Chapter 11: Clinical Laboratory Informatics Flashcards Preview

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Flashcards in Chapter 11: Clinical Laboratory Informatics Deck (99)
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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
Q

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

A

Network

26
Q

which covers a small geographic area

A

local area network (LAN)

27
Q

which covers a broad area

A

wide area network (WAN)

28
Q

refers to the rate of data transmission

A

bandwidth

29
Q

the computer/device that performs a task or with which the end-user interacts

A

client

30
Q

all application logic executes on the client server

A

thin client type

31
Q

the client performs most of the data processing operations

A

thick/ fat client type

32
Q

the most common type of networking standard

A

Ethernet

33
Q

fulfilled the roles of the servers and thin client

A

mainframes and terminals

34
Q
  • 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
A

terminal emulator

35
Q

accessible series of interconnected computer networks

A

Internet

36
Q

transmits the data by packet switching

A

Internet Protocol (IP)

37
Q
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)
A

World Wide Web (WWW)

38
Q

specifies appearance of a web page when interpreted by a web browser

A

HyperText Markup Language (HTML)

39
Q

a private network that uses the aforementioned Internet protocols to share information within an organization, as opposed to between separate entities

A

Intranet

40
Q

paramount importance for all networks

A

Dara Security

41
Q

refers to the conversion of data via an algorithm that rearranges bits that cannot be deciphered without decryption

A

Encryption

42
Q

a method by which a user can access an organization’s internal network over the Internet in a secure manner

A

Virtual Private Network (VPN)

43
Q

modulates an analog carrier signal to encode digital information

A

Modem (“modulator-demodulator”)

44
Q

routes and forwards information

A

Router

45
Q

accepts connections to service requests by sending back responses

A

Server

46
Q

application or system that accesses the server

A

Client

47
Q

device and/or software that inspects network traffic passing through it and denies or permits passage based on a set of rules

A

Firewall

48
Q

are building blocks of information systems (IS) mad structured collections of records

A

Databases

49
Q

A single two-dimensional array of data elements, similar to an electronic spreadsheet

A

Flat File

50
Q

The data are organized in tables.

A

Relational

51
Q

The virtue of this structure is that redundancy is eliminated

A

normalization.

52
Q

any hardware or software designed to perform data management operations

A

Information System

53
Q

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

A

Laboratory Information System

54
Q

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

A

Middleware

55
Q

refers to release of results from automated analyzers directly to the LIS without prior human review

A

autoverification

56
Q

Runs the entire patient workflow, from the registration of patient information to bed tracking and discharge

A

Admission, Discharge, and Transfer

57
Q

Contains patient information from all the inpatient and outpatient systems in an enterprise and is used for reviewing patient data

A

Electronic Clinical Information System (CIS)

58
Q

Electronic data processing and information management functions necessary for laboratory operations

A

Laboratory Information System

59
Q

A chronologically ordered paperless chart that summarizes the clinical history with diagnostic laboratory test results

A

Electronic Medical Record

60
Q

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

A

Enterprise Data Warehouse

61
Q

Receives information on charges and/or tests performed to calculate charges to patient insurance

A

Billing

62
Q

Pre-analysis LIS functions

A
Patient registration, 
test ordering,
customized requisitions, 
phlebotomy draw lists, 
bar-coded collection labels and aliquot labels, 
specimen tracking, 
racking system
63
Q

Analysis LIS functions

A
Instrument work list, 
manual work list, 
manual results entry, 
automated results entry via interface, 
result validation and manual or automatic release, quality control
64
Q

Post-Analysis LIS functions

A
Requisition-based patient reports, 
cumulative patient reports, 
corrected reports, 
results inquiry, 
electronic reporting to external interfaced systems
65
Q

Management

A
Pending list, 
turnaround time reports, 
workload statistics, 
Ad hoc report writer, 
CIS and instrument integrity monitoring tools
66
Q

Regulatory/accrediting bodies pertinent to LIS systems in the US Government

A

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
Q

Legal Requirements of LIS:

A
  • 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
Q

The general checklist of the CAP Laboratory requires:

A

periodic verification of data sent from an LIS to other computer systems.

