Glossary



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A


Term Acronym Source
abstract CMS
Is the collection of information from the medical record via hard copy or electronic instrument.


Term Acronym Source
abuse CMS
A range of the following improper behaviors or billing practices including, but not limited to:billing for a non-covered service; misusing codes on the claim (i.e., the way the service is coded on the claim does not comply with national or local coding guidelines or is not billed as rendered); or inappropriately allocating costs on a cost report


Term Acronym Source
abuse (personal) CMS
When another person does something on purpose that causes you mental or physical harm or pain.


Term Acronym Source
access CMS
Your ability to get needed medical care and services. The process of obtaining data from, or placing into a computer system or storage device. It refers to such actions by any individual or entity who has the appropriate authorization for such actions.


Term Acronym Source
accessibility of services CMS
Your ability to get medical care and services when you need them.


Term Acronym Source
accreditation for deeming CMS
Some States use the findings of private accreditation organizations, in part or in whole, to supplement or substitute for State oversight of some quality related standards. This is referred to as “deemed compliance” with a standard.


Term Acronym Source
administrative services only CMS
An arrangement whereby a self-insured entity contracts with a Third Party Administrator (TPA) to administer a health plan.


Term Acronym Source
administrative simplification CMS
Title II, Subtitle F, of HIPAA which authorizes HHS to: (1) adopt standards for transactions and code sets that are used to exchange health data; (2) adopt standard identifiers for health plans, health care providers, employers, and individuals for use on standard transactions; and (3) adopt standards to protect the security and privacy of personally identifiable health information.


Term Acronym Source
Administrative Simplification Compliance Act CMS
This Act (Public Law 107-105) provides a one-year extension to HIPAA “covered entities” (except small health plans, which already have until October 16, 2003) to meet HIPAA electronic and code set transaction requirements. Also, allows the Secretary of HHS to exclude providers from Medicare if they are not compliant with the HIPAA electronic and code set transaction requirements and to prohibit Medicare payment of paper claims received after October 16, 2003, except under certain situations.


Term Acronym Source
administratvie code sets CMS
Code sets that characterize a general business situation, rather than a medical condition or service. Under HIPAA, these are sometimes referred to as non-clinical or non-medical code sets. Compare to medical code sets.


Term Acronym Source
American Medical Association AMA
A professional organization for physicians. The AMA is the secretariat of the NUCC, which has a formal consultative role under HIPAA. The AMA also maintains the Current Procedural Terminology (CPT .) medical code set.


Term Acronym Source
American National Standards Institute ANSI eHealth Initiative
ANSI is a broad based agency charged with overseeing voluntary standards development for everything from computers to household products. ANSI accredits standards development organizations (SDO) based on their consensus process, then reviews and officially approves the SDO recommendations.


Term Acronym Source
American Society for Testing and Materials ASTM eHealth Initiative
American Society for Testing and Materials develops standards on characteristics and performance of materials, products, systems, and services. There are numerous standards-writing technical committees. E31 is the Committee on Computerized Systems and E31.28 is the subcommittee on Healthcare Informatics responsible for the Continuity of Care (CCR) standard.


Term Acronym Source
Annual Support & Maintenance eHealth Initiative
Costs that are typically 15-20% of the software license costs. Where the actual license is normally a one- time fee, the support and maintenance costs are renewed on a yearly basis. This yearly fee basically covers two areas: 1) any upgrades or new releases; and 2) customer service and support. It should be noted that both vendor EHR software and third party software will need support, so it is important to determine which components the support costs cover. Also, some vendors might have more than one service level agreement representing different support options at different costs.


Term Acronym Source
anonymity online Computerworld Privacy Glossary
Online, we can use an Internet site called a remailer that reposts a message from the site’s own address, thus concealing the originator of the message.


Term Acronym Source
anonymizer or web anonymizer Computerworld Privacy Glossary
This privacy service lets a user visit Web sites while preventing those sites from gathering information about the user (including IP address, browser and operating system identification, and cookie-stored data) or which sites he has visited


Term Acronym Source
Architecture eHealth Initiative
The orderly arrangement of parts; structure.


Term Acronym Source
ASTM eHealth Initiative
See American Society for Testing and Materials.


Term Acronym Source
Asymmetric Key System eHealth Initiative
A system that uses different keys for encryption and decryption. Within such a system, it is computationally infeasible to determine the decryption key (which is kept private) from the encryption key (which is made publicly available).


Term Acronym Source
Attribute eHealth Initiative
A characteristic or property.


Term Acronym Source
Audit trail eHealth Initiative
Chronological record of system activity which enables the reconstruction of information regarding the creation, distribution, modification, and deletion of data.


Term Acronym Source
Authentication eHealth Initiative
Verification of the identity of a person or process.


Term Acronym Source
Authorization eHealth Initiative
The role or set of permissions for information system activity assigned to an individual.


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B


Term Acronym Source
blanket coerced consent Deborah Peel
What the health plans make people sign at the start of the year as a condition of being in the plan–its NOT informed consent, because it says that you agree to release ALL past and future medical records (that is the blanket part) to the health plan or insurer if they request them, as a condition of being covered by the plan (that is the coercion part).


Term Acronym Source
Biometric Authentication Technology eHealth Initiative
Technology that uses some human biological feature (e.g. fingerprint, voice pattern, retina scan, or signature dynamics) to uniquely identify an individual.


Term Acronym Source
business associate BA or BAs CMS
A person or organization that performs a function or activity on behalf of a covered entity, but is not part of the covered entity’s workforce. A business associate can also be a covered entity in its own right. Also see Part II, 45 CFR 160.103.


Term Acronym Source
business associates American Psychoanalytic Association, Inc., 2003
A “business associate” is an individual or entity that performs certain functions on behalf of a covered entity, including billing companies, practice management firms, administrative services, accounting firms, law firms, telephone answering services, computer repair services and others. Employees of your medical practice are part of your workforce and are not your business associates. Disclosures between providers for treatment purposes do not create a business associate relationship. Also, HHS is not considered to be a business associate. Janitorial, maintenance and cleaning services are not considered business associates, assuming the services they provide do not involve the use or disclosure of protected health information, and any access to such information should be incidental if at all.

Term Acronym Source
business relationships CMS
The term agent is often used to describe a person or organization that assumes some of the responsibilities of another one. This term has been avoided in the final rules so that a more HIPAA-specific meaning could be used for business associate.


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C


Term Acronym Source
CA (certification authority) eHealth Initiative
The entity providing third party trust within PKI.


Term Acronym Source
Centers for Medicare and Medicaid Services CMS CMS
The HHS agency responsible for Medicare and parts of Medicaid.CMS is responsible for oversight of HIPAA administrative simplification transaction and code sets, health identifiers, and security standards.


Term Acronym Source
Certification/Conformance Testing eHealth Initiative
Testing a product for the existence of specific features, functions, or characteristics required by a standard in order to determine the extent to which that product satisfies the standard requirements.


Term Acronym Source
chain of trust agreement CMS
Contract needed to extend the responsibility to protect health care data across a series of sub-contractual relationships.


Term Acronym Source
Chief Complaint Mapper eHealth Initiative
A software product that maps chief complaints, captured as text, and transforms them into useful digital data that can be used in functions such as public health outbreak surveillance.


Term Acronym Source
claim status codes CMS
A national administrative code set that identifies the status of health care claims. This code set is used in the X12N 277 Claim Status Inquiry and Response transaction, and is maintained by the Health Care Code Maintenance Committee.


Term Acronym Source
Clinical Classification eHealth Initiative
A method of grouping clinical concepts in order to represent classes that support the generation of indicators of health status and health statistics.


Term Acronym Source
Clinical Data Repository eHealth Initiative
The data warehouse that contains clinical data (HL7 messages) centrally.


Term Acronym Source
Clinical Messaging eHealth Initiative
The communication among providers involved in the care process that can range from real time communication (for example, fulfillment of an injection while the patient is in the exam room), to asynchronous communication (for example, consult reports between physicians).
Reference: Health Level Seven, Inc. “HL7 EHR-S Functional Model and Standard.” July 2004.


Term Acronym Source
Clinical Messaging #1 eHealth Initiative
Continuity of Care Data Exchanges (Inter-Provider Communication): Communication among providers involved in the care process can range from real time communication (for example, fulfillment of an injection while the patient is in the exam room), to asynchronous communication (for example, consult reports between physicians). Some forms of inter-practitioner communication will be paper based and the EHRS must be able to produce appropriate documents.
Reference: Health Level Seven, Inc. “HL7 EHR-S Functional Model and Standard.” July 2004.


Term Acronym Source
Clinical Messaging #2 eHealth Initiative
Secure Patient/Physician e-mail (Provider and Patient or Family Communication): Trigger or respond to electronic communication (inbound and outbound) between providers and patients or patient representatives with pertinent actions in the care process.
Reference: Health Level Seven, Inc. “HL7 EHR-S Functional Model and Standard.” July 2004.


Term Acronym Source
Clinical Reminders (Clinical Guideline Prompts) eHealth Initiative
The ability to remind clinicians to consider certain actions at a particular point in time, such as prompts to ask the patient appropriate preventive medicine questions, notifications that ordered tests have not produced results when expected, and suggestions for certain therapeutic actions, such as giving a tetanus shot if one has not been given for 10 years.
Reference: eHealth Initiative Foundation. “Second Annual Survey of State, Regional and Community-based Health Information Exchange Initiatives and Organizations.” Washington: eHealth Initiative Foundation, 2005.


Term Acronym Source
Clinical User Authentication eHealth Initiative
The process used by the HIE to determine the identity of the person accessing the system with adequate certainty to maintain security and confidentiality of personal health information and to administer with certainty of identity a regulated process such as e-prescribing and chart signing.


Term Acronym Source
CMS-1450 CMS
The uniform institutional claim form.


Term Acronym Source
CMS-1500 CMS
The uniform professional claim form.


Term Acronym Source
code of federal regulations CMS
The official compilation of federal rules and requirements.


Term Acronym Source
code set CMS
Under HIPAA, this is any set of codes used to encode data elements, such as tables of terms, medical concepts, medical diagnostic codes, or medical procedure codes. This includes both the codes and their descriptions. Also see Part II, 45 CFR 162.103.


Term Acronym Source
compliance date CMS
Under HIPAA, this is the date by which a covered entity must comply with a standard, an implementation specification, or a modification. This is usually 24 months after the effective data of the associated final rule for most entities, but 36 months after the effective data for small health plans. For future changes in the standards, the compliance date would be at least 180 days after the effective data, but can be longer for small health plans and for complex changes.


Term Acronym Source
Community Health Record Sysytem
Information from different RHIO Participants is combined and integrated into a single record to form a Community Health Record System.


Term Acronym Source
Computerized Provider Order Entry eHealth Initiative
A computer application that allows a physician’s orders for diagnostic and treatment services (such as medications, laboratory, and other tests) to be entered electronically instead of being recorded on order sheets or prescription pads. The computer compares the order against standards for dosing, checks for allergies or interactions with other medications, and warns the physician about potential problems.
Reference: United States Department of Health and Human Services. Office of the National Coordinator for Health Information Technology (ONC) Glossary


Term Acronym Source
Confidentiality eHealth Initiative
A 3rd party’s obligation to protect the personal information with which it has been entrusted.


Term Acronym Source
confidentiality Computerworld Privacy Glossary
The expectation that personal information will be held in confidence.


Term Acronym Source
Controlled Clinical Vocabulary eHealth Initiative
A system of standardizing the terms used in describing client-centered health and health service-related concepts.


Term Acronym Source
Conversion Services eHealth Initiative
Consulting services offered by the vendor. These services will take your original data, either in paper or electronic form, and transfer the data into the EHR system database.


Term Acronym Source
coordination of benefits CMS
Process for determining the respective responsibilities of two or more health plans that have some financial responsibility for a medical claim. Also called cross-over.


Term Acronym Source
covered entity CE or CEs CMS
Under HIPAA, this is a health plan, a health care clearinghouse, or a health care provider who transmits any health information in electronic form in connection with a HIPAA transaction.


Term Acronym Source
current dental terminology CMS
A medical code set of dental procedures, maintained and copyrighted by the American Dental Association (ADA), and adopted by the Secretary of HHS as the standard for reporting dental services on standard transactions.


Term Acronym Source
current procedural terminology CPT CMS
A medical code set of physician and other services, maintained and copyrighted by the American Medical Association (AMA), and adopted by the Secretary of HHS as the standard for reporting physician and other services on standard transactions.


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D


Term Acronym Source
D-codes CMS
Subset of the HCPCS Level II medical codes identifying certain dental procedures. It replicates many of the CDT codes and will be replaced by the CDT. Descriptor: The text defining a code in a code set.


Term Acronym Source
Data Center eHealth Initiative
The physical space and hardware used by the HIE to house its operations if these assets are kept within the HIE.


Term Acronym Source
data condition CMS
A description of the circumstances in which certain data is required.


Term Acronym Source
data content CMS
Under HIPAA, this is all the data elements and code sets inherent to a transaction, and not related to the format of the transaction.


Term Acronym Source
data element CMS
Under HIPAA, this is the smallest named unit of information in a transaction.


Term Acronym Source
Data Integrity eHealth Initiative
The accuracy and completeness of data, to be maintained by appropriate security measures and controls. Preservation of the original quality and accuracy of data, in written or in electronic form.


Term Acronym Source
data mapping CMS
The process of matching one set of data elements or individual code values to their closest equivalents in another set of them. This is sometimes called a cross-walk.


Term Acronym Source
Data Recovery Services eHealth Initiative
A mechanism and process to safely store duplicate databases and recreate the data should a disaster occur.


Term Acronym Source
data warehouse silo system
The RHIO holds each RHIO Participant’s information in separate silos, but pulls information from applicable silos when information about a particular patient is requested. This is a ‘hub and spoke’ arrangement.


Term Acronym Source
Decision Support eHealth Initiative
Computerized functions that assist users in making decisions in their job functions. In the practice of medicine, these functions include providing electronic access to medical literature, alerting the user to potential adverse drug interactions, and suggesting alternative treatment plans for a certain diagnosis.


Term Acronym Source
Decryption eHealth Initiative
The technique of using mathematical procedures to “unscramble” data so that an unintelligible (encrypted) message becomes intelligible.


Term Acronym Source
Demographics eHealth Initiative
Information about name, address, age, gender, and role used to link patient records from multiple sources in the absence of a unique patient identifier.


Term Acronym Source
Department of Health and Human Services HHS HHS Website
The federal government department that has overall responsibility for implementing HIPAA.


Term Acronym Source
descriptor CMS
The text defining a code in a code set.


Term Acronym Source
designated code set CMS
A medical code set or an administrative code set that is required to be used by the adopted implementation specification for a standard transaction.


Term Acronym Source
designated standard CMS
A standard which HHS has designated for use under the authority provided by HIPAA.


Term Acronym Source
designated standard maintenance organization CMS
An organization, designated by the Secretary of the U.S. Department of Health & Human Services, to maintain standards adopted under Subpart I of 45 CFR Part 162. A DSMO may receive and process requests for adopting a new standard or modifying an adopted standard.


