Glossary of Health Care and Health Care Informatics

Dr Yaseen Hayajneh Website

موقع الدكتور ياسين هياجنه

Glossary of Health Care and Health Care Informatics Terms

This glossary is developed, designed and structured in a way to serve the learning needs of students and trainees enrolled in the courses or workshops of Dr. Yaseen Hayajneh.

Glossary of Organizations

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

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Academic Medical Center (AMC) Access Access Management Accreditation Activities of Daily Living ADL Acute Care Acute Care Hospital Acute Disease Additional Diagnosis Additional Drug Benefit List Adjusted Average Per Capita Cost AAPCC Administrative Services Organization ASO Administrative Simplification (A/S) Admission Admission Certification Advance Directive: Written instructions recognized under law relating to the provision of health care when an individual is incapacitated. An advance directive takes two forms: living wills and durable power of attorney for health care. Advanced Cable Tester Advanced Practice Nurse APN: An umbrella term that describes a registered nurse (RN) who has met advanced educational and clinical practice requirements beyond the two to four years of basic nursing education required of all RNs. Adverse Selection Affiliated Provider Agent Allowable Charge Allowable Costs Allowable Expenses Allowed Charge Alternate Care Alternate Delivery Systems Ambulatory Ambulatory Care Ambulatory Payment Classification APC Ambulatory Setting American National Standards ANS Analogue Ancillary Services Care Anniversary Date Any Willing Provider Application : Synonym for a computer program that carries out a specific type of task. Word-processors or spreadsheets are common applications available on personal computers. Application Service Provider ASP Appropriateness ARPAnet Artificial Intelligence (AI) Artificial Intelligence in Medicine Asynchronous communication Attending Physician Authentication Authorization Audit Trail Average Daily Census ADC Average Length of Stay ALOS Avoidable Hospital Condition : Medical diagnosis for which hospitalization could have been avoided if ambulatory care had been provided in a timely and efficient manner.

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Bandwidth Basic Cable Tester Bed Management System Behavioral Health Care: Treatment of mental health and/or substance abuse disorders. Benchmarking Beneficiary: A person who is eligible to receive insurance benefits. Benefit package: The covered services each patient is entitled to under a health insurance contract. Benefit Plan Summary Benefit Year: The coverage period, usually 12 months long, used for administration of a health insurance plan. Benefits Benefits Manager Billed Charges Bioinformatics Biometric Identifier Biotechnology B-ISDN Bit Bits per second BlackBerry Blog Bluetooth Board Certified Board Eligible Brain Death Brand-Name Drug Bridge Broadband Browser Byte

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Call Schedule : The schedule for physician availability for after-hours care. Capital Expense : An expenditure that benefits more than one accounting period such as the cost to acquire long-term assets. Capital investment decisions typically involve large sums of money for long periods of time and have a major impact on the future services provided by an organization. Capitalize : To record an expenditure that may benefit a future period as an asset rather than as an expense of the period of its occurrence. For example, research and development costs. Capitation Cardiac Catheterization Care Plan Carrier Case Management Catastrophic Health Insurance Census: The number of inpatients who receive hospital care each day excluding newborns. Centers of Excellence Certification Chain of Trust COT Channeling Chemical Dependency Services Chemical Equivalents Chemotherapy Chronic Care Chronic Disease Claim Claims Review Claude Shannon: An electrical engineer (1916 - 2001) who pioneered mathematical communication theory. Has been called "the father of information theory". Clearinghouse Client Client-Server Architecture Clinical Coding Engine Clinical Data Standards Clinical Information System (CIS) Clinical Laboratory Improvement Amendment of 1988 CLIA Clinical or Critical Pathways: A "map" of preferred treatment / intervention activities. Outlines the types of information needed to make decisions, the timelines for applying that information, and what action needs to be taken by whom. Provides a way to monitor care "in real time." These pathways are developed by clinicians for specific diseases or events. Proactive providers are working now to develop these pathways for the majority of their interventions and developing the software capacity to distribute and store this information. Clinical Practice Guidelines: General procedures and suggestions about what constitutes an acceptable range of practices for particular diseases or conditions. These guidelines are usually developed by a consensus of doctors in a given field, such as radiology or cardiology. Code Blue : Indicates an emergency situation has occurred and mobilizes staff to respond. Code Set Code Set Maintaining Organization: Under HIPAA, this is an organization that creates and maintains the code sets adopted by the Secretary for use in the transactions for which standards are adopted. Co-insurance Community Hospital Community Rating Co-Morbid Condition Co-Morbidity Compliance Date Complication Comprehensive Care Comprehensive Medical Care Plans Computer-assisted coding CAC Computer-based Patient Record CPR Computer Science Computerized Axial Tomography CAT Computerized Patient Record Concurrent Review Condition Report Confidentiality Consolidated Omnibus Budget Reconciliation Act COBRA Consultation: A discussion with another health care professional when additional feedback is needed during diagnosis or treatment. Usually, a consultation is by referral from a primary care physician. Consumer Price Index CPI Consumer Price Index-Medical Care Component Continuity of Care Continuous Quality Improvement (CQI) Continuum of Care Controlling Conversion Coordination of Benefits COB Co-payment Cost Benefit Analysis Cost Containment Cost Containment Guidelines Cost Sharing Cost Shifting Coverage or Covered Services Coverage Status Covered Benefit Covered Entity (CE) Covered Function Credentialing Credentialing and Privileging Crossing the Quality Chasm: The IOM Health Care Quality Initiative Critical Access Hospital (CAH) Critical Pathways Critical Thinking Current Dental Terminology CDT Current Procedural Terminology CPT Cyberspace

