of Health Services
-Providers and Locations
-ACA providers
-Provider Organization Ownership Status
-Supplier and Supply Chain
-Payers
-Insurers
-Education and Research
-Government
-Recognize the key external influencers of the healthcare delivery environment - --
Economic Factors: economy, elasticity
-Social Values: diversity, religion
-Global Influences: immigration, epidemics
-Population Characteristics: SDOH
-Political Climate: elected officials, interest groups
-Technology Development
-Physical Environment
-Identify three areas where misalignment between hospital components and
healthcare users may occur - --lack of coordination
-healthcare users on their own
-service coordination
-Identify the services performed at various points on the health continuum - --
preventative
-curative treatment
-chronic treatment
-restorative
-palliative
-facility hierarchy - --preventative care
-primary care
-acute care
-specialty care
-sub-acute care
, -rehab care
-chronic care
-long term care
-end of life care
-Recognize what strongly influence medical care decisions in regards to supply
sensitive care - -Decisions surrounding medical necessity are strongly influenced by
capacity rather than medical evidence of severity of illness
-Identify foundational drivers for change taking place in the industry - --
Transparency
-Understanding costs
-Community based services
-IHI Triple Aim
-Define HIPAA - -Health Insurance Portability and Accountability Act; organizations
that are a CE and, now, directly to business associates as well
-privacy rule
-accountability rule
-Define HITECH - -Health Information Technology for Economic and Clinical Health
Act
-both CE and individuals
-business associate contractors
Breach notification requirements: Accounting of PHI disclosures; allows for sanctions
for non-compliance including fines of up to 1.75M and 10 years imprisonment
-Identify fundamental purpose of engaging in analytics - -understand what is
happening and finding a path forward
-recognize the basic business functions of finance, marketing and operations - --
operations is the function that meets the demand for a service or product by
marketplace entities
-finance ensures monetary resources are in place to conduct operations
-marketing provides the market interface function that is focused on understanding
what the marketplace overtly seeks, specifically needs, anticipating shifts and
ensuring a strong marketplace presence
-recognize the dimensions of changes in the work and relationships of players in
the business of providing healthcare services - --role of nurses: integrated role
within team-based model of care; focus on standardization and improving outcomes
-role of case managers: minimizing 30-day re-admissions
-quality and performance improvement: work will be performed in direct
collaboration with clinicians, clinical informaticists, decision support professionals
and patient access team members
-operational management decision: increased focus on procurement sourcing and
management of suppliers and supply lines rather than on managing inventory and
processing orders
-decision support becomes a BI/Analytics function
-Internal Financial and Payer Experts