Find definitions for healthcare interfacing, HL7 and interoperability terminology. Visit the HL7 Resources section for more detailed information on the HL7 Standard.
If you do not find a definition related to healthcare interoperability, please email us at info@corepointhealth.com . We welcome your suggestions and ideas.
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ARRA
American Recovery and Reinvestment Act of 2009 (ARRA) is an economic stimulus package enacted by the 111th United States Congress in February 2009 to provide a stimulus to the U.S. economy in the wake of the economic downturn. The Act includes federal tax cuts, expansion of unemployment benefits and other social welfare provisions, and domestic spending in education, health care, and infrastructure, including the energy sector. In included in the ARRA legislation is a HITECH provision focused on health information technology adoption and funding.
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CCHIT - Certification Commission for Healthcare IT
CCHIT serves as the recognized US certification authority for electronic health records (EHR) and their networks. In September 2005, CCHIT was awarded a 3-year contract by the U.S. Department of Health and Human Services to develop and evaluate the certification criteria and inspection process for EHRs and the networks through which they interoperate. Visit the CCHIT website.
CCOW - Clinical Context Object Workgroup
CCOW is an HL7 standard protocol designed to enable disparate applications to synchronize in real-time and at the user-interface level. It is vendor independent and allows applications to present information at the desktop and/or portal level in a unified way. Visit HL7 CCOW website.
CDR - Clinical Document Repository
CDR enables hospitals to build a life-long health record environment using stored health records for the purpose of better treatment, clinical research and health statistics for policy making.
CCD - Continuity of Care Document
The HL7 CCD is the result of a collaborative effort between the Health Level Seven and American Society for Testing Materials (ASTM) to “harmonize” the data format between ASTM’s Continuity of Care Record (CCR) and HL7’s Clinical Document Architecture (CDA) specifications. Read HL7 and Continuity of Care Document white paper.
CCR - Continuity of Care Record
CCR is an XML-based standard for the movement of “documents” between clinical applications. Furthermore, it responds to the need to organize and make transportable a set of basic information about a patient’s health care that is accessible to clinicians and patients. Read Understanding the Continuity of Care Record white paper.
CDA - Clinical Document Architecture
HL7 CDA uses XML for encoding of the documents and breaks down the document in generic, unnamed, and non-templated sections. Documents can include discharge summaries, progress notes, history and physical reports, prior lab results, etc. HL7’s CDA defines a very generic structure for delivering “any document” between systems. CDA was previously known as the Patient Record Architecture (PRA).
Conformance Checking
Conformance checking or gap analysis for HL7 messages is a logical process used to determine whether a message from one particular medical device or application is compatible to the selected HL7 standard messaging format, or a custom format adopted by another device or application. Read Conformance Checking for HL7 white paper for more details.
Critical Access Hospital
In general, a Critical Access Hospital or CAH is a rural acute care hospital consisting of no more than 25 beds. Bed types can vary between acute care and swing, but cannot exceed 25. The Critical Access Hospital must not exceed a 96 hour length of stay and will have agreements, contracts or affiliations for transfer and services. Critical Access Hospitals must be certified to receive cost-based reimbursement from Medicare. The goal is to improve rural health care access and reduce hospital closures. Learn more at the Rural Access Center.
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DICOM - Digital Imaging and Communications in Medicine
DICOM is a common format for image storage. It allows for handling, storing, printing, and transmitting information in medical imaging. Visit DICOM website.
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EDI - Electronic Data Interchange
EDI is a standard format for exchanging business data. The standard is ANSI X12, developed by the Data Interchange Standards Association. An EDI message contains a string of data elements; each represents a singular fact, such as a price, product model number, and is separated by delimiter. The entire string is called a data segment. One or more data segments framed by a header and trailer form a transaction set, which is the EDI unit of transmission (equivalent to a message). A transaction set often consists of what would usually be contained in a typical business document or form. The parties who exchange EDI transmissions are referred to as trading partners.
EHR - Electronic Health Record
EHR, as defined in Defining Key Health Information Technology Terms (The National Alliance for Health Information Technology, April 28, 2008): An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one health care organization.
