CAIH cheat sheet

CAIH (Certified Associate in Healthcare Information and Management Systems) validates foundational knowledge across the HIMSS-defined domains: clinical informatics, information systems, data management, and healthcare leadership/management.

Health IT system categories: EHR/EMR (clinical documentation), CPOE (computerized provider order entry), CDS (clinical decision support), PACS (imaging), LIS (laboratory), RIS (radiology), pharmacy systems, and revenue cycle management (RCM) systems.

Interoperability standards: HL7 v2 (messaging, pipe-delimited segments), HL7 FHIR (RESTful resources, JSON/XML), CDA (clinical document architecture), DICOM (imaging), X12 (claims/EDI 837/835), and NCPDP (pharmacy).

Data vocabulary: ICD-10-CM/PCS (diagnoses/procedures), CPT (procedures), SNOMED CT (clinical terms), LOINC (lab observations), RxNorm (medications), and NDC (drug products).

Meaningful Use / Promoting Interoperability stages emphasize e-prescribing, patient electronic access, health information exchange, and public health reporting with certified EHR technology.

Confidentiality vs. integrity vs. availability (CIA triad); HIPAA Security Rule covers administrative, physical, and technical safeguards for ePHI.

System development life cycle (SDLC) phases: planning, analysis, design, implementation, testing, and maintenance/go-live support; waterfall vs. agile approaches.

Project management fundamentals: scope, schedule, budget, risk register, stakeholder analysis, and change control; RACI matrix assigns responsibility.

Common failure causes in health IT projects: inadequate clinician engagement, poor workflow analysis, insufficient training, and unclear governance.

Clinical decision support (CDS) types: alerts/reminders, order sets, templates, reference information, and predictive analytics; the 'five rights' of CDS are right information, person, format, channel, and time.

CPOE reduces medication errors by eliminating illegible handwriting and enabling dose-range checking, allergy checking, and drug-drug interaction alerts.

Alert fatigue results from excessive or low-specificity alerts; mitigation includes tiering by severity, suppressing low-value alerts, and measuring override rates.

Clinical workflow analysis uses process mapping, time-motion studies, and observation to identify bottlenecks before system design.

Structured vs. free-text documentation: structured data supports reporting and CDS but may reduce narrative nuance; templates should balance both.

Usability heuristics for health IT include visibility of system status, error prevention, match to user mental models, and minimal memory load.

Nursing informatics focuses on care documentation, medication administration (eMAR/barcode), and handoff communication standards (e.g., SBAR).

Telehealth and remote monitoring extend care delivery; considerations include licensure, reimbursement, bandwidth, and data security.

Evidence-based practice integration requires linking order sets and protocols to current clinical guidelines with version control.

Data governance defines ownership, stewardship, quality standards, and access policies; data stewardship assigns domain accountability.

Data quality dimensions: accuracy, completeness, consistency, timeliness, validity, and uniqueness.

Analytics maturity levels: descriptive (what happened), diagnostic (why), predictive (what will happen), prescriptive (what to do).

Key healthcare metrics: readmission rate, length of stay, mortality, HCAHPS patient satisfaction, and ED throughput.

Population health analytics stratify risk using registries, claims data, and social determinants of health.

HIPAA Privacy Rule governs use/disclosure of PHI; minimum necessary standard; de-identification via Safe Harbor (18 identifiers) or expert determination.

Security controls: role-based access control (RBAC), encryption at rest and in transit, audit logs, multi-factor authentication, and business associate agreements (BAAs).

Breach notification: notify affected individuals within 60 days; HHS notification thresholds depend on breach size (500+ requires immediate reporting).

Data exchange models: HIE (health information exchange), query-based vs. push-based, and the Trusted Exchange Framework and Common Agreement (TEFCA).

IT governance structures: steering committee, IT executive (CIO/CMIO/CNIO), and project prioritization aligned to organizational strategy.

IT strategic planning aligns technology investments with clinical, operational, and financial goals; ROI and total cost of ownership (TCO) guide decisions.

Vendor management: RFI vs. RFP vs. RFQ; contract terms should cover SLAs, uptime guarantees, data ownership, and exit/termination clauses.

Change management models: Kotter's 8 steps, ADKAR (awareness, desire, knowledge, ability, reinforcement), and Lewin's unfreeze-change-refreeze.

Budgeting types: capital (hardware, licenses) vs. operating (support, subscriptions); chargeback models allocate IT costs to departments.

Regulatory landscape: HIPAA, HITECH Act, 21st Century Cures Act (information blocking rules), and ONC certification criteria.

Risk management: identify, assess (likelihood × impact), mitigate, and monitor; business continuity and disaster recovery planning (RTO/RPO).

Staffing and competency: informatics roles include clinical analysts, CMIO, CNIO, data analysts, and interface engineers; ongoing training and certification support retention.

Quality improvement frameworks: PDSA (plan-do-study-act), Lean, and Six Sigma applied to health IT process improvement.