Glossary

 

The following are medical and computer terms used in this book with their definitions. Terms specific to this book begin with the phrase, "In this book, . . ."

abnormal:  A description for diagnostic findings, including clinical laboratory test results, meaning deviating from the normal. See “diagnostic findings”.

access to care:  The  ability of the patient to obtain the type of care needed at the time necessary.

access:  To store or retrieve data from a storage device such as a disk or magnetic tape. To provide the capability to initiate an automated service on a system.

ACR/NEMA:  American College of Radiology and the National Electrical Manufacturers Association. This relationship was formed in 1982 to develop the DICOM standard for medical imaging. See “DICOM”.

actionable information:   Data that can be used by its receiver to immediately analyze and resolve a problem.

active window:  A window is a rectangular box on the screen. The active window is the one currently being used, which appears on top of other windows.

activities of daily living:  Activities usually performed in the course of a normal day of a person to meet basic needs, such as eating, toileting, dressing, bathing, teeth brushing and grooming. While a patient is in the hospital, nurses are responsible for insuring they occur.

activity:  See “care activity”.

acuity:  Intensity of nursing care required to meet the needs of a patient; higher acuity usually requires longer and more frequent nurse visits and more supplies and equipment.

acupuncture:  A technique that relies on piercing parts of the body with needles to treat disease or relieve pain.

acute care:  Short term care, as opposed to long-term, “chronic”, care.

acute illness:  Illness characterized by symptoms that are of relatively short duration, are usually severe, and affect the functioning of the patient in all dimensions; not “chronic”.

addendum:  An appendage to an existing document that contains supplemental information. The parent document remains in place and its content is altered by the addendum. For example, a clarification or correction to an interpretation of an anatomic pathology specimen might produce an addendum.

administration of medication:  The process whereby a prescribed medication is given to a patient by one of several routes—oral, inhalation, topical or parenteral.

admission:  The formal acceptance by a hospital of a patient who is to be provided room, board, and continuous nursing services in an area of the hospital where patients generally stay at least overnight.

admitting diagnosis:  A statement of the provisional condition given as the basis for admission to the hospital for study.

admitting physician:  The physician who admits the patient to the hospital.

ADT (admission, discharge and transfer system):  A clinical system for recording admissions to a hospital, discharges from a hospital and transfers within a hospital and maintains the hospital census.

advance directive:  Written instructions a patient has prepared for medical personnel to inform them of the patient’s wishes for treatments and care when the patient is incapacitated, especially regarding life-sustaining treatment if the patient’s condition becomes irreversible. An advance directive is a legal document prepared when the individual is competent and able to make decisions.

advice nurse:   A nurse who takes patient phone calls and advises the patient on medical conditions according to protocol;  the advice nurse informs the patient when self care is appropriate and when a patient needs to come in and when the patient does not.

Agency for Health Care Policy and Research (AHCPR):  An agency of the U.S. Department of Health and Human Services whose mission is to enhance the quality, appropriateness, and effectiveness of health care services and access to these services. AHCPR has developed clinical practice guidelines based upon “evidence-based medicine”.

agent:  In this book, a way of categorizing and separating out a set of code and tables, interfaces between systems, databases, and user interfaces (possibly all spread across a number of different software systems), and administrative and operational procedures of employees implementing a business policy, so that the business policy could be implemented and changed by the people responsible for the business policy instead of relying totally on technical staff to do so.

aggregation:  For databases, a relationship where one entity (engine) is “a part of” another entity (e.g., car).

AHCPR clinical practice guidelines (AHCPR National Guideline Database):  A set of clinical practice guides for various diseases available on-line on the Internet. Each set of guidelines has several versions:  Clinical Practice Guidelines, Quick Reference Guides for Clinicians, and Consumer Guides. Examples of conditions for which there are guidelines are “acute pain management”, “urinary incontinence”, and “pressure ulcers in adults”.

alarm:  A notification message for an abnormal result, panic result, or other result of a caregiver order that the caregiver wants to be notified about.

alert:  A notification message describing a patient put in by one caregiver to later inform other caregivers.  More urgent messages are alerts and less urgent messages are reminders.

algorithm:  A generic procedure consisting of a finite sequence of well-defined steps (instructions) for producing one or more outputs from a set of inputs. For example, a set of instructions on how to generically draw a graph with its axes on the screen.

allergy:  A state of hypersensitivity induced by exposure to a particular antigen (allergen) resulting in harmful immunologic reactions on subsequent exposure.

alliance organizations:  Healthcare organizations that HMOs contract with to share hospital space or medical office facilities.

alternate delivery systems:  Health services provided as a less expensive substitute for care as an inpatient in a hospital. Examples within general health services include skilled and intermediary nursing facilities, hospice programs, and home health care.

alternative medicine:  Acupuncture, naturopathy, care given by chiropractors or osteopaths, and other approaches to medical diagnosis and therapy that have not been developed by use of generally accepted scientific methods. Also called “complementary medicine”.

ambiguous allergy:  An allergy that is not clear cut (e.g., the allergy is not confirmed, the benefit of the substance causing the allergy outweighs its allergic side effects, the substance causing the allergic reaction only causes the reaction some of the time).

American Medical Association (AMA):  A partnership of physicians and their professional associations dedicated to promoting the art and science of medicine and the betterment of public health.

ANSI (American National Standards Institute):  A group that publishes many computing standards. The U.S. representative is the ISO (International Standards Organization).  For example, ANSI has standards for COBOL and C.

ANSI ASC X12N:  A federally mandated EDI format to be used by providers and payers who electronically transmit claims and related transactions to the federal government.  ASC stands for Accredited Standards Committee.  The mandated version of ANSI ASC X12N is Version 4010.

ANSI Health Informatics Standards Planning Panel (HISPP):  The primary organization working to coordinate healthcare standards being developed by other standard development organizations

analog:  A flow of information where things change smoothly and have an infinite number of values, as opposed to “digital”.

analysis:  The determination of the total effects of any addition, change or deletion to a project to the other aspects of the project (e.g., requiring a user to remember a status code could divert the caregiver’s attention away from patient care).

analytic disease prediction:  In this book, disease prediction based upon a patient having a known risk factor for a disease (e.g., smoking increasing the risk of lung cancer, a severe knee injury increasing the risk of osteoarthritis and knee replacement, the presence of the BRCA1 or BRCA2 genes increasing the risk of breast cancer) or protective factors against that disease. Analytic disease prediction is based upon analytic epidemiology studies. See “disease prediction”, “risk factor” and “analytic epidemiology”.

analytic epidemiology:  A branch of epidemiology identifying the causations of diseases, also referred to as etiology.  See “etiology”.

anatomic pathology:  An ancillary department that determines if tissues are in fact abnormal or diseased. Anatomic pathology deals with wet specimens, tissues, anything out of the body (a piece of bone, skin tissue, muscle, blood vessel, bullet). Anatomic pathology includes surgical pathology, cytology (study of cells), histology (microscopic structure of tissues) and autopsy (multiple body parts). Cytology deals with smears: vaginal, sputum, semen--fluids with cellular material.

ancillary department:  Departments providing services for patients or services for departments providing direct medical care. For example, this may include the following: laboratory, x-ray, physical therapy, injections, pharmacy, optical sales and hearing center.

Andover Working Group for Interoperability:   A group of companies formed to build upon healthcare standards set up by the Hewlett-Packard Company. The principal standards supported are HL7, DICOM, ASTM for clinical lab data interchange, EDIFACT for healthcare data interchange, HTML for information on the Internet, and IEEE P1073 for medical device communication with computer systems.

angiography:  X-ray with contrast material injected into blood showing arteries and veins.

application:  A set of files (or databases), programs, equipment, and procedures to support a set of related functions suited to the user’s organizational needs. Such functions may be related to a business, entertainment, science or engineering organizational need.

application database: Any database that is not meant to be used by all automated systems in an organization, containing data specific to a single automated system or to a set of related automated systems. See “corporate database”.

application service provider:  “A company that offers individuals or enterprises access over the Internet to application and related services that would otherwise have to be located in their own personal or enterprise computers . . . on a rental, pay-as-you-use basis.” (From http://www.whatis.com/ .

appointment:  A scheduled outpatient meeting between a patient and a caregiver. Also, sometimes patients are also scheduled with a room, equipment, a class, etc. Making appointments minimizes wait time for patients and optimizes utilization of resources.

appointment clerk:  A person who takes member phone calls and who may schedule an appointment.

arbitration:  A dispute resolution process involving a hearing outside of court. The arbitrators, who are supposed to be neutral, hear a complaint and resolve the dispute. The resolution is final and binding to all parties.

architecture:  See “system architecture”.

archive:  Archiving is the process of long-term storage and organization of data and documents. An archive is an off-line storage of patient data or other information, in a way that ensures the possibility to restore them on-line when needed.

Arden Syntax:  Standards for defining and sharing medical knowledge bases

aspects:  Modular units of code that describe a recurring property within a software system that can be defined once and used wherever needed in the software system, possibly in different objects, applications, or computer systems.

aspect-oriented programming:  A programming paradigm providing modular units of code called aspects that can be used across objects, applications or computer systems.

ASCII:  American Standard Code for Information Exchange:  ASCII is a 7 bit code with an 8th bit used for parity (ISO-7 code) used for defining displayable and non-displayable characters.

assessment:   A clinician’s interpretation of the subjective and objective findings, including any tests, x-rays or procedures that are performed and thus an appraisal or evaluation of a patient’s condition, based upon clinical and laboratory data, medical history, and the patient’s account of symptoms.

association:  For databases, a relationship existing between instances of entities (e.g., a company has a number of offices, a person works for a company).

association class:  Data to describe a formal association (e.g., to describe a contract between an employee and employer).

ASTM (the American Society for Testing and Materials):  A not-for-profit organization that provides a forum for members of various groups to meet on common ground and write standards for materials, products, systems and services.

ASTM E1384:  ASTM standards for the content and structure of the Computer-Based Patient Record.

ASTM’s E31.12 Subcommittee:  An ASTM group meeting on standards for healthcare.

asynchronous communication:   Irregularly timed communication where each character is sent independently. Synchronization of the clock of the receiver generally is achieved by adding start and/or stop bits to each character transmitted. See “synchronous”.

Asynchronous Transfer Mode (ATM):  A standard for a packet-switched broadband network architecture that allows data, voice and multimedia transmission on the same line.

attending physician:  A physician directly responsible for the care of an inpatient.

audit:  An official examination and methodical review of the medical record in all aspects of medical care, based upon established standards, usually done by trained medical staff unaffiliated with the healthcare organization.

audit trail:   Computerized recording of transactions, the resources, or medical records, that were accessed and the identity of the user.

authentication:   (1)  computer science: In a computer system or network, the process of verifying that a person, organization, process or device seeking access to a computer system or network is who or what it claims to be; authorization of a person signing on to a system is often done at the time the person enters a user name and password. (2) medicine: Proof of authorship of a medical record entry, such as by a “digital signature”.

authorization:  (1) computer science: In a computer system or network, the determination by a security service of what access rights, if any, a person, organization, process or device seeking access has to a given device, application, process or information resource; (2) medicine: To use or disclose health information.

automated patient medical record:  Patient medical records available over a network.

automated speech recognition (ASR) access:  Access to computers through hardware and software to support interpretation of human speech into text. Same technology as “interactive voice recognition (IVR)”.

back up:  The process of copying important software, data or documents onto some other media (magnetic tape, floppy disks, etc.) to guard against its loss should anything happen to the original. 

Balanced Scorecard: A management technique for measuring the future financial health of an organization or the financial benefits of a  project. It does this by not only using financial figures to predict the future, but also by looking at positive aspects of an organization that would predict the financial health of the organization in the future.

bandwidth:  The amount of information that can be handled by a device or system, usually measured in baud rate or bps. Also the range of frequencies that can be passed through a communication channel.

bar code:  An array of rectangular marks and spaces in a predetermined pattern. Usually used for automatic product identification.

batch processing:  A mode of data processing where programs are put into queues to be processed off-line and where there is no user interaction.

baud:  When transmitting data, the number of times the medium’s “state” changes per second. A 2400 baud modem changes the signal it sends on the phone line 2400 times per second. Since each change in state can correspond to multiple bits, the actual bit rate of data may exceed the baud rate.

benefits:  The services payable under a specific payer plan.

benign:  Not malignant; not recurrent; favorable for recovery.

best practice guideline:  A guideline for treating a medical condition that is based upon the best current scientific research, that produces the best outcome.

binary number:  A number expressed in base 2. Internally, it is shown as a series of 1’s and/or 0’s and internally in the computer as on or off switches.

biometrics:  The utilization of an anatomical or behavioral characteristic in order to verify the identity of an individual;  an “authentication” technique.

bit:  Short for “binary digit”. A 0 or 1, on or off.  Computers use bits in combination to represent data, numbers, characters.

bitmap:  A pattern consisting of rows and columns of dots, or bits in memory, that correspond to pixels on a screen. 

black box: With regard to computer software systems, everything seen by the users of the system.  "Black box" is often used to describe testing, where "black box" testing is done without a knowledge of the internal workings of the system. See "white box" and "internal workings".

bps (bits per second):  The speed at which bits are transmitted over a communications medium. This speed may exceed the baud rate.

blood pressure:  The pressure exerted by the circulating volume of blood on the walls of the arteries, veins, and chambers of the heart. Systolic pressure is the highest level of blood pressure, which is the pressure exerted in the aorta and large arteries during systolic contraction of the left ventricle. Diastolic pressure is the minimum level of blood pressure, which occurs between contractions of the heart. A typical value for a young adult is 120 mm Hg during systole and 70 mm Hg during diastole.

board-certified:  A physician or other healthcare professional who has passed a test given by their national specialty organization.

body surface area:  The total area of skin on the entire or a particular part of the body, which is sometimes used in determining dosages of medications. Formulas exist based upon sex, height, weight, build. Body surface area is important in determining pediatric dosages, in determining the extent of burns and in determining radiation doses.

book:  The act of making an appointment and recording it in a schedule.

border:  A box around an object on a screen to mark its boundary.

bottleneck:  A system component that limits the performance of an automated system. Such components include disk subsystems, memory, CPU’s/processors, networks, buses, operating systems, databases, and transaction or application software.

brand-name:  See “trade-name”.

broadband:  Transmission facilities with a bandwidth greater than those for voice grade facilities.

broadness:   In this book, a description for a software system that is built to handle initial automation as well as the current non-automated environment.

browser:  A tool that provides an Internet Web user interface to access HTML pages.

business analysis: A process which identifies the changes to be accomplished by a project or phase in terms of a mission, objectives and business requirements for the project or phase.

business policy:  A policy to be applied throughout an organization via changes to workflows, systems and data kept for organizational business reasons.

business process reengineering (BPR):  Means the same thing as reengineering.

business requirement:  A required characteristic of an organization at the end of a project.

button:  In a graphical user interface (GUI), an object on the screen that the user can select, either by a mouse click or by an equivalent keyboard operation, sending a command to an application to trigger a specified action such as the start of a particular process.

byte:  Eight bits forming a meaningful unit. It may represent an ASCII character or some other coded meaning to the computer. A computer’s memory size is measured in megabytes where 1 megabyte is equal to 1,048,576 bytes.