EMR - Electronic Medical Record
EMR, as defined in Defining Key Health Information Technology Terms (The National Alliance for Health Information Technology, April 28, 2008): An electronic record of health-related information on an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within one health care organization.
ELINCS - EHR-Lab Interoperability and Connectivity Standards
The ELINCS specification provides a profile that refines (or constrains) “standard” HL7 messages to moving lab results from reference labs to physician offices.
See Accelerating EMR Interoperability with ELINCS white paper.
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Health IT Policy Committee
Under the American Recovery and Reinvestment Act of 2009 (ARRA), The Health IT Policy Committee will make recommendations to the National Coordinator for Health Information Technology – ONC - on a policy framework for the development and adoption of a nationwide health information infrastructure, including standards for the exchange of patient medical information.
Health IT Standards Committee
The Health IT Standards Committee will make recommendations to the National Coordinator for Health Information Technology (HIT) on standards, implementation specifications, and certification criteria for the electronic exchange and use of health information. In developing, harmonizing, or recognizing standards and implementation specifications, the HIT Standards Committee will also provide for the testing of the same by the National Institute for Standards and Technology (NIST).
HIE - Health Information Exchange
HIE focuses on the mobilization of healthcare information electronically across organizations within a region or community. HIE provides the capability to electronically move clinical information between disparate health care information systems while maintaining the meaning of the information being exchanged. The goal of HIE is to facilitate access to and retrieval of clinical data to provide safe, and efficient patient-centered care.
HIPAA
The Health Insurance Portability and Accountability Act (HIPAA) was enacted by the U.S. Congress in 1996. Title II of HIPAA, known as the Administrative Simplification (AS) provisions, requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers. This is intended to help people keep their information private, though in practice, it is normal for providers and health insurance plans to require the waiver of HIPAA rights as a condition of service.
The Administration Simplification provisions also address the security and privacy of health data. The standards are meant to improve the efficiency and effectiveness of the nation's health care system by encouraging the widespread use of electronic data interchange in the U.S. health care system.
HIPPA - Business Associate
A person or entity that performs certain functions or activities that involve the use or disclosure of Protected Health Information (PHI) on the behalf of, or provides services to, a covered entity. A member of the covered entity’s workforce is not a business associate. A covered health care provider, health plan, or health care clearinghouse can be a business associate of another covered entity.
The Privacy Rule lists some of the functions, activities, and services that make a person or entity a business associate, if the activity or service involves the use or disclosure of protected health information (PHI) covered under HIPAA. The types of functions or activities that may make a person or entity a business associate include payment or health care operations activities, and other activities regulated by the Administrative Simplification Rules.
Examples of Business Associates:
- A third party administrator that assists a health plan with claims processing.
- A CPA firm whose accounting services to a health care provider involve access to protected health information.
- An attorney whose legal services to a health plan involve access to protected health information.
- A consultant that performs utilization reviews for a hospital.
- A health care clearinghouse that translates a claim from a non-standard format into a standard transaction on behalf of a health care provider and forwards the processed transaction to a payer.
- An independent medical transcriptionist that provides transcription services to a physician.
- A pharmacy benefits manager that manages a health plan’s pharmacist network.
HIPAA - Protected Health Information (PHI)
Protected health information (PHI) under HIPAA, is any information about an individual’s health status that identifies or relates to an individual's past, present or future physical or mental health, the provision of health care to the individual, or the past, present or future payment for health care. Information is deemed to identify an individual if it includes either the individual's name or any other information that could enable someone to determine the individual's identity.
Identifiers include:
- Name
- Address (all geographic subdivisions smaller than state, including street address, city, county, ZIP code)
- All elements (except years) of dates related to an individual (including birth date, admission date, discharge date, date of death and exact age if over 89)
- Telephone numbers
- FAX number
- E-mail address
- Social Security number
- Medical record number
- Health plan beneficiary number
- Account number
- Certificate/license number
- Any vehicle or other device serial number
- Device identifiers or serial numbers
- Web URL
- Internet Protocol (IP) address numbers
- Finger or voice prints
- Photographic images
HITECH
As a part of the America Recovery and Reinvestment Act (ARRA) of 2009, Health Information Technology for Economic and Clinical Health (HITECH) refers to the portion of the ARRA that is used to increase the use of Electronic Health Records (EHR) by physicians and hospitals. This legislation provides immediate funding for health information technology infrastructure, training, dissemination of best practices, telemedicine, inclusion of health information technology in clinical education, and State grants to promote health information technology.
