In the Spirit of the Holiday Season I offer this Question and Answer Set for the Informatics Exam

These questions and answer sets came directly from
Joe Boyce, MD – CIO/CMIO at Heartland Health. St. Joseph, Mo 64506, who has kindly allowed me to share. Hope you enjoy it as much as I did.

His post appeared on a listServ and was his suggestion of exam questions for the currently developing Medical Informatics Board Certification

1. Organizational structure – Which is the most effective reporting arrangement for a new CMIO?
   

   1. CEO who has just been to a paid vendor sponsored conference at end of quarter.
   2. CIO – during a financial systems implementation, after a major downtime, during budget season.
   3. CFO who turns the lights off when he leaves the room (even if you are still there).
   4. Independent contractor reporting to all of the above paid on a “what you kill” basis after last 3 CMIOS quit.

2. Knowledge management – What is the most effective way to ensure people know what they are supposed to know?

   1. Assume they won’t, and build computer systems to compensate
   2. Video training with subliminal messaging on you tube.
   3. Classroom sessions combined with happy hour and pizza, during BMI measurement enrollment
   4. “First person who sees this message and calls me wins $20” buried in the body of an email
   5. Partial information distorted by least knowledgeable staff member delivered at most disruptive time

3. Probability theory – Which is more likely?

   1. Team based urologists
   2. Internists who cut to the chase
   3. ED docs who read the information before the meeting
   4. CIOs who “get it” with plenty of budget

4. Social networking – which environment is most dangerous for CMIOs?

   1. Physicians lounge during a documentation rollout
   2. Surgeon’s Christmas party at last call
   3. Nursing dept meeting after volunteering them to pick up a few more tasks
   4. Facebook after you’ve had a few drinks and a tough week

5. True or False – if you aren’t confused, you don’t know what is going on

   1. True
   2. False

6. Futures – After the singularity, how will you change a lightbulb?

   1. Answer – You don’t change lightbulbs that are smarter than you

7. Quality measures – As CMIO, you have been asked to redefine all workflows for new quality measures, ensure physician input/acceptance/compliance, and implement within a month across a four hospital system? What is the best approach?

   1. Do nothing – another list of measures will be out in a month.
   2. Simply declare salaries will be attached to the metrics, and announce it on twitter.
   3. Spend weekends doing flowcharts, spreadsheets, and education materials, only to find no one comes to dept meetings, they won’t read emails, and their office manager dumps all snail mail directly in trash
   4. Ask AMDIS

8. Finance – What is the best way to calculate ROI ?

   1. Detailed reductionist analysis of hardware, software, training, personnel and intangibles, pushing the project time past useful implementation
   2. 42 pages detailed with algorithms, charts, embedded spreadsheets, and complicated formulas downloaded off the internet, appended to the “project summary”.
   3. A simple spreadsheet, but password locked and key only distributed to the finance committee members who are on your side
   4. Make sure the dominant personalities in the system are project sponsors

9. Project mgmt. – As CIO/CMIO, you’ve been asked to cut budget on a critical project by 20%. What is the best approach?

   1. Call a crucial Saturday meeting of all involved parties to discuss in detail, and forget to show up
   2. Offer to cut whatever 20% is most closely associated with the requesting party
   3. Delegate/Defer to a weak link you’d been wanting to handle for a long time
   4. After much wailing and gnashing, cut the 20% cushion you put in long ago

10. Documentation – which of the following groups are most likely to complete their notes at the point of care?

    1. ED physicians with Scribes (assume the ED physicians still enter the room)
    2. Orthopedics with voice recognition (assume your orthopods have evolved to speaking)
    3. Internal medicine docs with a laptop and selection of branching templates via telemedicine. (assume your network will remain stable for 15 minutes)
    4. Residents with ipads, Bluetooth headsets, Kinect 3d mapping, and cell phones (assume they have not done a startup and retired already)

11. Management 101 – Which of the following surprises do CEOs prefer?

    1. Project failure realization while rounding in front of an entourage on the floor.
    2. Budget overruns to the board
    3. Parking spot occupied
    4. Being told personal assistant robots don’t exist yet

12. Planning – Your system has started a new ACO, opened a new hospital, upset the union, and had a security breach while revenues dropped by 10% . What went wrong in your planning?

    1. Nothing. That is the new normal.
    2. You listened to a consultant, who is now somewhere over Denver. For 2 weeks.
    3. Your genba mixed with your karma, and your black belt was in physiology
    4. You forgot to put lithium in the COO’s water again