EPIC CLINICAL INFORMATICS EXAM PREP QUESTIONS WITH CORRECT
ANSWERS 2026
Course
Epic
Q1: During an Epic implementation, which governance body is responsible for making final
decisions about system configuration, workflow design, and build prioritization?
ANSWER: The Operational Steering Committee (OSC)
RATIONALE: The OSC is a cross-functional body of clinical and operational leaders that owns
system design decisions, resolves workflow conflicts, and prioritizes the build backlog. It is the
primary governance structure in Epic implementations, ensuring alignment between IT and
organizational strategy.
Q2: A hospital finds that physicians are overriding 95% of all drug-allergy alerts in Epic. What
does this indicate?
ANSWER: Alert fatigue caused by low-specificity clinical decision support (CDS) rules
RATIONALE: An override rate above ~90% is a hallmark of alert fatigue. Clinicians learn to
dismiss all alerts, including critical ones. The correct response is to audit CDS rules, retire low-
value alerts, and reserve high-interrupt alerts for life-threatening interactions only.
Q3: Which standard enables direct electronic exchange of clinical records between Epic and a
non-Epic hospital, as required by the 21st Century Cures Act?
ANSWER: FHIR R4 with SMART on FHIR (OAuth 2.0)
RATIONALE: FHIR R4 is the federally mandated standard for patient data exchange. Epic's
Care Everywhere, CommonWell, and Carequality integrations use FHIR APIs for cross-
organization record retrieval.
Q4: A charge is created for a hospital service in Epic but fails to attach to the correct visit. What
is the most likely root cause?
ANSWER: A Charge Description Master (CDM) mapping error
RATIONALE: The CDM maps clinical activities to billing codes and encounter types. An
incorrect or missing mapping causes charges to float without an encounter or route to the wrong
account, resulting in claim failures or unbilled services.
,Q5: A nurse cannot administer a medication in Epic because it shows 'Not Given — Outside
Administration Window.' What is the best first action?
ANSWER: Override the administration window and document the clinical reason
RATIONALE: Administration windows are a safety guardrail, not an absolute lock. Nurses with
appropriate security can override and must document the reason. Canceling and reordering
creates unnecessary documentation gaps.
Q6: A quality analyst wants to track 30-day all-cause readmission rates across Epic. Which tool
is best suited for this population-level analysis?
ANSWER: Epic Clarity (the relational reporting database)
RATIONALE: Clarity is a nightly-refreshed relational database for complex SQL-based
population analytics. Readmission tracking requires joining encounter, discharge, and re-
admission records across time — ideal for Clarity.
Q7: A social worker requests access to a patient's entire chart, including psychiatric notes flagged
under 42 CFR Part 2. What Epic feature correctly restricts this access?
ANSWER: Behavioral Health (BH) sensitivity and note segregation
RATIONALE: Epic's BH segregation restricts 42 CFR Part 2 and psychiatric notes to users with
specific security points. This is configured through User Security and is distinct from break-the-
glass emergency access.
Q8: A physician accidentally activates all orders in a sepsis order set instead of selecting only
relevant ones. Which system design principle would best prevent this?
ANSWER: All orders in an order set should default to deselected (opt-in model)
RATIONALE: Best-practice order set design requires all orders to default to unchecked. Pre-
checked defaults increase the risk of unintended orders — a patient safety hazard endorsed by
ISMP and The Joint Commission.
Q9: A diabetic patient enrolled in MyChart wants their continuous glucose monitor (CGM) data
automatically shared with their care team. Which Epic feature facilitates this?
, ANSWER: MyChart device integration via FHIR APIs (patient-generated health data)
RATIONALE: Epic's MyChart supports PGHD from approved devices such as Dexcom CGM,
Apple Health, and Fitbit using FHIR APIs. Data flows into the patient's chart and can populate
flowsheets or trigger provider notifications.
Q10: Epic experiences an unplanned downtime. What is the most critical preparation a health
system must have in place according to regulatory standards?
ANSWER: Printed downtime forms and a current medication administration record (MAR) from
the prior 12–24 hours
RATIONALE: Joint Commission and CMS require documented, drilled downtime procedures.
Printing MARs and active order summaries at the time of downtime onset is the first line of
clinical continuity.
Q11: What does the Epic term "Chronicles" refer to?
ANSWER: Chronicles is Epic's proprietary database system that stores all clinical and
operational data in a hierarchical format.
RATIONALE: Chronicles uses a non-relational, hierarchical data model based on "INI" files
and "items." It stores real-time transactional data. For reporting purposes, Chronicles data is
extracted nightly into Clarity (relational) or Caboodle (data warehouse).
Q12: What is the function of Epic's "Caboodle" data warehouse?
ANSWER: Caboodle is Epic's enterprise data warehouse (EDW) built on Microsoft SQL Server,
designed for advanced analytics and business intelligence reporting.
RATIONALE: While Clarity is a relational replica of Chronicles, Caboodle is a fully structured
EDW that supports integration with third-party BI tools like Tableau and Power BI. It uses a star
schema model and is optimized for large-scale analytical queries across multiple domains.
Q13: A provider attempts to access a patient's chart who is not under their care. Epic logs this
access. What is this audit function called?
