Health Information Technology (IT) Simplified

Transcription

1 Health Information Technology (IT) Simplified A glossary of all things Health IT Accountable Care Organizations (ACO) - A group of health care providers who give coordinated care, chronic disease management, and improve the quality of care patients get. The organization's payment is tied to achieving health care quality goals and outcomes that result in cost savings. Advocate - A person who gives you support or protects your rights as a patient. Affordable Care Act A comprehensive healthcare reform law enacted in March 2010 to expand Medicaid coverage to low-income Americans and improve the Children s Health Insurance Program (CHIP). Ambulatory Care A health service that does not require an overnight hospital stay. American Recovery and Reinvestment Act (ARRA) An act signed by the Obama Administration in 2009 to increase funding for science, engineering research and infrastructure, as well as funding for education, social sciences and the arts. It also included the funding of informatics and the implementation of electronic health records and support for comparative effectiveness research. Attestation The process by which a healthcare provider legally states through CMS that they've demonstrated Meaningful Use with Certified EHR Technology. Beacon Community Program - A federal grant program for communities to build and strengthen their health information technology (IT) infrastructure and health information exchange (HIE) capabilities. Beneficiary - The name for a person who has health care insurance through the Medicare or Medicaid program. Blue Button An electronic application that allows veterans the capability to download their personal health information from their VA patient portal in a very simple text file.

2 Care Coordination - The organization of your treatment across several health care providers. Care Plan - A written plan for your care, describing what services you will get to keep your best physical, mental, and social well-being. Centers for Disease Control and Prevention (CDC) - A part of the US Department of Health and Human Services (HHS) with a mission to collaborate in creating the expertise, information, and tools that you and your community needs to protect your health. Centers for Medicare and Medicaid Services (CMS) The federal agency that works to make sure that the beneficiaries in the Medicaid and Medicare programs are able to get high quality health care. Certified Health IT Product List (CHPL) - The CHPL provides the authoritative, comprehensive listing of complete EHR systems that have been tested and certified under the ONC Certification Program. Chronic Disease Management - An integrated care approach to managing illness which includes screenings, check-ups, monitoring and coordinating treatment, and patient education, to improve the quality of your life while reducing your health care costs. Comprehensive Primary Care initiative (CPC) An initiative encouraging collaboration between public and private health care insurance payers to strengthen primary care by offering bonus payments to doctors who better coordinate care for you. Computer-Based Physician Order Entry (CPOE) - A clinical information system that allows doctors to record patient-specific orders (tests, treatments, and management plans) for communication to other doctors or care team members and to other information systems. Critical Access Hospitals - A small facility that gives limited outpatient and inpatient hospital services to people in rural areas.

3 Clinical Quality Measure (CQM) A tool that helps measure and track the quality of healthcare services provided by doctors within our health care system. These measures use a wide variety of data that are associated with doctor s ability to deliver high-quality care or relate to long term goals for healthcare quality. Clinical Decision-Support System (CDSS) - A computer-based system that assists a healthcare provider who must decide what actions to take in a given clinical setting, and making decisions about your care. Department of Health and Human Services (HHS) - The federal agency that oversees CMS, which administers programs for protecting the health of all Americans. Electronic Health Record (EHR) - A repository of electronically maintained information about your and healthcare and health status, stored such that it can serve the multiple legitimate users of the record. Federally Qualified Health Center (FQHC) - Federally funded non-profit health centers or clinics that serve medically underserved areas and populations and provide primary care services regardless of a patient s ability to pay. Fee for Service - A method in which doctors and other health care providers are paid for each service performed, such as tests and office visits. Formulary - A list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits. Health Information Exchange (HIE) A secure electronic exchange of your health information between doctors across multiple organizations within a specific network. Health Insurance Marketplace - A resource where you, your family, and small businesses can learn about their health coverage options; compare health insurance plans based on costs, benefits, and other important features; choose a plan; and enroll in coverage.

4 Health Information Technology for Economic and Clinical Health (HITECH) Act - Provides Department of Health and Human Services (HHS) with the authority to establish programs to improve healthcare quality, safety, and efficiency through the promotion of Health IT, including EHRs and private and secure electronic health information exchange (HIE). Health Insurance Portability & Accountability Act (HIPAA) - A law passed in 1996 which guarantees your rights and protections as a patient against the misuse or disclosure of health records. Health Maintenance Organization (HMO) - A type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won't cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage. Health Information Technology (Health IT) - The application of scientific knowledge to solving health problems. Health technologies include pharmaceuticals, medical devices, procedures or surgical techniques, and management and information systems innovations. International Classification of Diseases (ICD) - A three digit code used to indicate the nature of an injury for billing and insurance reimbursement purposes. Interoperability - The ability of two or more systems to communicate or exchange information and to use the information that has been exchanged. Meaningful Use - Sets specific objectives that doctors must achieve to qualify for the CMS EHR Incentive Programs. Simply put, Meaningful Use means providers need to show they're using EHR technology in ways that can be measured significantly in quality and in quantity. Medicaid - A state-administered health insurance program for low-income families and children, pregnant women, the elderly, and people with disabilities. Medicare - A Federal health insurance program for people who are age 65 or older and certain younger people with disabilities.

5 Navigator - An individual or organization that's trained and able to help consumers, small businesses, and their employees as they look for health coverage options through the Marketplace, including completing eligibility and enrollment forms. National Provider Identifier (NPI) - The name of the standard unique health identifier for health care providers. Office of the National Coordinator (ONC) The forefront of the administration's Health IT efforts and is a resource to the entire health system to support the adoption of Health IT and the promotion of health information exchange to improve health care. Payer - In healthcare, an entity that assumes the risk of paying for medical treatments. This can be an uninsured patient, a self-insured employer, a health plan, or an HMO. Patient-Centered Medical Home - An approach to care that consciously adopts a patent s perspective, patients values, preferences, and expressed needs; coordination and integration of care: information, communication and education; physical comfort; emotional support and alleviation offer and anxiety; involvement of family and friends; transition and continuity. Personal Health Record (PHR) - An electronic health record that is maintained by the patient, typically combining information from a variety of encounters with multiple providers. Preferred Provider Organization (PPO) - A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if you use providers that belong to the plan s network. You can use doctors, hospitals, and providers outside of the network for an additional cost.

6 Physician Quality Reporting System (PQRS) - a reporting program that uses a combination of incentive payments and payment adjustments to doctors who voluntarily report data on specific quality measures applied to the Medicare population. Patient Portal - a secure online website that gives you convenient 24 hour access to personal health information from anywhere within internet connection. Personal Health Information (PHI) - Information that is protected from inappropriate disclosure under the privacy and security mandates of HIPAA and subsequent related legislation. Quality Improvement Organization (QIO) - A private organization, that is trained to review medical care and help beneficiaries with complaints about the quality of care and to implement improvements in the quality of care available. Regional Extension Center (REC) - An entity that serves a defined geographical area, offering technical assistance, guidance, and information on best practices to support and accelerate a doctor s effort to become meaningful users of EHRs. Secure Messaging - Any electronic communication between you and a doctor or a doctor and another doctor that ensures only specific parties involved can access the message. Structured Data - Data that resides in fixed fields within a record or file. Structured templates, drop-down lists, radio buttons and check boxes are common ways to capture structured data. Telemedicine - The use of telecommunications and electronic information to support long-distance clinical healthcare to patient.