Term Acronym Source
DICOM (Digital Imaging Communications in Medicine) eHealth Initiative
A standard which defines protocols for the exchange of medical images and associated information (such as patient identification details and technique information) between instruments, information systems, and health care providers. It establishes a common language that enables medical images produced on one system to be processed and displayed on another.


Term Acronym Source
Digital Signature eHealth Initiative
A string of binary digits which is computed using an encryption algorithm. Digital signatures enable signatory authentication, confirmation of data integrity, and non-repudiation of messages.


Term Acronym Source
direct data entry CMS
Under HIPAA, this is the direct entry of data that is immediately transmitted into a health plan’s computer.


Term Acronym Source
disclosure of personal health information (PHI)
The sharing of PHI outside of the institution (i.e., from principal investigator to study sponsor).


Term Acronym Source
Doctor Matching eHealth Initiative
The process of cross-linking the multiple provider identifiers in a community from a variety of provider identifier sources and creating a master doctor identifier with a key for cross-referencing the various community identifiers.


Term Acronym Source
Document Review, Edit, Sign eHealth Initiative
A software process that allows for the secure review, editing, and signature through electronic, distributed technology of electronic health record components, such as operative reports, discharge summaries, and consultations.


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E


Term Acronym Source
EDI translator CMS
A software tool for accepting an EDI transmission and converting the data into another format, or for converting a non-EDI data file into an EDI format for transmission.


Term Acronym Source
effective date CMS
Under HIPAA, this is the date that a final rule is effective, which is usually 60 days after it is published in the Federal Register.


Term Acronym Source
eLaboratory eHealth Initiative
The electronic delivery of laboratory results to practices so that such data may be integrated into electronic patient records in a full EHR system, or used by a dedicated application to view structured, context-rich, and/or longitudinal laboratory results on a patient. eLaboratory includes closing the orders loop, documenting the review of results by clinicians, and documenting that the results have been communicated to the patient. The full benefits of eLaboratory are not achieved until the results are used as input into clinical decision support systems (CDSS).


Term Acronym Source
Electronic Billing (Claims, Eligibility, Remittance) eHealth Initiative
The ability to contact the payer before the patient is seen and get a response that indicates whether or not the services to be rendered will be covered by the payer. Reference: eHealth Initiative Foundation. “Second Annual Survey of State, Regional and Community-based Health Information Exchange Initiatives and Organizations.” Washington: eHealth Initiative, 2005.


Term Acronym Source
Electronic Billing Support eHealth Initiative
The ability to contact the payer before the patient is seen and get a response that indicates whether or not the services to be rendered will be covered by the payer.
Reference: eHealth Initiative Foundation. “Second Annual Survey of State, Regional and Community-based HIE Initiatives and Organizations.” Washington: eHealth Initiative Foundation, 2005.


Term Acronym Source
electronic data interchange CMS
Refers to the exchange of routine business transactions from one computer to another in a standard format, using standard communications protocols.


Term Acronym Source
electronic health record (s) EHR or EHRs
Health records kept in electronic form, as opposed to health records kept on paper.


Term Acronym Source
Electronic Health Record eHealth Initiative
Electronically maintained information about an individual’s lifetime health status and health care.


Term Acronym Source
Electronic Imaging Results Delivery eHealth Initiative
The ability to accept messages from radiology sources and integrate the data for presentation to a clinician.
Reference: eHealth Initiative Foundation. “Second Annual Survey of State, Regional and Community-based Health Information Exchange Initiatives and Organizations. ” Washington: eHealth Initiative Foundation, 2005.


Term Acronym Source
electronic media claims CMS
A flat file format used to transmit or transport claims.


Term Acronym Source
electronic medical record (s) EHR or EHRs
Medical records kept in electronic form (as opposed to medical records kept on paper).


Term Acronym Source
Electronic Prescribing (Pharmacy Communication) eHealth Initiative
Provides features to enable secure bidirectional communication of information electronically between practitioners and pharmacies or between practitioner and intended recipient of pharmacy orders.
Reference: Health Level Seven, Inc. “HL7 EHR-S Functional Model and Standard.” July 2004.


Term Acronym Source
Electronic Quality Data Submission (Performance and Accountability Measures) eHealth Initiative
Support the capture and reporting of quality, performance, and accountability measures to which providers/facilities/delivery.


Term Acronym Source
Electronic Referral Management eHealth Initiative
The ability to generate and/or receive summaries of relevant clinical information on a patient that are typically transferred between healthcare providers when a patient is referred to a specialist or admitted or discharged from a hospital.
Reference: eHealth Initiative Foundation. “Second Annual Survey of State, Regional and Community-based Health Information Exchange Initiatives and Organizations.” Washington: eHealth Initiative Foundation, 2005.


Term Acronym Source
Electronic Referrals and Authorizations eHealth Initiative
The ability to generate and/or receive summaries of relevant clinical information on a patient that are typically transferred between healthcare providers when a patient is referred to a specialist or admitted or discharged from a hospital.
Reference: eHI Foundation. “Second Annual Survey of State, Regional and Community-based HIE Initiatives and Organizations. ” Washington: eHealth Initiative Foundation, 2005.


Term Acronym Source
electronic remittance advice CMS
Any of several electronic formats for explaining the payments of health care claims.


Term Acronym Source
Electronic Signature eHealth Initiative
A digital signature, which serves as a unique identifier for an individual.


Term Acronym Source
employer identifier CMS
A standard adopted by the Secretary of HHS to identify employers in standard transactions. The IRS’ EIN is the adopted standard.


Term Acronym Source
Encryption eHealth Initiative
The process of enciphering or encoding a message so as to render it unintelligible without a key to decrypt (unscramble) the message.


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F


Term Acronym Source
Federal “regulatory permission” Amended Privacy Rule
“The consent provisions (in the Original Rule)…are replaced with a new provision…that provides regulatory permission for covered entities to use and disclose protected health information for treatment, payment, and health care operations.” 67 Fed. Reg. at 53,211


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G


Term Acronym Source
Gramm-Leach-Blyley Financial Services Act of 1999 GLB
A federal act that allows banks, financial institutions and all their affiliates and non-affiliates to share sensative financial and medical records without consent or notice (and affiliates are typically insurers).


Term Acronym Source
group health plan CMS
A health plan that provides health coverage to employees, former employees, and their families, and is supported by an employer or employee organization.


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H


Term Acronym Source
health care clearinghouse CMS
A public or private entity that processes or facilitates the processing of nonstandard data elements of health information into standard data elements.


Term Acronym Source
Health Care Interoperability eHealth Initiative
Assures the clear and reliable communication of meaning by providing the correct context and exact meaning of the shared information as approved by designated communities of practice. This adds value by allowing the information to be accurately linked to related information, further developed and applied by computer systems and by care providers for the real-time delivery of optimal patient care.


Term Acronym Source
health care operations American Psychoanalytic Association, Inc., 2003
Activities that are related to the general business and administrative functions of the covered entity regardless of whether they are connected to the treatment or payment of an individual. This may include quality assessment, accreditation and training, business planning and development, general administrative activities and due diligence in connection with the sale of a covered entity to another covered entity.


Term Acronym Source
health care provider Public Law 104-191 (HIPAA)
A provider of services (as defined in section 1861(u)), a provider of medical or other health services (as defined in section 1861(s)), and any other person furnishing health care services or supplies.


Term Acronym Source
health information Public Law 104-191 (HIPAA)
Any information, whether oral or recorded in any form or medium, that–“(A) is created or received by a health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse; and”(B) relates to the past, present, or future physical or mental health or condition of an individual, the provision of health care to an individual, or the past, present, or future payment for the provision of health care to an individual.


Term Acronym Source
Health Information Exchange (HIE) eHealth Initiative
The mobilization of healthcare information electronically across organizations within a region or community.HIE provides the capability to electronically move clinical information between disparate healthcare 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 safer, more timely, efficient, effective, equitable, patient-centered care.

Formal organizations are now emerging to provide both form and function for health information exchange efforts. These organizations (often called Regional Health Information Organizations, or RHIOs) are ordinarily geographically-defined entities which develop and manage a set of contractual conventions and terms, arrange for the means of electronic exchange of information, and develop and maintain HIE standards.

Although HIE initiatives differ in many ways, survey results and eHI experiences with states, regions and communities indicate that those who are experiencing the most success share the following characteristics. They are:

  • Governed by a diverse and broad set of community stakeholders;
  • Develop and assure adherence to a common set of principles and standards for the technical and policy aspects of information sharing, addressing the needs of every stakeholder;
  • Develop and implement a technical infrastructure based on national standards to facilitate interoperability;
  • Develop and maintain a model for sustainability that aligns the costs with the benefits related to HIE; and
  • Use metrics to measure performance from the perspective of: patient care, public health, provider value, and economic value.

Reference: eHealth Initiative. “Second Annual Survey of State, Regional and Community-based Health Information Exchange Initiatives and Organizations.” Washington: eHealth Initiative, 2005.


Term Acronym Source
Health Insurance Portablility and Accountability Act of 1996 HIPAA CMS
A Federal law that allows persons to qualify immediately for comparable health insurance coverage when they change their employment relationships.


Term Acronym Source
Health Level Seven (HL7) eHealth Initiative
An ANSI approved American National Standard for electronic data exchange in health care. It enables disparate computer applications to exchange key sets of clinical and administrative information.


Term Acronym Source
Health Maintenance Organization HMO CMS
A health maintenance organization (HMO) contracts with doctors, hospitals, and health care providers to provide medical care to a group of consumers. Generally, HMOs will not pay for your care unless you receive it from one of their health care providers. The HMO usually receives a fixed amount of money per patient for each enrollee. Enrollees of the HMO generally do not have any significant out-of-pocket expenses.


Term Acronym Source
health plan CMS
An entity that assumes the risk of paying for medical treatments, i.e. uninsured patient, self-insured employer, payer, or HMO.


Term Acronym Source
health plan public law 104-191 (HIPAA)
An individual or group plan that provides, or pays the cost of, medical care.


Term Acronym Source
healthcare provider taxonomy codes CMS
An administrative code set that classifies health care providers by type and area of specialization.


Term Acronym Source
hybrid entity CMS
A covered entity whose covered functions are not its primary functions.


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I


Term Acronym Source
ICD-9 (International Classification of Disease, 9th Revision) eHealth Initiative
The 1972 revision of the international disease classification system developed by the World Health Organization.


Term Acronym Source
ICD-9-CM (International Classification of Disease, 9th Revision, Clinical Modification) eHealth Initiative
The American modification of the ICD-9 classification system for both diagnoses and procedures.


Term Acronym Source
ICD-10 (International Statistical Classification of Diseases and Related Health Problems, 10th Revision) eHealth Initiative
The 1992 revision of the international disease classification system developed by the World Health Organization.


Term Acronym Source
ICD-10-CM (International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Clinical Modification) eHealth Initiative
The American modification of the ICD-10 classification system, for field review release in 1998.


Term Acronym Source
ICD-10-PCS (International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Procedural Classification System) eHealth Initiative
A classification system for reporting clinical procedures, to accompany ICD-10-CM, developed in the US, for 1998 field review release.


Term Acronym Source
implementation guide CMS
A document explaining the proper use of a standard for a specific business purpose. The X12N HIPAA IGs are the primary reference documents used by those implementing the associated transactions, and are incorporated into the HIPAA regulations by reference.


Term Acronym Source
Implementation Services eHealth Initiative
Consulting services offered by the vendor. These services will provide planning and actual implementation of an EHR system. It is important when comparing quoted implementation costs that physicians understand which detailed cost line items a particular vendor will be supplying. Also, make sure and take a look at their project plans.


Term Acronym Source
Informatics eHealth Initiative
The application of computer science and information science to the management and processing of data, information, and knowledge.


Term Acronym Source
individually identifiable health information public law 104-191 (HIPAA)
Any information, including demographic information collected from an individual, that– “(A) is created or received by a health care provider, health plan, employer, or health care clearinghouse; and “(B) relates to the past, present, or future physical or mental health or condition of an individual, the provision of health care to an individual, or the past, present, or future payment for the provision of health care to an individual, and– “(i) identifies the individual; or “(ii) with respect to which there is a reasonable basis to believe that the information can be used to identify the individual.


Term Acronym Source
informed Consent Saint Francis Care
Informed consent is a process of information exchange that may include, in addition to reading and signing the informed consent documents, subject recruitment materials, verbal instructions, question/answer sessions and measures of subject understanding. The clinical investigator is responsible for ensuring that informed consent is obtained from each research subject before that subject participates in the research study.


Term Acronym Source
informed contemporaneous consent Deborah Peel
The ethical standard in medicine is informed (meaning you know exactly what info you are consenting to release) contemporaneous (at the time the info is being requested or is needed, NOT before) consent. Informed also means that you can comprehend the effects of releasing the info, ie you are of sound mind and capable of understanding what is going on.


Term Acronym Source
Interface eHealth Initiative
Shared boundary between two functional units defined by various characteristics pertaining to the functions, physical interconnections, signal changes, and other characteristics as appropriate.


Term Acronym Source
Interface to ADT System eHealth Initiative
The interface between an HIE and the systems that are sources for admission, discharge and transfer (ADT) of patients in the care delivery setting and that are resident within care delivery institution.


Term Acronym Source
Interface to ASP EHR System eHealth Initiative
The interface between an HIE and Electronic Health Records (EHRs) that are maintained on ASP platforms (i.e. NexGen, AllScripts).


Term Acronym Source
Interface to Claims System eHealth Initiative
The interface between an HIE and the systems that are sources for or routing pathways for claims data that are resident within health plans and claims clearinghouses.


Term Acronym Source
Interface to EKG System eHealth Initiative
The interface between an HIE and the systems that are sources for EKG results that are resident within dispensing physician offices and hospitals.


Term Acronym Source
Interface to Eligibility System eHealth Initiative
The interface between an HIE and the source data of which people have eligibility for which type of benefits that are resident within health plans and are not infrequently web-enabled.


Term Acronym Source
Interface to Formulary System eHealth Initiative
The interface between an HIE and the systems that are sources for formulary status of specific drugs for specific health benefit designs and that are resident within pharmacy benefit management companies and hospitals.


Term Acronym Source
Interface to Laboratory System eHealth Initiative
The interface between an HIE and systems that are sources of laboratory data.


Term Acronym Source
Interface to Pharmacy System eHealth Initiative
The interface between an HIE and the systems that are sources for prescription data or that are resident within dispensing pharmacies, pharmacy benefit management companies and hospitals.


Term Acronym Source
Interface to Practice Management System eHealth Initiative
The interface between an HIE and the systems that are sources for the financial management systems of physician practices.


Term Acronym Source
Interface to Provider List System eHealth Initiative
The interface between an HIE and the systems that track the multiple providers and their identifying data that are resident within health plans, dispensing pharmacies, pharmacy benefit management companies laboratories, physician practices, and hospitals.


Term Acronym Source
Interface to Provider Office EHR System eHealth Initiative
The interface between an HIE and EHRs that are maintained in practice-specific systems (e.g. EPIC).


Term Acronym Source
Interface to Radiology System eHealth Initiative
The interface between an HIE and systems that are sources for radiological data.


Term Acronym Source
Interface to Transcribed Reports System eHealth Initiative
The interface between an HIE and the systems that are sources for transcribed reports. Typically these systems are based at a transcription service or at a hospital and contain admission and discharge notes and consultations, operative reports, and pathology and radiology results.


