Medical Records and Health Information Flashcard

Front

Why should an MA who works at a facility with electronic records also understand how to work with paper records?

Back

Because in some situations paper records may still be used alongside electronic records.

Front

A ______________________ medical record is arranged according to the patient’s treatments or diagnoses.

Back

Problem-oriented

Front

What must be true of a facility’s backup system for electronic health records?

Back

It must be HIPAA-compliant.

Front

In relation to electronic health records, what does a firewall do?

Back

Prevents unauthorized access

Front

CMS suggests that paper medical records be kept for a minimum of ___________ after the record is closed.

Back

10 years

Front

A new patient brings in paper copies of health records from previous providers. How will these records be added to the patient’s electronic health record at the new office?

Back

The paper records will be scanned and added to the EHR.

Front

If an MA is allowed to use CPOE to enter tests or prescriptions ordered by the provider, what should she do when given an order?

Back

Enter it carefully and double-check it

Front

What does it mean to index scanned material in a patient’s EHR?

Back

To add each item to the appropriate section of the patient’s record.

Front

Which of the following items is likely to be printed from the EHR for a patient who is scheduled for an endoscopy? Detailed medical instructions for performing an endoscopy, Information about the anatomy and physiology of the digestive system, A list of diagnoses likely to be made after an endoscopy is performed, Patient preparation instructions for the procedure

Back

Patient preparation instructions for the procedure

Front

One common administrative function that may be built into EHR systems is

Back

Creating patient billing statements