Salesforce Certified Health Cloud Accredited Professional Practice Test - Questions Answers, Page 15

The three features in Health Cloud that the consultant should recommend to the health plan provider are Business Rules Engine, Utilization Management data model, and Out-of-the-box Process libraries. These features enable the provider to manage prior authorizations with predefined approval criteria, store and track care requests, and leverage best practices and templates for common scenarios .

To create Salesforce reports to analyze patient outcomes and patient referrals, a consultant should recommend the following steps:

Create custom report types for clinical objects, such as Condition, Medication, or Encounter, to access the data stored in Health Cloud's clinical data model1.

Assign appropriate permissions to internal users, such as the Health Cloud Analytics permission set, to enable them to view and create reports and dashboards2.

Adjust template care management reports and dashboards, such as Patient Outcomes or Patient Referrals, to customize them for the customer's specific needs34. Enabling the enhanced Analytics for Healthcare setting or leveraging the Patient Referral Management unmanaged package are not required steps for this requirement.

To better plan and track surgical case visits, manage device inventory and run cycle counts, a consultant should recommend the MedTech company use the Life Sciences data model in Health Cloud.This data model provides objects and fields to store and manage information related to surgical cases, devices, inventories, cycle counts, and more5. Intelligent Sales, Inventory Management, or Provider Engagement are not data models that exist in Health Cloud.

To view medication data from Health Cloud leveraging FHIR standards, a consultant should use the clinical data model.This data model is built to align with HL7's FHIR R4 and provides objects and fields to store and access clinical information such as medications, conditions, encounters, observations, and more6.The clinical data model also supports FHIR APIs to enable interoperability between Health Cloud and external systems that use FHIR standards7. Integrated Care Management data model, Electronic health record (EHR) data model, or Virtual Care data model are not data models that can fulfill this requirement.

To help streamline caller authentication for Contact Center agents, a consultant should recommend Bloomington Caregivers use the Identity Verification Flow Templates feature in Health Cloud. This feature allows agents to launch a flow from the utility bar or a record page to verify a caller's identity before processing their requests involving sensitive information.The flow prompts the agent to search for the caller in Health Cloud, select a reason for the call, ask verification questions based on predefined rules, and capture engagement details8. Customer Identity OmniScript Templates, Reusable Verification FlexCards, or Verify Customer Identity Process Flow are not features that exist in Health Cloud.

To help the payer organization electronically receive requests for services from Bloomington Caregivers, a consultant should recommend the following business level APIs:

Prior Authorization API: This API allows Bloomington Caregivers to create requests for prior authorization for services that require approval from the payer organization.The API also allows Bloomington Caregivers to update or cancel existing requests or query the status of requests9.

Care Services API: This API allows Bloomington Caregivers to create requests for care services that are covered by the payer organization's benefit plans.The API also allows Bloomington Caregivers to update or cancel existing requests or query the status of requests10.

Referral Request API: This API allows Bloomington Caregivers to create requests for referrals to other providers that are part of the payer organization's network.The API also allows Bloomington Caregivers to update or cancel existing requests or query the status of requests11. Admission, Discharge, and Transfer (ADT) API or Benefit Verification API are not business level APIs that can fulfill this requirement.

To drive performance and scalability for Provider Search, a consultant should leverage the Data Processing Engine tool in Health Cloud. This tool allows pharma companies to map and transform the source data from the Provider Data Model into a searchable object called Care Provider Searchable Field.The Data Processing Engine also syncs the data with the Care Provider Searchable Field object once a day or manually as needed12. This process reduces the search time and improves the accuracy of the results. Flow for Industries, Pipeline Analytics, or Business Rules Engine are not tools that can fulfill this requirement.

The two objects that support Salesforce's recommended approach to model the doctors in the clinic's Health Cloud org are Contact and Healthcare Practitioner. Contact is used to store the personal information of the doctor, such as name, phone, and email. Healthcare Practitioner is used to store the professional information of the doctor, such as specialty, license, and credentials.

The set of Health Cloud capabilities that should enable the company to build this business process are Intelligent Document Automation, Intelligent Appointment Management, Intelligent Document Reader, and Benefits Verification. Intelligent Document Automation allows the company to upload a patient's insurance card and automatically create a Member Plan record. Intelligent Appointment Management allows the company to schedule on behalf of the patient with a provider. Intelligent Document Reader allows the company to extract data from the insurance card and populate the Member Plan fields. Benefits Verification allows the company to run a benefits verification check using a third-party service.