Term Acronym Source
internet privacy Computerworld Privacy Glossary
Within the context of the Internet, the right to privacy is still being defined.Generally, it involves a person’s right to control what information about himself is revealed and to whom, as well as what others may do with that information. It’s not the same thing as secrecy, but the distinction is sometimes murky. Privacy isn’t an absolute right, since it’s often trumped by laws and overriding social needs. For example, law enforcement officials may obtain warrants that allow them to intercept communications or search physical areas, activities that otherwise would be forbidden.


Term Acronym Source
Interoperability eHealth Initiative
The ability of two or more systems or components to exchange information and to use the information that has been exchanged accurately, securely, and verifiably, when and where needed.


Term Acronym Source
Interoperability eHealth Initiative
The ability of two or more systems or components to exchange information and to use the information that has been exchanged accurately, securely, and verifiably, when and where needed.


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Term Acronym Source
J-codes CMS
A subset of the HCPCS Level II code set with a high-order value of “J” that has been used to identify certain drugs and other items.


Term Acronym Source
Jaffee v. Redmond, 116 S. Ct. 1923,1928 (1996) Jim Pyles
The Supreme Court has found that the “reason and experience” of the country shows that effective psychotherapy can only be provided if there is a privilege that permits the disclosure of psychotherapy communications, in most instances, only with the patient’s permission.


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Term Acronym Source
Keys eHealth Initiative
A sequence of symbols that controls the operations of encryption and decryption.


Term Acronym Source
Key Certificate eHealth Initiative
A data record that authenticates the owner of a public key for an asymmetric algorithm. It is issued by a certification authority and is protected by a digital signature allowing the certificate to be verified widely. The certificate may also contain other fields beside the value to the key and the name of the owner, for example an expiration date.


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Term Acronym Source
local codes CMS
A generic term for code values that are defined for a State or other local division or for a specific payer. Commonly used to describe HCPCS Level III Codes.


Term Acronym Source
LOINC (Logical Observation Identifiers, Names, and Codes) eHealth Initiative
The LOINC databases provide sets of universal names and ID codes for identifying laboratory and clinical test results. The purpose is to facilitate the exchange and pooling of results, such as blood hemoglobin, serum potassium, or vital signs, for clinical care, outcomes management, and research.


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Term Acronym Source
Managed Care Organizations MCOs CMS
Managed care organizations have arrangements with doctors, hospitals, and other health care providers for their services. These doctors, hospitals, and health care providers form a network. Examples of managed care organizations include: Health MaintenanceOrganizations (HMOs) and Preferred Provider Organizations (PPOs)


Term Acronym Source
maximum defined data set CMS
Under HIPAA, this is all of the required data elements for a particular standard based on a specific implementation specification.


Term Acronym Source
medical code sets CMS
Long Description
Codes that characterize a medical condition or treatment.


Term Acronym Source
Medication Matching eHealth Initiative
The process of cross-linking the multiple possible medication identifiers naming conventions in a community from a variety of systems housing medication information and creating a master medication identifier with a key for cross-referencing the various community identifiers. For example there are hundreds of NDC codes for identical drugs as well as HCPCS codes that identify the same drug as NDC codes.


Term Acronym Source
medical privacy Original HIPAA Privacy Rule
As explained in the original HIPAA health privacy rule, the right of individuals to medical privacy means the right “to determine for themselves when, how, and to what extent information about them is communicated”.


Term Acronym Source
Medication Reconciliation eHealth Initiative
Alerts providers in real-time to potential administration errors such as wrong patient, wrong drug, wrong dose, wrong route and wrong time in support of medication administration or pharmacy dispense/supply management and workflow.
Reference: Health Level Seven, Inc. “HL7 EHR-S Functional Model and Standard.”July 2004.


Term Acronym Source
Medicare contractor CMS
A Medicare Part A Fiscal Intermediary (institutional), a Medicare Part B Carrier (professional), or a Medicare Durable Medical Equipment Regional Carrier (DMERC)


Term Acronym Source
medicare remittance advice remark codes CMS
A national administrative code set for providing either claim-level or service-level Medicare-related messages that cannot be expressed with a Claim Adjustment Reason Code. This code set is used in the X12 835 Claim Payment & Remittance Advice transaction.

Term Acronym Source
Message Integrity eHealth Initiative
Protecting a message against its unauthorized modification, often by the originator of the message generating a digital signature.


Term Acronym Source
Messaging to Pharmacies eHealth Initiative
The process of communicating electronically with pharmacies. This typically includes the cost of communication lines and processes between the HIE and pharmacies. This is necessary to support the e-prescribing function when that function includes the process of electronically sending a digital prescription to the pharmacy.


Term Acronym Source
Messaging to Providers eHealth Initiative
The process of communicating electronically with providers. This typically includes the cost of communication lines and processes between the HIE and provider terminals.


Term Acronym Source
minimum necessary standard American Psychoanalytic Association, Inc., 2003
The least amount of information required to achieve the purpose of the use, disclosure or request.


Term Acronym Source
Modify or Modification
Under HIPAA, this is a change adopted by the Secretary(HHS Secretary, Tommy Thompson), through regulation, to a standard or an implementation specification.


Term Acronym Source
mosaic effect Computerworld News Story
When combinations of data tidbits produce a picture that wasn’t apparent from the individual pieces.


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Term Acronym Source
National Committee on Vital and Health Statistics NCVHS NCVHS website
It serves as the statutory [42 U.S.C. 242k(k)] public advisory body to the Secretary of Health and Human Services in the area of health data and statistics. The Committee provides advice and assistance to the Department and serves as a forum for interaction with interested private sector groups on a variety of key health data issues.


Term Acronym Source
National Council for Prescription Drug Programs CMS
An ANSI-accredited group that maintains a number of standard formats for use by the retail pharmacy industry, some of which have been adopted as HIPAA standards.


Term Acronym Source
National drug code CMS
A medical code set maintained by the Food and Drug Administration that contains codes for drugs that are FDA-approved.


Term Acronym Source
National Health Information Network NHIN
The name of the federal government’s program to implement a national interoperable system for sharing electronic medical records or EMRs (AKA electronic health records or EHRs).


Term Acronym Source
National Health Information Network eHealth Initiative
An interoperable, standards-based network across the nation for the secure exchange of heath care information.
Reference: HHS Awards Contracts to Develop Nationwide Health Information Network. 2005.


Term Acronym Source
national provider identifier CMS
A system for uniquely identifying all providers of health care services, supplies, and equipment. A term proposed by the Secretary of HHS as the standard identifier for health care providers.


Term Acronym Source
national standard format CMS
Generically, this applies to any nationally standardized data format, but it is often used in a more limited way to designate the Professional EMC NSF, a 320-byte flat file record format used to submit professional claims.


Term Acronym Source
NCPDP batch standard CMS
A NCPDP format for use by low-volume dispensers of pharmaceuticals, such as nursing homes. The Secretary of HHS adopted Version 1.0 of this format as a standard transaction.


Term Acronym Source
NCPDP format telecommunication standard CMS
A NCPDP format designed for use by high-volume dispensers of pharmaceuticals, such as retail pharmacies. The Secretary of HHS adopted Version 5.1 of this format as a standard transaction.


Term Acronym Source
Network eHealth Initiative
A set of connected elements. For computers, any collection of computers connected together so that they are able to communicate, permitting the sharing of data or programs.


Term Acronym Source
Network Connectivity eHealth Initiative
The process used for maintaining connection for communication between the HIE and a data source (laboratory, radiology practice, physician practice, or hospital) and data user (physician practice or hospital).


Term Acronym Source
non-routine uses and disclosures of patient health information American Psychoanalytic Association, Inc., 2003
A non-routine use or disclosure is a use or disclosure other than for treatment, payment, or health care operations purposes that is not otherwise permitted or required by law. For example, an authorization would be required in connection with a pre-employment medical exam or the release of information to the patient’s attorney. The Privacy Rule requires that patients sign an Authorization form for most non-routine uses and disclosures of patient health information.


Term Acronym Source
Notice of Privacy Practices or Privacy Notice NPP
HIPAA requires all covered entities to give patients a notice of their privacy practices, which must include how information about how their medical records will be shared.


Term Acronym Source
notice of proposed rulemaking NPR CMS
A document that describes and explains regulations that the Federal Government proposes to adopt at some future date, and invites interested parties to submit comments related to them. These comments can then be used in developing a final regulation.


Term Acronym Source
NPLANID CMS
A term used by CMS for a proposed standard identifier for health plans. CMS had previously used the terms PayerID and PlanID for the health plan identifier.


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Term Acronym Source
Office for Civil Rights OCR CMS
This office is part of HHS. Its HIPAA responsibilities include oversight of the privacy requirements.


Term Acronym Source
Opt-in/Opt-out Computerworld Privacy Glossary
An important distinction in the privacy debate concerns the terms under which e-mail marketers (legitimate ones, not spammers that ignore ethical and legal concerns) can contact users, and how users can add or remove themselves from databases.


Term Acronym Source
Order Entry eHealth Initiative
The process of communicating health care provider orders through electronic, computerized processes.


Term Acronym Source
OSI (Open Systems Interconnection) eHealth Initiative
The process of communicating health care provider orders through electronic, computerized processes.


Term Acronym Source
Outbreak Surveillance eHealth Initiative
Support clinical health state monitoring of aggregate patient data for use in identifying health risks from the environment and/or population.
Reference: Health Level Seven, Inc. “HL7 EHR-S Functional Model and Standard.”July 2004.


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Term Acronym Source
Parallel Pathways for Quality Healthcare eHealth Initiative
eHI has developed a set of principles and framework for alignment of incentives with both quality and efficiency goals as well as HIT capabilities within the physician practice and health information exchange capabilities across markets. This Framework—entitled “Parallel Pathways for Quality Healthcare” offers significant guidance to states, regions and communities who are exploring health information exchange as a foundation to address quality, safety and efficiency challenges.


Term Acronym Source
Participant Roles eHealth Initiative
Examples of roles that may be recognized by the health system that participate in events affecting the health of people:

  • Provider
  • Governor
  • Manager
  • Recipient
  • Researcher
  • Educator
  • Worker
  • Family Member

Roles may be used to authorize an individual’s access to information system functionality.


Term Acronym Source
Patient Matching eHealth Initiative
The process of cross-linking the multiple patient identifiers in a community from a variety of patient identifier sources and creating a master patient identifier with a key for cross-referencing the various community identifiers. This is also referred to as a record locator service.


Term Acronym Source
Pay-for-Performance/Quality Data Reporting eHealth Initiative
Supports the capture and reporting of quality, performance, and accountability measures to which providers/ facilities/ delivery systems/communities are held accountable including measures related to process, outcomes, and/or costs of care, may be used in ‘pay for performance’ monitoring and adherence to best practice guidelines.
Reference: Health Level Seven, Inc. “HL7 EHR-S Functional Model and Standard.”July 2004.


Term Acronym Source
Personal Health Information PHI
A person’s identifable medical or health records.


Term Acronym Source
Personal Health Record PHR
Typically a health record that is initiated and maintained by an individual. An ideal PHR would provide a complete and accurate summary of the health and medical history of an individual by gathering data from many sources and making this information accessible online to anyone who has the necessary electronic credentials to view the information.From HITECH Act (page 145): The term “personal health record” means an electronic record of PHR identifiable health information (as defined in section 13407(f)(2)) on an individual that can be drawn from multiple sources and that is managed, shared, and controlled by or primarily for the individual.

From HHS OCR: In general, a PHR is an electronic record of an individual’s health information by which the individual controls access to the information and may have the ability to manage, track, and participate in his or her own heath care.


Term Acronym Source
plan sponsor CMS
An entity that sponsors a health plan. This can be an employer, a union, or some other entity.


Term Acronym Source
Platform for Privacy Preferences Project P3P Computerworld Privacy Glossary
This is a standard XML format adopted by the World Wide Web Consortium for Web sites to use to encode their privacy policies [see QuickLink 33484].


Term Acronym Source
Pointer System
The RHIO identifies where each patient’s information is located and serves as a master patient index. All RHIO Participants interact with each other to exchange information, although an intermediary may facilitate the exchange of information.


Term Acronym Source
Preferred provider organizations PPOs CMS
Preferred provider organizations have contracts with doctors, hospitals, and other health care providers and have negotiated certain fees. As long as you get your care from these providers, you will only have to make your co-payment. If you go to a provider outside of the PPO, your care may still be covered, but you may have to pay more.


Term Acronym Source
pricer or repricer CMS
A person, an organization, or a software package that reviews procedures, diagnoses, fee schedules, and other data and determines the eligible amount for a given health care service or supply. Additional criteria can then be applied to determine the actual allowance, or payment, amount.


Term Acronym Source
Privacy eHealth Initiative
Right of an individual to control the circulation of information about him-/herself within social relationships; freedom from unreasonable interference in an individual’s private life; an individual’s right to protection of data regarding him/her against misuse or unjustified publication.


Term Acronym Source
privacy in the law Computerworld Privacy Glossary
The U.S. government must not conceal the existence of any personal data record-keeping system by any agency.


Term Acronym Source
privacy policy Computerworld Privacy Glossary
Most Web sites have a page describing in detail the site’s privacy practices and what the site’s owners will do with any information they collect.


Term Acronym Source
privacy, the right of Original HIPAA Privacy Rule
“The right of privacy is: ‘the claim of individuals, groups, or institutions to determine for themselves when, how, and to what extent information about them is communicated’.” 65 Fed. Reg. at 82,465


Term Acronym Source
Private Key eHealth Initiative
In asymmetric cryptography, the key which is held only by the user for signing and decrypting messages.


Term Acronym Source
protected health information PHI 12/28/2000 Final Privacy Rule
Individually identifiable information transmitted or maintained in any form (electronic means, on paper, or through oral communication) that relates to the past, present or future physical or mental health or conditions that can reasonably be used to identify an individual.


Term Acronym Source
pseudonymity Computerworld Privacy Glossary
Pseudonymity is the ability to prove a consistent identity without revealing one’s actual name, instead using an alias or pseudonym.


Term Acronym Source
Public Health Outbreak Surveillance eHealth Initiative
Supports clinical health state monitoring of aggregate patient data for use in identifying health risks from the environment and/or population.
Reference: Health Level Seven, Inc. “HL7 EHR-S Functional Model and Standard.” July 2004


Term Acronym Source
Public Health Processor eHealth Initiative
A software product that processes extracted data from health care provider systems for the purpose of tracking, trending, and reporting for public health reasons.


Term Acronym Source
Public Key eHealth Initiative
In asymmetric cryptography, the key which is published by the user to encrypt messages and so that others may verify his/her signature.


Term Acronym Source
Public Key Certificate eHealth Initiative
A data record that authenticates the owner of a public key for an asymmetrical key system. It is issued by a CA and is protected by a digital signature, allowing the certificate to be verified widely.


Term Acronym Source
Public Key Infrastructure (PKI) eHealth Initiative
A conceptual framework that enables the encryption, decryption and electronic “signing” of data transmissions in a secure fashion within an open network environment.


