Pass Health-Cloud-Accredited-Professional Exam Guide

The Advanced Patient Card in Salesforce Health Cloud provides an organized and navigable view of critical patient information, such as insurance, clinical data, and details of the primary care physician. This feature allows healthcare providers to access key data quickly within a patient’s profile.

Key Features of Advanced Patient Card:

Data Aggregation: Consolidates insurance, clinical, and provider information in a single, easy-to-navigate view.

Customizable Fields: Allows organizations to configure the card to display the most relevant information.

Improved User Experience: Designed to streamline the workflow of care providers by providing quick access to key data.

Why Other Options Are Incorrect:

Patient Path: Focuses on tracking patient milestones rather than critical information at a glance.

Enhanced Timeline: Provides a chronological view of patient interactions, not immediate profile data.

Enhanced Highlights Panel: Displays high-level patient data but lacks the depth and configurability of the Advanced Patient Card.

References:

Advanced Patient Card Overview

For a payer implementing Health Cloud, leveraging predefined rules for prior authorization reviews can significantly improve efficiency and speed. Salesforce Health Cloud provides Expression Set Templates as an out-of-the-box feature to achieve this.

Predefined Rules:

Expression Set Templates come with prebuilt rule sets that can evaluate conditions, making them ideal for automating prior authorization request reviews.

Customizable Logic:

While they provide predefined logic, templates can also be customized to align with specific payer policies or regulatory requirements.

Faster Implementation:

Using out-of-the-box templates accelerates time-to-value, as they require minimal configuration compared to building rules from scratch.

A. Integration Procedures: Focuses on data integration and server-side processing but does not address predefined rules for authorization reviews.

C. FlexCards: Provides UI components for displaying information but does not support rule evaluation.

D. OmniScript Templates: Useful for guided workflows but not specifically for predefined rule management.

Key Features of Expression Set Templates:Why Other Options Are Less Suitable:References:

Expression Sets in Salesforce Health Cloud

Implementing Utilization Management in Salesforce Health Cloud to handle prior authorizations involves customizing specific components to streamline the submission and tracking processes.

1. Integrate Using MuleSoft Direct for Electronic Prior Authorizations (ePA):

MuleSoft Direct for Health Cloud facilitates seamless integration between Electronic Health Record (EHR) systems and Health Cloud. This integration enables providers to electronically submit and track prior authorization requests, eliminating manual processes and reducing decision times. By leveraging electronic prior authorization (ePA), healthcare organizations can automate workflows, ensure timely approvals, and enhance patient care delivery.

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2. Customize the Service Request Object:

The Service Request object in Health Cloud serves as a central repository for managing various patient-related requests, including prior authorizations. Customizing this object allows organizations to align the authorization process with their specific business requirements. Enhancements may include adding custom fields to capture necessary clinical information, modifying page layouts for improved user experience, and implementing validation rules to ensure data accuracy. Such customizations facilitate efficient tracking and management of authorization requests, ensuring that all relevant information is readily accessible to care teams.

References:

Get Started with Health Cloud Utilization Management

Manage Authorization Requests in a Provider’s Office

Salesforce Health Cloud includes several features to ensure compliance with regulations like the Health Insurance Portability and Accountability Act (HIPAA). Among these, user authentication and access control is a key feature that safeguards protected health information (PHI) by controlling and restricting access based on user roles, permissions, and organizational policies.

Why User Authentication and Access Control is Key for HIPAA Compliance:

Role-Based Access Control (RBAC):

Salesforce allows administrators to define and manage access through role hierarchies and sharing rules. Only authorized users can view, edit, or process sensitive health data.

Shield Platform Encryption:

Salesforce Shield provides encryption capabilities for PHI. It ensures data remains secure at rest and during transit, an essential requirement of HIPAA.

Audit Trails and Field Tracking:

Salesforce Health Cloud tracks changes to sensitive data fields, offering detailed logs for auditing purposes.

Two-Factor Authentication (2FA):

2FA ensures only authenticated users access the system, adding an extra layer of security to sensitive health information.

Compliance Policies:

Salesforce’s built-in compliance tools, like health data masking and logging, align with HIPAA requirements.

Why Other Options Are Incorrect:

A. Data visualization and analytics:While important for decision-making, this feature does not directly address HIPAA compliance as it focuses on operational insights rather than security.

B. Social media integration:Social media features are unrelated to HIPAA compliance and could pose risks if improperly managed.

D. Real-time monitoring and alerts:While useful for operational efficiency, this feature is not specifically tied to compliance with HIPAA’s privacy and security rules.

References:

Salesforce Security Guide

Shield Platform Encryption Guide

Administer Health Cloud