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Daily Census ADC Data Data Dictionary : A document or system that characterizes the data content of a system. Data Element : Under HIPAA, this is the smallest named unit of information in a transaction. Data Mapping : The process of matching one set of data elements or individual code values to their closest equivalents in another set of them. Data Retrieval : The collection of patient care data from medical records. Database Days per 1000 : The total number of hospital days incurred by a health plan’s members per thousand members enrolled in the health plan. Decision Support System : General term for any computer application that enhances a human’s ability to make decisions. Deductible Deficit : The decreased functionality of the affected body system as compared to a normal functioning system. Denial : Occurs when, during the course of reviewing a patient's treatment, the medical necessity cannot be validated based upon clinical guidelines or due to lack of information provided by the treating provider. Dependent : An individual who receives health insurance through a spouse, parent, or other family member. Decision Making Decision Making Process Decision Support System (DSS) Descriptor : The text defining a code in a code set. Designated Code Set : A code set or an administrative code set that HHS has designated for use in one or more of the HIPAA standards. Designated Standard : A standard which HHS has designated for use under the authority provided by HIPAA. Diagnosis : The identification of a disease or condition through examination. Diagnosis-Related Group DRG Digital Digital Imaging and Communications in Medicine DICOM Digital Library Digital Subscriber Line (DSL) Direct Contracting Direct Data Entry (DDE) Directing Disability Disallowance Discharge Planning Disclosure Disclosure History Disease Episode Disease Management Disease State Disenrollment Distributed Computing Document Management System (DMS) Draft Standard for Trial Use DSTU Drug Formulary Dual Choice Duplicate Coverage Inquiry Duplication of Benefits Durable Medical Equipment (DME) Durable Power of Attorney For Health Care

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EDI EDI Translator Effective Date Effectiveness Efficacy eHealth eHealth Initiative Efficiency Electronic Commerce EC Electronic Data Interchange EDI Electronic Health Record (EHR) Electronic Healthcare Network Accreditation Commission EHNAC Electronic Medical Record (EMR) Electronic Transactions and Code Sets Eligibility Eligible Covered Individual Eligible Dependent Eligible Employee Eligible Expenses Eligible Insured Eligible Person E-mail Emergicenter Employee Contribution Employee Retirement Income Security Act ERISA Employment Retirement Income Security Act of 1974 ERISA Encounter Endowment Fund Enrollee Engineering Enrollment Enrollment Area Episode of care Ethics Committee Events Evidence-Based Medicine (EBM) Executive Order on Health Information Technology (EO 13335) Excess Capacity Exclusions Exclusive Provider Organization EPO Experience Rating Experimental Procedures Expert System Explanation of Benefits EOB Extended Care Facility Extension of Benefits

