Chapter 11: Clinical Laboratory Informatics Flashcards
1
Q
device that follows instructions to work with electronic data based on user input
A
Computer
2
Q
the physical components of an information system
A
Hardware
3
Q
programs (which are essentially sets of instructions) that allow computers or other devices to perform tasks
A
Software
4
Q
collection of data identified by a specific name and grouped related to a specific purpose
A
File
5
Q
Also known as executable files
A
Application
6
Q
e.g., image, text/document, sound
A
Data
7
Q
refers to a collection of files
A
Folder
8
Q
the basic unit of digital information
A
Bit
9
Q
the most common unit of measurement used and almost always refers to 8 bits
A
Byte
10
Q
The standard dictionary for combinations of bits that represent the common letters, numbers, and symbols by which characters are represented on a computer screen or paper printout
A
ASCII (American Standard Code for Information Interchange)
11
Q
the circuitry that serves as the main information processor and is driven by clock pulses
A
Central processing unit (CPU)
12
Q
Common unit used for SPEED
A
gigahertz (1 GHz = 1 billion clock pulses per second)
13
Q
the physical chips on the motherboard that hold programs and data for rapid access by CPU
A
Memory
14
Q
Permanent Memory
A
Read-only Memory (ROM)
15
Q
Volatile Memory (the contents of these chips are lost when the computer is turned off)
A
Random-access Memory (RAM)
16
Q
the physical media that store data permanently
A
Storage
17
Q
Hard Drive
A
Internal Storage
18
Q
CD-ROM, USB drive
A
Removable Storage
19
Q
multiple hard drives configured to look like a single-system drive
A
Drive Array
20
Q
simultaneously uses two or more hard disk drives to achieve greater levels of performance, reliability, and/or larger data volume sizes
A
RAID (redundant array of independent [formerly inexpensive] disks)
21
Q
arrays where copies of files are written to each drive in the array
-This system is redundant: If one drive fails, a file can
be read from the other intact drive(s)
A
Mirrored drive arrays
22
Q
where data are saved via an Internet connection (see below) to an off-site storage system maintained by a third-party provider; this data can then be retrieved from the same or a different location or device as long as it also has Internet access
A
“cloud” storage systems
23
Q
a set of programs responsible for the management and coordination of activities and the sharing of resources
A
Operating System
24
Q
small specialized files that are specific to an operating system, which allows identification and utilization of various external peripherals and other devices
A
Drivers
25
interconnected group of computers that share information and resources, and as it pertains to the laboratory, it refers to the ability to obtain orders from and send results to other information systems
Network
26
which covers a small geographic area
local area network (LAN)
27
which covers a broad area
wide area network (WAN)
28
refers to the rate of data transmission
bandwidth
29
the computer/device that performs a task or with which the end-user interacts
client
30
all application logic executes on the client server
thin client type
31
the client performs most of the data processing operations
thick/ fat client type
32
the most common type of networking standard
Ethernet
33
fulfilled the roles of the servers and thin client
mainframes and terminals
34
- type of configuration generally cannot replace the old terminals once they begin to fail and therefore needs to run a program
- acts like a terminal but can be run on more modern hardware
terminal emulator
35
accessible series of interconnected computer networks
Internet
36
transmits the data by packet switching
Internet Protocol (IP)
37
```
a hypertext-based data system that uses the Internet as
its transportation (hypertext is text on a computer that will lead the user to other related information on demand)
```
World Wide Web (WWW)
38
specifies appearance of a web page when interpreted by a web browser
HyperText Markup Language (HTML)
39
a private network that uses the aforementioned Internet protocols to share information within an organization, as opposed to between separate entities
Intranet
40
paramount importance for all networks
Dara Security
41
refers to the conversion of data via an algorithm that rearranges bits that cannot be deciphered without decryption
Encryption
42
a method by which a user can access an organization’s internal network over the Internet in a secure manner
Virtual Private Network (VPN)
43
modulates an analog carrier signal to encode digital information
Modem (“modulator-demodulator”)
44
routes and forwards information
Router
45
accepts connections to service requests by sending back responses
Server
46
application or system that accesses the server
Client
47
device and/or software that inspects network traffic passing through it and denies or permits passage based on a set of rules
Firewall
48
are building blocks of information systems (IS) mad structured collections of records
Databases
49
A single two-dimensional array of data elements, similar to an electronic spreadsheet
Flat File
50
The data are organized in tables.
