Healthcare Interoperability Glossary
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An Accountable Care Organization (ACO), according to the Centers for Medicare & Medicaid Services (CMS) "is an organization of health care providers that agrees to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program who are assigned to it." Under the health care reform legislation passed in March 2010, the Medicare program is authorized to contract with ACOs.
Synonyms: Accountable Care Organization
- Argonaut Project
The Argonaut Project addresses the recommendations of the JASON Task Force, a joint task force of the ONC's HIT Standards and Policy Committees and is a joint project between HL7 International and several vendor and provider organizations. The purpose of the Argonaut Project is to develop a first-generation API and Core Data Services specification to enable expanded information sharing for electronic health records, documents, and other health information based on the FHIR specification.
American Recovery and Reinvestment Act of 2009 (ARRA) is an economic stimulus package enacted by the 111th United States Congress in February 2009 to provide a stimulus to the U.S. economy in the wake of the economic downturn. The Act includes federal tax cuts, expansion of unemployment benefits and other social welfare provisions, and domestic spending in education, health care, and infrastructure, including the energy sector. In included in the ARRA legislation is HITECH provision focused on health information technology adoption and funding.
Synonyms: American Recovery and Reinvestment Act
- Blue Button
The Blue Button initiative was first introduced by the VA, and subsequently began being promoted by many healthcare vendors. VA’s Blue Button allows a patient to access and download their information from a personal health record (PHR) into a very simple text file or PDF that can be read, printed, or saved on any computer. This enables patients to share this data with their health care providers, caregivers, or other people they trust.
The downloaded format is not in an industry standard format, such as CCD or CCR, which makes it less interoperable from an EHR-to-EHR sharing standpoint. The downloaded file is more targeted for human viewing and sharing.
In general, a Critical Access Hospital or CAH is a rural acute care hospital consisting of no more than 25 beds. Bed types can vary between acute care and swing, but cannot exceed 25. The Critical Access Hospital must not exceed a 96 hour length of stay and will have agreements, contracts or affiliations for transfer and services. Critical Access Hospitals must be certified to receive cost-based reimbursement from Medicare. The goal is to improve rural health care access and reduce hospital closures. Learn more at the Rural Access Center.
Synonyms: Critical Access Hospital
Continuity of Care Document (CCD) The HL7 CCD is the result of a collaborative effort between the Health Level Seven and American Society for Testing Materials (ASTM) to "harmonize" the data format between ASTM's Continuity of Care Record (CCR) and HL7's Clinical Document Architecture (CDA) specifications. Read HL7 and Continuity of Care Document white paper.
Synonyms: Continuity of Care Documen
Certification Commission for Healthcare IT (CCHIT) serves as the recognized US certification authority for electronic health records (EHR) and their networks. In September 2005, CCHIT was awarded a 3-year contract by the U.S. Department of Health and Human Services to develop and evaluate the certification criteria and inspection process for EHRs and the networks through which they interoperate. CCHIT serves one of the ONC-ATCB for electronic health record (EHR) certification. CCHIT was certified by the ONC on September 3, 2010 and is authorized to certify complete EHR and EHR modules Visit the CCHIT website.
Synonyms: Certification Commission for Healthcare I
Clinical Context Object Workgroup (CCOW) is an HL7 standard protocol designed to enable disparate applications to synchronize in real-time and at the user-interface level. It is vendor independent and allows applications to present information at the desktop and/or portal level in a unified way. Visit HL7 CCOW website.
Synonyms: Clinical Context Object Workgroup
Continuity of Care Record (CCR) is an XML-based standard for the movement of "documents" between clinical applications. Furthermore, it responds to the need to organize and make transportable a set of basic information about a patient's health care that is accessible to clinicians and patients. Read Understanding the Continuity of Care Record white paper.