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Federal Employees Health Benefits Program FEHBP Federal Qualification Fee Schedule Fee-For-Service FFS Fertility Rate File Transfer Protocol FTP Final Enrollment Firewall Firmware First-Dollar Coverage Fiscal Intermediary FI Flexible Benefits Plan Flowcharting Formulary For-Profit Hospital Free Text Freestanding Ambulatory Surgery Center Freestanding Emergency Medical Service Center Full-Time Equivalent Personnel FTES

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Gatekeeper Gatekeeper Model Gatekeeper PPO Gatekeeping Gene therapy Generic Drug Goal Goal Statement Granularity Graphical User Interface GUI Group Health Plan Group Insurance Group Model HMO Growth Rate Guaranteed Renewable

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Hardware HCPCS (Healthcare Common Procedural Coding System) Health Alliance Health and Human Services HHS Health Care Clearinghouse Health Care Code Maintenance Committee Health Care Provider Taxonomy Committee Health Informatics Health Insurance Portability and Accountability Act of 1996 (HIPAA) Health Insurance Purchasing Cooperative HIPC Health Level 7 HL7 Health Level Seven HL7 Health Maintenance Organization HMO Health Plan Employer Data and Information Set HEDIS Healthcare Common Procedural Coding System (HCPCS) HEDIS HIPAA Home Care Home Health Care Home Page Horizontal Integration Hospice Hospital Hospital Day Hospital Information System Hospital Market Basket Hospital Market Basket Index HMBI Hospital Preauthorization Hospitalists HTML HTTP Hybrid Entity Hyperlink Hypertext

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ICD 9 ICD 9 CM ICD CM ICF ID Card Implementation Guide IG Implementation Specification Incentives Indemnity Plan Infant Mortality Rate per 1000 Live Births Informatics Information Information Science Information Security Information System Information Technology Information Theory Inpatient Inputs Integrated Care Integrated Delivery Networks or System IDN or IDS Integrated Health Care System Integrated Services Digital Network ISDN Intermediate Care Facility International Classification of Diseases (ICD) International Classification of Diseases 9th Revision International Classification of Diseases - Clinical Modifications (ICD-CM) International Classification of Functioning, Disability and Health (ICF) International Organization for Standardization ISO International Standards Organization Internet Internetworking Protocol IP Interoperability Intranet IP Address J-Codes Joint Commission On Accreditation of Healthcare Organizations JCAHO Joint Venture Knowledge Knowledge Base Knowledge Management

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LAN Legend Drug Length of Stay (LOS) Life Expectancy at Birth Lifetime Maximum Living Will Local Codes Logical Observation Identifiers Names and Codes LOINC LOINC Long Term Acute Care Hospital Long Term Care

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Machine learning Magnetic Resonance Imaging MRI Mailing List Maintenance Medication Managed Care Managed Care Organization MCO Managed Care Plan Managed Collaboration Managed Competition Management Management Information System (MIS) Management Service Organization MSO Mandated Benefits Master Patient Index MPI Maximum Defined Data Set Medicaid (Title XIX) Medicaid Fiscal Agent FA Medicaid State Agency Medical Code Sets Medical Informatics Medical Management Services Medical Necessity Medically Necessary Medical Protocols Medical Records Institute (MRI) Medicare Medicare Geographic Classification Review Board Medicare Part A Fiscal Intermediary FI Medicare Part B Carrier Medicare-Supplement Policy Medigap Insurance Megabyte Member Microsoft Access (MS Access) Minimum Scope of Disclosure Mission Mixed-model HMO Modem Morbidity Mortality MS Access (Microsoft Access) Multi-Hospital System

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National Drug Code NDC National Employer ID National Health Information Infrastructure (NHII) National Health Information Network (NHIN) National Patient ID National Payer ID National Practitioner Data Bank National Provider File NPF National Provider ID NPI National Provider Registry National Provider System NPS National Standard Format NSF National Unique Identifier Rule Natural Language Processing (NLP) NCPDP Batch Standard NCPDP Telecommunication Standard Neonatal Network Non-Clinical or Non-Medical Code Sets Non-participating Provider Nosocomial Infection Not-For-Profit Hospital Nuclear Medicine Nurse Practitioner (NP) Nursing Care Delivery Systems Nursing Informatics Nursing Information System (NIS) Nursing Interventions Classifications(NIC)