Relational
51
The virtue of this structure is that redundancy is eliminated
normalization.
52
any hardware or software designed to perform data management operations
Information System
53
classically a standalone insulated system that released results for manual reporting by laboratory personnel or for viewing by the physician
- used to communicate with analyzers and external
systems like the larger clinical information systems (CISs) and/or billing systems
- a database that establishes and maintains standard definitions and information processing procedures
- provide logical framework for laboratory operations and workflow
- define allowable entries for data fields in addition to the content and format of elements that appear on reports
Laboratory Information System
54
ad hoc development of software
- developed and deployed to address functionalities often not included in a hospital system’s LIS to help improve different aspects of the laboratory workflow
Middleware
55
refers to release of results from automated analyzers directly to the LIS without prior human review
autoverification
56
Runs the entire patient workflow, from the registration of patient information to bed tracking and discharge
Admission, Discharge, and Transfer
57
Contains patient information from all the inpatient and outpatient systems in an enterprise and is used for reviewing patient data
Electronic Clinical Information System (CIS)
58
Electronic data processing and information management functions necessary for laboratory operations
Laboratory Information System
59
A chronologically ordered paperless chart that summarizes the clinical history with diagnostic laboratory test results
Electronic Medical Record
60
Similar to CIS, except the information is utilized in research through using databases and data analysis tools to uncover hidden patterns and relationships in data
Enterprise Data Warehouse
61
Receives information on charges and/or tests performed to calculate charges to patient insurance
Billing
62
Pre-analysis LIS functions
```
Patient registration,
test ordering,
customized requisitions,
phlebotomy draw lists,
bar-coded collection labels and aliquot labels,
specimen tracking,
racking system
```
63
Analysis LIS functions
```
Instrument work list,
manual work list,
manual results entry,
automated results entry via interface,
result validation and manual or automatic release, quality control
```
64
Post-Analysis LIS functions
```
Requisition-based patient reports,
cumulative patient reports,
corrected reports,
results inquiry,
electronic reporting to external interfaced systems
```
65
Management
```
Pending list,
turnaround time reports,
workload statistics,
Ad hoc report writer,
CIS and instrument integrity monitoring tools
```
66
Regulatory/accrediting bodies pertinent to LIS systems in the US Government
CMS (Center for Medical Services)
FDA (Food and Drug Administration)
CAP (Computer Electronic Accommodations Program)
TJC (The Joint Commission)
AABB (American Association of Blood Banks)
67
Legal Requirements of LIS:
- Unique specimen
- Patient Identification
- Date of specimen collection
- Date and time of specimen receipt in lab
- Records and dates of all specimen testing
- Personnel who performed the test(s)
- Name and address of lab
68
The general checklist of the CAP Laboratory requires:
periodic verification of data sent from an LIS to other computer systems.
69
An act that requires all health plans to accept electronically field claims ina standard format (EDI)
The Health Insurance Portability and Accountability Act of 1996 (HIPAA)
70
TRUE OR FALSE.
There are limits on the use of health information, and reasonable safeguards must be used to protect against accidental disclosure.
TRUE
71
PHI Acronym
Protected Health Information
72
TRUE OR FALSE.
A patient's consent is not required to use or disclose PHI for treatment., payment or health care operations.
FALSE. patient consent is required.
73
TRUE OR FALSE.
The law requires maximum necessary use or disclosure of PHI.
FALSE. minimum use only
74
The use of conventions and definitions TO STANDARDIZE information exchange between different systems is a LESS COMPLEX and time-consuming strategy THAN the traditional creation of custom interfaces between such applications.
Communication Standards
75
What was the major reason/need for electronic transmission of these data?
To bill the federal government (Medicare) and other payers for individual services provided.
76
What did the communication standard resulted to?