Synonyms: Continuity of Care Record
Clinical Document Architecture (CDA) HL7 CDA uses XML for encoding of the documents and breaks down the document in generic, unnamed, and non-templated sections. Documents can include discharge summaries, progress notes, history and physical reports, prior lab results, etc. HL7's CDA defines a very generic structure for delivering "any document" between systems. CDA was previously known as the Patient Record Architecture (PRA).
Synonyms: Clinical Document Architecture
Clinical Document Repository (CDR) enables hospitals to build a life-long health record environment using stored health records for the purpose of better treatment, clinical research and health statistics for policy making.
Synonyms: Clinical Document Repository
Certified Health IT Product List (CHPL) - The Office of the National Coordinator has organized a Certified Health IT Product List for Ambulatory and Inpatient facilities looking to purchase a complete EHR or EHR module certified for the Meaningful Use incentive program. Each complete EHR and EHR module listed has been certified by an ONC-ATCB and reported to the ONC for use in the list. You can find a list of the reported certified complete EHR and EHR modules at http://onc-chpl.force.com/ehrcert.
Synonyms: Certified Health IT Product List
- CommonWell Health Alliance
CommonWell is a healthcare technology vendor collaborative working to create a framework that facilitates interoperability between vendor partners, which incorporate CommonWell standards into their technology. CommonWell's services, provided by McKesson-owned HIE company RelayHealth, include patient identification and linking; patient record location and retrieval; and patient access, privacy, and consent management.
- Conformance Checking
Conformance checking or gap analysis for HL7 messages is a logical process used to determine whether a message from one particular medical device or application is compatible to the selected HL7 standard messaging format, or a custom format adopted by another device or application. Read Conformance Checking for HL7 white paper for more details.
Digital Imaging and Communications in Medicine (DICOM) is a common format for image storage. It allows for handling, storing, printing, and transmitting information in medical imaging. Visit DICOM website.
Synonyms: Digital Imaging and Communications in Medicine
- Direct Project
The Direct Project was launched by the ONC within Health and Human Services (HHS) on March 1, 2010. It was initially called NHIN Direct. The object of the Direct Project is to replace the use of faxes, phones, and paper transactions with a simple and secure point-to-point communication over the Internet.
The Direct Project achieves this in one of two ways:
Applicability Statement for Secure Health Transport: This is the primary Direct Project specification which uses the SMTP e-mail protocol with secure S/MIME attachments and x509 certificates.
These protocols ensure the secure delivery of messages between two trusted endpoints for a variety of purposes including transfer of patient health information in the form or a CCD document.
The DirectTrust organization is dedicated to build and strengthen the security and trust framework for the exchange of health data using the Direct Project protocol. DirectTrust members agree to participate in work groups dedicated to security, trust, and growth of the use of the Direct Project; attend monthly educational sessions; become involved with the Direct community; and support the membership growth of DirectTrust. Corepoint Health is a member of DirectTrust and currently a candidate for their accredidation.
- Drummond Group
The Drummond Group serves one of the ONC-ATCB for electronic health record (EHR) certification. The Drummond Group was certified by the ONC on September 3, 2010 and is authorized to certify complete EHR and EHR modules. Visit The Drummond Group website - www.drummondgroup.com.
Electronic Data Interchange (EDI) is a standard format for exchanging business data. The standard is ANSI X12, developed by the Data Interchange Standards Association. An EDI message contains a string of data elements; each represents a singular fact, such as a price, product model number, and is separated by delimiter. The entire string is called a data segment. One or more data segments framed by a header and trailer form a transaction set, which is the EDI unit of transmission (equivalent to a message). A transaction set often consists of what would usually be contained in a typical business document or form. The parties who exchange EDI transmissions are referred to as trading partners.
Synonyms: Electronic Data Interchange
Electronic Health Record (EHR), as defined in Defining Key Health Information Technology Terms (The National Alliance for Health Information Technology, April 28, 2008): An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one health care organization.
Synonyms: Electronic Health Recor
The EHR-Lab Interoperability and Connectivity Standards (ELINCS) specification provides a profile that refines (or constrains) "standard" HL7 messages to moving lab results from reference labs to physician offices.