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R


Term Acronym Source
radio frequency identification (tags) RFID Computerworld Privacy Glossary
Now on the verge of becoming a widespread supply chain tool, radio frequency identification tags are getting smaller and cheaper, and privacy concerns are being raised. It may not be long before such tags are built into individual items (such as clothing), not just shipping pallets, allowing an unprecedented amount of automated monitoring of people’s habits, behaviors and locations.


Term Acronym Source
Recommend Treatment and Monitoring eHealth Initiative
The basis of cost, local formularies or therapeutic guidelines and protocols.
Reference: Health Level Seven, Inc. “HL7 EHR-S Functional Model and Standard.” July 2004


Term Acronym Source
Record (PHR) eHealth Initiative
An electronic application through which individuals can maintain and manage their health information (and that of others for whom they are authorized) in a private, secure, and confidential environment.
Reference: United States Department of Health and Human Services. Office of the National Coordinator for Health Information Technology (ONC) Glossary 2005


Term Acronym Source
Regional Health Information Organization Participant(s) RHIO Participant(s)
RHIO Participants may include both covered and non-covered entities.


Term Acronym Source
Regional Health Information Organizations RHIOs
The government’s preferred approach to building a National Health Information Network (NHIN) is to build and link Regional Health Information Organizations. RHIOs will interact with each other to exchange patient information.


Term Acronym Source
Registration Authority eHealth Initiative
An entity (group or agency) that has been delegated by a CA to perform a specific set of ‘trusted authority’ functions within PKI.


Term Acronym Source
regulatory permission Amended Privacy Rule
“The consent provisions (in the Original Rule)…are replaced with a new provision…that provides regulatory permission for covered entities to use and disclose protected health information for treatment, payment, and health care operations.” 67 Fed. Reg. at 53,211


Term Acronym Source
Results Answer Matching eHealth Initiative
The process of cross-linking the multiple possible answers to asking for a given result. For instance, asking for the results of a chest x-ray could yield a dictated report or a digital image of an x-ray. In any case, the case received must be matched across the type of result to a term identifying a common result.


Term Acronym Source
Results Name Matching eHealth Initiative
The process of cross-linking the multiple possible names of data results that can contain the same information. For instance a blood glucose reading can be called up by a blood glucose test, an SMA panel, or a glucometer result.


Term Acronym Source
Results Review eHealth Initiative
The ability to interpret the clinical data that is entered about a patient using a set of rules or algorithms which will generate warnings or alerts at various levels of severity to a clinician. These are intended to make the clinician aware of potentially harmful events, such as drug interactions, patient allergies, and abnormal results, which may affect how a patient is treated, with the intention of speeding the clinical decision process while reducing medical errors.


Term Acronym Source
Results Review (Alerts to Providers) eHealth Initiative
The ability to interpret the clinical data that is entered about a patient using a set of rules or algorithms which will generate warnings or alerts at various levels of severity to a clinician. These are intended to make the clinician aware of potentially harmful events, such as drug interactions, patient allergies, and abnormal results that may affect how a patient is treated, with the intention of speeding the clinical decision process while reducing medical errors.
Reference: eHealth Initiative Foundation. “Second Annual Survey of State, Regional and Community-based Health Information Exchange Initiatives and Organizations.” Washington: eHealth Initiative Foundation, 2005.


Term Acronym Source
right of privacy Original HIPAA Privacy Rule
“The right of privacy is: ‘the claim of individuals, groups, or institutions to determine for themselves when, how, and to what extent information about them is communicated’.” 65 Fed. Reg. at 82,465


Term Acronym Source
right to be let alone Sup. Ct. Justice Brandeis
Protects Americans in their beliefs, their thoughts, their emotions and their sensations – the most comprehensive of rights and the right most valued by civilized men.


Term Acronym Source
right to be let alone Original HIPAA Privacy Rule
If in Justice Brandeis’ words, the “right to be let alone” means anything, then it likely applies to having outsiders have access to one’s intimate thoughts, words and emotions.” 65 Fed. Reg. at 82,464/3.


Term Acronym Source
right to privacy Cavourkian and Tapscott
Long Description
The right to privacy is the claim of individuals, groups or institutions to determine for themselves when, how, and to what extent information about them is communicated.


Term Acronym Source
Risk eHealth Initiative
The chance of a vulnerability being exploited.


Term Acronym Source
Risk Assessment eHealth Initiative
An evaluation of the chance of vulnerabilities being exploited based on the effectiveness of existing or proposed safeguards or countermeasures.


Term Acronym Source
routine purposes American Psychoanalytic Association, Inc., 2003
Routine purposes are defined as treatment, payment and health care operations.


Term Acronym Source
Rules Engine eHealth Initiative
A set of rules defined within a software process that converts clinical and administrative data streams into a meaningful representation of clinical quality markers to be used in functions such as pay for performance/quality data reporting.


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Term Acronym Source
Security eHealth Initiative
In information systems, the degree to which data, databases, or other assets are protected from exposure to accidental or malicious disclosure, interruption, unauthorized access, modification, removal or destruction.


Term Acronym Source
segment CMS
Under HIPAA, this is a group of related data elements in a transaction.


Term Acronym Source
self-insured CMS
An individual or organization that assumes the financial risk of paying for health care.


Term Acronym Source
Service Level Agreement-Compliance eHealth Initiative
A documented track record of how well the vendor is meeting it’s customer support commitments.


Term Acronym Source
Service Level Agreement-Customer Responsibilities and Duties eHealth Initiative
The steps that the customer needs to take in order to ensure that the vendor has all the information they need to resolve an issue.


Term Acronym Source
Service Level Agreement-Hours of Support eHealth Initiative
Methods that will be used for communicating and resolving issues. Typical methods are email, phone, and online chat. Ask whether remote diagnostics and/or on site visits by support analysts are available.


Term Acronym Source
Service Level Agreement-Methods of Support eHealth Initiative
Will be used for communicating and resolving issues. Typical methods are email, phone, and online chat. Remote diagnostics can be available and, in some instances, it might be necessary to have a support analyst come on site.


Term Acronym Source
Service Level Agreement-Problem Escalation & Triage eHealth Initiative
The mechanism that defines how a problem migrates through the support system and the different resources that get involved along the way. If a problem can’t be resolved in a certain amount of time, then it escalates until it is resolved.


Term Acronym Source
Service Level Agreement-Response Times eHealth Initiative
Different functions of the system might warrant different response times based on severity level. There should be a schedule of response times for different types of problems, and the service level agreement should define this accountability.


Term Acronym Source
Service Level Agreement-Severity/Priority Classification eHealth Initiative
Different types of problems have different levels of urgency and importance. The severity level of a problem is usually noted when a support ticket is opened up. Resolution guarantees are based on severity levels. For example, CPOE down would be a high severity level while a patient education database not working might be a lower level of severity.


Term Acronym Source
small health plan CMS
Under HIPAA, this is a health plan with annual receipts of $5 million or less.


Term Acronym Source
SNOMED International eHealth Initiative
A nomenclature for use by all health services professionals developed in the US and updated at least semi-annually.


Term Acronym Source
Spyware Computerworld Privacy Glossary
Any technology that aids in gathering information about persons or organizations without their knowledge.


Term Acronym Source
Stages of Health Information Exchange Development eHealth Initiative
  • Stage One: Recognition of the need for HIE among multiple stakeholders in your state, region, or community
  • Stage Two: Getting organized by defining shared vision, goals, & objectives, identifying funding sources, and setting up legal & governance structures
  • Stage Three: Transferring vision, goals, & objectives to tactics and business plan, defining needs and requirements and securing funding
  • Stage Four: Well under-way with implementation technical, financial, and legal
  • Stage Five: Fully operational health information organization. Transmitting data that is being used by healthcare stakeholders Sustainable business model.
  • Stage Six: Demonstration of expansion of organization to encompass a broader coalition of stakeholders than present in the initial operational model

Reference: eHealth Initiative Foundation. “Second Annual Survey of State, Regional and Community-based Health Information Exchange Initiatives and Organizations.” Washington: eHealth Initiative Foundation, 2005.


Term Acronym Source
standard public law 104-191 (HIPAA)
The term ‘standard’, when used with reference to a data element of health information or a transaction referred to in section 1173(a)(1), means any such data element or transaction that meets each of the standards and implementation specifications adopted or established by the Secretary (of HHS) with respect to the data element or transaction under sections 1172 through 1174.


Term Acronym Source
Term Acronym Source
Standard eHealth Initiative
Documented agreements containing technical specifications or other precise criteria to be used consistently as rules, guidelines, or definitions of characteristics to ensure that materials, products, processes, and services are fit for their purpose. A standard* specifies a well defined approach that supports a business process and:

  • Has been agreed upon by a group of experts
  • Has been publicly vetted
  • Provides rules, guidelines, or characteristics
  • Helps to ensure that materials, products, processes and services are fit for their intended purpose
  • Available in an accessible format
  • Subject to ongoing review and revision process

*This differs from the healthcare industry’s traditional definition of “standard of care.”


standard setting organization public law 104-191 (HIPAA)
A standard setting organization accredited by the American National Standards Institute, including the National Council for Prescription Drug Programs, that develops standards for information transactions, data elements, or any other standard that is necessary to, or will facilitate, the implementation of this part.


Term Acronym Source
standard transaction American Psychoanalytic Association, Inc., 2003
A standard transaction means the transmission of information between two parties to carry out financial or administrative activities related to health care, including health care claims, health care payment and remittance advice, coordination of benefits, health care claim status, enrollment and disenrollment in a health plan, eligibility for a health plan, health plan premium payments, referral certification and authorization, first report of injury, and health claims attachments.


Term Acronym Source
Statistical Deviation Detector eHealth Initiative
Identifies variances from patient-specific and standard care plans, guidelines, and protocols.


Term Acronym Source
strategic national implementation process CMS
A national WEDI effort for helping the health care industry identify and resolve HIPAA implementation issues.


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Term Acronym Source
The International Organization for Standardization (ISO) eHealth Initiative
It is a worldwide federation of national standards bodies from some 130 countries, one from each country. ISO’s work results in international agreements which are published as International Standards.


Term Acronym Source
third party administrator TPA CMS
Business associate that performs claims administration and related business functions for a self-insured entity.


Term Acronym Source
Third Party-EHR Specific eHealth Initiative
Applications that are essential to the basic infrastructure of the system. They are the building blocks, such as the technical platform upon which the EHR system is built (e.g.,Windows, Linux, or MacIntosh, etc.) Also what kind of database structure controls the system (e.g, SQL, Oracle, etc.). When comparing license costs, note if there are separate general system license costs or if these are rolled into the main cost. Also, ask whether there will be additional costs when the vendor upgrades their software and it becomes necessary to install a new version of the database or operating system. Make sure your infrastructure software will support any features you wish to add later on.


Term Acronym Source
Third Party-General System eHealth Initiative
Applications that are essential to the basic infrastructure of the system. They are the building blocks such as the technical platform the EHR system is built on such as, Windows, Linux, or MacIntosh, etc. Also what kind of database structure controls the system SQL, Oracle, etc. When comparing license costs note if there are separate general system license costs or if these are rolled into the main cost. Also, will there be additional costs when the vendor upgrades their software and it is necessary to install a new version of the database or operating system. Make sure your infrastructure software will support any features you wish to add later on.


Term Acronym Source
trading partner CMS
External entity with whom business is conducted, i.e. customer. This relationship can be formalized via a trading partner agreement. (Note: a trading partner of an entity for some purposes, may be a business associate of that same entity for other purposes.)


Term Acronym Source
Training Services eHealth Initiative
Consulting services offered by the vendor. They provide hands on training for all aspects of the system.


Term Acronym Source
transaction CMS
Under HIPAA, this is the exchange of information between two parties to carry out financial or administrative activities related to health care.


Term Acronym Source
transaction change request system CMS
A system established under HIPAA for accepting and tracking change requests for any of the adopted HIPAA transaction standards via a single web site. See www.hipaa-dsmo.org.


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U


Term Acronym Source
UB-92 CMS
An electronic format of the CMS-1450 paper claim form that has been in general use since 1993.


Term Acronym Source
UMLS (Unified Medical Language System) eHealth Initiative
A long-term research project developed by the US National Library of Medicine to assist health professionals and researchers to retrieve and integrate clinical vocabularies from a wide variety of information sources. The goal is to link information from scientific literature, patient records, factual databases, knowledge-based expert systems, and directories of institutions and individuals in health and health services.


Term Acronym Source
United Nations rules for electronic data interchange for administration, commerce, and transport CMS
An international EDI format. Interactive X12 transactions use the EDIFACT message syntax.


Term Acronym Source
use of private heatlh information (PHI)
The sharing of PHI within the institution (i.e., from nurse to doctor)


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V


Term Acronym Source
value-added network CMS
A vendor of EDI data communications and translation services.


Term Acronym Source
Vendor Software Licenses eHealth Initiative
License cost of various modules. Typically, modules will be licensed on a concurrent or named user basis. For example, with a concurrent license, if there are 4 providers and 8 employees, a minimum of 12 concurrent licenses would be needed. However, if the providers were halftime [meaning, they only used the system half time] (and all 4 never used the system at any one time, only 10 licenses would be needed). If using a named user license under the same circumstances, 12 licenses would always be needed as licenses are not shared among different people. There can be a provision though for “active” and “inactive” providers (which means they could look at information, but not enter it in the system). Under an ASP (monthly rental agreement), software licenses are not being purchased, but rented However, the same issues exist for determining number of ASP licenses as with a license purchase.


Term Acronym Source
virtual private network CMS
A technical strategy for creating secure connections, or tunnels, over the Internet.


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W


Term Acronym Source
Washington Publishing Company CMS
The company that publishes the X12N HIPAA Implementation Guides and the X12N HIPAA Data Dictionary. It developed the X12 Data Dictionary, and that hosts the EHNAC STFCS testing program.


Term Acronym Source
Web Anonymizer or Anonymizer Computerworld Privacy Glossary
This privacy service lets a user visit Web sites while preventing those sites from gathering information about the user (including IP address, browser and operating system identification, and cookie-stored data) or which sites he has visited.


Term Acronym Source
Web beacons, also called Web bugs Computerworld Privacy Glossary
Pixel tags or clear GIFs, these file objects (typically a single transparent pixel invisible to the user) are used along with cookies to help track the behavior of Web site visitors.


Term Acronym Source
workforce CMS
Under HIPAA, this means employees, volunteers, trainees, and other persons under the direct control of a covered entity, whether or not they are paid by the covered entity. Also see Part II, 45 CFR 160.103.


Term Acronym Source
workgroup for electronic data interchange CMS
A health care industry group that has a formal consultative role under the HIPAA legislation (also sponsors SNIP).


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X


Term Acronym Source
X12 eHealth Initiative
A committee chartered by the American National Standards Institute (ANSI) to develop uniform standards for inter-industry electronic interchange of business transactions—electronic data interchange (EDI).


Term Acronym Source
X12N eHealth Initiative
The principle responsibilities of ASC X12N Insurance Subcommittee are development and maintenance of X12 standards, standards interpretations, and guidelines for the insurance industry, including health insurance. Most electronic transactions regarding health insurance claims are conducted using these standards, many of which are mandated by HIPAA.