C:  A programming language developed in 1972 by Dennis Richie and Brian Kernighan of AT&T.

C++:  An object-oriented extension of the C language developed by Bjarne Stroustrup of AT&T - Bell Labs.

calibration:   The set of operations that establish, under specified conditions, the relationship between values indicated by a measuring instrument or measuring system, or values represented by a material measure or a reference material, and the corresponding values of a quantity realized by a reference standard.

call center:  A bank of telephones in a managed care healthcare organization with appointment clerks and advice nurses who together (1) make appointments for the member, (2) give the member advice on medical care based upon protocols, including when self care is appropriate and when the patient should come in, and (3) connect the member with medical resources, including physicians and patient education.

capitation:  The payment of premiums or dues directly to the provider organization in the form of fixed periodic payment for comprehensive care, set in advance.

capture (data):  The recording of data on a form or its entry into a computer.

care activity:   Specific tasks to be performed (that one “does”) in the care of a patient to arrive at a specific outcome in a clinical pathway.

caregiver:  A healthcare organization employee in any way, directly or indirectly, providing care for a patient.

caregiver messaging system:   A system to enable communication between caregivers for care of the patient using e-mail messages that includes the ability to identify a patient associated with the message and to include the message in the patient’s medical record.

care management: Aggregates encounters and other events into episodes for a particular occurrence of a medical condition, possibly across care settings, rather than just focusing on a single encounter or event of an illness or injury.

care plan:  A written framework that provides the direction of care for a patient.

care, primary:  See “primary care”.

care, secondary medical:  Medical care of a patient by a physician acting as a consultant. The physician providing primary care usually refers the patient for this care.

care team:  A group of caregivers who jointly care for patients. Care teams may be defined for one or all of the  following reasons:  (1) to identify nurse practitioners or physicians assistants who are supervised by a particular physician, (2) to identify other caregivers working with or supervised by the physician, (3) to identify to whom to send diagnostic test results if the ordering caregiver is unavailable, (4) to identify to whom to send clinical messages or e-mail if the recipient is not available, or (5) to identify physicians who will back up a physician if the latter physician is unavailable.

Cascading Style Sheets:  Tags within HTML that create templates to control different aspects the HTML page's layout, including text font-faces, text line-heights, text styles (like bolding and italics), colors, and margins.  

case:  One instance of case management for a particular patient. A case is often assigned to a case manager.

case management:  An organized system for delivering health care to an individual that  includes assessment and development of a plan of care, coordination of services, referrals and follow-ups.

case manager:  A person specifically assigned to oversee the case management of an individual for a particular case.

case notes:  A set of notes developed by a case manager for a particular case.

CD-ROM:  A term referring to storage of information on a CD (compact disc) using ROM (read-only-memory) format.

certified nurse-midwife:  A healthcare practitioner who is educated, and who has acquired a national certification and a license within a state, in the two disciplines of nursing and midwifery.

certified registered nurse anesthetist:  A registered nurse with training and certification in anesthesiology, who may substitute for an anesthesiologist in many surgical procedures.

change:  In this book, in the context of a project, a modification in the way an agreement, workflow or automated system is implemented when the implementation matches the documentation of the implementation.  See “error”.

change control board:  A group responsible for reviewing changes to controlled documents during a project.

change control process:  A defined process to insure that important documents on which a project depends are not changed without careful consideration. Often a change control board is set up to agree upon or reject changes to these “controlled documents”. See “controlled document”.

character: Any symbol, letter, digit, or punctuation mark that can be typed on a keyboard.

character-based terminal:  A type of data terminal that displays only alphanumeric or text characters

chart:  See “medical record”.

charting by exception:  A charting methodology in which data is entered only when there is an exception from what is normal, from what is expected or from what was previously recorded. Reduces time spent documenting.

chart room:  A location storing patient medical records.

check box:  A box where a pointing device can be put and with a button press a check mark can be entered or removed. A check sets an option. Where there are other check boxes, these check boxes remain as is. Compare this to a “radio button”, where selecting one radio button turns another off.

checkpoint/restart:  A technique associated with transactions where the state of the database is recorded at the start of a transaction, and if the transaction should abnormally terminate, then the database would be restored to that state.

chief complaint:  The primary reason a patient is coming in for medical care.

chiropractor:  A medical professional who treats disease based on the theory that disease is caused by interference with nerve function, and uses manipulation of the joints and the spine to restore normal function.

chronic condition:  A condition that lasts a long time, or recurs frequently, and can be treated but not eradicated;  opposite of  “acute illness”.

chronic disease:  Illness that persists over a long period of time and affects the physical, emotional, intellectual, social and spiritual functioning of the patient.

chronic disease management case:  A case to track a patient who is being treated for a chronic condition over many encounters where there is likely to be long term continuing care.

CICS (IBM Corporation’s Customer Information Control System):  A widely used teleprocessing monitor (transaction processing system) for online application systems found on IBM mainframes.

client:  A client process in a client-server architecture. A client is any computer that issues processing request to a server.

client-server architecture:  A network configuration in which decentralized client processes request services from centralized server processes.

clinical:   Pertaining to a clinic or to the bedside; pertaining to or founded on actual observation and treatment of patients, as distinguished from theoretical or basic sciences.

clinical checking:   Checking for patient drug allergies and for drug/drug, drug/food, drug/laboratory and other interactions.

clinical data repository (CDR):   A database that combines clinical data related to a patient from various healthcare organization clinical systems. Example information is patient demographics, radiology data, laboratory data, medications, physician orders and H&P’s. (In an automated patient medical record system, this is a portion of the information in the automated patient medical record.)

clinical epidemiology:  The use of epidemiology in direct patient care.

clinical information:  Data contained in the patient record. Information may also include summary information such as found in CPR repositories:  significant health problems, lab results, current medications, etc.

clinical laboratory:   Health care professionals who perform a variety of laboratory tests that contribute to the diagnosis and treatment of disease.  Areas covered by the clinical laboratory include hematology, clinical chemistry, immunology, immunohematology, and microbiology

clinical laboratory information system:  A clinical system that manages clinical laboratory data to support laboratory management, laboratory data collection and processing.

clinical pathway:  A structured way to identify care activities and caregiver work flow needed to care for a patient with a particular condition or disease. Paths through a clinical pathway can be adjusted for the particular needs of an individual patient. Also, clinical pathways for separate diseases can be combined into one clinical pathway.

clinical practice guidelines:  Parameters related to a specific disease or medical condition that help clinicians make clinical decisions.

clinical record:  See “medical record”.

clinical social worker (CSW): A person who possesses a master’s or doctor’s degree in social work, has performed at least two years of supervised clinical social work, and either: is licensed or certified as a clinical social worker by the State in which the services are performed, or in the case of an individual in a State that does not provide for licensure or certification, has completed at least 2 years or 3,000 hours of post master’s degree supervised clinical social work practice under the supervision of a master’s level social worker in an appropriate setting such as a hospital, SNF, or clinic.

clinical summary:  A summary of clinical information about a patient, which may include demographics information, significant health problems, past encounters, primary care physicians and other significant caregivers, and medications.

clinical system:  Information system that manages clinical data to support patient care and clinical decision making. 

clinical trial:  A scientifically rigorous investigation of new methods, materials such as medications, or procedures in the treatment of a particular disease or condition.

clinician:  Someone who sees, evaluates, and treats patients, especially a physician, nurse practitioner, or physician assistant.

cluster:  A group of computers working together to share resources or workload.

clustering:  The use of clusters.

code:  The programming content of any application.

coding scheme:  A method of replacing each member of a vocabulary of names (such as a patient problem or diagnosis) by a number or “mnemonic”.

column:  All the values from multiple rows in a database table corresponding to a particular data element in the table.

Common Gateway Interface (CGI) processing:  A protocol that enables a web server to pass a web user’s request to an application program and to receive data to forward back to the user. For example, a program using CGI can read and write data files and produce different results each time (whereas a Web server by itself can only read data files).

communicable disease:  Any disease that can be transmitted from one person or animal to another by direct or indirect contact.

communications protocol:  Communications standards that identify how two computers coordinate the exchange of data.

community-based charts:  When multiple facilities of a healthcare organization share the same set of paper patient medical records.

co-morbidity:  An accompanying illness or disease that coexists with an already established medical diagnosis.

compiler:  A program that translates programs written in a higher level language such as COBOL, C or C++, into code that a computer can execute. Compiled programs run faster than interpreted programs, such as those written in Java.  See “interpreter”.

complaint:  A reason a patient is coming in for medical care.

complementary medicine:  See “alternative medicine”.

component adaptability: The use of various strategies to procure, develop or structure a system or component of a system so that the system or component can more easily be replaced in the future by another equivalent system or component.

compression:  An algorithm to transform and compact text or image data to minimize storage requirements or transmission time.

computed radiography:  X-ray images captured in a computer,  instead of on film.

computer:  A device capable of accepting data, manipulating it in a prescribed way, and displaying or storing the results where it is instructed.

computer language:  The vocabulary and syntax of a set of symbols that may be used to tell a computer what it is to do.

computer-based patient record (CPR):  An electronic patient record.

Computer-based Patient Record Institute (CPRI):  An organization whose primary purpose is to promote automation of the patient chart

computer telephony integration (CTI):  Systems to enable a computer to act as a call center, accepting incoming calls and routing them to the appropriate device or person.

conceptual view:  Models of systems, workflows, etc. which are vehicles for communication and for critique.

concurrency:  (1) medicine: Multiple caregiver access to a patient’s medical record, which may be for the same encounter, with possibly more than one update occurring at the same time. (2) computer science: In database processing, the situation wherein multiple processes access the same database record at the same time for various database functions, which may include reading, updating, deleting, etc. In either case, concurrency rules must insure no loss or corruption of the data.

concurrent review:  The investigation of patient care while it is in progress, with the intention of modifying that care if appropriate and determining if continued treatment is medically necessary.

conditional order:  A type of medication where the medication is given based upon a condition occurring (e.g., the patient experiences pain).

conditional treatment case:   In this book, a case developed by a primary care physician, urgent care physician, nurse practitioner, or advice nurse that may be later used to generate a treatment case, or may later be dispensed with.

confidentiality:  The act of limiting disclosure of private matters; maintaining the trust that an individual has placed in one who has been entrusted with private matters;  not disclosing information about a patient that is considered to be privileged and cannot be disclosed to a third party without the patient’s consent.

consent:  The agreement of an individual for a given action relative to the individual. This may be consent for treatment, special procedures, release of information, and advance directives. “Expressed consent” is written; “implied consent” is an action other than an expressed consent on the part of a patient that demonstrates consent; while “informed consent” is freely given consent that follows a careful explanation by a caregiver.

consultation:   Process in which the help of a specialist is sought to provide advice or care for a patient. A request for a consultation is often accompanied by a referral; see “referral” and “referral letter”.

content facilitator:

contingency plan:  Plan of action to minimize or negate the adverse effects of a risk should it occur.

continuity of care:  The coordination of care received by a patient over time by possibly given by multiple caregivers.

contraindication:  Any condition, especially any condition of disease, which renders some particular line of treatment improper or undesirable.

control:  An item that may appear within a window to allow the user to control the window. These include list boxes, input fields, buttons, check boxes, radio buttons, and others.

control chart:  A control chart is a graph of data used in statistical process control that incorporates statistical content- a mean (average) and upper and lower statistical thresholds (control limits), to guide interpretation and decision-making of the data. A “trend document” is a form of control chart. See “trend document”.

controlled document:  An important document created during a project that can not be changed without approval of a change control board within a change control process. Examples of such documents are documents to record project objectives and goals, business requirements, workflow requirements, system requirements, program specifications, user documentation. See “change control process”.

controlled substance:  A drug whose distribution and use is controlled by federal and/or state government regulation.  Controlled substances, which may include narcotics, stimulants and sedatives, are divided into five classes called schedule I through schedule V. See “schedule I through V drugs”.

cooperative business objects (CBOs):  Real world “business objects” used in a GUI interface of a computer system that are relatively independent from each other.

cooperative editing systems:  Multi-user systems where the actions of one user are instantaneously propagated to all the other participating users.

coordination of care:  Methods to assist caregivers in coordinating their care of a patient.

copayment:  Fixed dollar payments a patient makes per visit or prescription filled.

copy:  (1) To copy information and keep it so you can paste it somewhere else on the screen. (2) To make an exact copy of a file so you can place the duplicate in another location.

corporate database:  A database sharing data across many systems in an organization to avoid redundant entrance of information and to insure that data in the organization is in a consistent format. See “application database”.

co-sign:  (1) Verbal medical orders from a physician may be entered and signed by a caregiver other than the physician (e.g.,  a registered nurse, physician assistant, pharmacist, respiratory therapist) but must be later co-signed by the  physician (e.g., within 24 hours). (2)  Medical or nursing students documentation (e.g., a progress note) may be co-signed by an instructor, indicating the instructors agreement with the information and acceptance of responsibility for the documentation.

cost-benefit analysis:  Identification and evaluation of all costs and benefits associated with a particular project.