See Accelerating EMR Interoperability with ELINCS white paper.
Synonyms: EHR-Lab Interoperability and Connectivity Standards
Electronic Medical Record (EMR), as defined in Defining Key Health Information Technology Terms (The National Alliance for Health Information Technology, April 28, 2008): An electronic record of health-related information on an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within one health care organization.
Synonyms: Electronic Medical Record
- Encryption Algorithm
An encryption algorithm is a mathematical procedure for converting plaintext into ciphertext, which can be decoded back into the original message.
The Eligible Professionals (EP) HITECH Act recognizes three types of payers eligible for incentive payments under Meaningful Use. Those types are 1) Medicare Fee For Service (FFS), 2) Medicare Advantage (MA) and 3) Medicaid. The subsequent definition of an eligible professional differs according to Medicare and Medicaid.
Eligible hospitals can be acute care (excluding long term care facilities), critical access hospitals and children’s hospitals.
Eligible providers include non-hospital-based physicians who receive reimbursement through Medicare FFS program or a contractual relationship with a qualifying MA organization. Eligible providers are widely considered to be physicians whose practices are less than 90% inpatient and ER.
Visit Everything HITECH for detailed information on eligible professionals.
Synonyms: Eligible Professionals
An HL7 standard that is short for Fast Healthcare Interoperability Resources and pronounced "Fire". The standard defines a set of "Resources" that represent granular clinical concepts. The resources provide flexibility for a range of healthcare interoperability problems, and they are based on simple XML with an HTTP-based RESTful protocol where each resource has a predictable URL.
Firewall refers to a hardware- or software-based method for controlling incoming and outgoing network traffic, based upon a predetermined rule set, to ensure that only trusted content is passed.
- Health IT Policy Committee
Under the American Recovery and Reinvestment Act of 2009 (ARRA), The Health IT Policy Committee will make recommendations to the National Coordinator for Health Information Technology – ONC - on a policy framework for the development and adoption of a nationwide health information infrastructure, including standards for the exchange of patient medical information.
- Health IT Standards Committee
The Health IT Standards Committee will make recommendations to the National Coordinator for Health Information Technology (HIT) on standards, implementation specifications, and certification criteria for the electronic exchange and use of health information. In developing, harmonizing, or recognizing standards and implementation specifications, the HIT Standards Committee will also provide for the testing of the same by the National Institute for Standards and Technology (NIST).
Health Information Exchange (HIE) focuses on the mobilization of healthcare information electronically across organizations within a region or community. HIE provides the capability to electronically move clinical information between disparate health care information systems while maintaining the meaning of the information being exchanged. The goal of HIE is to facilitate access to and retrieval of clinical data to provide safe, and efficient patient-centered care.
Synonyms: Health Information Exchange
The Health Insurance Portability and Accountability Act (HIPAA) was enacted by the U.S. Congress in 1996. Title II of HIPAA, known as the Administrative Simplification (AS) provisions, requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers. This is intended to help people keep their information private, though in practice, it is normal for providers and health insurance plans to require the waiver of HIPAA rights as a condition of service.
The Administration Simplification provisions also address the security and privacy of health data. The standards are meant to improve the efficiency and effectiveness of the nation's health care system by encouraging the widespread use of electronic data interchange in the U.S. health care system.
Synonyms: Health Insurance Portability and Accountability Act
- HIPAA - Business Associate
A HIPAA - Business Associate is a person or entity that performs certain functions or activities that involve the use or disclosure of Protected Health Information (PHI) on the behalf of, or provides services to, a covered entity. A member of the covered entity’s workforce is not a business associate. A covered health care provider, health plan, or health care clearinghouse can be a business associate of another covered entity.