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Y


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Z

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

A


Term Acronym Source
abstract CMS
Is the collection of information from the medical record via hard copy or electronic instrument.


Term Acronym Source
abuse CMS
A range of the following improper behaviors or billing practices including, but not limited to:billing for a non-covered service; misusing codes on the claim (i.e., the way the service is coded on the claim does not comply with national or local coding guidelines or is not billed as rendered); or inappropriately allocating costs on a cost report


Term Acronym Source
abuse (personal) CMS
When another person does something on purpose that causes you mental or physical harm or pain.


Term Acronym Source
access CMS
Your ability to get needed medical care and services. The process of obtaining data from, or placing into a computer system or storage device. It refers to such actions by any individual or entity who has the appropriate authorization for such actions.


Term Acronym Source
accessibility of services CMS
Your ability to get medical care and services when you need them.


Term Acronym Source
accreditation for deeming CMS
Some States use the findings of private accreditation organizations, in part or in whole, to supplement or substitute for State oversight of some quality related standards. This is referred to as “deemed compliance” with a standard.


Term Acronym Source
administrative services only CMS
An arrangement whereby a self-insured entity contracts with a Third Party Administrator (TPA) to administer a health plan.


Term Acronym Source
administrative simplification CMS
Title II, Subtitle F, of HIPAA which authorizes HHS to: (1) adopt standards for transactions and code sets that are used to exchange health data; (2) adopt standard identifiers for health plans, health care providers, employers, and individuals for use on standard transactions; and (3) adopt standards to protect the security and privacy of personally identifiable health information.


Term Acronym Source
Administrative Simplification Compliance Act CMS
This Act (Public Law 107-105) provides a one-year extension to HIPAA “covered entities” (except small health plans, which already have until October 16, 2003) to meet HIPAA electronic and code set transaction requirements. Also, allows the Secretary of HHS to exclude providers from Medicare if they are not compliant with the HIPAA electronic and code set transaction requirements and to prohibit Medicare payment of paper claims received after October 16, 2003, except under certain situations.


Term Acronym Source
administratvie code sets CMS
Code sets that characterize a general business situation, rather than a medical condition or service. Under HIPAA, these are sometimes referred to as non-clinical or non-medical code sets. Compare to medical code sets.


Term Acronym Source
American Medical Association AMA
A professional organization for physicians. The AMA is the secretariat of the NUCC, which has a formal consultative role under HIPAA. The AMA also maintains the Current Procedural Terminology (CPT .) medical code set.


Term Acronym Source
American National Standards Institute ANSI eHealth Initiative
ANSI is a broad based agency charged with overseeing voluntary standards development for everything from computers to household products. ANSI accredits standards development organizations (SDO) based on their consensus process, then reviews and officially approves the SDO recommendations.


Term Acronym Source
American Society for Testing and Materials ASTM eHealth Initiative
American Society for Testing and Materials develops standards on characteristics and performance of materials, products, systems, and services. There are numerous standards-writing technical committees. E31 is the Committee on Computerized Systems and E31.28 is the subcommittee on Healthcare Informatics responsible for the Continuity of Care (CCR) standard.


Term Acronym Source
Annual Support & Maintenance eHealth Initiative
Costs that are typically 15-20% of the software license costs. Where the actual license is normally a one- time fee, the support and maintenance costs are renewed on a yearly basis. This yearly fee basically covers two areas: 1) any upgrades or new releases; and 2) customer service and support. It should be noted that both vendor EHR software and third party software will need support, so it is important to determine which components the support costs cover. Also, some vendors might have more than one service level agreement representing different support options at different costs.


Term Acronym Source
anonymity online Computerworld Privacy Glossary
Online, we can use an Internet site called a remailer that reposts a message from the site’s own address, thus concealing the originator of the message.


Term Acronym Source
anonymizer or web anonymizer Computerworld Privacy Glossary
This privacy service lets a user visit Web sites while preventing those sites from gathering information about the user (including IP address, browser and operating system identification, and cookie-stored data) or which sites he has visited


Term Acronym Source
Architecture eHealth Initiative
The orderly arrangement of parts; structure.


Term Acronym Source
ASTM eHealth Initiative
See American Society for Testing and Materials.


Term Acronym Source
Asymmetric Key System eHealth Initiative
A system that uses different keys for encryption and decryption. Within such a system, it is computationally infeasible to determine the decryption key (which is kept private) from the encryption key (which is made publicly available).


Term Acronym Source
Attribute eHealth Initiative
A characteristic or property.


Term Acronym Source
Audit trail eHealth Initiative
Chronological record of system activity which enables the reconstruction of information regarding the creation, distribution, modification, and deletion of data.


Term Acronym Source
Authentication eHealth Initiative
Verification of the identity of a person or process.


Term Acronym Source
Authorization eHealth Initiative
The role or set of permissions for information system activity assigned to an individual.


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B


Term Acronym Source
blanket coerced consent Deborah Peel
What the health plans make people sign at the start of the year as a condition of being in the plan–its NOT informed consent, because it says that you agree to release ALL past and future medical records (that is the blanket part) to the health plan or insurer if they request them, as a condition of being covered by the plan (that is the coercion part).


Term Acronym Source
Biometric Authentication Technology eHealth Initiative
Technology that uses some human biological feature (e.g. fingerprint, voice pattern, retina scan, or signature dynamics) to uniquely identify an individual.


Term Acronym Source
business associate BA or BAs CMS
A person or organization that performs a function or activity on behalf of a covered entity, but is not part of the covered entity’s workforce. A business associate can also be a covered entity in its own right. Also see Part II, 45 CFR 160.103.


Term Acronym Source
business associates American Psychoanalytic Association, Inc., 2003
A “business associate” is an individual or entity that performs certain functions on behalf of a covered entity, including billing companies, practice management firms, administrative services, accounting firms, law firms, telephone answering services, computer repair services and others. Employees of your medical practice are part of your workforce and are not your business associates. Disclosures between providers for treatment purposes do not create a business associate relationship. Also, HHS is not considered to be a business associate. Janitorial, maintenance and cleaning services are not considered business associates, assuming the services they provide do not involve the use or disclosure of protected health information, and any access to such information should be incidental if at all.

Term Acronym Source
business relationships CMS
The term agent is often used to describe a person or organization that assumes some of the responsibilities of another one. This term has been avoided in the final rules so that a more HIPAA-specific meaning could be used for business associate.


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C


Term Acronym Source
CA (certification authority) eHealth Initiative
The entity providing third party trust within PKI.


Term Acronym Source
Centers for Medicare and Medicaid Services CMS CMS
The HHS agency responsible for Medicare and parts of Medicaid.CMS is responsible for oversight of HIPAA administrative simplification transaction and code sets, health identifiers, and security standards.


Term Acronym Source
Certification/Conformance Testing eHealth Initiative
Testing a product for the existence of specific features, functions, or characteristics required by a standard in order to determine the extent to which that product satisfies the standard requirements.


Term Acronym Source
chain of trust agreement CMS
Contract needed to extend the responsibility to protect health care data across a series of sub-contractual relationships.


Term Acronym Source
Chief Complaint Mapper eHealth Initiative
A software product that maps chief complaints, captured as text, and transforms them into useful digital data that can be used in functions such as public health outbreak surveillance.


Term Acronym Source
claim status codes CMS
A national administrative code set that identifies the status of health care claims. This code set is used in the X12N 277 Claim Status Inquiry and Response transaction, and is maintained by the Health Care Code Maintenance Committee.


Term Acronym Source
Clinical Classification eHealth Initiative
A method of grouping clinical concepts in order to represent classes that support the generation of indicators of health status and health statistics.


Term Acronym Source
Clinical Data Repository eHealth Initiative
The data warehouse that contains clinical data (HL7 messages) centrally.


Term Acronym Source
Clinical Messaging eHealth Initiative
The communication among providers involved in the care process that can range from real time communication (for example, fulfillment of an injection while the patient is in the exam room), to asynchronous communication (for example, consult reports between physicians).
Reference: Health Level Seven, Inc. “HL7 EHR-S Functional Model and Standard.” July 2004.


Term Acronym Source
Clinical Messaging #1 eHealth Initiative
Continuity of Care Data Exchanges (Inter-Provider Communication): Communication among providers involved in the care process can range from real time communication (for example, fulfillment of an injection while the patient is in the exam room), to asynchronous communication (for example, consult reports between physicians). Some forms of inter-practitioner communication will be paper based and the EHRS must be able to produce appropriate documents.
Reference: Health Level Seven, Inc. “HL7 EHR-S Functional Model and Standard.” July 2004.


Term Acronym Source
Clinical Messaging #2 eHealth Initiative
Secure Patient/Physician e-mail (Provider and Patient or Family Communication): Trigger or respond to electronic communication (inbound and outbound) between providers and patients or patient representatives with pertinent actions in the care process.
Reference: Health Level Seven, Inc. “HL7 EHR-S Functional Model and Standard.” July 2004.


Term Acronym Source
Clinical Reminders (Clinical Guideline Prompts) eHealth Initiative
The ability to remind clinicians to consider certain actions at a particular point in time, such as prompts to ask the patient appropriate preventive medicine questions, notifications that ordered tests have not produced results when expected, and suggestions for certain therapeutic actions, such as giving a tetanus shot if one has not been given for 10 years.
Reference: eHealth Initiative Foundation. “Second Annual Survey of State, Regional and Community-based Health Information Exchange Initiatives and Organizations.” Washington: eHealth Initiative Foundation, 2005.


Term Acronym Source
Clinical User Authentication eHealth Initiative
The process used by the HIE to determine the identity of the person accessing the system with adequate certainty to maintain security and confidentiality of personal health information and to administer with certainty of identity a regulated process such as e-prescribing and chart signing.


Term Acronym Source
CMS-1450 CMS
The uniform institutional claim form.


Term Acronym Source
CMS-1500 CMS
The uniform professional claim form.


Term Acronym Source
code of federal regulations CMS
The official compilation of federal rules and requirements.


Term Acronym Source
code set CMS
Under HIPAA, this is any set of codes used to encode data elements, such as tables of terms, medical concepts, medical diagnostic codes, or medical procedure codes. This includes both the codes and their descriptions. Also see Part II, 45 CFR 162.103.


Term Acronym Source
compliance date CMS
Under HIPAA, this is the date by which a covered entity must comply with a standard, an implementation specification, or a modification. This is usually 24 months after the effective data of the associated final rule for most entities, but 36 months after the effective data for small health plans. For future changes in the standards, the compliance date would be at least 180 days after the effective data, but can be longer for small health plans and for complex changes.


Term Acronym Source
Community Health Record Sysytem
Information from different RHIO Participants is combined and integrated into a single record to form a Community Health Record System.


Term Acronym Source
Computerized Provider Order Entry eHealth Initiative
A computer application that allows a physician’s orders for diagnostic and treatment services (such as medications, laboratory, and other tests) to be entered electronically instead of being recorded on order sheets or prescription pads. The computer compares the order against standards for dosing, checks for allergies or interactions with other medications, and warns the physician about potential problems.
Reference: United States Department of Health and Human Services. Office of the National Coordinator for Health Information Technology (ONC) Glossary


Term Acronym Source
Confidentiality eHealth Initiative
A 3rd party’s obligation to protect the personal information with which it has been entrusted.


Term Acronym Source
confidentiality Computerworld Privacy Glossary
The expectation that personal information will be held in confidence.


Term Acronym Source
Controlled Clinical Vocabulary eHealth Initiative
A system of standardizing the terms used in describing client-centered health and health service-related concepts.


Term Acronym Source
Conversion Services eHealth Initiative
Consulting services offered by the vendor. These services will take your original data, either in paper or electronic form, and transfer the data into the EHR system database.


Term Acronym Source
coordination of benefits CMS
Process for determining the respective responsibilities of two or more health plans that have some financial responsibility for a medical claim. Also called cross-over.


Term Acronym Source
covered entity CE or CEs CMS
Under HIPAA, this is a health plan, a health care clearinghouse, or a health care provider who transmits any health information in electronic form in connection with a HIPAA transaction.


Term Acronym Source
current dental terminology CMS
A medical code set of dental procedures, maintained and copyrighted by the American Dental Association (ADA), and adopted by the Secretary of HHS as the standard for reporting dental services on standard transactions.


Term Acronym Source
current procedural terminology CPT CMS
A medical code set of physician and other services, maintained and copyrighted by the American Medical Association (AMA), and adopted by the Secretary of HHS as the standard for reporting physician and other services on standard transactions.


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D


Term Acronym Source
D-codes CMS
Subset of the HCPCS Level II medical codes identifying certain dental procedures. It replicates many of the CDT codes and will be replaced by the CDT. Descriptor: The text defining a code in a code set.


Term Acronym Source
Data Center eHealth Initiative
The physical space and hardware used by the HIE to house its operations if these assets are kept within the HIE.


Term Acronym Source
data condition CMS
A description of the circumstances in which certain data is required.


Term Acronym Source
data content CMS
Under HIPAA, this is all the data elements and code sets inherent to a transaction, and not related to the format of the transaction.


Term Acronym Source
data element CMS
Under HIPAA, this is the smallest named unit of information in a transaction.


Term Acronym Source
Data Integrity eHealth Initiative
The accuracy and completeness of data, to be maintained by appropriate security measures and controls. Preservation of the original quality and accuracy of data, in written or in electronic form.


Term Acronym Source
data mapping CMS
The process of matching one set of data elements or individual code values to their closest equivalents in another set of them. This is sometimes called a cross-walk.


Term Acronym Source
Data Recovery Services eHealth Initiative
A mechanism and process to safely store duplicate databases and recreate the data should a disaster occur.


Term Acronym Source
data warehouse silo system
The RHIO holds each RHIO Participant’s information in separate silos, but pulls information from applicable silos when information about a particular patient is requested. This is a ‘hub and spoke’ arrangement.


Term Acronym Source
Decision Support eHealth Initiative
Computerized functions that assist users in making decisions in their job functions. In the practice of medicine, these functions include providing electronic access to medical literature, alerting the user to potential adverse drug interactions, and suggesting alternative treatment plans for a certain diagnosis.


Term Acronym Source
Decryption eHealth Initiative
The technique of using mathematical procedures to “unscramble” data so that an unintelligible (encrypted) message becomes intelligible.


Term Acronym Source
Demographics eHealth Initiative
Information about name, address, age, gender, and role used to link patient records from multiple sources in the absence of a unique patient identifier.


Term Acronym Source
Department of Health and Human Services HHS HHS Website
The federal government department that has overall responsibility for implementing HIPAA.


Term Acronym Source
descriptor CMS
The text defining a code in a code set.


Term Acronym Source
designated code set CMS
A medical code set or an administrative code set that is required to be used by the adopted implementation specification for a standard transaction.


Term Acronym Source
designated standard CMS
A standard which HHS has designated for use under the authority provided by HIPAA.


Term Acronym Source
designated standard maintenance organization CMS
An organization, designated by the Secretary of the U.S. Department of Health & Human Services, to maintain standards adopted under Subpart I of 45 CFR Part 162. A DSMO may receive and process requests for adopting a new standard or modifying an adopted standard.


