Term
| Standards Development Organization (SDO) |
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Definition
| private or government agency - develops health information standards for the goal of interoperability |
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| American National Standards Institute (ANSI) |
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| accredits the procedures of SDOs. Accreditation shows the SDO meets ANSI's requirements for openness, balance, consensus, and due process |
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| 1. Define what to collect. 2. decide how to represent what is collected 3. determine how to encode the data for transmission |
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| Structures that store and process data to ensure data quality and integrity. Interface of different types of data |
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| image data, unstructured text data, videos, diagnostic images. Index through bar codes or OCR |
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| aka 'discrete data' . Can have significant operations run on them |
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| Define the structure and the language used to supply the values of data. Purpose is to reduce inconsistency |
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| Meaningful Use set: LOINC, SNOMED-CT, RxNorm |
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| Grouping of terms of similar meaning, often for defined pupose. |
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| ICD-9, HCPCS, Revenue Code Sets, Claim adjustment Code Sets |
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| MU Content Exchange Standards |
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Definition
| HL7 CDA, HITSP HL7 CCD, ASTM CCR |
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| Clinical Document Architecture - exchange model for clinical documents |
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| Healthcare Information Technology Standards Panel. Helped developed CCD |
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| American Society for Testing and Materials International (ASTM International) |
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Definition
| Developed CCR (Continuing Care Record)' |
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Definition
| predefined group of data elements to be collected |
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| store and retrieve large amounts of data easily. Classify by document-text, statistical, etc. Managed by Database management systems. Ie - EHR MPI |
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Definition
| database with open structure, not dedicated to any particular vendor. Data from multiple systems. Important in clinical decision support |
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| secondary or derived database or repository that do not participate directly in patient care. Ie- used for public health data mining and stats. |
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| defines data fields, records of which fields may be a part, and any association between records. |
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| Entity-Relationship Model (Data Modeling) |
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Definition
| illustrates the relationship among a system's different elements |
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| Relational Model (data modeling) |
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Definition
| rows describe related information occurrences, columns provide attributes that describe that row |
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| Object Model (datamodeling) |
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Definition
| object-oriented databases. An object is an abstract of something.. Ie "name" is an identification function. Objects may be part of a larger set, class |
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| captures the results of data modeling. Structured around metadata. Most EHR vendors use proprietary data dictionary |
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| growing field of tools for processing data to support clinical decision making |
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| Extensible Markup Language (XML) |
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Definition
| allows users to tag and give attribute names. Good for EHRs + interoperability |
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Definition
| provide baseline understanding of EHR system functions. Recognize the importance of interoperability |
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| Standard Message Protocol Synonyms |
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Definition
| interoperability standards, data exchange standards, messaging standards |
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Definition
| digital imaging and ocmmunications in medicine. Retrieve info from imaging devices and workstations |
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| common standard. Rules for transmitting types of data (demographic, orders, observation, etc) |
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| National Council for Prescription Drug Programs. Supports HIPAA requirements for pharmacy exchanges. NCPDP is required if using e-prescribing |
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Definition
| Does not define specific Policy or Procedure. Details of managing privacy and security are up to facility - but must achieve regulation's standards |
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| Health Information Security and Privacy Collaboration (HISPC) |
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Definition
| develop plans to address privacy and security practices that may challenge Interoperable HIE |
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| Way you are going to carry out the attack |
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| What happens as a result of the threat or harm |
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| Risk assessment of privacy and security system; look for vulnerabilities |
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| National Institute for Standards and Technology |
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| Risk assumption, risk avoidance, risk limitation, risk planning, research and acknowledgement, risk transference |
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| made by person signing onto a signature pad (wet signature) image is stored. WEAK form of signature |
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| signature in paper environment |
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| use of a password, token, biometric, or some combination |
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| process of encryption and non-repudiation . |
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| Public Key Infrastructure (PKI) |
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| set of policies that enable use of digital signature. Certificate Authority verifies a digital signature. Registration Authority verifies the individual before CA before digital certificate is issued to individual. HIPAA does not require i's use |
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Definition
| New HIE technology; new PHR technology = increased risk for theft |
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| HIPAA Administrative Safeguards |
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Definition
| Security Management functions, assigning security responsibility, workforce security |