CPR repository:  In this book, a national database containing a summary of a patient’s clinical information in a format using national or international data standards. Possible information might include patient identification information, a patient problem list, patient practitioners, patient encounters, services (including medications, diagnostic tests,  immunizations, procedures and therapies), assessments/exams, and care plans.

CPT (Physicians’ Current Procedural Terminology):  A system describing medical and surgical procedures in a hierarchical format with six major sections, developed by the American Medical Association. The current version is CPT-4.

CPU (central processing unit):   The part of a computer that controls all the other parts. The CPU fetches instructions from memory and decodes them. This may cause it to transfer data to or from memory or to activate peripherals to perform input or output. Sometimes just called the “processor”.

credentialing:   A system that uses national databases to record or verify a healthcare practitioner’s professional credentials. For example, a credentialing system may (1) verify that a healthcare practitioner has a license to practice, (2) record or verify hospital privileges, (3) verify DEA certification, (4) record board certification, (5) identify sanctions against licensure, and (6) identify Medicare/Medicaid sanctions. 

crisis:  See “panic”.

critical pathway:  See clinical pathway.

cryptographic techniques:  Methods of concealing data by representing each character or group of characters by others.

CT (computed tomography) scan:  A diagnostic test that combines the use of x-rays through the body from multiple angles, the resultant absorption values are analyzed by a computer to produce cross-sectional slices.

cursor:  A flashing line, square, rectangle or other symbol on the screen that moves when you move the mouse or other pointing device and can also be moved around via characters or character combinations entered through the keyboard.

cut:  To remove information but keep it around so you can paste it back somewhere else.

Defense Advanced Research Projects Agency (DARPA):  The U.S. federal government agency that was the originator of the Internet.

data:  Symbols that represent observations; often called raw data to emphasize that they are unprocessed. Data are processed and interpreted to yield “information”.

database:  The collection of permanently stored data used by one or more applications.

database administration:  The tasks necessary to insure data integrity, non-redundancy of data, immediate up-to-dateness of data, integrity of the meaning of data as recorded in data dictionaries, security, and database software installation and upgrades.

database management system (DBMS):  A scheme using “software” and sometimes “hardware” to store and retrieve large quantities of interrelated data by one or many different application programs.

data communication:   The sending, transmission and reception of information between different electronic systems.

data dictionary: A database about data objects in a database, defining the use of each table in the database and the meaning of each row and data element in each table in a database. See “meta-data”.

data element:  The smallest, meaningful piece of information in a business transaction or database. A data element may condense lengthy descriptive information into a short code. Equivalent to a data field in a paper document; a series of data elements are used to build a row in a relational database.

Data Flow Diagrams (DFDs):  A structured analysis tool used to track the flow of data through an entire (business, software or other) system, identify transformations on data, and identify data repositories.

data mining: Discovering useful relationships in data warehouses. See “data warehouse”.

data model:  A model of the logical data content of a system, expressed in terms of entities, relationships and attributes, such as may appear in an entity-relationship diagram.

data warehouse:  A system for storing, retrieving and managing large amounts of data that planners and researchers can use without slowing down the day-to-day operations of the production database.

DEA license:  License allowing a physician to prescribe controlled substances. See “Drug Enforcement Administration (DEA)”.

deadlock:  A situation wherein two or more processes are unable to proceed because each is waiting for one of the others to do something.

decoupling:  Changing systems so they use industry standard connections so that any one system can be replaced by a different one using the same standards without having any effect on any of the other ones.

dedicated line:  A permanent connection with a network.

demand management:  An approach in HMOs to instruct a patient in self care or to “triage” the patient to the appropriate and most cost effective caregiver for the patient’s medical complaint.

descriptive disease prediction:  In this book, a method to predict disease by reviewing the medical records of a large number of persons over a long period of time and identifying those factors either singly or in combination predispose a person to a particular disease. No determination is made as to whether these factors could be used as risk factors for the disease or not. Descriptive disease prediction could be done through a computer program doing pattern matching or using a data warehouse to do on-line analytic processing (OLAP). See “disease prediction”, “on-line analytic processing” and “descriptive epidemiology”.

descriptive epidemiology:  A branch of epidemiology identifying patterns or trends in diseases and injuries.

desktop computer:  A microcomputer using the traditional full-size case, monitor and keyboard that are designed to be used in a stationary “desk-centered” environment. See “portable computer”.

development system:  An automated system used by the programmers, analysts and testers to develop, modify or test the system rather than one used by the organizational users of the system.

(medical) diagnosis (Dx):  Identification of the cause of a patient’s illness or discomfort; identification of a specific disease or pathological process.

DSM-IV (Diagnostic and Statistical Manual of Mental Disorders):  Diagnostic classification systems that allow consistent diagnoses of emotional illnesses published by the American Psychiatric Association.

diagnostic findings:  The results of a diagnostic test. For clinical laboratory tests, diagnostic findings (results) are identified as “normal”, “out-of-range”, “abnormal”, “negative”, “positive”, and “panic” or “crisis”. In general, for results of diagnostic procedures outside of the clinical laboratory, results are “normal”, “abnormal”, “negative” or “positive”. Some results, such as x-rays, require interpretation by an expert to get the results and this description.

diagnostic image:  A number of technologies producing images of the internal body including (1) x-rays, (2) fluoroscopy, (3) nuclear medicine, (4) angiography, (5) ultrasound (ultrasonography), (6) interventional radiology, (7) computed tomography, (8) magnetic resonance imaging (MRI) and (9) computed radiography.

diagnostic related group (DRG): A way of classifying patients for government reimbursement and sometimes to establish an initial care plan. Classification is based upon the following:  primary and secondary diagnoses, primary and secondary procedures, and length of stay.

diagnostic tests:  Clinical laboratory tests and other diagnostic procedures.

dialog box:  A window that a GUI program displays to prompt a reply from a user. The dialogue box could consist of multiple controls, which may include list boxes, input fields, buttons, check boxes, radio buttons, etc. See “modal dialog box” and “modeless dialog box”.

differential diagnosis:  Identification of a disease by comparison of the symptoms of two or more similar diseases.

DICOM (Digital Imaging and Communications in Medicine):  A standard that has been developed by ACR/NEMA to meet the needs of manufacturers and users of medical imaging equipment for interconnection of devices on standard networks. The current version is DICOM-3.

digital:  Information represented as discrete numeric values, such as 0 or 1, as opposed to analog.  See “analog”.

digital signature:  Cryptographic data that undeniably identifies a message with its sender.

dimmed:  A menu option that a user can see but not choose. Dimmed items are usually shown in gray letters instead of black.

direct cause disease prediction:  In this book, a theoretical approach to disease prediction where the total of a person’s genetics and significant environmental factors are recorded enabling prediction of future diseases based upon analytic epidemiology studies. See “disease prediction” and “analytic epidemiology”.

directory:   A listing of all the file names and subdirectories that are available on a computer system or on computers in a network.

discharge:  Termination of a period of inpatient hospitalization through the formal release of the inpatient by the hospital; to release from care at a medical care facility by a physician or other medical care worker, such as from the hospital or emergency department.

discharge planning:  Set of decisions and activities involved in providing continuity and coordination of care once the patient is discharged from a healthcare facility.

discrete event simulation:  The modeling of a system (e.g., a work flow) as it evolves over time by a representation in which the state variables change instantaneously at separate points in time. These points in time are the ones at which an “event” occurs. The time between events is modeled statistically and the expected total time of the running of the system (the execution of a work flow) can be determined by running the model, randomly selecting time values within constraints, over and over again.

disease:  A pathological condition of the body that presents a group of clinical signs, symptoms and laboratory findings peculiar to it.

disease management:  Identifying populations (patients) with particular acute and chronic diseases, such as diabetes, cancer, coronary artery disease or asthma, and introducing interventions throughout the life cycle of the disease that will both improve the quality of life and lower the costs associated with the disease process.

disease prediction:  In this book, any approach to predicting that a patient will get a disease, or to predicting when a patient will get a disease, when a disease will worsen, or when a treatment decision for a disease will need to be made, most often expressed in terms of the probability of that event happening compared to the probability of that event happening for the general population or for an applicable population group. This book identifies these forms of disease prediction: analytic disease prediction, direct cause disease prediction, descriptive disease prediction, and disease progression analysis.

disease progression analysis:  In this book, determining the probable progression of a disease or progression to developing a disease for a particular patient by measuring a medical value or state for that patient over time that is predictive of the disease and comparing this progression of values or states with other patients who have developed the disease. Measurements could be recorded on a trend document. See “disease prediction” and “trend document”.

disk:  The most common high volume auxiliary storage medium for a computer system. Usually refers to a magnetic disk, but also refers to an optical disk.

disk mirroring:   A method of fault tolerance for information stored on disks that involves writing the same information on two different disks with two different controllers. If one drive is lost or unavailable, the other is still available.

distributed database:  A database that is stored at multiple locations within a network either by partitioning the data or replicating the database.

distributed facility group:  In this book, the set of medical facilities of a healthcare organization handled by a particular computer system that is part of the automated patient medical record system, where the automated patient medical record system consists of a number of distributed computer systems, each in a different geographic location.

distributed systems:   Implementation of a single application system on multiple computer systems at different locations with the systems usually connected by a network.

docking station:  An addition to a portable computer, such as a pen computer, to add capabilities such as an AC power supply, full size monitor, CD-ROM drive, sound card, hard drive, a recharging unit, etc., to make the computer act more like a desk-top computer when it is being used in a designated fixed location.

document: Written, and sometimes pictorial, form of communication that permanently records information relevant to the health care of a patient.

document type definition (DTD): A DTD defines the elements, attributes, entities and rules for creating one or more documents in a markup language (SGML, HTML, or XML).

documentation:  Manuals, online help, README files and other instructions that come with a software package.

document list:  A list of documents in a medical record for an identified patient.

documentation management system:  A system that supports enterprise-wide on-line documentation on an Intranet.  A documentation management system enables enterprise wide creation, controlled access, review and update, routing and management of documents.  

domain:  The set of values allowed for a data element in a given column or for the set of data elements in a group of columns of a relational database.

domain name:   An addressing construct on the Internet network used for identifying and locating computers on the Internet (e.g., “www.whitehouse.gov”), which can be translated by a name server into a numeric IP address. Domain names must be registered through an agency associated with the National Science Foundation (NSF).

dosage:  The determination and regulation of the size, frequency, and number of doses of medication or radiation for a patient.

dose:  A quantity to be administered at one time, such as a specified amount of medication (e.g., 5 g. for 5 grams).

download:  Transferring data or software from a central location to a remote location (e.g., your server or workstation) via a communications link.

drag:  The action of using a mouse or other pointing device to select and move an object on the screen.

drag and drop:  The action of using a mouse or other pointing device to select and move an object, placing it somewhere else on the screen.

drill down:  For tree structured connected document such as hypertext, to go from a higher level down document to a lower level one by selection at the higher level.

drive:  Any device that reads and writes information, such as a hard drive, floppy drive, CD-ROM drive, or tape drive.

drug allergy:  Hypersensitivity to a pharmacological agent, with reactions that could range from those that are very mild (e.g., a rash) to those that very severe.

drug compendium:  A listing of drugs and information about them used by healthcare practitioners who prescribe them. It is used to validate drug orders. It includes both HMO formulary and non-formulary drugs,  enables clinical checking (drug interaction checking) and enables drug costing.

Drug Enforcement Administration (DEA):  U.S. Government agency that is part of the U.S. Department of Justice that enforces drug laws and regulations including regulations concerning the legal manufacture and distribution of controlled substances. See “DEA license”.

drug formulary:  In this book, a listing of all the drugs an HMO recommends, the most effective and least cost ones.  Some managed care organizations charge more for non-formulary drugs, whereas in some managed care organizations non-formulary drugs are not covered at all.

drug interaction:  Interactions of a drug with other drugs, with foods, with laboratory tests, or other interactions.

drug jumping:  Going from physician to physician and/or facility to facility to get a prescribed medication, especially a narcotic or other controlled substance, and especially for a patient who is addicted to that drug.

DTD (Document Type Definition):  See “XML DTD”.

durable medical equipment (DME):  Equipment leased or sold to patients for use in their homes (e.g., wheelchairs, walkers, canes).

durable medical equipment (DME) formulary:  A database that lists and describes all durable medical equipment (DME) offered to patients within a healthcare organization. See “durable medical equipment”.

durable power of attorney for healthcare: See “healthcare proxy”.

