Health-Cloud-Accredited-Professional Practice Exam Questions with Answers Salesforce Health Cloud Accredited ProfessionalAP 211Exam Certification

Tracking socioeconomic and cultural barriers that could hinder a patient's progress requires Salesforce Health Cloud’s Social Determinants of Health (SDoH) capability.

Comprehensive Patient View:

Captures data on factors like income, education, housing, and transportation that influence health outcomes.

Risk Identification:

Identifies potential barriers and integrates them into care plans, enabling proactive intervention.

Care Coordination:

Helps care teams design support services and interventions tailored to individual patient needs.

B. Clinical Barriers: While useful, this focuses on clinical obstacles rather than broader socioeconomic factors.

C. Utilization Management: Centers on managing care authorizations, not patient barriers.

D. Care Blockers: Not a formal Health Cloud capability; overlaps conceptually with SDoH.

To enable Assessments in Salesforce Health Cloud, administrators must configure the org appropriately, ensuring that users can effectively utilize assessment tools for patient evaluations. The following steps are essential:

Download and Install OmniStudio (Answer A):

Purpose: OmniStudio provides a suite of declarative tools, including OmniScripts and DataRaptors, essential for building and managing assessments within Health Cloud.

Implementation Steps:

Access Salesforce AppExchange: Navigate to the AppExchange marketplace.

Search for OmniStudio: Locate the OmniStudio package suitable for your Salesforce edition.

Install the Package: Follow the installation prompts, ensuring that all components are correctly deployed.

For a weekly billing cycle, the most appropriate integration pattern is a nightly batch extract using an ETL tool. This approach efficiently handles large volumes of patient visit data while preparing it for billing in the ERP system.

Key Features of Nightly Batch ETL:

Scheduled Processing: Automates the extraction and transformation of visit data at predefined intervals (e.g., nightly).

Data Transformation: Formats the data as required by the ERP system.

Scalability: Efficiently handles large datasets for periodic billing processes.

Why Other Options Are Incorrect:

B. Fire and Forget with ESB: Not suitable for scheduled bulk data processing. Fire-and-forget is better suited for real-time, event-driven integrations.

C. Request and Reply with ESB: Used for synchronous, real-time integrations, which is unnecessary for a weekly billing cycle.

D. FHIR Billing API: Health Cloud does not natively provide a FHIR Billing API, and this option assumes capabilities that Salesforce does not currently offer.

In Salesforce Health Cloud, managing prior authorizations involves utilizing specific objects designed to handle the complexities of authorization requests and their associated details. For an insurance provider aiming to display preauthorization outcomes from an external system that manages the end-to-end prior authorization process, the appropriate solution involves the Service Preauth and Preauth Detail objects.

Service Preauth Object:

Purpose: The Service Preauth object represents a preauthorization request within Health Cloud. It serves as a container for all relevant information pertaining to a specific authorization, including patient details, requested services, and status updates.

Integration Capability: This object is designed to integrate with external systems, allowing for the seamless import and display of preauthorization outcomes managed outside of Salesforce. By mapping external authorization data to the Service Preauth object, users can view and manage authorization statuses directly within Health Cloud.

Preauth Detail Object:

Purpose: The Preauth Detail object stores detailed information related to each preauthorization request captured in the Service Preauth object. This includes specifics about the services or procedures being authorized, such as service codes, descriptions, quantities, and any other pertinent details.

Integration Capability: By populating the Preauth Detail object with data from external systems, Health Cloud users gain comprehensive visibility into the components of each authorization request, facilitating informed decision-making and efficient care coordination.

Integration Process:

To effectively display preauthorization outcomes from an external system within Health Cloud, consider the following steps:

Data Mapping: Establish a data mapping strategy to align fields from the external system with the corresponding fields in the Service Preauth and Preauth Detail objects. This ensures that all relevant information is accurately captured and displayed within Health Cloud.

Data Import: Utilize Salesforce's data import tools or integration middleware (such as MuleSoft) to import preauthorization data into the Service Preauth and Preauth Detail objects. This process can be automated to ensure real-time or near-real-time updates, providing users with the most current information.

User Access and Permissions: Configure user permissions to ensure that appropriate personnel have access to view and manage preauthorization information. This includes setting up profiles and permission sets that grant access to the Service Preauth and Preauth Detail objects.