Term Acronym Source
DICOM (Digital Imaging Communications in Medicine) eHealth Initiative
A standard which defines protocols for the exchange of medical images and associated information (such as patient identification details and technique information) between instruments, information systems, and health care providers. It establishes a common language that enables medical images produced on one system to be processed and displayed on another.


Term Acronym Source
Digital Signature eHealth Initiative
A string of binary digits which is computed using an encryption algorithm. Digital signatures enable signatory authentication, confirmation of data integrity, and non-repudiation of messages.


Term Acronym Source
direct data entry CMS
Under HIPAA, this is the direct entry of data that is immediately transmitted into a health plan’s computer.


Term Acronym Source
disclosure of personal health information (PHI)
The sharing of PHI outside of the institution (i.e., from principal investigator to study sponsor).


Term Acronym Source
Doctor Matching eHealth Initiative
The process of cross-linking the multiple provider identifiers in a community from a variety of provider identifier sources and creating a master doctor identifier with a key for cross-referencing the various community identifiers.


Term Acronym Source
Document Review, Edit, Sign eHealth Initiative
A software process that allows for the secure review, editing, and signature through electronic, distributed technology of electronic health record components, such as operative reports, discharge summaries, and consultations.


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E


Term Acronym Source
EDI translator CMS
A software tool for accepting an EDI transmission and converting the data into another format, or for converting a non-EDI data file into an EDI format for transmission.


Term Acronym Source
effective date CMS
Under HIPAA, this is the date that a final rule is effective, which is usually 60 days after it is published in the Federal Register.


Term Acronym Source
eLaboratory eHealth Initiative
The electronic delivery of laboratory results to practices so that such data may be integrated into electronic patient records in a full EHR system, or used by a dedicated application to view structured, context-rich, and/or longitudinal laboratory results on a patient. eLaboratory includes closing the orders loop, documenting the review of results by clinicians, and documenting that the results have been communicated to the patient. The full benefits of eLaboratory are not achieved until the results are used as input into clinical decision support systems (CDSS).


Term Acronym Source
Electronic Billing (Claims, Eligibility, Remittance) eHealth Initiative
The ability to contact the payer before the patient is seen and get a response that indicates whether or not the services to be rendered will be covered by the payer. Reference: eHealth Initiative Foundation. “Second Annual Survey of State, Regional and Community-based Health Information Exchange Initiatives and Organizations.” Washington: eHealth Initiative, 2005.


Term Acronym Source
Electronic Billing Support eHealth Initiative
The ability to contact the payer before the patient is seen and get a response that indicates whether or not the services to be rendered will be covered by the payer.
Reference: eHealth Initiative Foundation. “Second Annual Survey of State, Regional and Community-based HIE Initiatives and Organizations.” Washington: eHealth Initiative Foundation, 2005.


Term Acronym Source
electronic data interchange CMS
Refers to the exchange of routine business transactions from one computer to another in a standard format, using standard communications protocols.


Term Acronym Source
electronic health record (s) EHR or EHRs
Health records kept in electronic form, as opposed to health records kept on paper.


Term Acronym Source
Electronic Health Record eHealth Initiative
Electronically maintained information about an individual’s lifetime health status and health care.


Term Acronym Source
Electronic Imaging Results Delivery eHealth Initiative
The ability to accept messages from radiology sources and integrate the data for presentation to a clinician.
Reference: eHealth Initiative Foundation. “Second Annual Survey of State, Regional and Community-based Health Information Exchange Initiatives and Organizations. ” Washington: eHealth Initiative Foundation, 2005.


Term Acronym Source
electronic media claims CMS
A flat file format used to transmit or transport claims.


Term Acronym Source
electronic medical record (s) EHR or EHRs
Medical records kept in electronic form (as opposed to medical records kept on paper).


Term Acronym Source
Electronic Prescribing (Pharmacy Communication) eHealth Initiative
Provides features to enable secure bidirectional communication of information electronically between practitioners and pharmacies or between practitioner and intended recipient of pharmacy orders.
Reference: Health Level Seven, Inc. “HL7 EHR-S Functional Model and Standard.” July 2004.


Term Acronym Source
Electronic Quality Data Submission (Performance and Accountability Measures) eHealth Initiative
Support the capture and reporting of quality, performance, and accountability measures to which providers/facilities/delivery.


Term Acronym Source
Electronic Referral Management eHealth Initiative
The ability to generate and/or receive summaries of relevant clinical information on a patient that are typically transferred between healthcare providers when a patient is referred to a specialist or admitted or discharged from a hospital.
Reference: eHealth Initiative Foundation. “Second Annual Survey of State, Regional and Community-based Health Information Exchange Initiatives and Organizations.” Washington: eHealth Initiative Foundation, 2005.


Term Acronym Source
Electronic Referrals and Authorizations eHealth Initiative
The ability to generate and/or receive summaries of relevant clinical information on a patient that are typically transferred between healthcare providers when a patient is referred to a specialist or admitted or discharged from a hospital.
Reference: eHI Foundation. “Second Annual Survey of State, Regional and Community-based HIE Initiatives and Organizations. ” Washington: eHealth Initiative Foundation, 2005.


Term Acronym Source
electronic remittance advice CMS
Any of several electronic formats for explaining the payments of health care claims.


Term Acronym Source
Electronic Signature eHealth Initiative
A digital signature, which serves as a unique identifier for an individual.


Term Acronym Source
employer identifier CMS
A standard adopted by the Secretary of HHS to identify employers in standard transactions. The IRS’ EIN is the adopted standard.


Term Acronym Source
Encryption eHealth Initiative
The process of enciphering or encoding a message so as to render it unintelligible without a key to decrypt (unscramble) the message.


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F


Term Acronym Source
Federal “regulatory permission” Amended Privacy Rule
“The consent provisions (in the Original Rule)…are replaced with a new provision…that provides regulatory permission for covered entities to use and disclose protected health information for treatment, payment, and health care operations.” 67 Fed. Reg. at 53,211


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G


Term Acronym Source
Gramm-Leach-Blyley Financial Services Act of 1999 GLB
A federal act that allows banks, financial institutions and all their affiliates and non-affiliates to share sensative financial and medical records without consent or notice (and affiliates are typically insurers).


Term Acronym Source
group health plan CMS
A health plan that provides health coverage to employees, former employees, and their families, and is supported by an employer or employee organization.


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H


Term Acronym Source
health care clearinghouse CMS
A public or private entity that processes or facilitates the processing of nonstandard data elements of health information into standard data elements.


Term Acronym Source
Health Care Interoperability eHealth Initiative
Assures the clear and reliable communication of meaning by providing the correct context and exact meaning of the shared information as approved by designated communities of practice. This adds value by allowing the information to be accurately linked to related information, further developed and applied by computer systems and by care providers for the real-time delivery of optimal patient care.


Term Acronym Source
health care operations American Psychoanalytic Association, Inc., 2003
Activities that are related to the general business and administrative functions of the covered entity regardless of whether they are connected to the treatment or payment of an individual. This may include quality assessment, accreditation and training, business planning and development, general administrative activities and due diligence in connection with the sale of a covered entity to another covered entity.


Term Acronym Source
health care provider Public Law 104-191 (HIPAA)
A provider of services (as defined in section 1861(u)), a provider of medical or other health services (as defined in section 1861(s)), and any other person furnishing health care services or supplies.


Term Acronym Source
health information Public Law 104-191 (HIPAA)
Any information, whether oral or recorded in any form or medium, that–“(A) is created or received by a health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse; and”(B) relates to the past, present, or future physical or mental health or condition of an individual, the provision of health care to an individual, or the past, present, or future payment for the provision of health care to an individual.


Term Acronym Source
Health Information Exchange (HIE) eHealth Initiative
The mobilization of healthcare information electronically across organizations within a region or community.HIE provides the capability to electronically move clinical information between disparate healthcare 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 safer, more timely, efficient, effective, equitable, patient-centered care.

Formal organizations are now emerging to provide both form and function for health information exchange efforts. These organizations (often called Regional Health Information Organizations, or RHIOs) are ordinarily geographically-defined entities which develop and manage a set of contractual conventions and terms, arrange for the means of electronic exchange of information, and develop and maintain HIE standards.

Although HIE initiatives differ in many ways, survey results and eHI experiences with states, regions and communities indicate that those who are experiencing the most success share the following characteristics. They are:

  • Governed by a diverse and broad set of community stakeholders;
  • Develop and assure adherence to a common set of principles and standards for the technical and policy aspects of information sharing, addressing the needs of every stakeholder;
  • Develop and implement a technical infrastructure based on national standards to facilitate interoperability;
  • Develop and maintain a model for sustainability that aligns the costs with the benefits related to HIE; and
  • Use metrics to measure performance from the perspective of: patient care, public health, provider value, and economic value.

Reference: eHealth Initiative. “Second Annual Survey of State, Regional and Community-based Health Information Exchange Initiatives and Organizations.” Washington: eHealth Initiative, 2005.


Term Acronym Source
Health Insurance Portablility and Accountability Act of 1996 HIPAA CMS
A Federal law that allows persons to qualify immediately for comparable health insurance coverage when they change their employment relationships.


Term Acronym Source
Health Level Seven (HL7) eHealth Initiative
An ANSI approved American National Standard for electronic data exchange in health care. It enables disparate computer applications to exchange key sets of clinical and administrative information.


Term Acronym Source
Health Maintenance Organization HMO CMS
A health maintenance organization (HMO) contracts with doctors, hospitals, and health care providers to provide medical care to a group of consumers. Generally, HMOs will not pay for your care unless you receive it from one of their health care providers. The HMO usually receives a fixed amount of money per patient for each enrollee. Enrollees of the HMO generally do not have any significant out-of-pocket expenses.


Term Acronym Source
health plan CMS
An entity that assumes the risk of paying for medical treatments, i.e. uninsured patient, self-insured employer, payer, or HMO.


Term Acronym Source
health plan public law 104-191 (HIPAA)
An individual or group plan that provides, or pays the cost of, medical care.


Term Acronym Source
healthcare provider taxonomy codes CMS
An administrative code set that classifies health care providers by type and area of specialization.


Term Acronym Source
hybrid entity CMS
A covered entity whose covered functions are not its primary functions.


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Term Acronym Source
ICD-9 (International Classification of Disease, 9th Revision) eHealth Initiative
The 1972 revision of the international disease classification system developed by the World Health Organization.


Term Acronym Source
ICD-9-CM (International Classification of Disease, 9th Revision, Clinical Modification) eHealth Initiative
The American modification of the ICD-9 classification system for both diagnoses and procedures.


Term Acronym Source
ICD-10 (International Statistical Classification of Diseases and Related Health Problems, 10th Revision) eHealth Initiative
The 1992 revision of the international disease classification system developed by the World Health Organization.


Term Acronym Source
ICD-10-CM (International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Clinical Modification) eHealth Initiative
The American modification of the ICD-10 classification system, for field review release in 1998.


Term Acronym Source
ICD-10-PCS (International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Procedural Classification System) eHealth Initiative
A classification system for reporting clinical procedures, to accompany ICD-10-CM, developed in the US, for 1998 field review release.


Term Acronym Source
implementation guide CMS
A document explaining the proper use of a standard for a specific business purpose. The X12N HIPAA IGs are the primary reference documents used by those implementing the associated transactions, and are incorporated into the HIPAA regulations by reference.


Term Acronym Source
Implementation Services eHealth Initiative
Consulting services offered by the vendor. These services will provide planning and actual implementation of an EHR system. It is important when comparing quoted implementation costs that physicians understand which detailed cost line items a particular vendor will be supplying. Also, make sure and take a look at their project plans.


Term Acronym Source
Informatics eHealth Initiative
The application of computer science and information science to the management and processing of data, information, and knowledge.


Term Acronym Source
individually identifiable health information public law 104-191 (HIPAA)
Any information, including demographic information collected from an individual, that– “(A) is created or received by a health care provider, health plan, employer, or health care clearinghouse; and “(B) relates to the past, present, or future physical or mental health or condition of an individual, the provision of health care to an individual, or the past, present, or future payment for the provision of health care to an individual, and– “(i) identifies the individual; or “(ii) with respect to which there is a reasonable basis to believe that the information can be used to identify the individual.


Term Acronym Source
informed Consent Saint Francis Care
Informed consent is a process of information exchange that may include, in addition to reading and signing the informed consent documents, subject recruitment materials, verbal instructions, question/answer sessions and measures of subject understanding. The clinical investigator is responsible for ensuring that informed consent is obtained from each research subject before that subject participates in the research study.


Term Acronym Source
informed contemporaneous consent Deborah Peel
The ethical standard in medicine is informed (meaning you know exactly what info you are consenting to release) contemporaneous (at the time the info is being requested or is needed, NOT before) consent. Informed also means that you can comprehend the effects of releasing the info, ie you are of sound mind and capable of understanding what is going on.


Term Acronym Source
Institutional Review Board IRB Healthwise
An institutional review board (IRB) is an independent committee made up of medical and nonmedical members, such as physicians, statisticians, and community advocates. It ensures that a clinical trial is ethical and that the rights of study participants are protected.All institutions that conduct or support biomedical research involving people, by U.S. government regulation, must have an IRB that initially approves and periodically reviews the research.

An IRB reviews and approves protocols, informed-consent forms, physician credentials and eligibility, and other patient materials. The role of an IRB is to work closely with the U.S. Food and Drug Administration (FDA) to make sure that patient safety is the main priority of a clinical trial.


Term Acronym Source
Interface eHealth Initiative
Shared boundary between two functional units defined by various characteristics pertaining to the functions, physical interconnections, signal changes, and other characteristics as appropriate.


Term Acronym Source
Interface to ADT System eHealth Initiative
The interface between an HIE and the systems that are sources for admission, discharge and transfer (ADT) of patients in the care delivery setting and that are resident within care delivery institution.


Term Acronym Source
Interface to ASP EHR System eHealth Initiative
The interface between an HIE and Electronic Health Records (EHRs) that are maintained on ASP platforms (i.e. NexGen, AllScripts).


Term Acronym Source
Interface to Claims System eHealth Initiative
The interface between an HIE and the systems that are sources for or routing pathways for claims data that are resident within health plans and claims clearinghouses.


Term Acronym Source
Interface to EKG System eHealth Initiative
The interface between an HIE and the systems that are sources for EKG results that are resident within dispensing physician offices and hospitals.


Term Acronym Source
Interface to Eligibility System eHealth Initiative
The interface between an HIE and the source data of which people have eligibility for which type of benefits that are resident within health plans and are not infrequently web-enabled.


Term Acronym Source
Interface to Formulary System eHealth Initiative
The interface between an HIE and the systems that are sources for formulary status of specific drugs for specific health benefit designs and that are resident within pharmacy benefit management companies and hospitals.


Term Acronym Source
Interface to Laboratory System eHealth Initiative
The interface between an HIE and systems that are sources of laboratory data.


Term Acronym Source
Interface to Pharmacy System eHealth Initiative
The interface between an HIE and the systems that are sources for prescription data or that are resident within dispensing pharmacies, pharmacy benefit management companies and hospitals.


Term Acronym Source
Interface to Practice Management System eHealth Initiative
The interface between an HIE and the systems that are sources for the financial management systems of physician practices.