DxPlain:   An experimental system of clinical decision support provided by time shared telephone links, which was developed at Harvard University Massachusetts General Hospital in the late 1960s.

EBCDIC:  Extended binary-coded decimal interchange code: A character-coding scheme found mostly in large-scale IBM computers.

E code:  An injury code, sometimes used for an injury registry, with the injury registry being a database for recording injuries from which epidemiological studies can be done.

EDIFACT:  EDI for Administration, Commerce, and Transportation (EDIFACT). An international UN-sponsored EDI standard primarily used in Europe and Asia. An alignment is envisioned between ANSI ASC X12N and EDIFACT EDI standards in the future to create a single EDI standard. The standard is used for the electronic interchange of structured data related to trade in goods and services.

effective:  Producing the intended result.

efficacy:  The ability to produce the desired effect.

efficient:  Serving as an immediate agent in the production of an event.

elective:   Subject to the choice or decision of the patient or physician; applied to procedures that are advantageous to the patient but not urgent.

electrocardiography (ECG or EKG):  ECG is the graphic tracing of the variations in electrical potential of the heart.

electroencephalography (EEG) :  A graphic tracing of the variations in electrical potential of the brain.

electronic clipboard:   A clipboard and a radio controlled pen. A writing tablet is put on the clipboard and any writing on the paper is also recorded through the clipboard. The commercial version of this is the CrossPad made by the Cross Pen Company.

electronic commerce (E-commerce):  The paperless exchange of business information using Electronic Data Interchange (EDI), electronic mail, electronic bulletin boards, electronic funds transfer and other similar technologies.  Also known as ANSI ASC X12N standards in the U.S.

Electronic Data Interchange (EDI):  The computer to computer exchange of business data in a standardized format between Trading Partners.

electronic health record (EHR):  Another term for the automated patient medical record. Health care record stored in electronic format.

electronic medical record (EMR):  Another term for the automated patient medical record. Health care record stored in electronic format.

electronic signature:  A code or symbol that is the electronic equivalent of a written signature can legally substitute for the written signature.

elective admission:  An admission to the hospital that could be medically delayed without endangering the patient, such as for an elective surgery.

eligibility/coverage:  Refers to the period of time a healthcare organization subscriber or dependent is entitled to benefits.

e-mail (electronic mail):  The use of a computer network by individual users to send, store, and receive messages or documents to and from other individuals.

emergency:  The sudden onset of a condition or an accidental injury requiring immediate medical or surgical care. See “prudent layperson standard”.

emergency department (ED):  A hospital area staffed and equipped for the reception and treatment of  persons requiring immediate medical care.

encapsulation:  Hiding data and methods within the object class from outside programmers.

encounter:  A face to face interaction between a patient and a healthcare provider. In some cases this may also include an interaction via a phone call or television if this takes the place of the face to face interaction.  Encounters could include all of the following:  an inpatient stay, outpatient visit, emergency department visit, advice nurse call, a phone call between a patient and a physician, a home health visit, a skilled nursing facility (SNF) visit.

encounter status:  An event that may logically precede, occur during or be a result of an encounter or potential encounter, or a result of a situation causing the encounter not to occur. For example, encounter statuses for an outpatient visit could be patient wait-listed, appointed, appointment canceled, appointment no show, patient registered, in the examination room, visit completed, diagnoses and procedures identified.

encounter synopsis:  A summary of a patient encounter.

encryption:  The transformation of confidential plain text into a cipher text in order to protect it from being read by a third party.

endemic:  Present or usually prevalent in a population or geographical area at all times; said of a disease. This is opposed to “epidemic” and “sporadic”.

end-stage renal disease (ESRD):  A disease of the kidneys that ends up requiring either dialysis or renal replacement.

enterprise management system:  A package of software systems that together manage a distributed computer network, composed of possibly disparate computers, as if the distributed network was a mainframe system.

enterprise scheduling system:  A multi-dimensional healthcare organization scheduling system that schedules patients with caregivers and resources (e.g., patients with caregivers, patients and caregivers with rooms--such as operating rooms, patients and caregivers with classes, patients and caregivers with equipment) and provides information for charging for associated services, for automatic ordering of associated supplies, and for recording caregiver time for the caregiver payroll system.

entity:  Something about which information is stored. An entity might be a tangible item, such as a patient, physician or room. An entity can also be intangible, such as an agent.

entity-relationship (ER) diagrams:  A database analysis diagram that documents business entities about which database information will be stored that shows the relationships that exist between the entities.

entrance “by exception” :  See charting by exception.

epidemic:  Occurring suddenly in numbers clearly in excess of normal expectancy; said especially of infectious diseases but applied also to any disease, injury, or other health-related event occurring in such outbreaks.  This is opposed to “endemic” and “sporadic”.

epidemiology:  Study of the occurrence, distribution, and causes of disease and the application of this study to the control of health problems.

episode:  One or more healthcare services received by an individual during a period of relatively continuous care by healthcare practitioners in relation to a particular clinical problem or situation.

episodic:  Care handled by a single outpatient encounter, possibly including calling back the patient. Also see “acute care”.

error:  In this book, in the context of a project, an inconsistency between how a project agreement, a workflow or an automated system is implemented and how it is documented—the error may either be an error in the implementation or in the documentation. See “change”.

error of commission:  Mistake resulting from overdiagnosis or diagnosing a nonexistent health problem.

error of omission:  Mistake resulting from failure of the caregiver to diagnose a health problem or disease.

essential business practice:  Some aspect of the current environment and systems that must be preserved in a changed environment because it is essential for the proper functioning of the organization.

Ethernet:  A local area network architecture (also known as the IEEE 803.2 standard) developed by the Xerox, Digital and Intel that operates at 10 Mbps and uses the CSMA/CD protocol for media access control. Ethernet is being extended to 100 Mbps. Also, gigabit Ethernets are being considered.

etiology:  A study of the causes of disease. Also see “analytic epidemiology”.

event:   Events are milestones one “sees” in a clinical pathway (e.g., patient has mammogram).  Also, a term used in discrete event simulation to describe an instantaneous occurrence that may change the state of the system (e.g., patient enters waiting room, patient registers, patient comes into the exam room).

evidence-based medicine:  Best treatments and practices for diseases that produce the best outcomes for the least cost as determined by the best scientific evidence.

exclusive searching:  In this book, searching for exact matches but also searching for all synonyms (e.g., a search for “myocardial infarction” would also find occurrences of “heart attack”).

expected outcome:  Expected condition of a patient at the end of therapy or the end of a disease process, including the degree of wellness and the need for continuing care, medications, support, counseling and education.

expert system:  A program that structures knowledge from business experts (such as experts in the medical field on a particular medical condition) to advise other people on how to make decisions based upon that knowledge. For example, an expert system may be created to determine a diagnosis in a specialized medical field based upon patient parameters.

extranet:  An intranet that is open to selective access by outside parties.

face sheet:   A document that is created at the time of a hospital admission that is used to collect information for the admission that includes the name, address, birthdate, contact and other patient demographics information, and may include admitting diagnosis, admitting physician, attending physician, unit, room and bed location and assigned diagnostic related group.

facilitator:  A process facilitator.

facsimile (fax):  The transmission of images, usually over the telephone network. Images are scanned and transmitted on a bit basis over the telephone system and reconstructed at the receiving end.

fail-over recovery:  When the primary server goes down, a backup server automatically takes over.

family history (FH):  Facts about the health of the patient’s parents, siblings, and other blood relatives that might be significant to the patient’s condition. Part of the subjective part of a SOAP note.

family physician:  A primary care physician for all members of a family.

FAQ (frequently asked questions):  A list of the most commonly asked questions with answers that appear in a newsgroup on the Internet or are asked regarding a subject presented at a Web site (e.g., regarding HL7 at the Duke Web site discussing HL7).  At the Web site, these FAQs are usually available via a hypertext selection.

fault tolerant:  Systems that have redundancy built into their components so that component failures do not cause the system to fail. Rather, the system switches processing from a failed component to its backup.

FDA (Federal Drug Administration):  FDA is a federal government public health agency, charged with protecting American consumers by enforcing the Federal Food, Drug, and Cosmetic Act and several related public health laws.

fee for service:  Paid for on the basis of individual services provided (as opposed to a prepayment scheme such as capitation).

field:  A discreet piece of information in a database, such as a first name, last name, street address, city address, state, or zip code. Fields are grouped together to make records or make rows in a table.

file:  A collection of information, stored in terms of records, especially a collection stored on an auxiliary storage medium, with a name for identification of the file.

file name:  An assigned name given to a file to enable the user to retrieve than file by name.

file server:  A server that stores the files for multiple users at other computers in a network.

file sharing:  Allowing multiple end users or application programs to access the same files or databases. In some computer systems, this may include allowing users to access the same file or database at the same time.

filler:  Used in HL7 to mean an application responding to an order or producing results. The ASTM term is a “producer”.

filtering:  A systematic approach to extracting information that a particular person finds important from a larger stream of information.

firewall filtering:  Software and/or dedicated computer system that sits between an organization’s internal network and the Internet and monitors all traffic from outside to inside, blocking any traffic that is unauthorized.

flexibility:   In this book, a description for a software system that is built to be scalable to handle more advanced automated capabilities.

flow sheet:   A inpatient nursing document to document the interventions used to meet the patient’s needs, which may include the type of intervention, the time of care and the identity of the nurse administering care. Flow sheets generally are designed to limit the need for long written patient care notes by allowing information to be recorded either in graphics or table form with display of values for variables (e.g., temperature or respiration) as they change over time.

fluoroscopy:  X-rays aided by use of a contrast material such as barium providing an outline of the structure of soft tissues including the esophagus, stomach and intestines.

font:  A set of characters with a particular design and size.

foreign key:  A data element in a table or data base that forms a primary key in some other table or data base.

formulary:  See “drug formulary”.

free text:  Unstructured, uncoded representation of information in text format; for example, sentences describing the results of a patient's physical examination. 

frequency:   The number of occurrences of a periodic or recurrent process per unit time, e.g., administering a medication to a patient (e.g., p.r.n. is a frequency meaning “as necessary” and q.h. is a frequency meaning every hour.).

FTP (file transfer protocol):  A popular way to transfer files between computers on the Internet or via a TCP/IP network.

full-time equivalent (FTE):  Effort equivalent to that of one full-time worker. For example, two half-time workers constitute an FTE.

function:  The smallest discrete, complete set of code of an automated system that can be initiated by the user and run to completion to produce a single purpose set of results (e.g., a stand-alone function to look up patient demographical information about a patient, a function to issue an order for medication, or a function to make an appointment for a patient); a set of commands that produce a single output, named so the function can be called from many different program locations by name, with parameters to pass data to the function or from the function.

functional specification: A document describing a function within an automated system for use by the programmers and testers of the automated system. A “functional specification” describes the external design and describes the internal design of a function generically, while an “internal design specification” for a function describes the internal design more specifically in terms of the code, databases and interfaces for the function. See “internal design specification”.

furnishing number:  Together with his/her name and furnishing number, a nurse practitioner can furnish medications to essentially healthy patients under standardized procedures.

gate:  A point where a project is to be re-evaluated for costs, feasibility and adherence to the goals of the organization.

gatekeeper:  A physician, usually a primary care physician, responsible for overseeing and coordinating all aspects of a patient’s care, through whom referrals to specialists must be preauthorized.

generalization:  For databases, a relationship where one entity is a sub-type (e.g., dog) of another entity (e.g., animal)--also referred to as inheritance or an “is-a” relationship. See “inheritance”.

generic drugs:  Non-brand name drugs, with a name not protected by trade mark with the name usually descriptive of its chemical structure. When a generic drug is ordered its name is usually in lower case, whereas brand-name drugs are capitalized.

gesture:  For a pen computer, entrance of information that is interpreted as a command to do something, rather than as character input, for example, to insert text at a certain location within text.

giga- (e.g., gigabit or gigabyte):  One billion. 1,073,741,824 (230) bits or bytes.

goal:  A target to be met and measured at a specific point in time that can be used to determine if and to what extent an objective or business requirement is being met. See “objective” and “business requirement”.

graph:  A picture created from a set of numbers. Popular graph types include line, bar, area and pie graphs.

GUI (graphical user interface):  A user interface that makes use of every addressable pixel on the screen and thus makes it possible to create detailed visual symbols for user navigation, characters, pictures, and lines.

Graphical User Interface Design and Evaluation (GUIDE):  A method for designing, evaluating and refining the design of GUI-based software systems.

grayscale:  A graduated variation in the luminous output of a screen at a pixel location, with the variation expressed in terms of a bit value.

group communication:   Concurrent view of documents by multiple users at the same time and possible updating at the same time.

groupware:  Software that lets several people work with the same file at once. It also helps coordinate and manage activities, such as scheduling a meeting.

Guardian Angel system:  A computer system for a high risk patient for use outside the healthcare organization, at home or away from home, that can be used to monitor the patient’s health either via patient input or instrumentation input. The system can give advice, health education and therapy plans to the patient, inform the patient of appointments or inform the patient to schedule appointments. The system can alarm physicians or other caregivers of critical situations.

handwriting recognition: The technique by which a computer system can recognize characters and other symbols written by hand.

hardware:  The mechanical and electronic components of a computer system.

HCPCS Medicare Level 2:  HCFA Common Procedure Coding System, National Level II:  codes and descriptive terminology used for reporting the provision of supplies, materials, injections and certain services and procedures to Medicare.

header:  The segment of data that indicates the start of an entity that is to be transmitted.