A Conditional Block in an Integration Procedure allows you to execute a group of actions based on specific conditions. This means that certain steps within the procedure will only run when predefined criteria are met, enabling dynamic and context-sensitive processing.

Implementation Steps:

Identify the Condition:

Determine the specific condition under which the email with the new address should be sent. For instance, if the appointment is booked at the new location, the condition could be based on the location ID or name.

Configure the Conditional Block:

Add a Conditional Block: Within your Integration Procedure, insert a Conditional Block where you want the conditional logic to apply.

Set the Execution Conditional Formula: Define the condition that evaluates to true when the email should be sent. For example, if the new location has an ID of 'New_Location_ID', the formula might be:

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%AppointmentLocationId% == 'New_Location_ID'

Add Actions Within the Conditional Block: Inside this block, include the necessary actions to send the email. This could involve:

Set Values Action: To define the email content, including the new address.

Email Action: To send the email to the patient.

Test the Integration Procedure:

Ensure that when an appointment is booked at the new location, the condition evaluates to true, triggering the email. Conversely, verify that appointments at other locations do not trigger this email.

Benefits of Using Conditional Blocks:

Dynamic Processing: Executes specific actions only when certain conditions are met, enhancing efficiency.

Simplified Logic Management: Organizes conditional logic within the Integration Procedure, making it easier to manage and maintain.

Improved Performance: By executing only necessary actions, it reduces processing time and resource consumption.

To enable the Clinical Data Model in Salesforce Health Cloud, the FHIR-Aligned Data Model org preference must be activated. This preference ensures compatibility with the Fast Healthcare Interoperability Resources (FHIR) standard, which is widely used for managing healthcare data.

FHIR-Aligned Data Model:

Supports the representation of clinical data such as medications, conditions, procedures, and encounters in a format compliant with the FHIR standard.

Aligns Health Cloud’s data structure with industry standards, facilitating interoperability with Electronic Health Record (EHR) systems and other healthcare platforms.

Why Not the Other Options?

B. Clinical R4 Model org preference: This is not a valid preference in Salesforce Health Cloud.

C. FHIR-Aligned EHR Data Model org preference: While EHR data models align with FHIR, this specific preference does not exist.

D. Clinical Data Model org preference: This is not specific to the FHIR-aligned framework and may not meet interoperability requirements.

Implementation Steps:

Navigate to Setup ? Health Cloud Settings.

Enable the FHIR-Aligned Data Model org preference.

Configure the required objects and fields for the Clinical Data Model.

In Salesforce Health Cloud, granting access to patient data for healthcare providers or supporting personnel is efficiently managed through Care Teams.

Key Details:

Care Teams in Health Cloud:

A Care Team represents the group of professionals supporting a patient.

Access levels (Read or Read/Write) can be explicitly granted to Care Team members.

Implementation Steps:

Navigate to the patient's record in Health Cloud.

Open the Care Team section and add the respiratory therapist.

Assign the appropriate Role (e.g., Respiratory Therapist).

Specify the required access level (Read or Read/Write).

Why Care Teams Are Preferred:

Specific Roles: Clearly defines the roles of individuals supporting the patient.

Access Flexibility: Provides fine-grained control over access to patient data.

Why Other Options Are Incorrect:

A and C (Account Team): Account Teams are not designed for patient care management and lack the granularity required for healthcare scenarios.

D (Care Team with Default Access): Default access is not automatically granted; permissions must be explicitly defined.

Supporting Documentation:

Manage Care Teams in Health Cloud (help.salesforce.com)

Role-Based Access in Health Cloud (developer.salesforce.com)

By leveraging Care Teams and assigning appropriate permissions, administrators can efficiently manage access to sensitive patient data while maintaining compliance with privacy regulations.

The Life Sciences data model in Salesforce Health Cloud is specifically designed to meet the needs of MedTech companies. It includes features for planning and tracking surgical case visits, managing medical device inventory, and conducting cycle counts, making it ideal for this use case.

Key Features of the Life Sciences Data Model:

Surgical Case Management: Tracks and plans surgical procedures, including device requirements and associated logistics.

Device Inventory Management: Manages medical device stock, including availability, usage, and maintenance schedules.

Cycle Counts: Ensures inventory accuracy through routine counting and tracking.

Why Other Options Are Incorrect:

Intelligent Sales: Focuses on sales processes, not surgical or inventory management.

Inventory Management: Generic inventory features lack the healthcare-specific capabilities provided by the Life Sciences model.