HITSP - Healthcare Information Technology Standards Panel
HITSP serves as a cooperative partnership between the public and private sectors for the purpose of achieving a widely accepted and useful set of standards specifically to enable and support widespread interoperability among healthcare software applications, as they will interact in a local, regional and national health information network for the United States. Visit HITSP website.
HL7 – Health Level Seven
HL7 is a Standards Developing Organization accredited by the American National Standards Institute (ANSI) to author consensus-based standards representing a board view from healthcare system stakeholders. HL7 has compiled a collection of message formats and related clinical standards that define an ideal presentation of clinical information, and together the standards provide a framework in which data may be exchanged. Visit the HL7 organization website or HL7Standards.com for more HL7 information.
HL7 Batch Protocol
The HL7 Batch Protocol transmits a batch of HL7 messages using FHS, BHS, BTS, and FTS segments to delineate the batch.
HIS - Hospital Information System
HIS is the main system in a hospital used by most caregivers. Sends ADT broadcasts to all ancillary applications. The HIS is typically the patient administrative system and order entry system for a hospital.
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ICD-9
ICD-9 is a classification used in the medical field that stands for International Classification of Diseases, 9th revision. This classification is predominately the standard classification of diseases, injuries, and cause of death for the purpose of health records. The World Health Organization (WHO) assigns, publishes, and uses the ICD to classify diseases and to track mortality rates based on death certificates and other vital health records. Medical conditions and diseases are translated into a single format with the use of ICD codes.
ID
ID is a coded value data type. The value of such a field follows the formatting rules for a ST field except that it is drawn from a table of legal values. Examples of ID fields include religion and sex.
IEEE - Institute of Electrical and Electronics Engineers
IEEE is accredited by ANSI to submit its documents for approval as American National Standards. IEEE subcommittee P1073 develops standards for healthcare informatics: MEDIX (P1157) and MIB (P1073).
Interface Engine
An interface engine can transform or map the data to the receiving application’s requirements while the message is in transit so that it can be accepted by the receiving application. The application interface is built with one-to-many concepts in mind. These import/export modules then are connected to an interface engine so that the mapping, routing, and monitoring are managed by this system.
IHE - Integrating the Healthcare Enterprise
IHE is an initiative by healthcare professionals and industry to improve the way computer systems in healthcare share information. Visit the IHE website.
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LIS - Laboratory Information System
LIS is an information system that receives, processes, and stores information generated by a medical laboratory processes. LIS is often interfaced with HIS and EMR applications.
LOINC - Logical Observation Identifiers Names and Codes
LOINC applies universal code names and identifiers to medical terminology related to the EHR and assists in the electronic exchange and gathering of clinical results (such as laboratory tests, clinical observations, outcomes management and research). See What are LOINC Codes?
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Meaningful Use
A term associated with The American Recovery and Reinvestment Act of 2009 (ARRA) that authorizes the Centers for Medicare & Medicaid Services (CMS) to provide reimbursement incentives for medical professionals and hospitals that become compliant in the use of certified electronic health record (EHR) technology. Professionals and hospitals that meet the criteria of “meaningful use” will begin receiving incentive payments in 2011 with a gradual decline in reimbursement amounts until the year 2015. By this date, providers are expected to have adopted and be actively utilizing a certified EHR in compliance with the "meaningful use" definition or be subject to financial penalties under Medicare. To read more articles on this topic, visit our Meaningful Use & HITECH section.
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NCIN - Nationwide Health Information Network
NIHN is one of the ONC's major initatives. As defined by the ONC, NIHN is: "a set of standards, services and policies that enable secure health information exchange over the Internet. The NHIN will provide a foundation for the exchange of health IT across diverse entities, within communities and across the country, helping to achieve the goals of the HITECH Act."