Term Acronym Source
Interface to Provider List System eHealth Initiative
The interface between an HIE and the systems that track the multiple providers and their identifying data that are resident within health plans, dispensing pharmacies, pharmacy benefit management companies laboratories, physician practices, and hospitals.


Term Acronym Source
Interface to Provider Office EHR System eHealth Initiative
The interface between an HIE and EHRs that are maintained in practice-specific systems (e.g. EPIC).


Term Acronym Source
Interface to Radiology System eHealth Initiative
The interface between an HIE and systems that are sources for radiological data.


Term Acronym Source
Interface to Transcribed Reports System eHealth Initiative
The interface between an HIE and the systems that are sources for transcribed reports. Typically these systems are based at a transcription service or at a hospital and contain admission and discharge notes and consultations, operative reports, and pathology and radiology results.


Term Acronym Source
internet privacy Computerworld Privacy Glossary
Within the context of the Internet, the right to privacy is still being defined.Generally, it involves a person’s right to control what information about himself is revealed and to whom, as well as what others may do with that information. It’s not the same thing as secrecy, but the distinction is sometimes murky. Privacy isn’t an absolute right, since it’s often trumped by laws and overriding social needs. For example, law enforcement officials may obtain warrants that allow them to intercept communications or search physical areas, activities that otherwise would be forbidden.


Term Acronym Source
Interoperability eHealth Initiative
The ability of two or more systems or components to exchange information and to use the information that has been exchanged accurately, securely, and verifiably, when and where needed.


Term Acronym Source
Interoperability eHealth Initiative
The ability of two or more systems or components to exchange information and to use the information that has been exchanged accurately, securely, and verifiably, when and where needed.


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Term Acronym Source
J-codes CMS
A subset of the HCPCS Level II code set with a high-order value of “J” that has been used to identify certain drugs and other items.


Term Acronym Source
Jaffee v. Redmond, 116 S. Ct. 1923,1928 (1996) Jim Pyles
The Supreme Court has found that the “reason and experience” of the country shows that effective psychotherapy can only be provided if there is a privilege that permits the disclosure of psychotherapy communications, in most instances, only with the patient’s permission.


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Term Acronym Source
Keys eHealth Initiative
A sequence of symbols that controls the operations of encryption and decryption.


Term Acronym Source
Key Certificate eHealth Initiative
A data record that authenticates the owner of a public key for an asymmetric algorithm. It is issued by a certification authority and is protected by a digital signature allowing the certificate to be verified widely. The certificate may also contain other fields beside the value to the key and the name of the owner, for example an expiration date.


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Term Acronym Source
local codes CMS
A generic term for code values that are defined for a State or other local division or for a specific payer. Commonly used to describe HCPCS Level III Codes.


Term Acronym Source
LOINC (Logical Observation Identifiers, Names, and Codes) eHealth Initiative
The LOINC databases provide sets of universal names and ID codes for identifying laboratory and clinical test results. The purpose is to facilitate the exchange and pooling of results, such as blood hemoglobin, serum potassium, or vital signs, for clinical care, outcomes management, and research.


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Term Acronym Source
Managed Care Organizations MCOs CMS
Managed care organizations have arrangements with doctors, hospitals, and other health care providers for their services. These doctors, hospitals, and health care providers form a network. Examples of managed care organizations include: Health MaintenanceOrganizations (HMOs) and Preferred Provider Organizations (PPOs)


Term Acronym Source
maximum defined data set CMS
Under HIPAA, this is all of the required data elements for a particular standard based on a specific implementation specification.


Term Acronym Source
medical code sets CMS
Long Description
Codes that characterize a medical condition or treatment.


Term Acronym Source
Medication Matching eHealth Initiative
The process of cross-linking the multiple possible medication identifiers naming conventions in a community from a variety of systems housing medication information and creating a master medication identifier with a key for cross-referencing the various community identifiers. For example there are hundreds of NDC codes for identical drugs as well as HCPCS codes that identify the same drug as NDC codes.


Term Acronym Source
medical privacy Original HIPAA Privacy Rule
As explained in the original HIPAA health privacy rule, the right of individuals to medical privacy means the right “to determine for themselves when, how, and to what extent information about them is communicated”.


Term Acronym Source
Medication Reconciliation eHealth Initiative
Alerts providers in real-time to potential administration errors such as wrong patient, wrong drug, wrong dose, wrong route and wrong time in support of medication administration or pharmacy dispense/supply management and workflow.
Reference: Health Level Seven, Inc. “HL7 EHR-S Functional Model and Standard.”July 2004.


Term Acronym Source
Medicare contractor CMS
A Medicare Part A Fiscal Intermediary (institutional), a Medicare Part B Carrier (professional), or a Medicare Durable Medical Equipment Regional Carrier (DMERC)


Term Acronym Source
medicare remittance advice remark codes CMS
A national administrative code set for providing either claim-level or service-level Medicare-related messages that cannot be expressed with a Claim Adjustment Reason Code. This code set is used in the X12 835 Claim Payment & Remittance Advice transaction.

Term Acronym Source
Message Integrity eHealth Initiative
Protecting a message against its unauthorized modification, often by the originator of the message generating a digital signature.


Term Acronym Source
Messaging to Pharmacies eHealth Initiative
The process of communicating electronically with pharmacies. This typically includes the cost of communication lines and processes between the HIE and pharmacies. This is necessary to support the e-prescribing function when that function includes the process of electronically sending a digital prescription to the pharmacy.


Term Acronym Source
Messaging to Providers eHealth Initiative
The process of communicating electronically with providers. This typically includes the cost of communication lines and processes between the HIE and provider terminals.


Term Acronym Source
minimum necessary standard American Psychoanalytic Association, Inc., 2003
The least amount of information required to achieve the purpose of the use, disclosure or request.


Term Acronym Source
Modify or Modification
Under HIPAA, this is a change adopted by the Secretary(HHS Secretary, Tommy Thompson), through regulation, to a standard or an implementation specification.


Term Acronym Source
mosaic effect Computerworld News Story
When combinations of data tidbits produce a picture that wasn’t apparent from the individual pieces.


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Term Acronym Source
National Committee on Vital and Health Statistics NCVHS NCVHS website
It serves as the statutory [42 U.S.C. 242k(k)] public advisory body to the Secretary of Health and Human Services in the area of health data and statistics. The Committee provides advice and assistance to the Department and serves as a forum for interaction with interested private sector groups on a variety of key health data issues.


Term Acronym Source
National Council for Prescription Drug Programs CMS
An ANSI-accredited group that maintains a number of standard formats for use by the retail pharmacy industry, some of which have been adopted as HIPAA standards.


Term Acronym Source
National drug code CMS
A medical code set maintained by the Food and Drug Administration that contains codes for drugs that are FDA-approved.


Term Acronym Source
National Health Information Network NHIN
The name of the federal government’s program to implement a national interoperable system for sharing electronic medical records or EMRs (AKA electronic health records or EHRs).


Term Acronym Source
National Health Information Network eHealth Initiative
An interoperable, standards-based network across the nation for the secure exchange of heath care information.
Reference: HHS Awards Contracts to Develop Nationwide Health Information Network. 2005.


Term Acronym Source
national provider identifier CMS
A system for uniquely identifying all providers of health care services, supplies, and equipment. A term proposed by the Secretary of HHS as the standard identifier for health care providers.


Term Acronym Source
national standard format CMS
Generically, this applies to any nationally standardized data format, but it is often used in a more limited way to designate the Professional EMC NSF, a 320-byte flat file record format used to submit professional claims.


Term Acronym Source
NCPDP batch standard CMS
A NCPDP format for use by low-volume dispensers of pharmaceuticals, such as nursing homes. The Secretary of HHS adopted Version 1.0 of this format as a standard transaction.


Term Acronym Source
NCPDP format telecommunication standard CMS
A NCPDP format designed for use by high-volume dispensers of pharmaceuticals, such as retail pharmacies. The Secretary of HHS adopted Version 5.1 of this format as a standard transaction.


Term Acronym Source
Network eHealth Initiative
A set of connected elements. For computers, any collection of computers connected together so that they are able to communicate, permitting the sharing of data or programs.


Term Acronym Source
Network Connectivity eHealth Initiative
The process used for maintaining connection for communication between the HIE and a data source (laboratory, radiology practice, physician practice, or hospital) and data user (physician practice or hospital).


Term Acronym Source
non-routine uses and disclosures of patient health information American Psychoanalytic Association, Inc., 2003
A non-routine use or disclosure is a use or disclosure other than for treatment, payment, or health care operations purposes that is not otherwise permitted or required by law. For example, an authorization would be required in connection with a pre-employment medical exam or the release of information to the patient’s attorney. The Privacy Rule requires that patients sign an Authorization form for most non-routine uses and disclosures of patient health information.


Term Acronym Source
Notice of Privacy Practices or Privacy Notice NPP
HIPAA requires all covered entities to give patients a notice of their privacy practices, which must include how information about how their medical records will be shared.


Term Acronym Source
notice of proposed rulemaking NPR CMS
A document that describes and explains regulations that the Federal Government proposes to adopt at some future date, and invites interested parties to submit comments related to them. These comments can then be used in developing a final regulation.


Term Acronym Source
NPLANID CMS
A term used by CMS for a proposed standard identifier for health plans. CMS had previously used the terms PayerID and PlanID for the health plan identifier.


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Term Acronym Source
Office for Civil Rights OCR CMS
This office is part of HHS. Its HIPAA responsibilities include oversight of the privacy requirements.


Term Acronym Source
Opt-in/Opt-out Computerworld Privacy Glossary
An important distinction in the privacy debate concerns the terms under which e-mail marketers (legitimate ones, not spammers that ignore ethical and legal concerns) can contact users, and how users can add or remove themselves from databases.


Term Acronym Source
Order Entry eHealth Initiative
The process of communicating health care provider orders through electronic, computerized processes.


Term Acronym Source
OSI (Open Systems Interconnection) eHealth Initiative
The process of communicating health care provider orders through electronic, computerized processes.


Term Acronym Source
Outbreak Surveillance eHealth Initiative
Support clinical health state monitoring of aggregate patient data for use in identifying health risks from the environment and/or population.
Reference: Health Level Seven, Inc. “HL7 EHR-S Functional Model and Standard.”July 2004.


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Term Acronym Source
Parallel Pathways for Quality Healthcare eHealth Initiative
eHI has developed a set of principles and framework for alignment of incentives with both quality and efficiency goals as well as HIT capabilities within the physician practice and health information exchange capabilities across markets. This Framework—entitled “Parallel Pathways for Quality Healthcare” offers significant guidance to states, regions and communities who are exploring health information exchange as a foundation to address quality, safety and efficiency challenges.


Term Acronym Source
Participant Roles eHealth Initiative
Examples of roles that may be recognized by the health system that participate in events affecting the health of people:

  • Provider
  • Governor
  • Manager
  • Recipient
  • Researcher
  • Educator
  • Worker
  • Family Member

Roles may be used to authorize an individual’s access to information system functionality.


Term Acronym Source
Patient Matching eHealth Initiative
The process of cross-linking the multiple patient identifiers in a community from a variety of patient identifier sources and creating a master patient identifier with a key for cross-referencing the various community identifiers. This is also referred to as a record locator service.


Term Acronym Source
Pay-for-Performance/Quality Data Reporting eHealth Initiative
Supports the capture and reporting of quality, performance, and accountability measures to which providers/ facilities/ delivery systems/communities are held accountable including measures related to process, outcomes, and/or costs of care, may be used in ‘pay for performance’ monitoring and adherence to best practice guidelines.
Reference: Health Level Seven, Inc. “HL7 EHR-S Functional Model and Standard.”July 2004.


Term Acronym Source
Personal Health Information PHI
A person’s identifable medical or health records.


Term Acronym Source
Personal Health Record PHR
Typically a health record that is initiated and maintained by an individual.  An ideal PHR would provide a complete and accurate summary of the health and medical history of an individual by gathering data from many sources and making this information accessible online to anyone who has the necessary electronic credentials to view the information.From HITECH Act (page 145): The term “personal health record” means an electronic record of PHR identifiable health information (as defined in section 13407(f)(2)) on an individual that can be drawn from multiple sources and that is managed, shared, and controlled by or primarily for the individual.

From HHS OCR: In general, a PHR is an electronic record of an individual’s health information by which the individual controls access to the information and may have the ability to manage, track, and participate in his or her own heath care.


Term Acronym Source
plan sponsor CMS
An entity that sponsors a health plan. This can be an employer, a union, or some other entity.


Term Acronym Source
Platform for Privacy Preferences Project P3P Computerworld Privacy Glossary
This is a standard XML format adopted by the World Wide Web Consortium for Web sites to use to encode their privacy policies [see QuickLink 33484].


Term Acronym Source
Pointer System
The RHIO identifies where each patient’s information is located and serves as a master patient index. All RHIO Participants interact with each other to exchange information, although an intermediary may facilitate the exchange of information.


Term Acronym Source
Preferred provider organizations PPOs CMS
Preferred provider organizations have contracts with doctors, hospitals, and other health care providers and have negotiated certain fees. As long as you get your care from these providers, you will only have to make your co-payment. If you go to a provider outside of the PPO, your care may still be covered, but you may have to pay more.


Term Acronym Source
pricer or repricer CMS
A person, an organization, or a software package that reviews procedures, diagnoses, fee schedules, and other data and determines the eligible amount for a given health care service or supply. Additional criteria can then be applied to determine the actual allowance, or payment, amount.


Term Acronym Source
Privacy eHealth Initiative
Right of an individual to control the circulation of information about him-/herself within social relationships; freedom from unreasonable interference in an individual’s private life; an individual’s right to protection of data regarding him/her against misuse or unjustified publication.


Term Acronym Source
privacy in the law Computerworld Privacy Glossary
The U.S. government must not conceal the existence of any personal data record-keeping system by nay agency.


Term Acronym Source
privacy policy Computerworld Privacy Glossary
Most Web sites have a page describing in detail the site’s privacy practices and what the site’s owners will do with any information they collect.


Term Acronym Source
privacy, the right of Original HIPAA Privacy Rule
“The right of privacy is: ‘the claim of individuals, groups, or institutions to determine for themselves when, how, and to what extent information about them is communicated’.” 65 Fed. Reg. at 82,465


Term Acronym Source
Private Key eHealth Initiative
In asymmetric cryptography, the key which is held only by the user for signing and decrypting messages.


Term Acronym Source
protected health information PHI 12/28/2000 Final Privacy Rule
Individually identifiable information transmitted or maintained in any form (electronic means, on paper, or through oral communication) that relates to the past, present or future physical or mental health or conditions that can reasonably be used to identify an individual.


Term Acronym Source
pseudonymity Computerworld Privacy Glossary
Pseudonymity is the ability to prove a consistent identity without revealing one’s actual name, instead using an alias or pseudonym.


Term Acronym Source
Public Health Outbreak Surveillance eHealth Initiative
Supports clinical health state monitoring of aggregate patient data for use in identifying health risks from the environment and/or population.
Reference: Health Level Seven, Inc. “HL7 EHR-S Functional Model and Standard.” July 2004


Term Acronym Source
Public Health Processor eHealth Initiative
A software product that processes extracted data from health care provider systems for the purpose of tracking, trending, and reporting for public health reasons.