The Privacy Rule lists some of the functions, activities, and services that make a person or entity a business associate, if the activity or service involves the use or disclosure of protected health information (PHI) covered under HIPAA. The types of functions or activities that may make a person or entity a business associate include payment or health care operations activities, and other activities regulated by the Administrative Simplification Rules.
Examples of Business Associates:
- A third party administrator that assists a health plan with claims processing.
- A CPA firm whose accounting services to a health care provider involve access to protected health information.
- An attorney whose legal services to a health plan involve access to protected health information.
- A consultant that performs utilization reviews for a hospital.
- A health care clearinghouse that translates a claim from a non-standard format into a standard transaction on behalf of a health care provider and forwards the processed transaction to a payer.
- An independent medical transcriptionist that provides transcription services to a physician.
- A pharmacy benefits manager that manages a health plan’s pharmacist network.
- HIPAA - Protected Health Information (PHI)
Protected health information (PHI) under HIPAA, is any information about an individual’s health status that identifies or relates to an individual's past, present or future physical or mental health, the provision of health care to the individual, or the past, present or future payment for health care. Information is deemed to identify an individual if it includes either the individual's name or any other information that could enable someone to determine the individual's identity.
- Address (all geographic subdivisions smaller than state, including street address, city, county, ZIP code)
- All elements (except years) of dates related to an individual (including birth date, admission date, discharge date, date of death and exact age if over 89)
- Telephone numbers
- FAX number
- E-mail address
- Social Security number
- Medical record number
- Health plan beneficiary number
- Account number
- Certificate/license number
- Any vehicle or other device serial number
- Device identifiers or serial numbers
- Web URL
- Internet Protocol (IP) address numbers
- Finger or voice prints
- Photographic images
Hospital Information System (HIS) is the main system in a hospital used by most caregivers. Sends ADT broadcasts to all ancillary applications. The HIS is typically the patient administrative system and order entry system for a hospital.
Synonyms: Hospital Information System
HISP, or Health Information Service Provider, is an email service provider that follows Direct Project standards and provides a mechanism to grant users a Direct email address. The HISP provides the framework to secure messages and define a circle of trust for secure communications.
As a part of the America Recovery and Reinvestment Act (ARRA) of 2009, Health Information Technology for Economic and Clinical Health (HITECH) refers to the portion of the ARRA that is used to increase the use of Electronic Health Records (EHR) by physicians and hospitals. This legislation provides immediate funding for health information technology infrastructure, training, dissemination of best practices, telemedicine, inclusion of health information technology in clinical education, and State grants to promote health information technology.
Synonyms: Health Information Technology for Economic and Clinical Health
- HITRUST Common Security Framework
In an effort to normalize the security requirements of healthcare organizations, the HITRUST organization developed the CSF (Common Security Framework) which combines standards and regulations from 17 authoritative sources. The CSF is not a new standard, but rather a comprehensive tool that provides clarity and consistency among all the authoritative sources.The CSF provides an online tool that can be used by a healthcare organization to help determine compliance of a system or the organization against the appropriate standards and regulations. The baseline assessment of the CSF provides a HIPAA scorecard and can scale for organizations large or small. The assessment can be a self-assessment, or one conducted by an authorized HITRUST assessor.
Healthcare Information Technology Standards Panel (HITSP) serves as a cooperative partnership between the public and private sectors for the purpose of achieving a widely accepted and useful set of standards specifically to enable and support widespread interoperability among healthcare software applications, as they will interact in a local, regional and national health information network for the United States. Visit the HITSP website at www.hitsp.org.
Synonyms: Healthcare Information Technology Standards Panel
HL7 is a Standards Developing Organization accredited by the American National Standards Institute (ANSI) to author consensus-based standards representing a board view from healthcare system stakeholders. HL7 has compiled a collection of message formats and related clinical standards that define an ideal presentation of clinical information, and together the standards provide a framework in which data may be exchanged. Visit the HL7 organization website (www.hl7.org) or www.HealthStandards.com for more HL7 information.