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Objective Office for Civil Rights Office of Management and Budget OMB On-Line Adjudication Ontology Open Access Open Enrollment Period Open panel HMO Open System Interconnection OSI Operating Margin Operational Data Organizational Chart Organizing Original Research Orthotic Devices OSI Seven Layer Model Out of Network Benefits Outcomes Outlier Out of Area Out of Area Benefits Out of Area Services Out of Network Services Out of pocket Expenses Out of Pocket Limit Out of Pocket Payments OPP Outpatient Care Outputs Over-The-Counter OTC

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Palliative Care Partial Hospital Services : A mental health or substance abuse program operated by a hospital which provides clinical services as an alternative or follow-up to inpatient care. Participant : An eligible covered individual pursuant to the insurance policy or certificate of coverage offered by the client. Participating Physician or Participating Provider Patient Care Pathway Patient Days Patient Flow Payer : In health care, an entity that assumes the risk of paying for health care. This can be an uninsured patient, an employer, or a health insurance plan. Peer Review Perinatal Personal Health Record (PHR) Pharmacogenomics Physical Therapy Physician Assistant PA Physician Dispensing Physician Hospital Organization PHO Physician’s Assistant PA Plan ID Planning Point of service POS plan Policy Policyholder Portability Positron Emission Tomography PET Practice Guidelines Pre-Admission Certification Pre-Admission Review Pre-Authorization Pre-Certification Pre-existing Condition Preferential Discounts Preferred Provider Preferred Provider Health Care Act of 1985 Preferred Provider Organization PPO Premium Preventive Care Pricer or Repricer Primary Care Primary Care Network PCN Primary Care Physician Primary Care Provider PCP Principal Diagnosis Privacy Privacy Rule Privileges Procedure Process Prospective Payment System PPS Prosthesis (Prosthetic Devices) Protected Health Information (PHI) Protocol Provider Provider Taxonomy Codes PSTN Public Health Public Health Informatics

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Quality Quality Assurance (QA) Quality Improvement (QI) Quality of Care Quality of Life Measures

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Radio Frequency Identification (RFID) RAID Array RFID Reasonable and Customary Charge Referral Referral Center Regenstrief Institute Reinsurance Relative Value Scale RVS Resource Based Relative Value Scale RBRVS Restricted Funds Retrospective Review Process Risk Adjustment Risk Pool Risk Sharing Rural Health Clinic

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Schedule of Benefits Science Screening Seamless Care Secondary Insurance Secretary Security Rule Segment Self Funding Self Insurance Self-Insurance Self-Insured Self-Insured Plan Sentinel Event Server SGML Shannon, Claude Single Payer System Skilled Nursing Facility SNF Small Health Plan Smartphone SMI-S Standard - the Storage Management Interface Specification SNOMED (Systematized Nomenclature of Medicine) Software Sole Community Hospital Specialists Specialty HMOs Specialty PPOs Staff Model HMO Staffing Standard Benefit Package Standard Transaction Standard Transaction Format Compliance System STFCS State Law State Uniform Billing Committee SUBC Status Change Stop-loss Insurance Storage Management Storage Management Interface Specification (SMI-S Standard) Structured Data Structured Input Subscriber Summary Plan Description Superbill Surgicenter Swing Beds Synchronous communication Systematized Nomenclature of Medicine (SNOMED) Syntax System

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Teaching Hospital Technology Telemedicine Terminal Terminology Tertiary Care Theory Therapeutic Substitution Third Party Administrator TPA Throughput Title XIX To Err is Human: Building A Safer Health System Tomography Total Quality Management TQM Transaction Transaction Change Request System Treatment Episode Triage

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UB UB-82 Ub-92 UCF Ultrasound Uncompensated Care Underwriting Uniform Claim Task Force UCTF Unstructured data Urgent Care Urgent Care Center URL User interface Usual Customary and Reasonable UCR Utilization Utilization Management Utilization Review Validation Criterion Veterans Health Information Systems and Technology Architecture (VistA) Virtual Private Network VPN Virtual Reality VistA Veterans Health Information Systems and Technology Architecture Wellness Wide Area Network WAN Withhold Work-Related Injury or Illness Work-up World Wide Web Wraparound Plan X12 X12 Standard