Health Information Technology Glossary

American National Standards Institute (ANSI) –An organization that establishes procedures for the development and coordination of voluntary standards for a wide range of industries and services which includes standards applicable to health care and health information exchange.

Application Service Provider (ASP) – A business that deploys, hosts, and manages access to software applications for multiple parties from a central facility. The ASP usually charges a subscription fee to users of the applications, which are delivered over the Internet or other public or private networks.

Certified Electronic Health Record – A qualified electronic health record that is certified pursuant to s. 3001(c) (5) of the Federal Public Health Service Act as meeting standards adopted under s. 3004 of such act which are applicable to the type of record involved, such as an ambulatory electronic health record for office-based physicians or an inpatient hospital electronic health record for hospitals.

Continuity of Care Document (CCD) – Summarizes a consumer's medical status in a standard format for the purpose of information exchange. The content may include administrative (e.g., registration, demographics, insurance, etc.) and clinical (problem list, medication list, allergies, test results, etc.) information. The CCD promotes interoperability between participating systems such as Personal Health Record Systems (PHRs), Electronic Health Record Systems (EHRs), Practice Management Applications, and other systems.

Computerized Provider Order Entry (CPOE) – A computer application that allows a physician’s orders for diagnostic and treatment services (such as medications, laboratory, and other tests) to be entered electronically instead of being recorded on order sheets or prescription pads. The computer compares the order against dosage standards, checks for allergies or interactions with other medications, and warns the physician about potential problems.

Decision-Support System (DSS) – Computer tools or applications to assist physicians in clinical decisions by providing evidence-based knowledge in the context of patient specific data. Examples include drug interaction alerts at the time medication is prescribed and reminders for specific guideline-based interventions during the care of patients with chronic disease. Information should be presented in a patient-centric view of individual care and also in a population, or aggregate view to support population management and quality improvement.

Data Use and Reciprocal Support Agreement (DURSA) – A multi-party agreement that establishes the rules of engagement and obligations to which all National Health Information Network (NHIN) Exchange participants agree and that all NHIN Exchange participants sign as a condition of joining.7.29.2010 2

Digital Imaging and Communications in Medicine (DICOM) – The industry standard for the transfer of radiologic images and other medical information between computers. DICOM enables digital communication between diagnostic and therapeutic equipment and systems from various manufacturers.

Direct – An Office of the National Coordinator for Health IT (ONC) project that specifies a simple, secure scalable, standards-based transportation mechanism that enables participants to send (push) encrypted health information directly to known, trusted recipients over the Internet.

Electronic Health Record (EHR) – A real-time (instantly updatable) electronic patient health record with access to evidence-based decision support tools to aid clinicians in decision making. Electronic Health Records can also be exchanged through a Health Information Exchange program to other physicians to ensure that patient data is accurate and up to date. The EHR can automate and streamline a clinician's workflow, ensuring that all clinical information is communicated. It can also prevent delays in response that result in gaps in care. The EHR can also support the collection of data for uses other than clinical care, such as billing, quality management, outcome reporting, and public health disease surveillance and reporting.

Electronic Prescribing (E-prescribing or eRx) – A type of computer technology physicians use to review drug and formulary coverage and to transmit prescriptions to a local pharmacy. E-prescribing software can be integrated into existing clinical information systems to allow physician access to patient specific information to screen for drug interactions and allergies.

Florida Health Information Exchange (HIE) Cooperative Agreement Program – On August 20, 2009, the Office of the National Coordinator for Health Information Technology (ONC) announced the State Health Information Exchange Cooperative Agreement Program through a Funding Opportunity Announcement. The Florida HIE Cooperative Agreement Program application was submitted on October 15, 2009 to the Office of the National Coordinator for Health Information Technology. In March 2010, the Agency was notified that it was awarded $20.7 million in federal funding to be used over a four-year period for the purpose of supporting statewide health information exchange. The 2010 Florida Legislature directed the Agency to issue an Invitation to Negotiate (ITN) by July 15, 2010 for the selection of a technology organization to implement the statewide HIE infrastructure under the HIE Cooperative Agreement.

Florida Health Information Network (FHIN) website – A clearinghouse of information relating to the active role of the Agency for Health Care Administration in promoting the adoption and use of appropriate health information technology. See FHIN.net.

Florida Medicaid Health Information Network (FMHIN) – A secure portal made available by the Agency for Health Care Administration that uses Medicaid claims data to give clinicians access to patient specific Medicaid claims information at the point of care. Using the secure network portal, providers can access patient specific claims-based data, along with patient eligibility and benefit look-up. The data includes prescription history, lab event history, hospital visits, diagnoses, and any other paid Medicaid claims information retroactive 18 months. The information comes directly from the Medicaid Management Information System (MMIS), to the Decision Support System (DSS), and is extracted and stored in a database maintained by the Agency’s Division of Information Technology.7.29.2010 3
Health Information Exchange (HIE) – The mobilization of health care information electronically across organizations within a state, region, community, or hospital system.

Health Information Technology (HIT) – The application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of health care information, data, and knowledge for communication and decision making.

Health Insurance Portability and Accountability Act (HIPAA) – A US law that provides (among other provisions) privacy standards to protect patients' medical records and other health information provided to health plans, doctors, hospitals, and other health care providers.