- HL7 Batch Protocol
The HL7 Batch Protocol transmits a batch of HL7 messages using FHS, BHS, BTS, and FTS segments to delineate the batch.
- HL7 FHIR
FHIR stands for Fast Healthcare Interoperable Resource. This emerging standard combines the best features of HL7 V2, HL7 V3, and CDA, while leveraging the latest web service technologies. The design of FHIR is based on RESTful web services. With RESTful web services, the basic HTTP operations are incorporated including Create, Read, Update and Delete. FHIR is based on modular components called “resources,” and these resources can be combined together to solve clinical and administrative problems in a practical way. The resources can be extended and adapted to provide a more manageable solution to the healthcare demand for optionality and customization. Systems can easily read the extensions using the same framework as other resources.
HTTP (Hypertext Transfer Protocol) is the foundation for application-level communication on the internet.
HTTPS (Hypertext Transfer Protocol Secure) is the product of layering HTTP on top of the SSL/TLS encryption protocol with the goal of preventing “man in the middle” eavesdropping during network transport.
ICD-9 is a classification used in the medical field that stands for International Classification of Diseases, 9th revision. This classification is predominately the standard classification of diseases, injuries, and cause of death for the purpose of health records. The World Health Organization (WHO) assigns, publishes, and uses the ICD to classify diseases and to track mortality rates based on death certificates and other vital health records. Medical conditions and diseases are translated into a single format with the use of ICD codes.
Synonyms: International Classification of Diseases, 9th revision
- ICSA Labs
ICSA Labs serves one of the ONC-ATCB for electronic health record (EHR) certification. ICSA Labs was certified by the ONC on December 10, 2010 and is authorized to certify complete EHR and EHR modules. Visit the ICSA Labs website.
ID is a coded value data type. The value of such a field follows the formatting rules for a ST field except that it is drawn from a table of legal values. Examples of ID fields include religion and sex.
Institute of Electrical and Electronics Engineers (IEEE) is accredited by ANSI to submit its documents for approval as American National Standards. IEEE subcommittee P1073 develops standards for healthcare informatics: MEDIX (P1157) and MIB (P1073).
Synonyms: Institute of Electrical and Electronics Engineers
Synonyms: Integrating the Healthcare Enterprise
- InfoGuard Laboratories, Inc.
InfoGuard Laboratories, Inc. serves one of the ONC-ATCB for electronic health record (EHR) certification. InfoGuard Laboratories, Inc. was certified by the ONC on September 24, 2010 and is authorized to certify complete EHR and EHR modules. Visit the InfoGuard Laboratories, Inc. website.
- Interface Engine
An interface engine can transform or map the data to the receiving application's requirements while the message is in transit so that it can be accepted by the receiving application. The application interface is built with one-to-many concepts in mind. These import/export modules then are connected to an interface engine so that the mapping, routing, and monitoring are managed by this system.
Interoperability refers to the ability of two or more systems or components to exchange information and to use the information that has been exchanged.
Laboratory Information System (LIS) is an information system that receives, processes, and stores information generated by a medical laboratory processes. LIS is often interfaced with HIS and EMR applications.
Synonyms: Laboratory Information System
Logical Observation Identifiers Names and Codes (LOINC) applies universal code names and identifiers to medical terminology related to the EHR and assists in the electronic exchange and gathering of clinical results (such as laboratory tests, clinical observations, outcomes management and research). See What are LOINC Codes?
Synonyms: Logical Observation Identifiers Names and Codes
- Meaningful Use
Meaningful Use is a term associated with The American Recovery and Reinvestment Act of 2009 (ARRA) that authorizes the Centers for Medicare & Medicaid Services (CMS) to provide reimbursement incentives for medical professionals and hospitals that become compliant in the use of certified electronic health record (EHR) technology. Professionals and hospitals that meet the criteria of "meaningful use" will begin receiving incentive payments in 2011 with a gradual decline in reimbursement amounts until the year 2015. By this date, providers are expected to have adopted and be actively utilizing a certified EHR in compliance with the "meaningful use" definition or be subject to financial penalties under Medicare. To read more articles on this topic, visit our Meaningful Use & HITECHsection.