Health Care Financing Administration (HCFA):  A U.S. Government agency responsible for the administration of Medicare and Medicaid.

healthcare proxy: A method of giving another person legal power to make medical decisions when you are no longer able to, also called a “durable power of attorney for healthcare”.

healthcare service representative:  In this book, an HMO employee to whom an HMO member could be assigned. A healthcare service representative would serve as an ombudsman who the member could call to resolve problems, to learn more about how the HMO functions and to learn more about the benefits provided to the member

health care team records:  During a patient’s hospital stay, notes from other departments, such as physical and respiratory therapy.

Health Industry Business Communications Council (HIBCC):  An industry-sponsored, nonprofit standards development organization (SDO), accredited member of the American National Standards Institute (ANSI), to facilitate electronic commerce by developing appropriate standards for information exchange among health care trading partners.

Health Industry Number (HIN):   A number for Electronic Data Interchange (EDI) assigned by HIBCC to every health care provider facility in the United States. It includes identifiers for hospitals, nursing homes, HMOs, pharmacies and also specific locations or departments within them.

Health Maintenance Organization (HMO):  A corporate entity (profit or non-profit) that provides comprehensive health care for members for a fixed periodic payment specified in advance. See capitation.

Health Plan Employer Data and Information Set (HEDIS):  A set of health care quality measures developed by the National Committee for Quality Assurance (NCQA) consisting of statistics on health care delivered by managed care plans, including preventive care and rates for certain surgical procedures.

highlight:  (1) In a GUI system, to select text or graphic data that is to be altered. For example, a highlighted item can be selected to be deleted or moved. (2) In a character-based system, showing text on the screen with higher intensity to make it stand out.

history and physical (H&P):  Documentation of health history and physical examination. The purpose of the health history is to collect “subjective” data, what the person says about himself or herself. The physical examination collects “objective” data, a record of the clinician’s examination of the patient and of diagnostic measurements.

history of present illness (HPI): The following information pertaining to the patient’s illness: (1) the symptoms that are troubling the patient; (2)  when the symptoms were first noted; (3) the patient’s opinion as to the cause of the illness; (4) possible influences by any external factors; (4) any remedies that the patient may have tried; and (5) any medical treatment the patient may have been given. Part of the subjective part of a SOAP note.

HHS (The Department of Health and Human Services):  A federal government agency that administers over 300 programs, including medical research, financial assistance, substance abuse treatment, Medicare and Medicaid, and Head Start.

HIPAA (The Health Insurance Portability and Accountability Act of 1996 for Medicare and Medicaid programs): A federal bill that includes standards for security and electronic signatures, provider identifiers and taxonomy, electronic transfers, and employer identifiers.

HISPP:  See ANSI HISPP.

HL7 (Health Level 7):   Messaging standards for information exchange between disparate clinical, administrative and financial computer systems for the healthcare industry, developed by ANSI. “7” refers to the seventh level of the OSI / ISO interconnection reference model.

HMO member: A person who pays a fixed periodic payment to an HMO in exchange for comprehensive health care.

HMO report card:  See the “Health Plan Employer Data and Information Set (HEDIS)”.

home health care:  Skilled nursing and related care supplied to a patient at home.

home page:  On the Internet World Wide Web, a screen related to a company, government organization or person that is identified and initiated by an Internet user entering a domain name or IP address in a browser or by user selection of a hyperlink on an Internet page that causes entrance of the domain name or IP address.

hospice care:  Care specifically given to terminally ill patients—generally those with six months or less to live.

hospital:  An establishment with an organized medical staff with permanent facilities that include inpatient beds and continuous medical/nursing services and that provides diagnosis and treatment for patients.

hospitalist:   A physician who is a specialist in in-patient medicine, who takes responsibility for a patient’s care from the personal care provider during the patient’s entire hospital stay.

HSQ 2.0 (Health Status Questionnaire 2.0): A trade-name product of National Computer Systems, Inc., a survey to be filled out by a patient related to a particular medical condition that identifies the patient perception of his/her quality of life, and which can be used by healthcare providers to identify which treatments and physicians provide the best outcomes from the patients’ point of view. It captures aspects of both physical and emotional health.  It contains all items found in SF-36.

HTML (Hyper Text Markup Language): An SGML-based language used as a standard language for creation of Internet World Wide Web pages that can be used to incorporate hypertext links, text, graphics, sound and video.

HTTP (Hypertext Transfer Protocol): The protocol for transporting Web pages across the Internet.

hypertension:  A condition where the patient has a higher than normal blood pressure.

hypertext:  A method of linking different parts of a database where the database could consist of text, graphics, data files, video and sound, usually in a top-down tree like structure, that enables a user to display and navigate through the links depending upon his or her interests, jumping from one related topic to another, by enabling text to be selected to present a connected document. This structure is used extensively in the Internet.

hypothetico-deductive approach:  A classical data collection and interpretation strategy followed by many physicians, nurse practitioners and other clinicians within the examination room or hospital room, applicable both for the outpatient and inpatient setting.

icon:  A small pictorial representation of an object (for example, a patient, the patient chart, an appointment form) appearing as part of a screen using a graphical user interface.

instance:  Naming and using an object class to generate code.

IEEE (Institute for Electrical and Electronic Engineers): An association for professionals in electrical engineering and computing, which also establishes standards for electrical devices.

IEEE Medix:  IEEE P1157 Medical Data Interchange (Medix) Committee. A object-oriented standard for exchange of data between hospital computer systems, compatible with HL7 and DICOM. MEDIX is a comprehensive specification for a health data exchange standard, which its developers have stated has an objective of eventually supporting the transfer of the entire patient record.

IEEE P1073:  An IEEE family of standards for medical device communication with hospital information systems.

ICU (intensive care unit):  An area of the hospital where there are critically ill patients who are closely monitored.

ICD (International Classification of Diseases):  A hierarchical system published by the World Health Organization using three-digit codes describing procedures, health status, categories of diseases, disablements and reasons for contact with healthcare professionals. Because ICD-9 was not felt to be adequate, a set of clinical modifiers of two additional digits were added, known as ICD-9-M. A new set of codes is being developed, ICD-10-CM.

IETF (Internet Engineering Task Force):  The standards body for the Internet community.

immunization:  The process of inducing or providing immunity artificially by administering a vaccine, toxoid or antibody containing preparation.

incident report:  Document that describes any patient accident while the patient is on the premises of a healthcare institution.

inclusive searching: In this book, searching for exact matches and also searching for all synonyms and related items (e.g., a search for “urogenital” would find occurrences of “bladder” and “uterus”).

indication:  A sign or circumstance that points to or shows the cause, pathology, treatment, or issue of an attack of disease

index:  An object consisting of identified data elements in a relational database table that is used to control the order in which the table is accessed or stored.

information:  “Data” processed in some way, usually by selection and formatting, so that it has meaning and may facilitate decision making.

information hiding:  Hiding data from other programmers in order to protect the data from corruption and to simply the overall system structure.

information retrieval:   A field of computer science that deals with the automated storage and retrieval of textual documents.

informed consent:  Process of obtaining permission from a patient to perform a specific test or procedure after describing all the risks, side effects and benefits.

infrastructure: The underlying foundation or basic framework of a system which must be done before the functional part of the system can be done.

inheritance:   (1) A relationship between object classes where an object class that inherits from another may share the data and methods of that other class. (2) For both databases and object classes an “is-a” relationship between two objects or entities (e.g., an “inpatient” is a “patient” and an “outpatient” is a “patient” and may both inherit from “patient”).

injection:  Act of introducing a liquid into the body by means of a syringe.

inpatient:  Patient admitted for treatment within a hospital over the course of more than one day.

Inpatient Census:  A patient list of all patients in rooms within a particular hospital unit at the current time, including patient identity and bed and room within the unit.

Inpatient Clinician List:  A patient list for an inpatient clinician (physician or nurse) listing all inpatients assigned to the clinician and role of the clinician (attending physician, admitting physician, primary care physician, nurse, etc.).

interactive voice recognition (IVR):   A technology for “automated speech recognition” associated with a call center that interprets the caller’s voice and performs actions accordingly. Same technology as “voice response unit (VRU)”.

interface:  The connection between any two components of a computer system and the protocols of information passed between the components. (Interfaces include connections between a user and an application, two computers, a computer and a hardware device such as a disk drive.)

interface engine: A hardware/software system used by the healthcare industry to support network communication  and perform other functions. A typical interface engine provides a message queue, translates transmitted information, and stores the translated information on databases. Because interface engines are generally used in healthcare, they often support HL7.

interface standard:   Standard that specifies requirements concerned with the compatibility of products or systems at their points of interconnection.

intermediate care:  In this book, off-chart and strictly confidential counciling by a psychologist or clinical social worker (CSW) to either (1) provide the patient with a means to cope with a life situation, (2) refer the patient to appropriate medical care if this is necessary, or (3) suggest patient education classes to take.

internal design specification: A program specification to describe the code, databases and interfaces that implement a function or implement a capability within an automated system. See “functional specification”.

internal workings: Used in this book for computer software systems to mean everything not seen by the users of the system. See "black box" and "white box".

Internet:  Worldwide network of interconnected computers. Uses the TCP/IP communications protocol.

Internet service provider (ISP): A company that sells an account providing Internet access.

interpretation:   Analysis of diagnostic images or test results for indications of abnormalities and possible disease.

interpreter:  A program that reads computer source language code statements one by one, evaluating  a statement, immediately executing the statement and advancing to the next statement. This is opposed to a compiler where the total of source language code statements making up a program are translated to a program in a form directly executable by the computer; a program in a form executable directly by the computer is said to be a program in “machine language”. Machine language programs always run (execute) faster than interpreted programs. JAVA is a language where programs are interpreted within the browser. 

interval:  The lapse of time between two recurrences.

interventional radiology:  Use of x-rays to help guide biopsy needles to evaluate tumors or place catheters for widening narrowed arteries and draining infections.

intervention:  The act or fact of interfering so as to modify.

interview:  Type of communication with a patient initiated for a specific purpose and focused on a specific content area.

intranet:  A private computer network based upon the data communication standards of the public Internet

intravenous (I.V.) therapy:  Form of injection in which fluid is introduced directly into the vein.

I/O:  Input/Output device. An external device connected to a computer to allow input or output of information,  such as a disk, keyboard, mouse, screen or printer.

IP (internet protocol):  Defines how each packet of a message travels across a TCP/IP network. IP assigns an address to each packet.

IP addresses:  A unique, numeric identifier used to specify hosts and networks on the Internet and TCP/IP networks.

ISO (International Standards Organization):  An international group of experts that sets standards for technology. For example, ISO 9660 is a CD-ROM standard.

ISO/OSI interconnection reference model:  International Standards Organization / Open System Interconnection Reference Model:  A model for networks developed by the ISO to act as a framework for developing standards that will achieve the concept of an open network architecture. The model is a layered model with seven layers.

invasive:  Referring to procedures that involve puncture, incision, or insertion of a foreign object, such as a needle or catheter, into the body.

Java:  Interpreted, object-oriented programming language developed by Sun Microsystems. Derived from C++.

Java applets:  Interactive pieces of code written in Java that may be downloaded from the Web at the same time as HTML pages.

Joint Committee of Accreditation of Healthcare Organizations (JCAHO):  A private, nongovernmental agency that establishes guidelines for the operation of hospitals and other health care facilities.

JPEG (Joint Photographic Experts Group):  Image compression technique. The amount of information lost depends on the level of compression.

Kardex:  Trade-name for card-filing system that allows quick reference to the particular need of an inpatient for certain aspects of nursing care.

kilo- (e.g., kilobyte):  One thousand. 1024 (210) bytes and represented by K such as 10K for ten kilobytes.

Labeler Identification Codes (LICs):   Part of a uniform bar code labeling standard for products shipped to hospitals developed by the HIBCC. LICs identify manufacturers.

LAN (Local Area Network):  A network of computers that uses direct cable connections or short wireless connections rather than telecommunications; thus, the computers are in a localized area (such as a building).

layer:  A set of data in a network message with a header and trailer for a particular purpose and intervening data. A layer may be inside another layer. Headers and trailers are added to create a layer before the message is sent, and removed as it is received. For example, one layer may be used for routing the message through a complex telecommunications network; once the associated header and trailer is not needed it is removed.

laptop computer:  A class of portable briefcase-sized computers with capabilities similar to desktop computers. See “portable computer”.

length of stay (LOS):  The number of days between admission and discharge of a hospital stay or other inpatient stay.

licensed practical nurse (LPN):  A nurse who is licensed by a state board of nursing after completing an education program and passing the licensure exam who practices under the supervision of a registered nurse.

life care path:  A clinical pathway identifying preventative care for a member over a long period of time, which may be used for long term preventative care, or alternatively, for a chronic disabling disease that must be tracked over a very long period of time.

load balancing: Distributing processing and communications activity evenly among computers in a cluster so no computer is overloaded

local system:  In this book, a computer system that is a portion of a distributed automated patient medical record system for a healthcare organization that records patient clinical information for a set of healthcare organization facilities and performs all the functions of the automated patient medical record system for caregivers at these facilities.

locking:  The process of prohibiting dual access to a file, database, record or field that has been accessed with the potential of change of the data. This is to prevent conflict or corruption of the data.

logical database design:  A part of the design of a database where sets of data (“tables”, “records” or “entities”) making up the database are identified, the format of data elements making up each entity is identified, and the relationships between the entities is identified.

log in / log on:  To gain access to a computer system, usually by entering a user identifier and password.

log off:  To sign off a computer system performing all clean-up processing necessary to not lose data and to restore the system to a consistent state.