Provider Engagement: Centers around provider relationship management rather than surgical and inventory processes.

In Salesforce Health Cloud, Identity Verification Processes allow you to configure how patient or contact identities are verified during interactions. The requirements from the call center team involve modifying the verification process to:

Include "Bloomington ID":

This custom field should be added as a required verifier and also included in search results.

Modify "Birth Date":

Remove it as a required verifier while keeping it available as an optional verifier in the process.

Steps to Implement the Solution:

Add Two New Identity Verification Process Field Records for ‘Bloomington ID’:

Field Type: Result Field: Ensures the field appears in the search results.

Field Type: Required Verifier: Makes this field mandatory for identity verification.

Modify Birth Date Record:

Update the existing record for Birth Date by changing its Field Type from "Required Verifier" to "Optional Verifier." This adjustment makes the field optional in the verification process.

This approach ensures the flexibility and compliance requested by the call center manager while aligning with Salesforce Health Cloud's configurable Identity Verification features.

When the default appointment management solutions in Salesforce Health Cloud are not viable, leveraging a prebuilt package from an Independent Software Vendor (ISV) is the most robust and efficient solution. These packages are designed to integrate seamlessly with Health Cloud, offering advanced features that meet specific requirements like external appointment scheduling.

Why ISV Packages Are Recommended:

Purpose-Built: Designed for healthcare providers, these packages address appointment management complexities out of the box.

Seamless Integration: Built on Salesforce, these solutions are easily customizable and work with existing Health Cloud features.

Scalability: Offers long-term adaptability for growing healthcare organizations.

Why Other Options Are Incorrect:

Apex Class and Intelligent Appointment Management: Requires custom development, which can be costly and time-consuming.

EHR Routing System: External EHR systems often require complex integrations and may not align with Health Cloud workflows.

Custom FHIR Adapter: FHIR Adapters are typically used for clinical data exchange, not appointment management.

For implementing a Contact Center leveraging Health Cloud, identifying pain points and defining project requirements involves collaborating with:

Contact Center Agent (Persona):

Frontline staff who interact directly with patients.

Provide insights into the day-to-day challenges in appointment scheduling, billing inquiries, and plan updates.

Salesforce Administrator (Stakeholder):

Responsible for configuring Health Cloud and implementing workflows to address identified pain points.

Integration Architect (Stakeholder):

Ensures smooth integration between Health Cloud and external systems like billing platforms or insurance providers.

Why Other Options Are Incorrect:

A: Care coordinators are not directly involved in patient-initiated contact center interactions. Tableau developers focus on reporting, not operational processes.

C: MuleSoft developers are not primary stakeholders for contact center operations.

D: General physicians and Marketing Cloud administrators do not contribute directly to Contact Center workflows.

To update an existing field on a custom SObject using OmniScript, the following components are essential:

DataRaptors (C):

DataRaptors are used to read, write, or transform Salesforce data.

In this case, a DataRaptor Load would be configured to update the field on the custom SObject.

Integration Procedures (D):

Integration Procedures orchestrate data operations and can combine multiple DataRaptors or external API calls.

Used to call the DataRaptor Load and manage complex logic if needed.

Why Other Options Are Incorrect:

API Actions: Primarily used for invoking external APIs, not for internal Salesforce data operations.

SOQL Query: Retrieves data from Salesforce but does not update fields.

When launching a patient portal with contact tracing functionality as part of a Health Cloud implementation, it's crucial to select a license that supports advanced sharing capabilities and customizable dashboards for external patient users. The Customer Community Plus for Health Cloud license is the most appropriate choice to meet these requirements.

Key Features of Customer Community Plus for Health Cloud:

Advanced Sharing: This license offers advanced sharing capabilities, allowing for more granular control over data access. This ensures that patients can securely access their health information while maintaining compliance with privacy regulations.

Customizable Dashboards: With this license, users have access to customizable dashboards, enabling the presentation of personalized health data, appointment schedules, and other relevant information in an intuitive and user-friendly interface.

Enhanced Permissions: Customer Community Plus provides enhanced permissions compared to the standard Customer Community license, including the ability for users to manage their own records and collaborate more effectively with healthcare providers.

Considerations:

User Access Requirements: Assess the specific needs of your patient users, including the types of data they need to access and the level of interaction required within the portal. Customer Community Plus supports more complex use cases involving data sharing and collaboration.

