Healthcare and Health Informatics Glossary

Here is a glossary of terms useful in Healthcare and Health Informatics

ACO (Accountable Care Organization) MEDICARE’s outcomes-based contracting approach

Arden Syntax an approach to specifying medical knowledge and clinical decision support rules in a form that is independent of any EHR and thus sharable across hospitals

ARRA (American Recovery and Reconstruction Act) the Obama administration’s 2009 economic stimulus bill

Blue Button an ASCII text based standard for heath information sharing first introduced by the Veteran’s Administration to facilitate access to records stored in VistA by their patients. The newer Blue Button + format provides both human and machine readable formats.

CCD (Continuity of Care Document) an XML-based patient summary based on the CDA architecture

CCOW (Clinical Context Object Workshop) an HL7 standard for synchronizing and coordinating applications to automatically follow the patient, user (and other) contexts to allow the clinical user’s experience to resemble interacting with a single system, when they are using multiple, independent applications from many different systems

CCR (Continuity of Care Record) an XML-based patient summary format that preceded CDA

CCDA (Consolidated Clinical Document Architecture) the second
revision of HL7’s CDA architecture that attempts to introduce more standard templates to facilitate information sharing (a mandate of Meaningful Use 2)

CDA (Clinical Document Architecture) an XML-based markup standard intended to specify the encoding, structure and semantics of clinical documents

CDC (Centers for Disease Control and Prevention) the federal agency focused on disease in the community.

CA (Certificate Authority) an entity that digitally signs certificate requests and issues X.509 digital certificates that link a public key to attributes of its owner

CIMI (Clinical Information Modeling Initiative) an independent collaboration of major health providers improve the interoperability of healthcare information systems through shared and implementable clinical information models

CMS (Centers for Medicare & Medicaid Services) the component of the Department of Health and Human Services that administers the Medicare and Medicaid programs

CommonWell Alliance a group of major health IT companies that is working to achieve interoperability among their respective software products and services

Complete EHR an EHR software product that, by itself, is capable of meeting the requirements of certification and Meaningful Use

CONNECT ONC supported open source software for managing the centralized model of health information exchange

CPT (Current Procedural Terminology) the American Medical Association’s standard for coding medical procedures

De-identified Patient Health Information PHI from which all data elements that could allow the data to be traced back to the patient have been removed

Direct a set of ONC supported standards for secure exchange of health information using email

DNS (Domain Name System) the naming system for computers, services, or any resource connected to the Internet (or a private network). Among other things, it translates domain names (e.g. eBay.com) to the numerical IP addresses needed to locate Internet connected resources.

EDI/X12 a format for electronic messaging that utilizes cryptic but compact notation primarily to support computer-tocomputer commercial information exchange

eHealth Exchange a set of standards, services and policies that enable secure nationwide, Internet-based health information exchange using CONNECT or one of the commercial HIE products that support eHealth Exchange

EHR (Electronic Health Record) a stakeholder wide electronic record of a patient’s complete health situation

EHR Certification a set of technical requirements developed by ONC that, if met, quality an EHR to be used by an Eligible Professional to achieve Meaningful Use

Eligible Professionals (Medicaid) health providers who are eligible for Medicaid Meaningful Use payments: doctors of medicine, osteopathy, dental surgery, dental medicine, nurse practitioners, nurse certified nurse-midwifes, and physician assistants who working in a Federally Qualified Health Center or Rural Health Clinic that is led by a physician assistant

Eligible Professionals (Medicare) health providers who are eligible for Medicare Meaningful Use payments: doctors of medicine, osteopathy, dental surgery, dental medicine, podiatry, optometry and chiropractic

EMPI an enterprise master patient index

EMR (Electronic Medical Record) an electronic record used by a licensed professional care provider

GELLO a programming language intended for use as a standard query and expression language for clinical decision support. Now compatible with the HL7 version 3.0 Reference Information Model (RIM).

HDF (HL7 Development Framework) the framework used by HL7 to produce specifications for data, messaging process and other standards

Health System a network of providers that are affiliated for the more integrated delivery of care

Healtheway an ONC supported public-private partnership to promote nationwide health information exchange via the eHealth Exchange

HIE (Health Information Exchange) the sharing of digital health information by the various stakeholders involved, including the patient

HIMSS describes itself as a “a global, cause-based, not-forprofit organization focused on better health through information technology (IT)”

HIPAA (Health Insurance Portability and Accountability Act of 1996) legislation intended to secure health insurance for employees changing jobs and simplify administration with electronic transactions. It also defines the rules concerning patient privacy and security for PHI

HISP (Health ISP) a component of Direct that provides a provider directory, secure email addresses and public-key infrastructure (PKI)

HIT (Health Information Technology) the set of tools needed to facilitate electronic documentation and management of healthcare delivery

HITSP (Healthcare Information Technology Standards Panel) a public/private partnership to promote interoperability through standards

HL7 (Health Level 7) a not-for-profit global organization to establish standards for interoperability

HMO (Health Maintenance Organization) an organization that provides managed healthcare on a prepaid basis. Employers with 25 or more employees must offer federally certified HMO options if they offer traditional healthcare options

hQuery an ONC funded, open source effort to develop a generalized set of distributed queries across diverse EHRs for purposes such as clinical research

HTTP (Hypertext Transfer Protocol) a query-response protocol used to transfer information between web browsers and connected servers. HTTPS is the secure version.

ICD (International Classification of Disease) the World Health Organization’s almost universally used standard codes for diagnoses. The current version is ICD-10 but ICD-9 is used in most US institutions. The conversion target, set by CMS, is currently October 1, 2014.