69
Q

An act that requires all health plans to accept electronically field claims ina standard format (EDI)

A

The Health Insurance Portability and Accountability Act of 1996 (HIPAA)

70
Q

TRUE OR FALSE.

There are limits on the use of health information, and reasonable safeguards must be used to protect against accidental disclosure.

A

TRUE

71
Q

PHI Acronym

A

Protected Health Information

72
Q

TRUE OR FALSE.

A patient’s consent is not required to use or disclose PHI for treatment., payment or health care operations.

A

FALSE. patient consent is required.

73
Q

TRUE OR FALSE.

The law requires maximum necessary use or disclosure of PHI.

A

FALSE. minimum use only

74
Q

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.

A

Communication Standards

75
Q

What was the major reason/need for electronic transmission of these data?

A

To bill the federal government (Medicare) and other payers for individual services provided.

76
Q

What did the communication standard resulted to?

A

Coding of laboratory procedures using Current Procedural Terminology (CPT) and coding medical conditions using International Classification of Diseases (ICD) have BEEN THE NORM.

77
Q

A widely adopted standard developed by the health care industry.

A

Health Level 7 (HL7)

78
Q

most current version of HL7 (HL7 Version 3) utilizes a messaging syntax based on?

A

XML (Extensible Markup Language).

79
Q

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;

A

XML (Extensible Markup Language).

80
Q
  • 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.
A

Logical Observation Identifiers Names and Codes (LOINC)

81
Q

Specifies protocols and formats for

instrument interfaces, bar codes and other systems and components.

A

ASTM (American Society for Testing and Materials)

82
Q

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

A

Bioinformatics

83
Q

Steps in laboratory information flow for a hospital patient

A
Register patient
Order tests
Collect sample
Receive sample
Run sample
Review results
Release results
Report results
84
Q

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”

A

Batley and Edwards (2009)

85
Q

Their study claimed that informatics can facilitate patient registration, specimen tracking, tissue cataloguing, quality assurance, and specimen availability.

A

Qualman et al, 2003

86
Q

Examples of areas of Bioinformatics: (before translational bioinformatics into health informatics)

A

Clinical Genomics
Genomic medicine
Pharmacogenomics
Genetic Epidemiology

87
Q

a detailed listing of required functionality and features

A

Request for Proposal (RFP)

88
Q

provider delivers a service remotely over a network, and the vendor manages everything (hardware, software, security, upgrades)
fixed subscription fee:
-per transaction
-flat rate

A

Application Service Provider (ASP) Model

89
Q

a contract that defines the technical and business parameters of the relationship between the IT vendor and the client

A

Service Label Agreement (SLA)

90
Q

Key points of SLA

A

responsibility
performance
remediation

91
Q

Issues Regarding Implementation of Bioinformatics

A
  • 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
Q

What is the significant advantage in network speed and the increased graphics capabilities of most computers, especially portable ones in a laboratory?

A

It allows pathologists to learn about a variety of topics in both the clinical and anatomic fields and obtain credit for it.

93
Q

TRUE OR FALSE.

The field of pathology informatics doesn’t have it’s own dedicated web page.

A

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
Q

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.

A

TRUE.

95
Q

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).

A

MICROFLUIDIC INSTRUMENTATION

96
Q

They created an informatics model for sharing information involving tissue banks from different institutions.

A

PATEL AND COLLEAGUES (2007)

97
Q

Define as an approach to diagnosis that incorporates multiple sources of raw data to generate diagnostic inferences and predictions.

A

COMPUTATIONAL PATHOLOGY

98
Q

Computational Pathology involves:

A
  • 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
Q

epidemiology is prompting the maturation of a related gestalt called:

A

translational bioinformatics.