Compliance and Security: Ensure that the chosen license aligns with healthcare compliance standards, such as HIPAA, to protect patient information. The advanced sharing and security features of Customer Community Plus support adherence to these regulations.

To address the use case of creating a UI component for a MedTech company that displays customer data, allows initiating a new order process, and displays available products for purchase, the following OmniStudio capabilities are required:

1. Integration Procedures:

Purpose: Integration Procedures handle server-side logic by connecting with external systems, databases, or Salesforce objects to fetch or update data efficiently.

Role in Use Case: The new order process will likely require data from external systems, such as a product catalog or inventory system. Integration Procedures are ideal for orchestrating these back-end calls and consolidating data to display product availability or order information.

Key Features:

Perform complex, multi-step actions in a single server call.

Fetch data asynchronously, improving UI performance.

Utilization Management is a critical component in healthcare that focuses on ensuring the appropriateness, necessity, and efficiency of healthcare services. For payers working with plan members and medical providers, the case-by-case review of care appropriateness requires thorough processes to streamline authorization and review tasks.

Designing Care Requests to Seek Authorization (Answer B):

Purpose: The Care Request object in Health Cloud is essential for seeking authorizations from a health plan for specific healthcare services, drugs, or admissions. This object ensures that requests are appropriately documented and tracked.

Functionality:

It allows users to create and manage care requests linked to plan members.

Integrates with payer systems to capture critical details for authorization, such as service codes, plan information, and medical necessity documentation.

Supports automation through workflows and approvals, speeding up the decision-making process.

Relevance: By designing efficient Care Requests, the consultant ensures that all required details for preauthorizations or service reviews are captured seamlessly, meeting regulatory and operational needs.

Considering Request Review Types (Answer C):

Purpose: UM processes in Health Cloud must address the three primary types of reviews:

Prior Authorization Review: Conducted before the service is provided to determine medical necessity.

Concurrent Review: Evaluates the necessity of ongoing care during hospitalization or service delivery.

Retrospective Review: Analyzes the appropriateness of care after it has been delivered.

Implementation in Health Cloud:

The consultant must design workflows and data models to capture the details of these review types, including timestamps, reviewer notes, and outcomes.

Health Cloud supports tracking and documenting these reviews within the UM module, ensuring compliance with healthcare regulations.

Relevance: These review types allow the payer to influence decisions by ensuring appropriate care is provided while managing costs and maintaining high-quality outcomes.

Why the Other Options Are Less Relevant:

A. Designing Next Best Action and Recommendations for the Care Management Team: While recommendations and next-best-action features are beneficial for care management, they are not directly tied to the case-by-case review process of Utilization Management, which focuses more on care appropriateness and authorizations.

D. Considering the Number of Intake Agents Using Health Cloud: While operational considerations like staffing are important, this is not a Utilization Management process. It's a broader organizational concern unrelated to the core functionality of UM in Health Cloud.

Bloomington Caregivers is transitioning from legacy Care Plans to Integrated Care Management (ICM) in Salesforce Health Cloud to enhance care coordination and patient outcomes. Understanding the features and setup of ICM is crucial for a successful transition.

Enabling Integrated Care Management (Answer C):

Enhanced Care Management Setting:

Purpose: Activating the Enhanced Care Management setting in Salesforce Setup enables Integrated Care Management features within Health Cloud.

Implementation Steps:

Navigate to Setup: In Salesforce, go to Setup.

Search for Health Cloud Settings: Enter "Health Cloud" in the Quick Find box and select Health Cloud Settings.

Enable Enhanced Care Management: Locate the Enhanced Care Management option and toggle it to enable.

The FHIR R4 (Fast Healthcare Interoperability Resources) standard is the most suitable industry data standard for designing interoperability with Electronic Health Record (EHR) systems in Salesforce Health Cloud.

Widespread Adoption:

FHIR R4 is the industry standard for modern EHR systems, supported by regulatory bodies like the ONC (Office of the National Coordinator for Health IT).

Compatibility:

Salesforce Health Cloud’s Clinical Data Model and FHIR-compliant APIs are built to align with FHIR R4 standards.

Data Interoperability:

Facilitates seamless exchange of clinical data (e.g., medications, conditions, and encounters) between Health Cloud and EHR systems.

