Accountable care organizations (ACOs)
ACOs refer to a network of doctors, hospitals and other healthcare providers who voluntarily come forward to provide quality care for Medicare patients. ACOs are accountable in all the aspects of quality, cost, and overall care. They are characterized by a payment and care delivery model tying provider reimbursements to quality metrics. The focus of ACOs is to ensure that patients get coordinated care at reduced health care costs.
A branch of secondary health care, Acute care is where a patient receives necessary treatment for a disease, an urgent medical condition or severe episode of illness for a short period of time. Acute care settings include but are not limited to neonatal intensive care, coronary care, cardiology, emergency department, intensive care and many general areas. It is usually delivered by health care professionals from a range of surgical and medical specialties.
Ambulatory care (aka Outpatient care) refers to medical care provided on an outpatient basis. A patient focused service, Ambulatory care is where some conditions are treated without the need for an overnight stay in hospital. It includes consultation, intervention, diagnosis, treatment, observation, and rehabilitation services.
Chronic care refers to medical care addressing pre-existing or long term illness. Chronic medical conditions include chronic bronchitis, congestive heart disease, asthma, diabetes, emphysema, depression, hypertension and cirrhosis of the liver among others. Keeping symptoms in remission, it aims to maintain wellness, while at the same time balancing treatment regimes and quality of life.
Clinical Data Repository (CDR)
CDR is a real time database that consolidates data from various clinical sources and presents a unified view of a single patient. Typical data types found in CDR include patient demographics, pharmacy information, pathology reports, hospital admission, clinical laboratory test results, radiology reports and images, ICD-9 codes, discharge summaries, discharge and transfer dates, hospital admission and progress notes.
Clinical Informatics (aka Health Informatics) refers to the study and use of data and information technology for delivering health care services. It improves patients’ ability to monitor and maintain their own health. It includes a wide range of topics ranging from clinical documentation to provider order entry system; system design to system implementation and adoption issues; and from clinical decision support to visual images.
Continuity of Care Document (CCD)
A joint effort of HL7 International and ASTM, CCD is an electronic document exchange standard for sharing summary information of a patient. It furthers interoperability of clinical data allowing physicians to send medically relevant information electronically to other healthcare service providers without any loss of meaning, enabling overall improvement of patient care.
Digital Imaging and Communications in Medicine (DICOM)
DICOM is a standard for the transmission of medical images, waveforms and accompanying information. It comprises file format definition and a network communications protocol. An application layer network protocol, DICOM uses TCP/IP to communicate between systems. The files can be shared between two different entities that support DICOM format, capable of receiving image and patient data.
Delivery System Reform Incentive Payment (DSRIP)
DSRIP is a mechanism by which New York State implements Medicaid Redesign Team (MRT) Waiver Amendment. The program aims at reducing avoidable hospital use by 25% in the period of next five years. By reinvesting in the Medicaid program, DSRIP program focuses on restructuring the health care delivery system.
Electronic Health Records (EHR)
EHRs are digital medical records of patients maintained by the healthcare providers over a period of time. It includes patient related key administrative clinical data under a particular provider. The EHR record has information on patient’s demographics, problems and medications, progress notes, past medical history, immunizations, vital signs, laboratory data and radiology reports. It automates and streamlines the clinician’s workflow, reducing the incidence of medical error and improving the accuracy of medical records.
Fast Healthcare Interoperability Resources (FHIR)
Pronounced ‘Fire’, FHIR is a draft standard for electronic exchange of healthcare information. It is developed by Health Level Seven International (HL7) health-care standards organization. FHIR has information on exchange, integration, sharing and retrieval of digital health information. Furthermore, supporting delivery and evaluation; clinical practice and management of health services.
Healthcare Effectiveness Data and Information Set (HEDIS)
HEDIS is a widely used performance measuring tool in the healthcare industry, based on the important dimensions of care and service. Developed and maintained by National Committee for Quality Assurance (NCQA), it has 81 measures across 5 domains of care. HEDIS also helps in comparing performance of various health plans on an “apples-to-apples” basis.
Health Industry Number System (HIN)
HIN is a unique identifier created by the health industry to identify all the partners in the supply chain. It supports the business needs of all trading partners during their electronic communications and transactions. Additionally, HIN helps in reducing transmission costs in EDI messages and facilitates customer account file clean-up and sales roll-up.
Healthcare Information Exchange (HIE)
HIE is the digital movement of health-related information across organizations within a region, community or hospital system. It allows healthcare providers to securely access vital medical information of a patient electronically. HIE aims to facilitate access to and retrieval of clinical data providing safer, effective, patient-centered care.
Healthcare Information Systems (HIS)
An element of health informatics, HIS focuses on various administrational needs of hospitals. It is a comprehensively integrated information system designed to manage every aspect of hospital’s operation including administrative, financial, medical, and related legal issues. Additionally, the usage of HIS enhances information integrity; reduces transcription errors and duplication of information entries; and optimizes report turnaround times.