NAT (Network Address Translation) is the process of modifying IP addresses by a traffic routing device. The typical use of NAT is to allow multiple users on a private network to use a single IP address to access the internet.
The National Council for Prescription Drug Programs (NCPDP) creates and promotes the transfer of data related to medications, supplies, and services within the healthcare system through the development of standards and industry guidance. Visit the NCPDP website at www.ncpdp.org.
Synonyms: National Council for Prescription Drug Programs
Nationwide Health Information Network (NHIN) is one of the ONC's major initiatives. As defined by the ONC, NHIN is: "a set of standards, services and policies that enable secure health information exchange over the Internet. The NHIN will provide a foundation for the exchange of health IT across diverse entities, within communities and across the country, helping to achieve the goals of the HITECH Act."
Synonyms: Nationwide Health Information Network
National Institute of Standards and Technology - Founded in 1901, NIST is a non-regulatory federal agency within the U.S. Department of Commerce. NIST's mission is to promote U.S. innovation and industrial competitiveness by advancing measurement science, standards, and technology in ways that enhance economic security and improve our quality of life. NIST have made solid contributions to image processing. Visit the NIST website at www.nist.gov.
Synonyms: National Institute of Standards and Technology
Office of the National Coordinator for Health Information Technology (ONC) - Located within the Office of the Secretary for the U.S. Department of Health and Human Services (HHS), the Office of the National Coordinator (ONC) coordinates nationwide efforts to support the adoption of health information technology and the promotion of health information exchange to improve health care. The ONC position was established in 2004 with an Executive Order and legislatively mandated in the Health Information Technology for Economic and Clinical Health Act (HITECH Act) of 2009.
Synonyms: Office of the National Coordinator for Health Information Technology
ONC-Authorized Testing and Certification Bodies - Following the Meaningful Use stage one final rule in July of 2010, the Office of the National Coordinator selected six organizations to assume responsibility for the certification of complete EHR and EHR modules. These ONC-ATCB are required to certify based upon the certification requirements outlined in the Standards and Certification Criteria Final Rule. According to the ONC, "Certification by an ATCB will signify to eligible professionals, hospitals, and critical access hospitals that an EHR technology has the capabilities necessary to support their efforts to meet the goals and objectives of Meaningful Use."
Synonyms: ONC-Authorized Testing and Certification Bodies
Picture Archiving Communication Systems (PACS) are devoted to the storage, retrieval, distribution, and presentation of images. The medical images are stored in an independent format, most commonly DICOM.
Synonyms: Picture Archiving Communication System
PAT (Port Address Translation) is a type of network address translation in which each device on a LAN is translated to the same IP address, but with a different port number assignment.
Payload refers to the content of the message being sent (i.e., the message body).
Patient Demographics Query (PDQ) - What it's used for: Requesting patient ID's from a central patient information server based on patient demographic information. It is used when a system has only demographic data for patient identification.
Example: Hospital A admits Patient Y, who has not been at the hospital before. Hospital A submits a request to the local HIE, based on demographic information such as name, birth date, sex, etc., to obtain the appropriate HIE patient ID for Patient Y.
Synonyms: Patient Demographics Query
Personal Health Record (PHR), as defined in Defining Key Health Information Technology Terms (The National Alliance for Health Information Technology, April 28, 2008): An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual.
Synonyms: Personal Health Record
Patient Identifier Cross Referencing (PIX) What it is used for: Cross-referencing multiple local patient ID's between hospitals, sites, health information exchange networks, etc. Used when local patient ID's have been registered with a PIX manager.
Example: Hospital A transmits Patient D's ID information to the HIE for cross referencing. Hospital A receives Patient D's local ID for Hospital B which they can use to request information from Hospital B, based on need.