IHTSDO (International Health Terminology Standard Development Organisation) the multinational organization that maintains SNOMED

IP Address a 32 bit (the standard is changing to 128 bit to accommodate Internet growth) number assigned to each device in an Internet Protocol network and that indicates where it is in that network.

I2b2 (Informatics for Integrating Biology and the Bedside) a scalable query framework for exploration of clinical and genomic data for research to design targeted therapies for individual patients with diseases having genetic origins

Interoperability the ability of diverse information systems to seamlessly share data and coordinate on tasks involving multiple systems.

LDAP (Lightweight Directory Access Protocol) is a protocol for accessing (including searching) and maintaining distributed directory information services (such as an email directory) over an IP network.

LOINC (Logical Observation Identifiers Names and Codes) the Regenstrief Institute’s standard for laboratory and clinical observations

Meaningful Use a set of usage requirements defined in three stages by ONC under which eligible professionals are paid for adopting a certified EHR

MedDRA (Medical Dictionary for Regulatory Activities) the International Conference on Harmonisation’s classification of adverse event information associated with the use of biopharmaceuticals and other medical products

Medicaid the joint federal/state program to provide healthcare services to poor and some disabled US citizens

Medicare the federally operated program to provide healthcare services to US citizens over the age of 65

MIME (Multipurpose Internet Mail Extensions) the Internet standard for the format of email attachments used in Direct. S/MIME is the secure version.

MLM (Medical Logic Module) the basic unit in the Arden Syntax that contains sufficient medical knowledge and rules to make one clinical decision.

Modular EHR a software component that delivers at least one of the key services required of a Certified EHR

MPI (Master Patient Index) software to provide correct
matching of patients across multiple software systems, typically within a health enterprise

MUMPS (Massachusetts General Utility Multi-Programming System) an integrated programming language and file management system designed in the late 1960’s for medical data processing that is the basis for some of the most widely installed enterprise health information systems

NDC (National Drug Codes) the Food and Drug Administration’s numbering system for all medications commercially available in the US

ONC (Office of the National Coordinator for Health Information Technology) the agency created in 2004 within the Department of Health and Human Services to promote the deployment of HIT in the US

Outcomes-based Contract an approach to pay for healthcare that rewards physician performance against certain defined quality metrics when combined with a lower than predicted cost of care

P4P (Pay for Performance) an approach to pay for healthcare that rewards physician performance against certain defined quality metrics

PCMH (Patient-Centered Medical Home) a team based healthcare delivery model often particularly focused on the management of chronic disease

PCP (Primary Care Physician) the generalist in a patient’s care team who assumes overall responsibility for all their health issues and often the gatekeeper who must generate referrals to specialists

PHI (Protected Health Information) any health or health related information that can be related back to a specific patient. PHI is subject to HIPAA regulations.

PKI (Public Key Infrastructure) a widely used system for
protection of documents, messages and other data that rests on a pair of public and private keys to allow for a variety of use cases

Private Key the protected (known only to its owner) part of the special pair of numbers used to encrypt documents using PKI

Provider health professionals including physicians, nurse practitioners, physicians’ assistants that are engaged in direct patient care

Public Key the public part of the special pair of numbers used to encrypt documents using PKI

RA (Registration Authority) an entity that collects information for the purpose of verifying the identity of an individual or organization and produces a certificate request

Synthetic Health Data facsimile clinical data created by a software system to realistically resemble actual patient data

Templates (CDA) the reusable basic XML-based building blocks of a CDA document that can represent the entire document, its sections or the data entries within a section

Read Codes a hierarchical clinical terminology system used in General Practice in the United Kingdom

Resource Description Framework (RDF) a method for describing or modeling of information on the web using subject-predicateobject expressions (triples) in the form of subject-predicateobject expressions that could be used to represent health ontologies (SNOMED, ICD-1)

RIM (Reference Information Model) a pictorial representation of the HL7 clinical data (domains) that illustrates the life cycle of an HL7 message or groups of related messages

Semantic web the proposed next generation of web in which technologies like RDF would create a “web of data” in which browsers (and other tools) could “understand” the content of web pages

SMTP (Simplified Mail Transport Protocol) the Internet standard for email used by Direct. The secure version is S/SMTP

SNOMED (Standard Nomenclature of Medicine) a comprehensive, hierarchical healthcare terminology system.

SNOMED CT (Standard Nomenclature of Medicine) SNOMED subset for the electronic health record

ToC (Transition of Care Initiative) the effort to develop a standard electronic clinical summary for transitions of care from one venue to another

TPO HIPAA exception for providers, insurance companies and other health-care entities to exchange information necessary for Treatment, Payment or Operations of healthcare businesses

VDT (View, Download, Transmit) a requirement of Meaningful Use Stage 2 that patients view, download or transmit their health information

VistA (Veterans Health Information Systems and Technology Architecture) the Veteran’s Administration’s system wide, MUMPS based health information infrastructure

X.509 digital certificate the technical name for an electronic document issued by a CA that uses a digital signature to bind a public key with an identity based on information from an RA

XDR (External Data Representation) an operating system and transport method agnostic mechanism for exchanging data that is encoded/decoded into/from the XDR format.

XDM (IHE Cross Enterprise Document Media Interchange) a standard mechanism for including both documents and meta-data in zip format using agreed upon conventions for directory structure and location of files.

XDS (Cross-Enterprise Document Sharing) the use of federated document repositories and a document registry to create a longitudinal record of information about a patient

XML (Xtensible Markup Language) a widely used standard for machine and human readable electronic documents and the language used to define CDA templates

XMPI a cross organizational master patient index capable of dealing with many unaffiliated hospitals and health systems