Patient Safety/Data/Ethics

Question 1

What are common data communication protocols in healthcare?

Answer 1

DICOM, HL7, TCP/IP

Question 2

What dose DICOM stand for?

Answer 2

digital imaging and communication in medicine

Question 3

How are data organized in DICOM?

Answer 3

DICOM groups information into structures called datasets. Each dataset consists of a group of data elements.
Each data element consists of a tag (what is it), a value representation (format, e.g., string, double), a value length (e.g., how many bits), and the value itself

Question 4

What is HL7?

Answer 4

Health Level 7 - international standards for transfer of clinical and administrative data between software applications used by various providers. HL7 primarily used to pull patient demographic data from patient information system (e.g., EPIC), to the Radiation Oncology Information System (ROIS) (e.g., MOSAIQ/ARIA).

Question 5

What is TCP/IP?

Answer 5

Transmission control protocol/internet protocol.
used to interconnect network devices

Question 6

What are the 4 layers of abstraction in the TCP/IP system?

Answer 6

1) Physical (ethernet) 2) Network (IP) 3) Transport (IP) 4) Application (DICOM)

Question 7

How does the TCP/IP establish a connection between client and server?

Answer 7

3-way handshake:
1) client requests a connection to server - SYN packet
2) server acknowledges receipt SYN-ACK packet
3) client responds to validate the connection - ACK packet

Question 8

What are safety mechanisms to verify data are accurately transferred between systems after initial validation and commissioning?

Answer 8

1) transaction logging on both sender and receiver side
2) mechanism to compare sender and receiver logs
3) mechanism to verify uptime
4) end-to-end testing

Question 9

What are the 5 types of DICOM-RT files?

Answer 9

image (CT)
RT structure
RT plan
RT dose
treatment record

Question 10

Draw the DICOM-RT diagram thing

Question 11

What are some key points of the 2019 Intersociety Conference Statement of Professionalism?

Answer 11

1) All members feel valued and respected
2) foster collaborative and inclusive culture
3) non-discrimination or harassment
4) freedom from harassment, qualified freedom of speech
5) advocate for those who cannot advocate for themselves

Question 12

What are some important principles for a medical code of professional behavior/ethics?

Answer 12

1. beneficence (uphold patient’s best interests)
2. provide the best quality of care possible
3. protect safety, privacy, and confidentiality of patients and research participants
4. act with integrity
5. strive to be impartial and be transparent about conflicts of interest
6. be open, collegial, and respectful to other medical professionals
7. always be learning (striving to improve)
8. always operate within the limits of your knowledge, skills, and available resources
9. adhere to legal and regulatory requirements
10. be just and fair in the allocation of scarce medical resources
11. be professionally responsible for your actions (or inactions)

Question 13

What is a logic gate?

Answer 13

a physical or idealized device that does boolean/logical operations on single or multiple binary inputs to produce a single binary output

Question 14

What are the 5 logic gates?

Answer 14

And - if both/all inputs are 1, output is 1
Or - if one of all inputs is 1, output is 1
Nand - opposite of and - 0 if all inputs are 1 but 1 otherwise
Nor - opposite of or (0 if any of inputs is 1, 1 otherwise)
Xor - this or that but not both
xnor - either both 0 or both 1, but nothing in between

Question 15

How are logic gates created in the real world?

Answer 15

diodes or transistors acting as switches. Most in modern times are MOSFETs (metal oxide semiconductor field effect transistors)

Question 16

What does FLOPS stand for?

Answer 16

Floating Point Operations Per Second - measure of computing speed

Question 17

What are floating point operations?

Answer 17

floating point operations are mathematical functions that use approximations of real numbers, similar to scientific notation. The approximation consists of the significant (the number), a base, and an exponent (eg., x10^9).

floating point numbers require less memory than the full number for very small and very large numbers, and so floating point operations are faster than the full number algebra, but they are approximations so the introduce uncertainty into the operation too.

Question 18

What are the requirements for being listed as a co-author on a paper?

Answer 18

1) substantial contributions to conception, design, data collection, analysis, or interpretation
2) drafting the work or revising it critically for publication
3) final approval of the version to be published
4) agreement to be accountable for all aspects of the work

Question 19

What are the 3 components of FMEA?

Answer 19

Occurrence (how likely is it to happen), severity (how bad is it if it does happen) and detectability (how likely is it to be detected if it does happen)

Question 20

What are the 3 most common failure modes in IMRT delivery?

Answer 20

1) incorrect interpretation of tumor or normal tissue (from imaging)
2) contouring error (wrong organ/site/expansion)
3) linac hardware failure

Question 21

What is PACS?

Answer 21

Picture Archiving and Communication System

Question 22

What does HIPAA require data be protected against?

Answer 22

unintentional access (password protected/encrypted) and unintentional destruction (off-site backup, like iron mountain)

Question 23

What type of information is protected under HIPAA?

Answer 23

any information that is uniquely identifiable (name, address, phone number, SS#, etc.)