Health Information Technology for Economic and Clinical Health Act (HITECH) – This legislation was included in the American Recovery and Reinvestment Act (ARRA or Act) to accomplish four major goals that advance the use of health information technology (Health IT).  The government will take a leadership role in developing standards by 2010 that allow for the nationwide electronic exchange and use of health information to improve quality and coordination of care. The legislation included $20 billion in health information technology infrastructure, and Medicare and Medicaid incentives to encourage doctors and hospitals to use Health IT to electronically exchange patients’ health information. This generated savings throughout the health sector through improvements in quality of care and care coordination, and reduced medical errors and duplicative care. The Act strengthened Federal privacy and security laws to protect identifiable health information from misuse as the health care sector increases use of Health IT.

Health Level 7 (HL7) – An ANSI accredited organization that develops international standards for health care. HL7 standards specify a number of flexible standards, guidelines, and methodologies by which various healthcare systems can communicate with each other. The HL7 Continuity of Care Document (CCD) specifies a standard format for the exchange of clinical information, including patient demographics, problems, medications, and allergies.

Integrated Delivery Network (IDN) – An organization that combines hospital, physician and other medical services as part of a larger health care system.

Integrating the Healthcare Enterprise (IHE) – An organization that promotes the coordinated use of established standards for health information exchange. Systems developed in accordance with IHE processes communicate with one another better, are easier to implement, and enable care providers to use information more effectively.

Interface – Equipment or programs designed to communicate information from one system of computing devices or programs to another.7.29.2010 4
Interoperability – The ability of a system (i.e., Electronic Medical Records system) to work with or use the parts or equipment of another system.

Logical Observation Identifiers Names and Codes (LOINC) – A database and universal standard for identifying medical laboratory observations.

Meaningful Use – Under the HITECH Act, an eligible professional or hospital is considered a "meaningful EHR user" if they use certified EHR technology in a manner consistent with criteria established by the Secretary of Health & Human Services (HHS), including but not limited to e-prescribing through an EHR and the electronic exchange of information for the purposes of quality improvement, such as care coordination. In addition, eligible professionals and hospitals must submit clinical quality and other measures to HHS.

Stage 1 Meaningful Use (2011 and 2012) – Meaningful use includes both a core set and a menu set of objectives that are specific for eligible professionals and hospitals. For Eligible Professionals, there are a total of 25 meaningful use objectives. Twenty of the objectives must be completed to qualify for an incentive payment. Fifteen are core objectives that are required, and the remaining 5 objectives may be chosen from the list of 10 menu set objectives. For Hospitals, there are a total of 24 meaningful use objectives. Fourteen are core objectives that are required, and the remaining 5 objectives may be chosen from the list of 10 menu set objectives.

National Health Information Network (NwHIN) – The NwHIN is a federal initiative to develop a set of standards, services, and policies that enable the secure exchange of health information over the Internet for sharing among health decision makers, including consumers and patients, to promote improvements in health and health care. A group of federal agencies, local, regional and state-level Health Information Exchange Organizations (HIOs) and integrated delivery networks has been helping to develop the NwHIN standards, services and policies. Currently, the Nationwide Health Information Network (NwHIN) is operating as the NwHIN Exchange. By the end of 2010, it is expected that approximately a dozen federal and private entities will be securely sharing live health information.

Open Source – Systems whose human-readable ("source") code is always freely available to anyone who is interested in downloading it. This is in contrast to most commercial software, whose source code is considered intellectual property and a trade secret not to be disclosed. Advantages of open source include availability, extensibility, and the opportunity for peer review. Open source products are made available under a variety of licenses.

Patient Identifier Cross-Reference (PIX)/ Patient Demographic Query (PDQ) – Patient Identifier Cross-referencing is an integration profile that enables the cross referencing of patient identifiers from multiple patient identifier domains by transmitting patient identity information from an identity source to the Patient Identifier Cross-reference Manager, and providing the ability to access the list(s) of cross-referenced patient identifiers either via a query/response or via an update notification. A Patient Demographics Query is an integration profile that lets 7.29.2010 5
applications query a central patient information server in order to retrieve patient demographics and encounter information.

Personal Health Record (PHR) – An electronic application through which individuals can maintain and manage their health information (and that of others for whom they are authorized) in a private, secure, and confidential environment.

Public Key Infrastructure (PKI) – Enables users of a basically unsecure public network, such as the Internet, to securely and privately exchange data through the use of a public and a private cryptographic key pair that is obtained and shared through a trusted authority. The public key infrastructure provides for a digital certificate that can identify an individual or an organization and directory services that can store and, when necessary, revoke the certificates.

Qualified Electronic Health Record – An electronic record of health-related information concerning an individual which includes patient demographic and clinical health information, such as medical history and problem lists, and which has the capacity to provide clinical decision support, to support physician order entry, to capture and query information relevant to health care quality, and to exchange electronic health information with, and integrate such information from, other sources. (See Certified Electronic Health Record)

Record Locator Services (RLS) – An electronic index of patient identifying information that directs providers in a health information exchange to the location of patient health records held by providers and other data sources.

Regional Extension Centers (REC) – Created in the Health Information Technology for Economic and Clinical Health (HITECH) Act to furnish assistance, defined as education, outreach, and technical assistance, to help providers in their geographic service areas select, successfully implement, and meaningfully use certified EHR technology to improve the quality and value of health care.

Regional Health Information Organization (RHIO) – A regional multi-stakeholder organization that enables the exchange and use of health information in a secure manner for the purpose of promoting the improvement of health care quality, safety, and efficiency.

State Medicaid HIT Plan (SMHP) – The Centers for Medicare and Medicaid Services (CMS) requires each state to have a plan with a common vision of how Medicaid’s provider incentive program will operate in concert with the larger health system and statewide efforts. The plan must include at least four components: a current landscape assessment, a vision of the State’s HIT future, specific actions necessary to implement the incentive payments program, and a HIT road map.

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