Coding of laboratory procedures using Current Procedural Terminology (CPT) and coding medical conditions using International Classification of Diseases (ICD) have BEEN THE NORM.
77
A widely adopted standard developed by the health care industry.
Health Level 7 (HL7)
78
most current version of HL7 (HL7 Version 3) utilizes a messaging syntax based on?
XML (Extensible Markup Language).
79
method to describe data, structure information, and format documents, and it accomplishes this by using markup tags that describe the data marked by the tag;
XML (Extensible Markup Language).
80
- set of universal identifiers for laboratory test code data fields within HL7 messages and in databases.
- provides a structured naming convention for describing laboratory tests.
- fewer limitations than CPT.
Logical Observation Identifiers Names and Codes (LOINC)
81
Specifies protocols and formats for
| instrument interfaces, bar codes and other systems and components.
ASTM (American Society for Testing and Materials)
82
refers to the division of informatics that studies how information is stored in biological systems, from the molecular to the macro molecular level, with a large part of the focus being on DNA, RNA, and protein sequences
Bioinformatics
83
Steps in laboratory information flow for a hospital patient
```
Register patient
Order tests
Collect sample
Receive sample
Run sample
Review results
Release results
Report results
```
84
Their study said that “the numerous improvements in DNA sequencing technology have led to a corresponding marked increase in the amount of sequence data generated”
Batley and Edwards (2009)
85
Their study claimed that informatics can facilitate patient registration, specimen tracking, tissue cataloguing, quality assurance, and specimen availability.
Qualman et al, 2003
86
Examples of areas of Bioinformatics: (before translational bioinformatics into health informatics)
Clinical Genomics
Genomic medicine
Pharmacogenomics
Genetic Epidemiology
87
a detailed listing of required functionality and features
Request for Proposal (RFP)
88
provider delivers a service remotely over a network, and the vendor manages everything (hardware, software, security, upgrades)
fixed subscription fee:
-per transaction
-flat rate
Application Service Provider (ASP) Model
89
a contract that defines the technical and business parameters of the relationship between the IT vendor and the client
Service Label Agreement (SLA)
90
Key points of SLA
responsibility
performance
remediation
91
Issues Regarding Implementation of Bioinformatics
- Quantifiable metrics need to be specified.
- can cause considerable logistical and operational problems down the road.
- most critical features of an information system is receiving assurance that the data that are transferred from one system to another are accurate and valid.
- CAP Laboratory General Checklist Questionnaire requires periodic verification of data sent and Absence of proof of fulfilling this requirement is a Phase II violation.
- CIS must also be able to store and link together all identifiers generated for the same patient
- All laboratories should have safeguards in place to ensure that patient data are accessed only by the appropriate individuals in the appropriate circumstances.
92
What is the significant advantage in network speed and the increased graphics capabilities of most computers, especially portable ones in a laboratory?
It allows pathologists to learn about a variety of topics in both the clinical and anatomic fields and obtain credit for it.
93
TRUE OR FALSE.
The field of pathology informatics doesn't have it's own dedicated web page.
FALSE. Pathology informatics have a dedicated web page to help interested students learn or instructors to develop a curriculum for teaching various topics in different informatics-related categories.
94
TRUE OR FALSE.
With the emergence of new technologies, especially in the realm of bioinformatics, the roles of pathologists and the laboratory will be redefined over time.
TRUE.
95
Technique being applied to common laboratory techniques, essentially providing a “lab-on-a-chip”solution that allows a patient-centric approach to testing and may eventually erform at levels comparable to centralized analyzers (Yager et al,2006).
MICROFLUIDIC INSTRUMENTATION
96
They created an informatics model for sharing information involving tissue banks from different institutions.
PATEL AND COLLEAGUES (2007)
97
Define as an approach to diagnosis that incorporates multiple sources of raw data to generate diagnostic inferences and predictions.
COMPUTATIONAL PATHOLOGY
98
Computational Pathology involves:
- electronic medical records
- laboratory data and imaging
- extracts biologically and clinically relevant information from those data
- uses mathematical models at the levels of molecules, individuals, and populations
99
epidemiology is prompting the maturation of a related gestalt called:
translational bioinformatics.