Synonyms: Patient Identifier Cross Referencing
Practice Management System (PMS) applications facilitate the day-to-day operations of a medical practice. PMS software enables users to capture patient demographics, schedule appointments, maintain lists of insurance payers, perform billing tasks, and generate reports. It handles the administrative and financial matters for a practice.
Synonyms: Practice Management System
- Point-To-Point Interface
A point-to-point interface is one in which the receiving vendor provides a specification on what data it can receive and in what format it needs to be in. The sending application then builds an interface to that specification for that application. It is a one-to-one relationship. For each application requiring an interface, there is a new request and point-to- point interface developed. Read What is Your Healthcare Interface Method white paper.
- Public IP Address
The Public IP Address (vs. Private or LAN Address) The public IP address is the outward-facing IP address that is presented to the internet by the router hardware. A private IP address is an internal IP address that is discernible only by devices on the same local network. (See NAT and PAT.)
RadLex is a controlled terminology for radiology. The purpose of RadLex is to provide a uniform structure for capturing, indexing, and retrieving a variety of radiology information sources. This may facilitate a first step toward structured reporting of radiology reports. The RadLex project - to develop a comprehensive radiology lexicon - is sponsored by the Radiological Society of North America (RSNA), along with the collaboration of the American College of Radiology (ACR) and other subspecialty societies. Read more about RadLex.
Regional Health Information Organization (RHIO) - The terms "RHIO" and "Health Information Exchange" or "HIE" are often used interchangeably. A RHIO is a group of organizations with a business stake in improving the quality, safety and efficiency of healthcare delivery. RHIOs are the building blocks of the proposed National Health Information Network (NHIN) initiative proposed by David Brailer, MD, and his team at the Office of the National Coordinator for Health Information Technology (ONCHIT). To build a national network of interoperable health records, the effort must first develop at the local and state levels. The concept of NHIN requires extensive collaboration by a diverse set of stake holders. The challenges are many to achieve success for a health information exchange or a RHIO.
Synonyms: Regional Health Information Organization
Radiology Information System (RIS) is the main application in an imaging center or radiology department. RIS is used by to store, manipulate and distribute patient radiological data and imagery. RIS are used for patient scheduling, tracking, and image tracking. Read Rethinking Radiology Workflow white paper.
Synonyms: Radiology Information System
- SLI Global Solutions
SLI Global Solutions serves one of the ONC-ATCB for electronic health record (EHR) certification. SLI Global Solutions was certified by the ONC on December 10, 2010 and is authorized to certify complete EHR and EHR modules. Visit the SLI Global Solutions website.
- SMART HealthIT
SMART is a program coordinated by Boston Children’s Hospital Computational Health Informatics Program and the Harvard Medical School Department for Biomedical Informatics. SMART is funded by the U.S. government. The purpose of SMART HealthIT is to standardize API application and standards across healthcare. They describe their goal: "The goal of SMART is audacious and can be expressed concisely: an innovative app developer can write an app once, and expect that it will run anywhere in the healthcare system. Further, that one app should be readily substitutable for another. When apps are substitutable, they compete with each other which drives up quality and down price." SMART HealthIT is working to create this type of framework for applications using HL7 FHIR, which is commonly referred to as SMART on FHIR.
SMTP represents Simple Mail Transfer Protocol. SMTP is widely utilized for e-mail transmissions across Internet Protocol (IP) networks.
The SMTP protocol started out purely ASCII text-based, it did not deal well with binary files or characters in many non-English languages. Because of this, standards such as Multipurpose Internet Mail Extensions (MIME) were developed to encode binary files for transfer through SMTP.
In healthcare, the MIME standard CCD documents can be treated as a MIME package in an SMTP e-mail. To make the SMTP e-mail secure, a secure version of MIME, called S/MIME, can be utilized. S/MIME along with certificates can be combined with SMTP to keep patient health information safe. The Direct Project provides the specifications for accomplishing this.