LOINC (Logical Observation Identifier, Names and Codes):  A set of names and ID codes for identifying laboratory and clinical observations.

longitudinal patient record:  A life time patient record.

long term care:  Non-acute hospital care, for chronic conditions (e.g. nursing homes, psychiatric institutions, geriatrics, etc.).

low utilizer:  A health organization member who seldom comes in for care.

machine language:  The language characteristic of a particular computer. 

magnetic resonance imaging (MRI):   A technique using magnetic fields that produces anatomic images in multiple planes and may provide information on tissue characterization. A type of diagnostic imaging.

magnetic tape:  A reel of pliable plastic, coated with magnetizable material on which may be recorded signals that represent data.

mainframe:  A large, powerful, central computer, typically operated and maintained by professional computing personnel.

maintenance:  The process of changing an automated system after it has been delivered and is in use; also, changes to functionality in an automated system after the function has been implemented. Also called “software maintenance”.

malignant:  Tending to become progressively worse and to result in death.

malpractice:  Injurious or unprofessional actions that harm another.

mammography:  Diagnostic imaging examination of the breast for screening and diagnosis of breast disease.

managed care:  An arrangement where a third-party payer (such as an insurance company, federal government, or corporation) mediates between physicians and patients, negotiating fees for service and overseeing the types of care given.

master file:  Common reference files, such as clinical lab test codes, caregiver identifiers, etc., that must be synchronized across clinical systems.

Master Patient Index (MPI):   In this book, a MPI is a set of patient identifiers, such as name, gender, date of birth, mother’s maiden name, etc., which together can be used to uniquely and unambiguously identify a patient.  An MPI may also contain a cross reference of all the identifiers that the various information systems use to identify a person.

Medicaid:  A government program that provides medical assistance for certain low-income individuals and families.

medical:  Pertaining to medicine or to the treatment of diseases; pertaining to medicine as opposed to surgery.

medical assistant:  A multi-skilled healthcare professional who performs a variety of clinical, clerical and administrative duties within a healthcare setting.

medical informatics:  The use of computers in medicine.

medically necessary:  Services or supplies that meet the following tests:

·they are appropriate and necessary for the symptoms, diagnosis, or treatment of the medical condition
·they are provided for the diagnosis or direct care and treatment of the medical condition
·they meet the standards of good medical practice within the medical community in the service area
·they are not primarily for the convenience of the plan member or a plan provider
·they are the most appropriate level or supply of service that can safely be provided.

medical record:  A written transcription of information obtained from a patient, guardian or medical professional concerning a patient’s health history, diagnostic tests, diagnoses, treatment and prognosis.

medical references:  Used in this book to mean compendiums of information on medicine available on the Internet or an Intranet or otherwise available through an automated patient medical record system. Medical references include poisons information, AHCPR clinical practice guidelines, drug compendiums and formularies, the PDR and others.

medical vocabularies:  Medical terms, including diseases, diagnoses, procedures, and codes for them.

Medicare:  A health insurance program for people over age 65, the disabled, and people with end-stage renal disease who require dialysis or transplantation.

Medication Administration Record (MAR):  In a hospital, a record of medication orders for a patient and documentation of their execution.

medication scheduler: In this book, a person who assists in creating patient medication schedules. See “patient medication schedule”.

MEDLARS (MEDical Literature Analysis and Retrieval System):  A computerized system of databases and databanks offered by the National Library of Medicine for medical literature retrieval, which includes specialized databases in health administration, toxicology, cancer, medical ethics and population studies.

Medline:   An on-line bibliographic database of medical information.

mega- (e.g., megabyte):  One million. A megabyte is equal to 1,048,576 (220) bytes and is represented by Mb such as 10Mb for ten megabytes.

member:  An HMO member profile. The same as a “patient profile”.

memory:  The part of a system that holds program instructions and information being processed. See “RAM” and “ROM”.

menu:  A list of options from which a user chooses.

menu bar:  A strip across the top of a window in a GUI system, listing all the menus available in that program.

message:  The atomic unit of data transferred between systems, containing address information and content.

message queuing:  Programs on separate computers with queues on each computer to store and then forward a message from one computer to another. Even though a computer or the network is down, the message will not be lost and will still eventually arrive. See “store-and-forward”.

messaging:  See “caregiver messaging system”.

meta-data:  In databases, data that describes data objects in the database. Data about data. See “data dictionary”.

metastasis: The change in location of a disease.

method:  A routine within an object class.

microbiology:   The science that deals with microorganisms, including algae, bacteria, fungi, protozoa and viruses.

microcomputer:  A small computer generally with one user.

Micromedix:   A product of the Micromedix company in Denver, Colorado that offers current, comprehensive reference libraries for toxicology, pharmacology, emergency and acute care, occupational medicine, chemical safety, and industrial regulatory compliance.

Microsoft Windows: A window system and user interface software released by Microsoft in 1985 to run on top of an older, character-based operating system, MS-DOS.

middleware:  Software that mediates between an application program and a network, managing the interaction between disparate applications across heterogeneous computer systems.

milestone:  A major event (often at the start of a stage) which is used to monitor the progress at a summary level of a project.

minicomputer: A computer with a size and computing capacity between that of the mainframe and the microcomputer.

mission:  A summary of the change to the organization expected to be produced by a project or a phase of a project.

mnemonic:  A code that serves as a representation and memorable abbreviation for some word or phrase.

mobile code:   The transmission of code across a network from one computer system to another for execution on the second computer system.

modal dialog box: A dialog box that takes control of an application and requires the user to close the dialog box before continuing the application.

modeless dialog box: A dialog box that does not take control of the application, allowing the user to work within other dialog boxes while the dialog box is open.

module:  Logical combinations of code specific to the subsystem functionality.

monitor:  A television-type device that displays text and graphics generated by a computer.

monitoring:  The process of continually checking, observing, recording or testing the operation of some procedure or one or several physiological parameters.

monitoring systems:  A system that monitors a patient, collecting large amounts of information, such as ECGs and Guardian Angel systems. Monitoring systems could potentially produce large volumes of information; therefore, much filtering of such information has to be done to determine the significant information to store.

morbidity:  A diseased condition or state, the incidence of a disease or of all diseases in a population.

morbidity rate:  The sickness rate, the number of people who are sick or have a disease compared with the number who are well.

mortality:  Death rate in a given population.

mortality rate:  The proportion of deaths in a population or to a specific number of the population.

mouse:  A hand-manipulated computer input device used for pointing and drawing with computer programs. When the device is moved across a flat surface, a ball on the bottom causes the cursor to be moved on the screen.

multimedia:  A blend of text, graphics, sound, animation and video.

multiplexing: Combining several signals for transmission on some shared medium (e.g. a telephone wire). The signals are combined at the transmitter by a multiplexor (a "mux") and split up at the receiver by a demultiplexor.

multiplicity:  In a GUI system, allowing the user to work on two instances of an object at the same time (e.g., two different patient lists, two different clinical summaries).

multiprocessing:  Executing tasks or programs on separate processors, thus allowing them to execute concurrently. Conversely, if tasks and/or programs share a processor, then processing switches between the various tasks and programs.

multiprogramming:  A technique used in an operating system for executing several independent programs at the “same time”, either on the same processor or multiple processors.

multitasking / multithreading:  A technique used in an operating system for executing several tasks, either part of the same program or not, at the “same time”, either on the same processor or multiple processors.

name server: In the Internet or TCP/IP networks, a computer that has both the software and the data required to resolve domain names to Internet Protocol (IP) addresses.

(XML) namespace: A collection of element type and attribute names identified by a name and associated URL, with the name preceding the element type and attributes identifying these as part of a certain markup vocabulary.

NANDA (North American Nursing Diagnosis Association) nursing diagnoses:  A set of nursing diagnoses developed by a group, NANDA, that meets every two years. NANDA developed the following definition for nursing diagnosis:  “Nursing diagnosis is a clinical judgment about individual, family, or community responses to actual and potential health problems/life processes. Nursing diagnoses provide the basis for selection of nursing interventions to achieve outcomes for which the nurse is accountable” (NANDA, 1990).

narcotic:  An agent that produces insensibility or stupor, applied especially to the opioids, i.e. to any natural or synthetic drug that has morphine-like actions.

natal:  Associated with one’s birth.

National Drug Code (NDC):  A drug code maintained by the FDA (Federal Drug Administration).

National Formulary:  Collection of officially recognized drug names published by the U.S. Pharmacopical convention.

National Guideline Database:  See AHPCR National Guideline Database.

National Library of Medicine (NLM):   Located in Bethesda, Maryland, the world's largest repository of biomedical health sciences information.

National Patient Identifier (NPI identifier):  A standard unique identifier mandated by the U. S. government for health plans and health care providers by the year 2000.

National Patient Identifier Assigning Authority:  In this book, a national location to send information to uniquely identify a patient. The location will return either an existing national patient identifier for the patient or a new national patient identifier.

National Science Foundation:  A U.S. federal government foundation that extended the Internet from a government network to a public network.

naturopathy:  A system for treating diseases that relies largely on natural agencies such as air, heat, water, massage, and sunshine and rejects the use of drugs or medicines.

NCQA (National Committee for Quality Assurance):   A non-profit oversight organization for the managed care industry.

NCQA database:  A national database for evaluating HMOs, which includes information for generation of the HEDIS report, an HMO “report card”.

negative:  Not affirming the presence of the organism or condition in question.

neonatal:  Pertaining to the first four weeks after birth.

network:  A system of interconnected computers and terminals.

network access point (NAP): Several major Internet connections that tie together Internet service providers. See “Internet service provider”.

NIC (Nursing Intervention Classifications):  A comprehensive classification of nursing interventions developed by a research team at the University of Iowa.

NOC (Nursing Outcomes Classifications):  A standardized terminology and criteria for measurable or desirable nursing-sensitive patient outcomes that result from nursing interventions. Links can be made between NOC outcomes and NANDA nursing diagnoses.

normal:  A description for diagnostic findings, including clinical laboratory test results. See “diagnostic findings”. Performing proper functions; natural; regular.

normalization:  A procedure for placing data elements in tables in databases according to a set of dependency rules so as to create stable data structures that minimize data redundancy and maximize data independence.

nosocomial:  Pertaining to or originating in the hospital, said of an infection not present or incubating prior to admittance to the hospital, but generally occurring 72 hours after admittance; the term is usually used to refer to patient disease, but hospital personnel may also acquire a nosocomial infection.

nuclear medicine:  X-ray with tiny amounts of radioactive tracer material (radioisotopes) that are absorbed by an organ reveal how the organ works, rather than just its structure.

nurse:  A profession concerned with the diagnosis and treatment of human responses to actual and potential health problems.

nurse practitioner (NP):  A registered nurse who has completed an advanced training program in primary health care delivery, and may provide primary care for non-emergency patients, usually in an outpatient or community setting.

nursing assessment:  The systematic collection of data related to the patient’s nursing needs.

nursing diagnosis:  Identification of a health problem made as a result of the nursing assessment.

nursing intervention:  An action deliberately selected and performed to implement the plan of care.

nursing plan of care:  A written guideline for patient care that documents the patient’s health needs determined by assessment and nursing diagnoses, priorities, goals and expected outcomes.

nursing unit: an area of the hospital serving a specific purpose (e.g., ICU, medical/surgical, respiratory, etc.)  Also simply termed a “unit”.

object:  A term used in object oriented computing and analysis to mean a package of information and processes related to a definable entity.

object class:  The name of an object, inheritance relationships of the object with other objects, together with the data and methods describing how the object is implemented.

object-oriented user interface (OOUI):  A GUI interface using cooperative business objects.

object request broker (ORB):  Software middleware that manages communication between objects.

objective:  A future position of an organization expected from implementing changes in the organization. See “goal” and “strategy”.

objective:  A record of the clinician’s examination of the patient and of diagnostic measurements. See section 3.4.3.1.

object-oriented design:  A way of designing an application system by breaking the system program code into objects.

observation visit:  A visit where the patient is in for observation for possible admittance to the hospital, such as a pregnant woman having contractions.

obstacle:  Any actual or potential hindrance to the successful completion of a project.

one off order:  When there is  a repeating medication order, a type of medication order where an extra dose is given this one time only.

on-line:  Connected to and controlled by the computer.

on-line analytical processing (OLAP):  A system software system to transform or limit data from data warehouses in order to discover patterns, trends and exceptions in business, medical or other operations. OLAP was a term coined by E.F.Codd in 1993.

on-line transaction processing (OLTP):  A system software system to handle real-time transactions (e.g., medical orders), requiring transaction management, extensive audit trails, routing, scheduling and administration.  See “transaction”.

open architecture:  (1) Use of standardized technology and structures for hardware, operating systems, data bases, fault tolerances, and network and communications transport. (2) Program structure and hardware is compatible with the hardware and software of other vendors.

operating system:  The master control program scheduling, running and providing services (such as file I/O, database processing, screen display or printer output) for application programs and other service programs. Popular operating systems are Windows 3.1 under DOS and Windows NT.

optical character recognition (OCR):  A process wherein a printed page is scanned and the resulting image of the page or line is interpreted and translated into a sequence of ASCII or EBCDIC characters.

order:  A request for service from a clinician to an ancillary department for a particular patient, which may be sent from a clinical application where the order was created to another clinical application where the performing area is located.

order result responsibility group:  In this book, a set of caregivers and/or print locations associated with a caregiver doing ordering at a particular ordering location identifying where, when and to whom alarm and order result information is to be sent beside to the ordering caregiver.

Organization for the Advancement of Structured Information Standards (OASIS): An organization that sponsors an initiative to develop industry-specific standards for XML and a registry and repository for specifications for these standards.