ANSWER: Break-the-glass access logging / Buddy Record access audit
RATIONALE: Epic tracks all instances where a user accesses a record outside their standard
patient panel. These are flagged in audit reports. Compliance and privacy officers use these logs
ANSWERS 2026
Course
Epic
Q1: During an Epic implementation, which governance body is responsible for making final
decisions about system configuration, workflow design, and build prioritization?
ANSWER: The Operational Steering Committee (OSC)
RATIONALE: The OSC is a cross-functional body of clinical and operational leaders that owns
system design decisions, resolves workflow conflicts, and prioritizes the build backlog. It is the
primary governance structure in Epic implementations, ensuring alignment between IT and
organizational strategy.
Q2: A hospital finds that physicians are overriding 95% of all drug-allergy alerts in Epic. What
does this indicate?
ANSWER: Alert fatigue caused by low-specificity clinical decision support (CDS) rules
RATIONALE: An override rate above ~90% is a hallmark of alert fatigue. Clinicians learn to
dismiss all alerts, including critical ones. The correct response is to audit CDS rules, retire low-
value alerts, and reserve high-interrupt alerts for life-threatening interactions only.
Q3: Which standard enables direct electronic exchange of clinical records between Epic and a
non-Epic hospital, as required by the 21st Century Cures Act?
ANSWER: FHIR R4 with SMART on FHIR (OAuth 2.0)
RATIONALE: FHIR R4 is the federally mandated standard for patient data exchange. Epic's
Care Everywhere, CommonWell, and Carequality integrations use FHIR APIs for cross-
organization record retrieval.
Q4: A charge is created for a hospital service in Epic but fails to attach to the correct visit. What
is the most likely root cause?
ANSWER: A Charge Description Master (CDM) mapping error
RATIONALE: The CDM maps clinical activities to billing codes and encounter types. An
incorrect or missing mapping causes charges to float without an encounter or route to the wrong
account, resulting in claim failures or unbilled services.
,Q5: A nurse cannot administer a medication in Epic because it shows 'Not Given — Outside
Administration Window.' What is the best first action?
ANSWER: Override the administration window and document the clinical reason
RATIONALE: Administration windows are a safety guardrail, not an absolute lock. Nurses with
appropriate security can override and must document the reason. Canceling and reordering
creates unnecessary documentation gaps.
Q6: A quality analyst wants to track 30-day all-cause readmission rates across Epic. Which tool
is best suited for this population-level analysis?
ANSWER: Epic Clarity (the relational reporting database)
RATIONALE: Clarity is a nightly-refreshed relational database for complex SQL-based
population analytics. Readmission tracking requires joining encounter, discharge, and re-
admission records across time — ideal for Clarity.
Q7: A social worker requests access to a patient's entire chart, including psychiatric notes flagged
under 42 CFR Part 2. What Epic feature correctly restricts this access?
ANSWER: Behavioral Health (BH) sensitivity and note segregation
RATIONALE: Epic's BH segregation restricts 42 CFR Part 2 and psychiatric notes to users with
specific security points. This is configured through User Security and is distinct from break-the-
glass emergency access.
Q8: A physician accidentally activates all orders in a sepsis order set instead of selecting only
relevant ones. Which system design principle would best prevent this?
ANSWER: All orders in an order set should default to deselected (opt-in model)
RATIONALE: Best-practice order set design requires all orders to default to unchecked. Pre-
checked defaults increase the risk of unintended orders — a patient safety hazard endorsed by
ISMP and The Joint Commission.
Q9: A diabetic patient enrolled in MyChart wants their continuous glucose monitor (CGM) data
automatically shared with their care team. Which Epic feature facilitates this?
, ANSWER: MyChart device integration via FHIR APIs (patient-generated health data)
RATIONALE: Epic's MyChart supports PGHD from approved devices such as Dexcom CGM,
Apple Health, and Fitbit using FHIR APIs. Data flows into the patient's chart and can populate
flowsheets or trigger provider notifications.
Q10: Epic experiences an unplanned downtime. What is the most critical preparation a health
system must have in place according to regulatory standards?
ANSWER: Printed downtime forms and a current medication administration record (MAR) from
the prior 12–24 hours
RATIONALE: Joint Commission and CMS require documented, drilled downtime procedures.
Printing MARs and active order summaries at the time of downtime onset is the first line of
clinical continuity.
Q11: What does the Epic term "Chronicles" refer to?
ANSWER: Chronicles is Epic's proprietary database system that stores all clinical and
operational data in a hierarchical format.
RATIONALE: Chronicles uses a non-relational, hierarchical data model based on "INI" files
and "items." It stores real-time transactional data. For reporting purposes, Chronicles data is
extracted nightly into Clarity (relational) or Caboodle (data warehouse).
Q12: What is the function of Epic's "Caboodle" data warehouse?
ANSWER: Caboodle is Epic's enterprise data warehouse (EDW) built on Microsoft SQL Server,
designed for advanced analytics and business intelligence reporting.
RATIONALE: While Clarity is a relational replica of Chronicles, Caboodle is a fully structured
EDW that supports integration with third-party BI tools like Tableau and Power BI. It uses a star
schema model and is optimized for large-scale analytical queries across multiple domains.
Q13: A provider attempts to access a patient's chart who is not under their care. Epic logs this
access. What is this audit function called?
ANSWER: Break-the-glass access logging / Buddy Record access audit
RATIONALE: Epic tracks all instances where a user accesses a record outside their standard
patient panel. These are flagged in audit reports. Compliance and privacy officers use these logs