SOAP (Simple Object Access Protocol) is a web services protocol used heavily in healthcare to implement IHE profiles. SOAP is an enterprise standard that is typically used by business applications to exchange information across the enterprise.
- SOAP Envelope
SOAP Envelope refers to the outermost wrapper of a SOAP message, containing addressing and security information.
- Surescripts LLC
Surescripts LLC serves one of the ONC-ATCB for electronic health record (EHR) certification. Surescripts LLC was certified by the ONC on December 23, 2010 and is authorized to certify EHR modules for e-prescribing, privacy and security. Visit the Surescripts LLC website.
Transmission Control Protocol/Internet Protocol (TCP/IP) is a low-level communications protocol used to connect hosts on the Internet or a network. TCP/IP connections are established between clients and servers via sockets. TCP/IP is stream-oriented meaning it deposits bits in one end and they show up at the other end.
- Socket is "communication endpoint"
- Server = wait for connection
- Client = initiate connection
- Sequenced, reliable transport
- Bi-directional by definition
- Sometimes/often used uni-directionally
Synonyms: Transmission Control Protocol/Internet Protocol
Vendor Enterprise Archive (VEA) - PACS vendors archive solution that stores multi-department images. As in the past, software upgrades and new PACS or storage system changes with a VEA can result in data migration of entire image repository. See the definition courtesy of ACUO Technologies.
Synonyms: Vendor Enterprise Archive
Vendor Neutral Archive (VNA) - A software solution that acts as a middleware application between one or many clinical workflow applications, formerly known as PACS, and various storage platforms and IT strategies. VNA will support: one or many clinical viewing applications, a standards based environment, storage virtualization strategies, robust business continuity deployments and virtual environments. See the definition courtesy of ACUO Technologies.
Synonyms: Vendor Neutral Archive
- Web Services
Web services are a standardized way of integrating applications. Using open standards, businesses can communicate without in-depth knowledge of one another’s systems, beyond the communication protocol. Because all communication is XML-based, web services are not restricted to a specific operating system or programming language and do not require the use of browsers or HTML.
A WSDL is an XML-based document for locating and describing a web service. WSDLs contain the identifying information and configuration data for a web service. An application developer will produce a WSDL to make it easier to configure the user's application to communicate with their web service.
X12 provides for electronic exchange of business transactions-electronic data interchange (EDI). The American National Standards Institute (ANSI) chartered the Accredited Standards Committee (ASC) X12 to develop uniform standards.
Cross-enterprise Document Media Interchange (XDM) - What itss used for: According to IHE, XDM transfers documents and metadata using CDs, USB memory or email attachments. This profile supports environments with minimal capabilities in terms of using Web Services and generating detailed metadata. This standard is utilized by the Direct Project.
Synonyms: Cross-enterprise Document Media Interchange
Cross-enterprise Document Reliable Interchange (XDR) - What it's used for: The exchange of health documents between health enterprises using a web-based, point-to-point push network communication, permitting direct interchange between EHRs, PHRs and other systems without the need for a document repository.
Synonyms: Cross-enterprise Document Reliable Interchange
Cross-enterprise Document Sharing for Imaging - What it’s used for: The sharing of images, diagnostic reports and related information through a commonregistry.
Synonyms: Cross-enterprise Document Sharing for Imaging
Cross-enterprise Document Sharing What it's used for: The sharing of documents between any health care enterprise, ranging from a private physician office to a clinic to an acute care in-patient facility, through a common registry. Medical documents can be stored, registered, found and accessed.
- Hospital A has a document to store. Hospital A creates a description and metadata for the document and submits it to the HIE Repository.
- The HIE Repository accepts the document with metadata. It stores the document and forwards the metadata to the HIE Registry.
- The HIE Registry receives a query from Hospital B and identifies the document as a match based on the metadata.
- Hospital B retrieves the document from the HIE Repository.
Synonyms: Cross-enterprise Document Sharing