Health Information Technology for Economic and Clinical Health (HITECH)
A part of American Recovery and Reinvestment Act of 2009, HITECH Act is formed to stimulate the adoption of EHRs and supporting technology. It provides US Department of Health and Human Services (HHS) with the authority to establish health care programs that drive quality, safety, and efficiency by the promotion of health IT technologies.
Health Level 7 (HL7)
HL7 is a set of standards for the transfer of administrative and clinical data between software applications employed by various healthcare providers. The HL7 standards are defined by the Health Level Seven International, an international standards organization. These standards define how information flows between various systems, setting up the language, structure and data types essential for the seamless integration.
ICD-10 is the tenth revision of The International Classification of Diseases (ICD), a clinical cataloguing system classified by the World Health Organization (WHO). It has information on the codes for diseases, social circumstances, abnormal findings, complaints, signs and symptoms, and external causes of injury or diseases. ICD-10 is used by physicians and other healthcare providers in the United States to classify and code all diagnoses, procedures and symptoms recorded in alignment with hospital care.
An important aspect of healthcare information technology, Interoperability underlies all initiatives for coordinated healthcare. It describes the extent to which systems and devices can exchange and interpret the shared data, displaying it in a user-friendly way. Interoperability allows data to be shared across healthcare channels including pharmacies, labs, hospitals, clinicians and patients.
Internet of things (IoT) holds a greater promise in the field of healthcare, with its disruptive innovation. The data analysis enabled by IoT sensors holds the potential to save lives. It reduces hospitalizations, re-admissions and even lowers the risk of death. Several IoT applications can help doctors remotely monitor daily activities of the patient. It enables real-time response and action in the health care space, bringing in a paradigm shift in the domain where the speed and timing are essential deciding factors.
Laboratory Information Systems (LIS)
LIS is a system software processes, stores and manages data from different stages of medical processes and tests. It allows clinicians to quickly access reports and results, leading to quicker diagnosis and treatment. The electronic data capture process in LIS reduces the time spent and cutting down errors associated with the transcribing process.
Meaningful use defines minimum US government standards for using EHRs for exchanging clinical data between healthcare providers, insurers and patients. It improves quality, safety, efficiency, and helps reduce health disparities. Additionally, it also improves care coordination; and population and public health maintaining privacy and security of patient health information.
National Quality Forum (NQF)
An US-based non-profit membership organization, NQF focuses on improving the quality of health care. NQF embodies a three-part mission setting goals to promote educational and outreach programs, performance improvement and to endorse standards for measuring and reporting on performance. Its members include certification bodies, nurses, hospitals, purchasers, physicians and fellow quality improvement organizations.
Picture Archiving and Communication System (PACS)
PACS is a medical imaging technology focused on providing economical storage and convenient access to images from various modalities. It allows healthcare firms to capture, view, share and store all types of images internally and externally. The universal format for PACS image storage and transfer is DICOM.
Patient Protection and Affordable Care Act (PPACA)
PPACA (also known as Affordable Care Act) is US health care reform legislation. Since the passage of Medicare and Medicaid, PPACA represents the most significant regulatory overhaul of the US healthcare system. The act puts in place comprehensive health insurance reforms that have improved access, quality and affordability in health care for Americans. It enables hospitals and primary physicians transform their practices financially, clinically and technologically to drive better health outcomes.
Personal Health Information (PHI)
PHI refers to demographic information, test and laboratory results, insurance information, medical history and other data collected by healthcare professionals for identifying an individual and determining appropriate care.
Physician Quality Reporting System (PQRS)
PQRS is a US-based voluntary CMS Quality Program, encouraging group practices and health care professionals to report information on health care practices. It gives healthcare professionals the opportunity to assess the quality of care they offer to their patients, ensuring patients get the appropriate care at the right time.
Practice Management Software (PMS)
A category of healthcare software, PMS deals with the day-to-day operations of a medical practise. It allows users to capture patient demographics, maintain lists of insurance payors, perform billing tasks, schedule appointments and generate reports. PMS is often connected to EMR systems and is used for is used for administrative and financial matters.
Population health is defined as the health outcomes of a group of individuals, including the distribution of such outcomes within the group. It aims to improve the health of an entire human population by reducing disparities in health among different population groups.
Predictive analytics in healthcare makes use of technology and statistical methods to scan through massive amounts of data, analyzing it to predict outcomes for individual patients. It also helps reveal surprising associations in data that human brains would never suspect. Furthermore, it increases the accuracy of diagnoses, providing physicians with answers they seek for individual patients.
Radiology Information Systems (RIS)
Radiology information systems (RIS) are networked software systems that are utilized to manipulate, track, and distribute patient data and imagery. The basic functions of RIS include patient management, scheduling, patient tracking, results reporting, image tracking and billing.