NCPDP - National Council for Prescription Drug Programs
The NCPDP creates and promotes the transfer of data related to medications, supplies, and services within the healthcare system through the development of standards and industry guidance. Visit the NCPDP website.
NIST - National Institute of Standards and Technology
Founded in 1901, NIST is a non-regulatory federal agency within the U.S. Department of Commerce. NIST's mission is to promote U.S. innovation and industrial competitiveness by advancing measurement science, standards, and technology in ways that enhance economic security and improve our quality of life. NIST have made solid contributions to image processing. Visit the NIST website.
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ONC - Office of the National Coordinator for Health Information Technology
Located within the Office of the Secretary for the U.S. Department of Health and Human Services (HHS), the Office of the National Coordinator (ONC) coordinates nationwide efforts to support the adoption of health information technology and the promotion of health information exchange to improve health care. The ONC position was established in 2004 with an Executive Order and legislatively mandated in the Health Information Technology for Economic and Clinical Health Act (HITECH Act) of 2009.
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PACS - Picture Archiving Communication System
PACS are devoted to the storage, retrieval, distribution, and presentation of images. The medical images are stored in an independent format, most commonly DICOM.
PHR - Personal Health Record
PHR, as defined in Defining Key Health Information Technology Terms (The National Alliance for Health Information Technology, April 28, 2008): An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual.
PMS - Practice Management System
PMS applications facilitate the day-to-day operations of a medical practice. PMS software enables users to capture patient demographics, schedule appointments, maintain lists of insurance payers, perform billing tasks, and generate reports. It handles the administrative and financial matters for a practice.
Point-To-Point Interfaces
A point-to-point interface is one in which the receiving vendor provides a specification on what data it can receive and in what format it needs to be in. The sending application then builds an interface to that specification for that application. It is a one-to-one relationship. For each application requiring an interface, there is a new request and point-to- point interface developed. Read What is Your Healthcare Interface Method white paper.
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RadLex
RadLex is a controlled terminology for radiology. The purpose of RadLex is to provide a uniform structure for capturing, indexing, and retrieving a variety of radiology information sources. This may facilitate a first step toward structured reporting of radiology reports. The RadLex project - to develop a comprehensive radiology lexicon - is sponsored by the Radiological Society of North America (RSNA), along with the collaboration of the American College of Radiology (ACR) and other subspecialty societies. Read more about RadLex.
RHIO - Regional Health Information Organization
The terms “RHIO” and “Health Information Exchange” or “HIE” are often used interchangeably. RHIO (regional health information organization) is a group of organizations with a business stake in improving the quality, safety and efficiency of healthcare delivery. RHIOs are the building blocks of the proposed National Health Information Network (NHIN) initiative proposed by David Brailer, MD, and his team at the Office of the National Coordinator for Health Information Technology (ONCHIT). To build a national network of interoperable health records, the effort must first develop at the local and state levels. The concept of NHIN requires extensive collaboration by a diverse set of stake holders. The challenges are many to achieve success for a health information exchange or a RHIO.
RIS - Radiology Information System
RIS is the main application in an imaging center or radiology department. RIS is used by to store, manipulate and distribute patient radiological data and imagery. RIS are used for patient scheduling, tracking, and image tracking. Read Rethinking Radiology Workflow white paper.
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TCP/IP - Transmission Control Protocol/Internet Protocol
TCP/IP is a low-level communications protocol used to connect hosts on the Internet or a network. TCP/IP connections are established between clients and servers via sockets. TCP/IP is stream-oriented meaning it deposits bits in one end and they show up at the other end.
TCP/IP Basics:
- Socket is "communication endpoint"
- Server = wait for connection
- Client = initiate connection
- Sequenced, reliable transport
- Bi-directional by definition
- Sometimes/often used uni-directionally
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X12
X12 provides for electronic exchange of business transactions-electronic data interchange (EDI). The American National Standards Institute (ANSI) chartered the Accredited Standards Committee (ASC) X12 to develop uniform standards.
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