Name:
First
MI
Last
Department: (pick if listed or
type in space below):
Other - Please list below
Allergy
Anesthesia
ATRC
Burn
Cancer Institute
Cardiac Surgery
Cardiology/Cardiology Assoc.
Cardiovascular
Research Inst
Colon/Rectal Surgery
Critical Care Medicine
Dermatology
Diabetes &
Endocrine Section
Diabetes/Atherosclerosis
Electrodiagnostic Med
Emergency
Endocrinology
ENT
Gastroenterology
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Center
Hematology
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Inst. Asthma &
Allergy
Internal Medicine
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Medical Affairs
Medical Onc/Hema Center
Medical Oncology
Medicine
MedStar CRC
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Nursing Research
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Medicine
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Outcomes Analysis
Pain Management Svcs
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Penn Medical Lab
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Rehab
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VNA
Wash Cardiology Ctr
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Washington Heart
WNEC
Office Address:
Institution:
Other - please list below
WHC
MRI
NRH
MCRC
Good Samaritan Hosp
Harbor Hospital
Union Memorial
Franklin Sq Hospital
Georgetown University
Georgetown Hospital
Building/Room:
,
AL
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DE
DC
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GA
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Email Address
(user@host.domain):
Research Role (pick if listed or
type in space below):
Other - please list below
Primary Investigator
Co-Investigator
Sub-Investigator
Clinical Coordinator
Research Fellow/Clinical Fellow
Date Completed Training
(mm-dd-yyyy)
1 .
The criminal penalties for
improperly disclosing PHI can be as high as fines of $250,000 and sentences
of up to 10 years in prison.
True
False
2.
What type of information does
the HIPAA privacy rule protect?
a.
patient information in electronic form
b.
patient information spoken out loud
c.
patient information on paper
d.
all of the above
3 .
Which of the following are
common ways researchers protect patient privacy?
a.
not speaking about patient conditions in public areas
b.
remembering to turn off unattended laptops that contain patient information
c.
keeping labeled tissue samples in a private place
d.
all of the above
4 .
In September 2002, 30 subjects
signed valid consents for research, which did not contain HIPAA
language. Your study continues into the summer of 2003. These
subjects must sign a new consent containing HIPAA authorization language?
True
False
5 .
What research is covered by
HIPAA? (Choose the best answer.)
a.
any research done by a covered entity
b.
research involving patients funded by the federal government
c.
all research on people, living or dead
d.
FDA Phase III trials
6 .
Who can see the general medical
record for research with the patient's authorization? (Choose the best
answer.)
a.
the study nurse only
b.
the study nurse, the PI, monitor, IRB and oversight organizations
c.
the study nurse and PI only
d.
It depends on the wording of the informed consent/authorization form
7 .
Which of the following features
of a consent for research are completely new with the HIPAA
requirements? (Choose all that apply.)
a.
the purpose of the use or disclosure
b.
expiration date or event
c.
right to refuse to participate
d.
re-disclosure by the recipient of the data
8 .
How long must you retain a
consent/authorization for research?
a.
until the end of the study
b.
for at least six years or the minimum amount of time required under
state law, whichever is longer
c.
at least 10 years or the minimum amount of time required under
state law, whichever is longer
d.
at least 14 years or the minimum amount of time required under
state law, whichever is longer
9.
How long can a study site use
or disclose PHI for research?
a.
forever
b.
six years
c.
as long as described in the research authorization or waiver request
d.
until the end of the study
10.
How can you perform
pre-screening for research under HIPAA?
a.
under a waiver of authorization from an IRB
b.
using a notice of review preparatory to research
c.
with no changes from current practices
d.
a or b, depending on the study needs
11.
How should you pre-screen
patients if you want to call them on the phone?
a.
under a waiver of authorization by an IRB
b.
with a notice of review preparatory to research, provided no PHI
leaves the covered entity
c.
with no changes from current practices
d.
either a or b
12.
If you want to send
pre-screening logs to the sponsor for research, what steps should you take?
a.
obtain a waiver of authorization from an IRB
b.
send de-identified data
c.
send a limited data set with data use agreement
d.
any of the above
13.
Which of the following is true
about PHI you obtain in pre-screening performed under reviews preparatory to
research?
a.
The sponsor's monitor can review it for subject recruitment purposes.
b.
The investigator can send the PHI, as is, to the sponsor.
c.
The PHI must stay at the health care facility.
d.
both a and c
14.
How much PHI are you permitted
to obtain during pre-screening?
a.
the entire medical record
b.
only the patient's name and admission date
c.
the minimum amount you need for your study, which is stated in the
notice of reviews preparatory to
research or in the request for
waiver of authorization
15.
You conduct pre-screening using
the review preparatory to research. Now, the study sponsor would like
a copy of some of the items on the pre-screening log for research
purposes. What can you do? (Choose all that apply.)
a.
nothing
b.
de-identify the data and send it
c.
create a limited data set and obtain a data use agreement with the sponsor
d.
go back to the IRB and request a waiver of authorization for the
information you have in the log
16.
You are a clinical trials
coordinator employed by a doctor who is conducting research at a nearby
hospital. You have been reviewing hospital logs to pre-screen 40
subjects for a study. You must keep track of the patients you've
reviewed in case the hospital needs to inform the patients about your
activities.
True
False
17.
You must obtain a business
associate agreement with the sponsor in pharmaceutical company-sponsored
studies for which you've obtained authorization from subjects.
True
False