Wearables in healthcare are gadgets which help people track medically useful information. In remote monitoring scenarios, wearable health technologies help in detecting serious medical conditions in early stages. The most popular wearable technologies in use include Smart watches, Smart-Eyewear, Fitness trackers, Head-mounted displays, implantables and health wear devices.
X12 is a US-based standards organization, established for the maintenance and development of Electronic Data Interchange (EDI) standards. Its membership portfolio includes 3,000 standards experts including technologists and business process experts from various fields such as insurance, transportation, healthcare, government, supply chain, finance and other industries.
According to a recent report published by Accenture, only 2% of the patients are actively using the mobile health apps offered by largest US hospitals. The report further estimates that these hospitals could lose more than $100 million in annual revenue if they fail to align healthcare mobile apps to the services consumer’s demand.
Among the 100 largest U.S. hospitals, which are assessed for the mobile app usage, the research found that two-thirds (66%) of these hospitals offer patients mobile health applications and approximately, two-fifths (38%) of that subset developed in-house apps for its consumers.However, many of these mobile applications have failed to win over more patients, owing to the non-alignment of their functions with respect to the user experience. For example, only 11% of the mobile health apps offer at least one of the three most desired functions, the consumers expect which include the ability to book, change and cancel appointments; access to medical records; and ability to request prescription refills. Further, the report found that about 7% of patients have switched healthcare providers because of poor experiences with online customer service channels such as web chat and mobile apps.
Accenture suggested that healthcare providers will likely see higher switching rates in future as the service expectations from the consumers will be high. The switching rates are likely to be on par with the cable TV providers (11%), mobile phone industry (9%), or even retail (30%).
The researchers analyzed both the mobile health apps that are being offered by the hospitals as well as independent digital health disruptors such as ZocDoc, WebMD and Good Rx, through iTunes app stores and Google Play. The report further suggests a way for the hospitals to improve the customer experience which is to partner with digital disruptors to create mobile platforms aimed at specific patient demands. It also suggests the hospitals to build in house solutions as the pace and size of the mobile health technology is expected to grow faster and larger.
As there is a pressing need for interoperability, the HIE’s are coming to the aid of the clinicians to help in avoiding productivity-sapping phone calls and faxes while meeting the requirements of the ever talked about meaningful use requirements.
What calls for the need of HIE’s?
• When EHR integration is not present
• When responding to business pressures such as accountable care has to be essential
• When streamlining the workflow
• When integrating the Healthcare Enterprise’s EHR-to-EHR integration
• When Direct secure messaging connectivity built into meaningful use-compliant EHR software
HIE’s connects a wide range of hospitals, clinics and physician practices. An example of this is the Keystone Health Information Exchange that connects 20 hospitals, 239 physician practices, and 30 home health locations primarily located in 31 counties in central, northern, and northeastern Pennsylvania, as well as 69 long-term care facilities spread throughout the state.
Read the full story here: http://healthleadersmedia.com/content/TEC-320613/How-HIEs-are-Becoming-Essential-to-Clinicians
This is an era of transforming the healthcare industry the digital way. This is an era where Providers and Developers are looking at developing technologies that try to minimize the costs & improve the overall efficiency in delivering patient care.
Telehealth is one such technology that can aid in better patient engagement and improved and enhanced care. However, does it substitute for the care that can be provided in the Hospital? Many believe that there could be a possibility of vital symptoms and signs of the patient going unnoticed due to the mediums used for communication with the patient. A recent study proves otherwise.
Researchers at Vanderbilt University and the Department of Veterans Affairs Medical Center in Nashville evaluated data collected between May 2014 and June 2014 from 23 veterans. These veterans were seen three times after an operation. One visit was conducted via video, the second over the telephone and the third visit was in-person.
69% of the veterans had also given their preference for Telehealth rather than a Hospital visit owing to the long distances between the patients home and hospitals. If Telehealth is used accurately and in the interest of the patient it could be of great help to both the providers and patients.
Read more on: http://www.healthcareitnews.com/news/telehealth-shines-post-surgery-care-us-veterans
- Exchanging protected health information (PHI): It is the foremost requirement for HIPAA. If the application has any chance of storing, collecting, managing or transmitting PHI, it is imperative that it conforms the HIPAA regulatory compliance.
- The channels used for sending the information should be secure: HIPAA regulations were being mandated with a sole aim of protecting patient information. E-mail that are not compliant with HIPAA lack the encryption ability for the content it contains. It is hence important to understand the content categories that should be strictly avoided as a part of such mails. In such cases, it is a safer bet to send such communication through a HIPAA compliant e-mail service provider.
- PHI should not be sent over push notifications: Push notifications usually appear on mobile phones and can be viewed by anyone even while the phone is locked. It is hence critical to ensure that any information which falls in the category of PHI is not used for push notification for mobile phones.
- Your app could fall under the category of a medical device: Mobile applications that deal with PHI can also be classified as “medical devices”. Such medical devices need to be compliant to FDA regulations, apart from HIPAA mandates.