Term
Electronic Health Record System
(EHRS) |
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Definition
Computerized version of health records. |
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Common process, content, or vocabulary. |
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Standard development organization and a messaging standard. |
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Personal Data Assistant
(PDA) |
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Wireless device that allows for information to enter data at the point of care. |
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The ability of systems to work together through common standards. |
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Uses both electronic and paper-based forms of documentation. |
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Protection ocurring while electronic information is transmitted.
Text becomes unreadable. |
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Process of identifying the author. |
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Allowing multiple users to view a record from different locations. |
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| Accessed based on what a person "needs to know". Typically based on the professional responsibility of the user. |
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| Offers assitance when clinicians make complex decisions. |
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An automatic message or reminder.
Ex: Drug interaction alert. |
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Analyzing data or information. |
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Traditional method to collect medical information.
Strictly a paper format. |
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Info such as patient's full name, DOB, phone #, SSN. |
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Type of care and treatment a patient receives. |
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A practice that allows only authorized individuals to access medical information. |
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The right to control personal health information with the understanding the info will not be given out without permission. |
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| A mechanism with the protections or safeguards to protect health information. |
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Standardized electronic data interchange.
Protects privacy
Securing health data in electronic systems. |
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Healthcare provider, plan, or clearinghouse. |
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Company that performs billing functions. |
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| The mechanisms put in place to protect the systems, equipment, and date from threats or hazards. |
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| The processes used to protect data and control entry into the system. |
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| You may only release the necessary amount of information needed to fulfill a request. |
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Intentional act, deception, or misrepresentation for the purpose of gaining insurance benefits. |
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| Practice or behavior that results from errors or inconsistencies in billing practices. |
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| A federal law that prohibits fraudulent claims to the government. |
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| A person with evidence of fraud against the government may file a claim. |
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Stark Statutes
(Anti-Referral Statutes) |
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| Physicians and their immediate family cannot have a financial relationship with an entity that is referring a patient. |
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| It is a criminal offense to accept bribes or payment for services rendered. |
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