OSHA (U.S. Department of Labor Occupational Safety & Health Administration):  A department of the U.S. government that enforces various healthcare regulations.

osteopathic physician:  Doctor with training that places special emphasis on the relationship between the musculoskeletal system and the body’s other systems.

outcome:  Measurement of the impact of treatments, procedures or other care strategies on specific measures of a patient’s health at the end of therapy.  May include financial, clinical and patient satisfaction measures. Outcomes may be positive or negative.

out-of-range:  A description for clinical laboratory test results. See “diagnostic findings”.

out-of-area benefits (HMO):  Benefits supplied by a plan to its subscribers or enrollees when they need services outside the geographic limits of the HMO. These benefits usually include emergency care benefits, plus low fee-for-service payments for nonemergency care.

outpatient:  Patient who has not been admitted to a hospital but receives treatment in a clinic or facility associated with a hospital or in a medical office building.

Overall Clinical Summary:  A summary of clinical information for the patient including patient description information, a list of all encounters, significant health problems, and current medications.

over-the-counter drug:  Drug available to a consumer without a prescription.

packet switching:  A method of passing information between any two points in a network in units (packets). The information to be passed is disassembled into packets on entry into the network, and packets then proceed individually by any available route to their destination. Before leaving the network, the packets are reassembled into their original form. TCP/IP and ATM use packet switching.

panic: A description for diagnostic findings, including clinical laboratory test results. See “diagnostic findings”.

Pap smear, Pap test, Papanicolaou test:   A screening test for cervical cancer.

paradigm:  An original pattern or model of which all things of the same type are representations or copies.

parameter:  (1) medicine: A variable whose measure is indicative of a quantity or function that cannot itself be precisely determined by direct methods; e.g., blood pressure and pulse rate are parameters of cardiovascular function, and the level of glucose in blood and urine is a parameter of carbohydrate metabolism. (2) computer science: Data passed between programs via a routine (aka a function, subroutine or procedure) or method.

parenteral:  Not in or through the digestive system; typically refers to administering medications by injection.

password:  A secret string of characters a user types to prove who he or she says she is, used for “authentication”.

paste:  To insert the last information that was cut.

past medical history (PMH):  Any illnesses the patient has had in the past along with the treatments administered or operations performed. Part of the subjective part of a SOAP note.

pathogen:  Any disease-producing microorganism.

pathology:  Branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease

patient:   One who is sick with, or being treated for, an illness or injury.

patient-centered care:  Used in this book to mean (1) care systems that center on patients, not caregivers, or (2) a situation where the patient is given full time care with the assistance of computers or monitoring systems.

patient demographics:  Information that identifies, locates, or describes a patient.

patient education:  Instruction to the patient and his/her family, for the purpose of improving or maintaining an individual’s health status.

patient list:  A list of patients of interest to a caregiver stored within the automated patient medical record system, usually automatically built from encounters and encounter statuses from other clinical systems.

patient (management) case:  Documents to support the overall tracking by a case manager of high cost, high risk patients, such as elderly, frail Medicare or workers’ compensation patients.

patient medication schedule: In this book, a schedule for patients on when to take medications.

patient profile:  In this book, a quick summary of the attributes of the patient, preferrably created by the patient, which would be used locally within a healthcare organization only and would not be devulged to anyone outside the healthcare organization.

patient registry:  In this book, a database and software system identifying all patients in the CPR repositories and identifying subscribing healthcare and other organizations, such as insurance companies, who are interested in each patient. Upon a patient encounter recorded in a CPR repository, a subscriber to the patient registry would be informed of the encounter. Also, a subscriber could request identification of all patient encounters for a patient and the CPR repositories containing the encounter information.

patient panel:  A patient list for a caregiver of all patients for whom the caregiver is a primary care physician, case manager, or other defined relationship.

payback period:  The amount of time it takes before a system will fully recover its investment (development) costs.

PDA:  Stands for personal data assistant. See “personal data assistant”.

peer review:  The inspection by one or more physicians of the process and outcome of a patient’s healthcare as recorded in the patient’s medical record.

peer-to-peer: A network in which each party has equal capabilities and each can initiate a communication with the other.

pen computer:  A portable computer that mainly uses pen for input, with the user “writing” on the screen.  See “portable computer”.

peripheral:  A physically independent device linked to a “CPU” and controlled by it. Examples are a terminal, printer, disc drive, or magnetic-tape drive.

personal identification number:  See PIN.

performance monitoring:  Measuring the performance of an automated system while it is in operation.

performance testing:  A carefully designed, repeatable experiment used to evaluate the performance characteristics of an automated system, hardware or application.

performing area:  A location where an order can be sent to be put on a work list or to be transferred to a clinical system for execution of the order.

personal digital assistant (PDA):  Also called “hand held computers”, these are computers small enough to be carried around in a coat pocket or handbag.

pharmacist:  Licensed professional who formulates and dispenses medications.

pharmacy:  A place of business that specializes in preparing, identifying, and dispersing drugs.

pharmacy information system:   Clinical system that deals with the pharmacy. Such systems can be linked to prescribing systems for electronic processing of a request for medication and can provide inventory control.

phone message:  A message from a patient, e.g., from an advice nurse, to a physician or other caregiver, which may be saved in the patient medical record.

physical database design:  A part of the design of a database where the logical database design is used to map the data in the database to physical files.

physical exam (PE):  A recording of the results of a clinician’s examination of the patient, which may, for example, include clinical laboratory and x-ray results. Usually findings for each of the major areas of the body are included under separate subheadings. Part of the objective part of a SOAP note.

physician:  Health care professional who has the degree of Doctor of Medicine (MD) or Doctor of Osteopath (OD) and is licensed to provide medical, surgical and other treatment.

physician assistant:  A practitioner trained in aspects of the practice of medicine who works with or under the supervision of a physician to provide diagnostic and therapeutic care.

PDR (Physicians’ Desk Reference):  A book updated every year by Medical Economics Data with cooperation of manufacturers that lists essential information on major pharmaceutical and diagnostic products.

pick list:  A drop-down list of items, one of which can be selected, to fill in a text item.

PACS (picture archiving and communication system):   A software / hardware system for the management, acquisition, transmission, storage, retrieval and display of digitally acquired images which may include the following types of diagnostic images: CT scan, MRI, Ultrasound, Computed Radiography, Angiography, Mammography, Fluoroscopy and Nuclear Medicine

pilot:  Implementing a computer software system using a portion of the potential customers and users, such as at a single facility of an HMO.

PIN (personal identification number):  A numeric value used to identify a particular user.

pixel:  A point on a monitor screen that may be set on or to an identified color or shade of gray located in terms of a rectangular array of picture elements (“pixels”) on a screen. The smallest addressable element on a display screen, located by horizontal and vertical position on the screen (x,y).

placer:  The application (system or individual) originating a request for services (an order).

plan:  Information regarding a clinician’s treatment of an illness, including:  (1)  Prescribed medications along with exact dosages; (2) instructions given to the patient; (3) recommendations for hospitalization or surgery; and (4) any special tests that need to be performed.

platform:  The hardware and software of a specific computer system.

pointing device:  A device a user can use to control the movement of the cursor on a display screen. Examples are mice, trackballs, touchpads and light pens.

point-of-care computing:  Capturing and entering data at the locations where patients receive care, such as by bedside terminals or pen computers during the time of interviewing an outpatient.

point of service:  Managed care plan that allows patients to see physicians not included in the plan for an increased fee.

point-to-point: A direct connection between two computers.

poison:  Any substance that impairs health or destroys life when ingested, inhaled, or otherwise absorbed by the body in relatively small amounts.

pop-up menu:  A list of options that appears on the screen when you click the right mouse button.

port:  An input-output connection through which data flow can be directed.

portable computer:  Designates a type of computer that is easily moved from place to place and that normally contains battery power to use on the go.

portability:  The ability of a program to run on systems with different architectures.

porting:  Moving software and data files to other computer systems.

positive:  Indicating existence or presence of a condition, organism, etc.

postnatal: Occurring after birth, with reference to the newborn.

postoperative:  Occurring after a surgical operation.

post partum: After childbirth, or after delivery.

pre-admission:  The entrance of admission information at a time ahead of the admission, such as for an elective admission.

precision:  A term used in information retrieval to mean retrieving only exactly what you need, limiting the number of items retrieved.

pre-existing condition:  A medical condition that began before a plan member became covered under the plan.

PPO (preferred provider organization):  A method of health care financing where a network of physicians and others enter into an agreement with an insurer to provide health care services on a discounted fee schedule in exchange for the insurer sending patients their way.

prepayment:  Payment in advance for health care, for example by fixed amounts monthly.

prescribe:  To indicate the medicine to be administered.

prescription:  Authorized order for medication, therapy, or a therapeutic device. It is signed by a physician or other practitioner licensed by law to prescribe such a drug, therapy or device.

preventive care:  Interventions directed toward preventing illness and promoting health.

primary care:  The first contact in a given episode of illness that leads to a decision regarding a course of action to resolve the health problem.

primary care physician:  A physician responsible for overseeing and coordinating all aspects of a patient’s care. A primary care physician is usually a family practitioner, general internist, pediatrician and sometimes an ob/gyn. The PCP in an HMO initiates most referrals for specialty care.

primary care provider:   A nurse practitioner, physician assistant or physician who is responsible for overseeing and coordinating all aspects of a patient’s care.

primary key:  A data element or group of data elements in a table or data base that can be used to uniquely identify a row of the table or record of the data base.

printer:  A device for producing hard copy (usually on paper) of data from a computer.

priority: Each patient entering the emergency department must be appropriately assessed to identify a priority for the patient for treatment.

privacy:  The right of individuals and organizations to establish when, how, and to what extent, information about themselves is transmitted to and used by others.

printer spooling:  To send printouts to a storage file for a specific printer to be queued for later printing for that printer. This enables the program creating the printout to continue processing without waiting for the printer and for printouts to be saved even though the program has terminated or been interrupted.

p.r.n.:  Abbreviation for “whenever necessary” used for prescriptions for a medication meaning to give the medication whenever it is necessary. A frequency.

probability density functions (pdf):  A graph of the occurrence of a value (x) versus the probability of the value’s occurrence (y).  For example, the number of days it takes a simple fracture of a femur to heal versus the probability for each of those days. pdfs are generally shown as continuous functions interpreted from a set of sampled values.

problem:  (1)  Short for a “significant health problem”. (2) Same as a “nursing diagnosis”. A problem of a given individual can be described by formal diagnosis coding systems (e.g., DRG’s, NANDA nursing diagnosis, ICD9, DSM, etc.) or by other professional descriptions of health care conditions affecting an individual.

problem list:  (1)  A list of significant health problems in a clinical summary. (2) A list of numbered patient problems used with the “problem-oriented medical record (POMR)” that provide a way to cross reference a problem with its manifestation in other places in the patient medical record.

problem-oriented medical record (POMR):   A structured medical record fronted by a list of the patient’s problems introduced by Dr. Lawrence Reed. All findings and treatments recorded are linked to the relevant problems.  Within the POMR the SOAP note format was first introduced.

procedure:  (1) medicine: A series of steps by which a desired result is accomplished. (2) computer science: A block of code which may be initiated (called) from many different programs with return to the next location in the calling program after completion; also called a “function” or “subroutine”. A procedure may have parameters to pass data to the procedure or from the procedure.

process:  A piece of code that can execute as a unit; the way a group agrees to function to be most productive.

process facilitator: A person who attends group meetings to help establish a group dynamic, making the group function effectively and efficiently.

producer:  See “filler”.

product:  The final results of a project or phase remaining after the project or phase is complete.

production system:  The automated system used by the day-to-day organizational users.

prognosis (Px):  The clinician’s opinion of what the outcome of the illness will be, the patient’s chances of improvement or cures—often expressed as “good”, “fair”, “poor” or “guarded”.

program: (1) Instructions coded in a computer language. (2) Loosely coupled but tightly aligned sets of projects aimed to deliver the benefits of part of a business plan or strategy.

program design language (PDL):  A structured English description of the code for a module or routine which can be used to code it in a programming language.

programmer:  A person who writes computer programs.

progress note:  A document recording notes of the patient’s progress. An initial medical examination is recorded in a History and  Physical, subsequent encounters result in recording notes of the patient’s progress.

progressive:  Advancing; going forward; going from bad to worse; increasing in scope or severity.

project:  A project, in a business environment, is:  (1) a finite piece of work (i.e., it has a beginning and an end), (2) undertaken within defined cost and time constraints, and (3) directed at achieving a stated business benefit.

project constraints:  Resource restrictions on the project determined by organizational management such as the project budget or the allowed number of workers of various types to accomplish the project.

project life cycle:  The duration of a project, especially the sequence of defined stages in the project.

project management:  A systems approach to development and implementation of a defined set of inter-related products with the development and implementation described by a project plan breaking the development and implementation into tasks stated in terms of time, costs, resources, and performance parameters.

project mission:  A summary of the change to the organization expected to be produced by the project.

project strategy: A change in direction of an organization that is part of a project that is presumed to result in an objective or objectives of the organization being fulfilled. See “strategy”.

proposal:  A short document for the initial investigation of a proposed project, which usually identifies the impact of the project on the organization, broad estimates of benefits and costs, and expected time to complete.

protective factor:  In this book, something that is done that protects against a specific disease. See “risk factor”.

protocol:  (1)  medicine: Written and approved plan specifying the procedures to be followed during an assessment or in providing treatment. (2)  computer science: A set of rules for how two computers speak to one another through a network.

prototyping:  The process of developing and interacting with a partial version of a system in order to gain user feedback and to evaluate feasibility.

prudent layperson standard:  Emergency care is covered in a health care plan if the decision to go to the ED was one that an average person with average medical knowledge would make at the time.

psychiatry:  The branch of medicine that deals with diagnosis and treatment of mental illness.

public health: Community efforts to improve the health of the community through health education, the detection and prevention of disease, and the control of communicable diseases

pull-down menu:  A list of options that is revealed when you select a menu name at the top of a window.

pulse:  The regular, recurrent expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts.

quality of service (QofS): The ability to differentiate between classes of network traffic and users and give the highest priority and error correction to the most critical messages.

queue:  An ordered list in which items are inserted and later removed. Queues are usually FIFO, meaning an item put into the list first is removed first. In a LIFO list, an item that is put in last is removed first.

radio button:  A circle where a pointing device can be put and with a button press the circle is filled in with black or returned to white. Setting to black sets an option. Where there are other radio buttons, other radio buttons are turned back to white. Compare this to a “check box”.

radiology:  The acquisition and analysis of medical images.