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Term
| HIPAA Security Management Process Standard |
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Definition
| Required: risk analysis, risk management, sanction policy, information system activity review |
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| Emergency Access Procedures |
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Definition
| Under 'Access Control Standard' - establish procedures for obtaining PHI during emergency (electrical power outage etc( |
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| Ways to overcome EHR resistance |
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Definition
| 1) engage clinicians in the process of conception through benefits realization. 2) effect change so that EHR is more trusted than paper |
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| Natural Language Processing |
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Definition
| the deriving of structure from unstructured text - technical process. |
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| Clinical Decision Support |
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Definition
| CDS: Rules engine, online transaction processing, reminders and alerts, clinical guideline advice, benchmarking |
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Definition
| special case of CPOE only in ambulatory environment. Transmits Rx to Surescripts .. Pharmacy must meet NCPDP standards |
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| National Health Information Infrastrcture (NHII) |
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Definition
| think tank to guide information sharing idea creation in provider, population health, and personal health dimension |
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| National Health Information Network (NHIN) |
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Definition
| HHS awarded HIT contracts to develop prototypes for NHIN architecture based on NHII ideas |
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| hybrid between an EHR, a patient-managed HIE architecture, and a PHR. HIM could help compile the record for individual's use |
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| comination of CCR and CDA that allows it to be rendered in either XML or PDF |
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Definition
| standardized data content; ability to be sourced to their original author. Increased data integrity |
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Term
| Pro Forma Cost Benefit Analysis (Financial Impact Analysis) |
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Definition
| Rough estimates. Determine feasibility of EHR project |
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| ROI Analysis (Financial Impact Analysis) |
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Definition
| Firm cost and benefit estimates. Compare against product's functionality and requried payback period (IRR). Done to justify expenditure |
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| Benefits Realization Study (Financial Impact Analysis) |
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Definition
| evaluate the benefits from EHR investment. May be done throughout the project; helps in future planning and implementation. Helps develop vision and migration path |
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Definition
| hardware, software, implementation, maintenance and support. "total cost of ownership" |
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| cost savings, productivity improvements.. Both tangible and intangible |
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| SLA (service level agreement) from vendors. Maintainence of hardware and software |
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| ongoing costs to keep system up. Upgrades, testing |
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| benefit ie = do not have to rent warehouse for paper charts; productivity improvements reduce overtime |
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| EHR can give imrpoved coding + more revenue |
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| # of years to recoup expenditure; ignores time value of money |
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| Internal Rate of Return IRR |
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Definition
| considers the time value of money |
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| most precise of cash flow analysis. Uses org's cost of financing to determine the present value of incremental cash inflows. Compares the present value with the cost of the project. Favorable if NVP is positive. |
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Definition
| 1) overall approach 2) specific tasks, dependencies, milestones, resources, and budget |
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Term
| Straight Turnover Strategy |
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Definition
| paper processes cease after Go-Live. Go live at one time. Most typical form of turnover for EHR |
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| Parallel turnover strategy |
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Definition
| org continues manual/paper form as well as electronic form. Meant to validate electronic form against paper… but usually time consuming and error prone |
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Definition
| Pre Load Strategy-- how much of the existing paper records will be moved to EHR prior to or during Go-Live |
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Definition
| People preparation. Communicate with newsletter, place status reports, begin list serv of FAQ |
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Definition
| receives and documents issues to track them to their resolution. Project manager logs them and identifies scope of issues to be tracked or escalated to higher authority. Issues involving time delays, budget increases = escalation |
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Definition
| configure software's data dictionaries, table development, rules logic, data and code set mapping, file designs, screen layouts, report design, technical controls. More detailed and labor intensive step |
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| RAND Corporation says adopted requires acceptance and use of system on regular basis |
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| documentation of EHR User manuals, practice guidelines, decision spuport rules |
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| Unit and Function, System, Integrated System Testing , Performance and stress Testing |
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Definition
| test individual modules or applications. Most basic |
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| test how well modules or applications work together; look at workflow of department |
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| Integrated System Testing (Interface Testing) |
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Definition
| testing of systems that had to be interfaced to ensure proper exchange of data |
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| Performance/ Stress/Load Testing |
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Definition
| testing of system performance |
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Definition
| the point at which organization signs off that the implementatino is working as expected. Usually occurs 30-60 days |
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