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Epic Bridges Computer Science Practice Exam With Answers (226 Solved Questions)

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    Epic Bridges Exam Trigger - Serves as the integration point between the application workflow and Bridges generally, an action in Hyperspace, like clicking a button or closing an activity - a single, clearly defined action that a user or process can take those results in an interface message being created and sent An interface message contains.... - Data about an event (like a patient being admitted to the hospital) MSH - 11 and MSH - 12 are... - the HL7 processing ID and version; Epic checks these values on an incoming message and rejects the message if they do not match the expected values Segment Identifier - Three character code that identifies what kind of data that segment contains PID - 5 - patient name NTE segment - can follow many different segments Z - segment - custom segment for a specific implementation Is it necessary to send empty fields following the last valued field? - No Within a field do you need to send all components? - On ly as many as are valued Blank fields... - don't file anything

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    Delete character HL7 - double quotes " " --- tells the receiving system to delete a piece of info it has FHIR - specifies RESTful exchange method via HTTPs to access data Other standards supported by Bridges - X12, FHIR, NCPDP, DICOM, and Direct Event (in context of outgoing message flow) - small set of values with the necessary info to build the message: patient ID, patient contact, type of message, and additional info - contains directions for where the interface should pull the information it needs from the database Queue - storage location outside of Chronicles database structure Event Queue is processed by... - the Event Daemon Daemon (Outgoing Message Flow) - proces s that runs in the background without any direct user action Event Daemon (Outgoing Message Flow) - pulls an event off the Event Queue, uses the information in the event to build the message and finally deletes the event from the event queue. The event daemon puts the message it has built onto the data queue and adds an instruction to the Control Queue builds an HL7 message based on data pulled from Chronicles Data Queue (Outgoing Message Flow) - contains the full text of the message along with some ad ditional metadata (i.e. timestamp) about message processing

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    Control Queue (Outgoing Message Flow) - a to - do list and contains very little data - processed by the Communications Daemon - maintains a list of messages waiting to be processed Comm Deamon (Outg oing Message Flow) - reads an instruction from the Control Queue and copies the appropriate message off the Data Queue - sends the message out of Epic and waits for an ACK to be reutrned - deletes instruction from the Control Queue and proceeds to the next instruction - sends or receives acknowledgments over a TCP/IP connection Comm Daemon (Incoming Message Flow) - - listens constantly for messages coming into the system - validates MSH - 11 and MSH - 12 before accepting it, storing it in the data queue, and adding instruction to the control queue - sends or receives acknowledgments ov er a TCP/IP connection Control Queue (Incoming Message Flow) - processed by the Filer Daemon Filer Daemon - pulls an instruction from the Control Queue, retrieves the corresponding message from the Data Queue, and then attempts to file the message. Fili ng means that the Filer Daemon attempts to store the data in Chronicles.

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    If the filer daemon is successful, the data is added to the appropriate records in Chronicles. When there is a problem, and the data in the message cannot be filed, an interface err or message is logged Translates HL7 data into something that can be stored to the database When the filer daemon attempts to process a message, there are three things that can happen - 1) it files the message into Chronicles, possibly with one or more wa rning or notification errors 2) its unable to file the entire message because there is something critically wrong with the message. This is indicated by a fatal or critical error 3) it's unable to file the message because part of the record to which the message needs to file is locked Resequencing - - a record is locked when a user or process is updating it - IF a filer daemon receives a message for a patient, but that patient's record is already being updated with an active lock, then the Filer stores the instruction for that message on another queue - the Holding Queue. - the message remains on the Holding Queue until the lock is released, so that the Filer Daemon can move onto the next message in the Control Queue for processing The filer Daemon checks messages on the Holding Queue periodically to determine whether messa ges on the Holding Queue are ready to file

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    If the Filer Daemon encounters a message on the Control Queue that needs the same locks as a message already on the Holding Queue, that message is also added to the Holding Queue. This ensures that the messages a lways file into Chronicles in the same order they were received for a patient Holding QUeue - Acts as a waiting area for messages that cannot get a lock to store information to the database Interconnect - Epic's web services framework - enables Epic appli cations to initiate and receive web service requests with an external application - sometimes used as an alternate communication method to TCP/IP for interfaces - communicates messages securely using an HTTPS framework An interface requires interconnect if one or more of the following are true: - 1) the message uses an XML framework 2) communication requires HTTPS (web) protocol to reach securely outside your firewall 3) the interface handles a job in a windows .NET framework, such as extracting an embedd ed PDF from an HL7 v2 message and storing it to a BLOB server Common uses of interconnect include - e - Prescribing, Care Everywhere, Meaningful Use interfaces to state registries ( i.e., immunizations, results and cancer reporting), Eligibility and X12 inter faces, EMFI and Chart Such interfaces, Research Protocol interfaces, Real Time Location System Tracking, IHE interfaces, country - specific interfaces

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    Outgoing Message Flow with Interconnect - Comm daemon sends the content of the data queue to Interconnect , where the message is packaged and sent Incoming Message Flow with Interconnect - - Exists within the firewall; - constantly listening for messages coming into the system - most incoming interconnect interfaces don't require a separate Comm Daemon, since th e Interconnect server handles all of the communication in this direction. Chronicles - contains all the information for a patient in the form of records What are stored in the Event Queue, Data Queue, and Control Queue? - Event Queue: info needed to build a message (i.e. patient ID, encounter date, type of message, etc.) Data Queue: text of HL7 message and additional metadata Control Queue: to - do list wi th instructions to send or file messages stored in the Data Queue What are two ways that interface messages are sent and received - TCP/IP with an interface engine is the most common. Interconnect is used for HTTPS or other communication outside your loc al network What does it mean for an interface to process a message? - the incoming interface's Filer Daemon tries to find the correct patient and file the data in the message into Chronicles

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    the outgoing interface's Event Daemon creates an HL7 message, b ased on information in Chronicles, and sends it out through the port defined in the Comm Daemon. Are messages ever manually deleted from the Data Queue? - No, never. They are purged only by an automated purge job. Communication Status (Interface Monitor Column) - whether the comm daemon is stopped or running Total Rav’d /Sent (Interface Monitor Column) - total number of messages sent (outgoing) or received (incoming) i.e. count Last Rav’d /Sent (Interface Monitor Column) - Number of the Last message se nt (outgoing) or received (incoming) i.e. message number Time since last message(Interface Monitor Column) - Elapsed time since a message was last sent (for an outgoing interface) or received (for an incoming interface) Queued Messages (Interface Monitor Column) - number of messages waiting to be sent (outgoing) or processed (incoming) Queued Events (Interface Monitor Column) - number of events waiting to be processed from the Event Queue (outgoing only) Waiting Message s (Interface Monitor Column) - Number of messages waiting to be processed from the Holding Queue Filer/Event Status (Interface Monitor Column) - Whether the Event Daemon (outgoing) or Filer Daemon (incoming) is stopped or running

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