HAC Health Information Exchange & Interoperability 3 — Questions and Answers
Question 1: A healthcare analytics team wants to query patient records on demand from multiple EHRs without a central repository. Which HIE model best fits this approach?
- Centralized HIE
- Federated HIE (Correct answer)
- Hybrid HIE
- Consolidated Clinical Document Architecture
Correct answer: Federated HIE
A federated HIE leaves data at source systems and enables queries across them in real time, without centralizing patient records.
Question 2: Under the HIPAA Privacy Rule, which of the following is a permitted use of PHI without patient authorization for HIE purposes?
- Marketing research
- Treatment, payment, and healthcare operations (TPO) (Correct answer)
- Employer health screening
- Life insurance underwriting
Correct answer: Treatment, payment, and healthcare operations (TPO)
HIPAA permits disclosure of PHI without authorization for treatment, payment, and healthcare operations activities, which are foundational to HIE.
Question 3: What is the role of a Record Locator Service (RLS) in a federated HIE?
- Translating between HL7 v2 and FHIR formats
- Identifying which participating organizations hold data for a given patient (Correct answer)
- Encrypting records during cross-network transmission
- Aggregating clinical summaries into a longitudinal record
Correct answer: Identifying which participating organizations hold data for a given patient
An RLS maintains a directory of which network participants have records for specific patients, enabling targeted queries without a central data store.
Question 4: Which FHIR capability allows a client system to subscribe and receive automatic notifications when patient data changes?
- FHIR Subscription resource (Correct answer)
- FHIR Questionnaire
- SMART on FHIR launch
- FHIR Bulk Data Export
Correct answer: FHIR Subscription resource
The FHIR Subscription resource enables server-driven notifications to clients when specific resources matching defined criteria are created or updated.
Question 5: Semantic interoperability in health data exchange is primarily achieved through:
- Standardized transport protocols like HTTPS
- Common clinical terminologies such as SNOMED CT and LOINC (Correct answer)
- Uniform patient consent forms across organizations
- Shared network infrastructure between hospitals
Correct answer: Common clinical terminologies such as SNOMED CT and LOINC
Semantic interoperability requires that systems share a common understanding of the meaning of data, achieved through standardized terminologies and ontologies.
Question 6: Which ONC-defined exchange framework establishes the governance structure for nationwide health information exchange in the US?
- CommonWell Health Alliance
- Trusted Exchange Framework and Common Agreement (TEFCA) (Correct answer)
- Carequality Interoperability Framework
- eHealth Exchange
Correct answer: Trusted Exchange Framework and Common Agreement (TEFCA)
TEFCA, established under the 21st Century Cures Act, creates a universal governance framework and common agreement to enable nationwide HIE.
Question 7: When de-identifying data under HIPAA's Safe Harbor method, how many specific identifiers must be removed?
- 12
- 16
- 18 (Correct answer)
- 21
Correct answer: 18
HIPAA's Safe Harbor de-identification method requires removal of 18 specific identifiers including names, dates, geographic data, and other direct identifiers.
HAC Health Information Exchange & Interoperability 3
A healthcare analytics team wants to query patient records on demand from multiple EHRs without a central repository.
Which HIE model best fits this approach?