A. Clinical Data Acquisition: A generic concept rather than a specific standard.

B. Personal Health Record (PHR): Focuses on patient-controlled data, not interoperability.

C. HL7 v1 Messaging: An outdated standard superseded by FHIR for modern systems.

The Actionable Relationship Center (ARC) in Salesforce Health Cloud provides a 360-degree view of complex associations between patients, their personal relationships, healthcare practitioners, and organizations. It visually represents these relationships in an interactive graph, helping care coordinators understand and manage these connections effectively.

Key Features of ARC:

Relationship Visualization: Displays all relevant relationships for a patient, including family members, caregivers, and healthcare providers.

Interactive Interface: Users can click on entities to view detailed information and take actions like assigning tasks or sending messages.

Customization: Supports the addition of custom relationship types tailored to the organization’s needs.

Why Other Options Are Incorrect:

Care Team: Focuses on defining and managing members of the care team but does not provide a visual representation of all relationships.

Enhanced Timeline: Tracks patient interactions chronologically but does not map relationships.

Patient Card: Displays patient-specific information but lacks relationship visualization capabilities.

Implementing Home Health scheduling in Salesforce Health Cloud requires assigning appropriate permission set licenses to users responsible for scheduling patient visits.

Field Dispatch Scheduler Permission Set License:

The Field Dispatch Scheduler permission set license is designed for users who manage and schedule field service operations, including home health visits. Assigning this license grants schedulers access to functionalities necessary for coordinating and dispatching healthcare providers to patient locations. This includes capabilities such as:

Scheduling Visits: Schedulers can create and manage appointments for initial assessments and recurring visits, ensuring that patients receive timely care.

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Resource Management: Effectively allocate healthcare providers based on availability, location, and required skills to meet patient needs.

Access to Field Service Tools: Utilize tools within Salesforce to optimize routing, manage workloads, and monitor service delivery.

By assigning the Field Dispatch Scheduler permission set license, Bloomington Caregivers ensures that their scheduling personnel have the necessary access to efficiently coordinate home health services, thereby enhancing operational efficiency and patient satisfaction.

The Benefits Verification component in Salesforce Health Cloud is designed to help agents respond to member inquiries regarding benefits coverage. This feature integrates seamlessly with Health Cloud objects and data, offering agents real-time access to benefit information.

Key Features of Benefits Verification:

Real-Time Verification: Displays benefits data retrieved through integrations, allowing agents to answer member questions promptly.

Comprehensive Coverage Details: Includes plan benefits, covered services, and limits.

Customizable Layout: Can be configured on the record page to provide relevant benefit details in a user-friendly format.

Why Other Options Are Incorrect:

A. Eligibility Validation: Focuses on determining program eligibility rather than detailed benefits coverage.

B. Benefits Coverage: While related, it is not the specific tool designed for verifying benefits inquiries.

C. Coverage Confirmation: Typically used for confirming specific services under a plan, not general benefits questions.

To enhance the user experience for call center agents in Salesforce Health Cloud, particularly on patient records, implementing specific components from the Contact Center for Health Cloud is essential.

1. Timeline:

The Timeline component provides a chronological view of all interactions and events related to a patient. This includes appointments, communications, and care activities. By presenting this information in a consolidated timeline, agents gain a comprehensive understanding of the patient's history, enabling informed and personalized interactions.

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2. Member Plan FlexCard:

The Member Plan FlexCard displays essential details about a patient's insurance plan, such as coverage information, benefits, and eligibility. This readily accessible information allows agents to address patient inquiries regarding their insurance without navigating through multiple systems, thereby improving efficiency and service quality.

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3. Record Alerts:

Record Alerts notify agents of critical changes or important information related to a patient's record. These alerts can be configured to highlight updates such as changes in contact information, care plans, or new health concerns. By receiving timely alerts, agents can proactively address issues and provide up-to-date information to patients.

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Implementing these components ensures that call center agents have a holistic view of patient information, can promptly respond to changes, and access insurance details efficiently. This integrated approach enhances patient engagement, satisfaction, and overall care coordination.

Implementing patients or members in Health Cloud requires careful configuration to accurately represent individual relationships and household structures.

1. Ensure the Account is the Parent to Household Accounts (Answer C):

Purpose: In Health Cloud, modeling household relationships is essential for understanding the familial and support networks of patients. By setting the Account as the parent to Household Accounts, you can effectively represent and manage these relationships.

Implementation Steps:

Create a Household Account to represent the family or support group.

Associate individual Person Accounts (patients) as members of this Household Account.

Use the Account Hierarchy to visualize and manage these relationships.