Term Acronym Source
Public Key eHealth Initiative
In asymmetric cryptography, the key which is published by the user to encrypt messages and so that others may verify his/her signature.


Term Acronym Source
Public Key Certificate eHealth Initiative
A data record that authenticates the owner of a public key for an asymmetrical key system. It is issued by a CA and is protected by a digital signature, allowing the certificate to be verified widely.


Term Acronym Source
Public Key Infrastructure (PKI) eHealth Initiative
A conceptual framework that enables the encryption, decryption and electronic “signing” of data transmissions in a secure fashion within an open network environment.


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Q


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R


Term Acronym Source
radio frequency identification (tags) RFID Computerworld Privacy Glossary
Now on the verge of becoming a widespread supply chain tool, radio frequency identification tags are getting smaller and cheaper, and privacy concerns are being raised. It may not be long before such tags are built into individual items (such as clothing), not just shipping pallets, allowing an unprecedented amount of automated monitoring of people’s habits, behaviors and locations.


Term Acronym Source
Recommend Treatment and Monitoring eHealth Initiative
The basis of cost, local formularies or therapeutic guidelines and protocols.
Reference: Health Level Seven, Inc. “HL7 EHR-S Functional Model and Standard.” July 2004


Term Acronym Source
Record (PHR) eHealth Initiative
An electronic application through which individuals can maintain and manage their health information (and that of others for whom they are authorized) in a private, secure, and confidential environment.
Reference: United States Department of Health and Human Services. Office of the National Coordinator for Health Information Technology (ONC) Glossary 2005


Term Acronym Source
Regional Health Information Organization Participant(s) RHIO Participant(s)
RHIO Participants may include both covered and non-covered entities.


Term Acronym Source
Regional Health Information Organizations RHIOs
The government’s preferred approach to building a National Health Information Network (NHIN) is to build and link Regional Health Information Organizations. RHIOs will interact with each other to exchange patient information.


Term Acronym Source
Registration Authority eHealth Initiative
An entity (group or agency) that has been delegated by a CA to perform a specific set of ‘trusted authority’ functions within PKI.


Term Acronym Source
regulatory permission Amended Privacy Rule
“The consent provisions (in the Original Rule)…are replaced with a new provision…that provides regulatory permission for covered entities to use and disclose protected health information for treatment, payment, and health care operations.” 67 Fed. Reg. at 53,211


Term Acronym Source
Results Answer Matching eHealth Initiative
The process of cross-linking the multiple possible answers to asking for a given result. For instance, asking for the results of a chest x-ray could yield a dictated report or a digital image of an x-ray. In any case, the case received must be matched across the type of result to a term identifying a common result.


Term Acronym Source
Results Name Matching eHealth Initiative
The process of cross-linking the multiple possible names of data results that can contain the same information. For instance a blood glucose reading can be called up by a blood glucose test, an SMA panel, or a glucometer result.


Term Acronym Source
Results Review eHealth Initiative
The ability to interpret the clinical data that is entered about a patient using a set of rules or algorithms which will generate warnings or alerts at various levels of severity to a clinician. These are intended to make the clinician aware of potentially harmful events, such as drug interactions, patient allergies, and abnormal results, which may affect how a patient is treated, with the intention of speeding the clinical decision process while reducing medical errors.


Term Acronym Source
Results Review (Alerts to Providers) eHealth Initiative
The ability to interpret the clinical data that is entered about a patient using a set of rules or algorithms which will generate warnings or alerts at various levels of severity to a clinician. These are intended to make the clinician aware of potentially harmful events, such as drug interactions, patient allergies, and abnormal results that may affect how a patient is treated, with the intention of speeding the clinical decision process while reducing medical errors.
Reference: eHealth Initiative Foundation. “Second Annual Survey of State, Regional and Community-based Health Information Exchange Initiatives and Organizations.” Washington: eHealth Initiative Foundation, 2005.


Term Acronym Source
right of privacy Original HIPAA Privacy Rule
“The right of privacy is: ‘the claim of individuals, groups, or institutions to determine for themselves when, how, and to what extent information about them is communicated’.” 65 Fed. Reg. at 82,465


Term Acronym Source
right to be let alone Sup. Ct. Justice Brandeis
Protects Americans in their beliefs, their thoughts, their emotions and their sensations – the most comprehensive of rights and the right most valued by civilized men.


Term Acronym Source
right to be let alone Original HIPAA Privacy Rule
If in Justice Brandeis’ words, the “right to be let alone” means anything, then it likely applies to having outsiders have access to one’s intimate thoughts, words and emotions.” 65 Fed. Reg. at 82,464/3.


Term Acronym Source
right to privacy Cavourkian and Tapscott
Long Description
The right to privacy is the claim of individuals, groups or institutions to determine for themselves when, how, and to what extent information about them is communicated.


Term Acronym Source
Risk eHealth Initiative
The chance of a vulnerability being exploited.


Term Acronym Source
Risk Assessment eHealth Initiative
An evaluation of the chance of vulnerabilities being exploited based on the effectiveness of existing or proposed safeguards or countermeasures.


Term Acronym Source
routine purposes American Psychoanalytic Association, Inc., 2003
Routine purposes are defined as treatment, payment and health care operations.


Term Acronym Source
Rules Engine eHealth Initiative
A set of rules defined within a software process that converts clinical and administrative data streams into a meaningful representation of clinical quality markers to be used in functions such as pay for performance/quality data reporting.


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S


Term Acronym Source
Security eHealth Initiative
In information systems, the degree to which data, databases, or other assets are protected from exposure to accidental or malicious disclosure, interruption, unauthorized access, modification, removal or destruction.


Term Acronym Source
segment CMS
Under HIPAA, this is a group of related data elements in a transaction.


Term Acronym Source
self-insured CMS
An individual or organization that assumes the financial risk of paying for health care.


Term Acronym Source
Service Level Agreement-Compliance eHealth Initiative
A documented track record of how well the vendor is meeting it’s customer support commitments.


Term Acronym Source
Service Level Agreement-Customer Responsibilities and Duties eHealth Initiative
The steps that the customer needs to take in order to ensure that the vendor has all the information they need to resolve an issue.


Term Acronym Source
Service Level Agreement-Hours of Support eHealth Initiative
Methods that will be used for communicating and resolving issues. Typical methods are email, phone, and online chat. Ask whether remote diagnostics and/or on site visits by support analysts are available.


Term Acronym Source
Service Level Agreement-Methods of Support eHealth Initiative
Will be used for communicating and resolving issues. Typical methods are email, phone, and online chat. Remote diagnostics can be available and, in some instances, it might be necessary to have a support analyst come on site.


Term Acronym Source
Service Level Agreement-Problem Escalation & Triage eHealth Initiative
The mechanism that defines how a problem migrates through the support system and the different resources that get involved along the way. If a problem can’t be resolved in a certain amount of time, then it escalates until it is resolved.


Term Acronym Source
Service Level Agreement-Response Times eHealth Initiative
Different functions of the system might warrant different response times based on severity level. There should be a schedule of response times for different types of problems, and the service level agreement should define this accountability.


Term Acronym Source
Service Level Agreement-Severity/Priority Classification eHealth Initiative
Different types of problems have different levels of urgency and importance. The severity level of a problem is usually noted when a support ticket is opened up. Resolution guarantees are based on severity levels. For example, CPOE down would be a high severity level while a patient education database not working might be a lower level of severity.


Term Acronym Source
small health plan CMS
Under HIPAA, this is a health plan with annual receipts of $5 million or less.


Term Acronym Source
SNOMED International eHealth Initiative
A nomenclature for use by all health services professionals developed in the US and updated at least semi-annually.


Term Acronym Source
Spyware Computerworld Privacy Glossary
Any technology that aids in gathering information about persons or organizations without their knowledge.


Term Acronym Source
Stages of Health Information Exchange Development eHealth Initiative
  • Stage One: Recognition of the need for HIE among multiple stakeholders in your state, region, or community
  • Stage Two: Getting organized by defining shared vision, goals, & objectives, identifying funding sources, and setting up legal & governance structures
  • Stage Three: Transferring vision, goals, & objectives to tactics and business plan, defining needs and requirements and securing funding
  • Stage Four: Well under-way with implementation technical, financial, and legal
  • Stage Five: Fully operational health information organization. Transmitting data that is being used by healthcare stakeholders Sustainable business model.
  • Stage Six: Demonstration of expansion of organization to encompass a broader coalition of stakeholders than present in the initial operational model

Reference: eHealth Initiative Foundation. “Second Annual Survey of State, Regional and Community-based Health Information Exchange Initiatives and Organizations.” Washington: eHealth Initiative Foundation, 2005.


Term Acronym Source
standard public law 104-191 (HIPAA)
The term ‘standard’, when used with reference to a data element of health information or a transaction referred to in section 1173(a)(1), means any such data element or transaction that meets each of the standards and implementation specifications adopted or established by the Secretary (of HHS) with respect to the data element or transaction under sections 1172 through 1174.


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Standard eHealth Initiative
Documented agreements containing technical specifications or other precise criteria to be used consistently as rules, guidelines, or definitions of characteristics to ensure that materials, products, processes, and services are fit for their purpose. A standard* specifies a well defined approach that supports a business process and:

  • Has been agreed upon by a group of experts
  • Has been publicly vetted
  • Provides rules, guidelines, or characteristics
  • Helps to ensure that materials, products, processes and services are fit for their intended purpose
  • Available in an accessible format
  • Subject to ongoing review and revision process

*This differs from the healthcare industry’s traditional definition of “standard of care.”


standard setting organization public law 104-191 (HIPAA)
A standard setting organization accredited by the American National Standards Institute, including the National Council for Prescription Drug Programs, that develops standards for information transactions, data elements, or any other standard that is necessary to, or will facilitate, the implementation of this part.


Term Acronym Source
standard transaction American Psychoanalytic Association, Inc., 2003
A standard transaction means the transmission of information between two parties to carry out financial or administrative activities related to health care, including health care claims, health care payment and remittance advice, coordination of benefits, health care claim status, enrollment and disenrollment in a health plan, eligibility for a health plan, health plan premium payments, referral certification and authorization, first report of injury, and health claims attachments.


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Statistical Deviation Detector eHealth Initiative
Identifies variances from patient-specific and standard care plans, guidelines, and protocols.


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strategic national implementation process CMS
A national WEDI effort for helping the health care industry identify and resolve HIPAA implementation issues.


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The International Organization for Standardization (ISO) eHealth Initiative
It is a worldwide federation of national standards bodies from some 130 countries, one from each country. ISO’s work results in international agreements which are published as International Standards.


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third party administrator TPA CMS
Business associate that performs claims administration and related business functions for a self-insured entity.


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Third Party-EHR Specific eHealth Initiative
Applications that are essential to the basic infrastructure of the system. They are the building blocks, such as the technical platform upon which the EHR system is built (e.g.,Windows, Linux, or MacIntosh, etc.) Also what kind of database structure controls the system (e.g, SQL, Oracle, etc.). When comparing license costs, note if there are separate general system license costs or if these are rolled into the main cost. Also, ask whether there will be additional costs when the vendor upgrades their software and it becomes necessary to install a new version of the database or operating system. Make sure your infrastructure software will support any features you wish to add later on.


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Third Party-General System eHealth Initiative
Applications that are essential to the basic infrastructure of the system. They are the building blocks such as the technical platform the EHR system is built on such as, Windows, Linux, or MacIntosh, etc. Also what kind of database structure controls the system SQL, Oracle, etc. When comparing license costs note if there are separate general system license costs or if these are rolled into the main cost. Also, will there be additional costs when the vendor upgrades their software and it is necessary to install a new version of the database or operating system. Make sure your infrastructure software will support any features you wish to add later on.


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trading partner CMS
External entity with whom business is conducted, i.e. customer. This relationship can be formalized via a trading partner agreement. (Note: a trading partner of an entity for some purposes, may be a business associate of that same entity for other purposes.)


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Training Services eHealth Initiative
Consulting services offered by the vendor. They provide hands on training for all aspects of the system.


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transaction CMS
Under HIPAA, this is the exchange of information between two parties to carry out financial or administrative activities related to health care.


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transaction change request system CMS
A system established under HIPAA for accepting and tracking change requests for any of the adopted HIPAA transaction standards via a single web site. See www.hipaa-dsmo.org.


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UB-92 CMS
An electronic format of the CMS-1450 paper claim form that has been in general use since 1993.


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UMLS (Unified Medical Language System) eHealth Initiative
A long-term research project developed by the US National Library of Medicine to assist health professionals and researchers to retrieve and integrate clinical vocabularies from a wide variety of information sources. The goal is to link information from scientific literature, patient records, factual databases, knowledge-based expert systems, and directories of institutions and individuals in health and health services.


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United Nations rules for electronic data interchange for administration, commerce, and transport CMS
An international EDI format. Interactive X12 transactions use the EDIFACT message syntax.


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use of private heatlh information (PHI)
The sharing of PHI within the institution (i.e., from nurse to doctor)


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value-added network CMS
A vendor of EDI data communications and translation services.


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Vendor Software Licenses eHealth Initiative
License cost of various modules. Typically, modules will be licensed on a concurrent or named user basis. For example, with a concurrent license, if there are 4 providers and 8 employees, a minimum of 12 concurrent licenses would be needed. However, if the providers were halftime [meaning, they only used the system half time] (and all 4 never used the system at any one time, only 10 licenses would be needed). If using a named user license under the same circumstances, 12 licenses would always be needed as licenses are not shared among different people. There can be a provision though for “active” and “inactive” providers (which means they could look at information, but not enter it in the system). Under an ASP (monthly rental agreement), software licenses are not being purchased, but rented However, the same issues exist for determining number of ASP licenses as with a license purchase.


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virtual private network CMS
A technical strategy for creating secure connections, or tunnels, over the Internet.


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Washington Publishing Company CMS
The company that publishes the X12N HIPAA Implementation Guides and the X12N HIPAA Data Dictionary. It developed the X12 Data Dictionary, and that hosts the EHNAC STFCS testing program.


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Web Anonymizer or Anonymizer Computerworld Privacy Glossary
This privacy service lets a user visit Web sites while preventing those sites from gathering information about the user (including IP address, browser and operating system identification, and cookie-stored data) or which sites he has visited.


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Web beacons, also called Web bugs Computerworld Privacy Glossary
Pixel tags or clear GIFs, these file objects (typically a single transparent pixel invisible to the user) are used along with cookies to help track the behavior of Web site visitors.


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workforce CMS
Under HIPAA, this means employees, volunteers, trainees, and other persons under the direct control of a covered entity, whether or not they are paid by the covered entity. Also see Part II, 45 CFR 160.103.


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workgroup for electronic data interchange CMS
A health care industry group that has a formal consultative role under the HIPAA legislation (also sponsors SNIP).


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X12 eHealth Initiative
A committee chartered by the American National Standards Institute (ANSI) to develop uniform standards for inter-industry electronic interchange of business transactions—electronic data interchange (EDI).


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X12N eHealth Initiative
The principle responsibilities of ASC X12N Insurance Subcommittee are development and maintenance of X12 standards, standards interpretations, and guidelines for the insurance industry, including health insurance. Most electronic transactions regarding health insurance claims are conducted using these standards, many of which are mandated by HIPAA.


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