RAID:  Short for Redundant Array of Independent Disks. .A method of using two or more standard, lower cost, disks for fault tolerance of information on the disks--Normally fault tolerance of information on disks requires expensive disk hardware. The most common types of fault tolerance supported by RAID technology are disk mirroring (referred to as RAID level 1) and striping (referred to as RAID level 5).

RAM (Random Access Memory):   Memory area in a computer where information can be temporarily written and read for the execution of program.

random access:  Reading or writing to a type of memory where every location of memory is equally available (e.g., RAM).  This is opposed to sequential access.

ROM (Read-Only Memory):  Memory containing information written during the manufacturing process of a computer that physically cannot be overwritten.

Read Classification System (RCS) or Read Code:  A coding system used in the United Kingdom that is a superset of several international classifications, including ICD-9, where this coding schedule is controlled by the NHS Centre for Coding and Classification. Read Codes cover such topics as occupations, signs and symptoms, investigations, diagnoses, treatments and therapies, drugs and appliances. Each clinical term in a clinical document is replaced by a Read Code when it is stored; when the clinical document is retrieved, the clinician is not presented with the code but with the clinical term.

real-time:  Occurring immediately.

recall:  A term used in information retrieval to mean retrieving everything you need.

record:  (1) computer science: A group of related fields or data elements about a person, place, thing or abstract concept. In a relational database, a row of a table. (2) medicine: Written form of communication that permanently documents information relevant to health care management.

reengineering:  Rethinking and redesigning business processes to achieve quantum improvements in the performance of the business, which may be improvements in cost, quality, service and speed.

referential integrity:  A database rule or constraint stating that every foreign key value in one table or database must either match a primary key in some other table or database, or it must be null.

referral:   Sending or directing a patient for treatment with another caregiver or another medical department for consultation or service, usually where the referred to caregiver is a particular specialist physician or a caregiver in a specialty department and the referring caregiver is a primary care physician. A referral involves a delegation of responsibility which should be followed up to ensure satisfactory care.

referral letter:  A letter accompanying a referral, describing the reason and details of the referral.

reflex testing:   An order generated automatically by some clinical laboratory systems if a test is out of range, usually to verify that the result is actual rather than due to equipment problems

registered nurse (RN):  In the U.S., a person who completed a prescribed course of study from an approved nursing education program and who has passed the National Council Licensure Examination for Registered Nurses (NCLEX-RN) exam.

regional system:   In this book, a computer system that is a portion of a distributed automated patient medical record system that stores patient clinical summary information, handles communication outside the healthcare organization and interfaces with other healthcare organization clinical systems.

registration:  Recording that a patient showed up for an outpatient visit and creation of a billing record for the visit.

registry:  A voluntary or mandated government database for recording various disease and health problems, including cancer, AIDS, birth defects, diabetes, implants, organ transplants, measles, trauma and hazardous substances, from which epidemiological studies can be done.

regression testing:  Testing after a program correction to insure that no previously-working function fails as a result of the correction.

relational database:  A database made up of tabular data structures that conforms to a set of formalized mathematically based rules described in terms of objects, operators that can be applied to these objects and a set of integrity rules.

relationship:  How two entities are related. Common relationships are the following is-a, is-part-of, causes, associated-with, equivalent-to, is-in.

release:  A fully functioning automated system or set of automated systems that is delivered to customers.  See “release process”.

release process:  The process of keeping previous releases when delivering a new release to a customer so that the release can be backed out if necessary putting back the previous release. Releases are given version numbers. See “version” and “version control”.

reliability:  A measure of how well a software system provides the services expected of it by its users, including up time, accessibility and accuracy of stored information (e.g., patient medical record information), and speed in operation.

reminder:  A notification message describing a patient put in by one caregiver to later inform other caregivers.  More urgent messages are alerts and less urgent messages are reminders

remote consultation:  In this book, a consultation with a caregiver located in a different distributed facility group than that of the patient encounter.  The significance is a technical one.

remote procedure call (RPC):  A protocol that allows a program running on one computer to cause code to be executed on another computer without the programmer needing to explicitly code for this. An RPC is initiated by the caller (client) sending a request message to a remote system (the server) to execute a certain procedure using arguments supplied, and possibly returning results. It is a method for implementing the client/server model for distributed computing.

remote system:  In this book a computer system or combination of computer systems serving as part of the automated patient medical record system located in another healthcare organization or another region of a healthcare organization.

repeating orders:  A type of medication order that is carried out at prescribed intervals.

requirement:  A required characteristic of the changed organization resulting from a project (a business requirement) or a required characteristic of a new or changed automated system resulting from a project (a system requirement).

requirements traceability:  The ability to trace a requirement through the entire systems life cycle, e.g., to source code, data on databases, etc.  See “traceability”.

resolution:  (1) The amount of information that a monitor can display, measured by number of pixels horizontally and vertically. (2) The quality of the images on a printed page, measured in dots per inch (dpi). (3) The amount of detail a scanner can detect, measured in dots per inch (dpi).

resource:  A resource is any person, place or thing that must be reserved prior to its use.

respiration:  Breaths per minute. Normal respiratory rates vary according to the age of the patient.

response:  An action or movement due to the application of a stimulus

restore:  To retrieve a backup and copy it to a computer or computers.

results:  See “diagnostic findings”.

return on investment:  Over the life of the project, the total costs as compared with the increased revenue that will accrue.

review of systems (ROS):  A review of each body system with the patient (e.g., the respiratory system, the urogenital system) by asking the patient questions and by review of the patient chart. Part of the subjective part of a SOAP note.

RFI:  Request for Information. A request from companies for information on a product.

RFP:  Request for Proposal. A request for a proposal to implement a project.

RFQ:  Request for Quote. A request for a quote (monetary cost) to implement a project.

risk factor:  An environmental, psychological, physiological, or genetic element thought to predispose an individual to the development of a disease. 

risks:  Potential occurrences that may result in jeopardy to the success of the project.

room map:  A type of patient list identifying rooms in a nursing unit, outpatient clinic or emergency department that identifies for each room, any patient in the rooms and the caregivers in the room caring for the patient.

route:  The method by which the medication is given (e.g., sublingual, underneath the tongue).

router:  A specialized computer that finds the best way to get an electronic message to its proper destination. It is an integral part of the Internet.

routine:  General purpose code that may be used in many subsystems or in many modules, generally including the passing of data via input and output parameters associated with a routine name.

row:  A particular entity occurrence or instance in a relational database table. A particular row contains a set of data elements each with a value, one data element for each column in the table. A row corresponds to a record in a non-relational database.

RSA encryption:  A public key cryptography algorithm developed by mathematicians Rivest, Shamir and Adelman of MIT.

Russell-Soundex coding scheme:  A method of encoding patient names phonetically, so entrance of a name would bring back all names that phonetically sound the same.  Same as “Soundex search”.

SAN (storage area network): A network to link storage devices (such as disk arrays, magnetic tape drives) to create a pool of storage, often using fiber channel technology.

scalable:  Those characteristics of system structure that allow it to grow gracefully:  the number of users or distributed computers or the data volume can be increased and the system still works and still works efficiently.

schedule:  A type of date-oriented patient list for a particular caregiver listing patients with appointments that day and their times, may identify patients who have been registered, identifies unbooked time and identifies time where the caregiver does not normally see patients.

schedule I through V drugs:  Controlled substances, which may include narcotics, stimulants and sedatives, are divided into five classes called schedule I through schedule V. Schedule I drugs are experimental and can be dispensed by a very limited number of institutions or are drugs that, on an emergency or temporary basis, have been determined to pose an imminent hazard to the public safety. Prescriptions for schedule II drugs must be written and may not be refilled. Prescriptions for schedule III and IV drugs may be written or oral but may only be refilled up to five times within 6 months. Schedule V drugs are less restricted but can be dispensed only to patients at least 18 years old;  a patient must offer identification and have his or her name entered into a log maintained by the pharmacist.

script:  A recording of the input actions of a user so they can mimic the user during performance and regression testing.

scroll:  To move through a document using a scroll bar.

scroll bar:  A bar at the edge of a window displaying a document the user can use to scroll (move) through the document.

search:  A method of finding information in a document or database.

second opinion:  To be seen by another physician to confirm a diagnosis, to help decide on a surgical procedure, or to get more information or another explanation of a medical condition.

Secure Electronic Transactions (SET):  Encryption standards for credit card information over the Internet

security:   Safeguards applied to an automated system to insure that it behaves as expected. The desired level of integrity, exclusiveness, availability and effectiveness to protect data from loss, corruption, destruction and unauthorized use; the means by which “privacy” and “confidentiality” are attained in computer systems.

selection:  Identification of the relationship between types of data (e.g., patients and the patient’s chart) so that selection of the first item could go to the second item.

selectivity:  In pharmacology, the degree to which a dose of a drug produces the desired effect in relation to adverse effects.

sentinel event:  JCAHO defines this as “an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof”.

sequential access:  Reading or writing to a type of memory where memory locations are ordered and a later memory location is not available until the earlier one is first available (e.g., a magnetic tape).  This is opposed to random access.

server:  A server process in a client-server architecture. A server is the central computer that stores everyone’s files.

Service Level Agreement (SLA):  A contract between the end users of a system and the group running the system and/or the vendor providing the system that agrees upon a predefined level of service, in particular upon availability and performance levels.

SF-12:   Short Form Health Survey-12 Questions: A trade-name for a survey to be filled out by a patient related to a particular medical condition that identifies the patient perception of his/her quality of life that can be used by healthcare providers to identify which treatments and physicians provide the best outcomes from the patients’ point of view. SF-12 is a survey of 12 questions.

SF-36:  Short Form Health Survey-36 Questions: A trade-name for a survey with the same purpose as SF-12. It differs in that it is longer, having 36 questions to be answered by the patient.

SGML:  Standard Generalized Markup Language: an international standard to enable the electronic exchange of documents between dissimilar systems. SGML is a language that can be used to create HTML or XML.

shared medical decision:  Medical care where information regarding treatment outcomes are freely and accurately shared with the patient, so the patient can intelligently give his / her preferences on medical decisions.

side effect:  A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration.

sign:  Objective finding perceived by an examiner, such as a fever, rash, abnormal reflex, or abnormal breath sound.

significant health problem:  A current, permanent or long-lasting disease or medical condition. Significant health problems appear in “clinical summaries”.

single (one-time) order:   An order given only once.

single point (of) failure: An item that, if failed, would cause a failure of the system.

skilled nursing facility (SNF):   An establishment with a nursing staff that bridges the gap between hospital and home for elderly patients who need skilled nursing care or rehabilitation services. It may be a separate facility or a distinct part of another facility such as a hospital.

slate computer:  Same as a “tablet computer”.

smart card:  A credit care size plastic card containing a microprocessor.

SNMP (Simple Network Management Protocol):  A TCP/IP-derived protocol governing network management and monitoring of network services. This is a common protocol, but some people have concerns about network security using this protocol.

SNOMED (Systematized Nomenclature of Human and Veterinary Medicine):  Nomenclature covering the concepts of organism, disease, procedure, signs, symptoms and diagnosis, developed by the College of American Pathologists. It is intended for use in coding all content contained in electronic health records.

SOAP Notes:  Notes on the care of the patient that is part of the patient medical record and is sequenced in the order of sections: subjective, objective, assessment, and plan. A “problem” section may be included before the “subjective” section. The SOAP note format was introduced by Dr. Lawrence Weed as part of a system of organizing the medical record called the problem-oriented medical record (POMR).

socialeconomic status: “A composite measure that typically incorporates economic status, measured by income; social status, measured by education; and work status, measured by occupation”. See chapter 18.

social engineering: Tricking people to get around normal security procedures.

social history (SH):  Information regarding the patient’s eating, drinking, or smoking habits, the patient’s occupation, and the patient’s interests, if pertinent. Part of the subjective part of a SOAP note.

software:  The components of a computer system other than hardware, including the program, documentation and the stored data to use the program.

software configuration management:  The discipline of managing the evolution of large and complex software systems.  See “version” and “version control”.

software maintenance:  The process of changing a system after it has been delivered and is in use; also, changes to functionality in an automated system after the function has been implemented. Also simply called, “maintenance”.

Sonet (Synchronous Optical Network):  A data communications standard resulting in a very high-speed network that operates over fiber optic cable. 

sort:  To arrange information in a specified order, such as alphabetical, numerical or chronological.

sound card:  A hardware device in a computer that can be used to reproduce almost any sound from music to speech to sound effects.  Can be used in conjunction with CD-ROM drives, microphones, speakers, MIDI devices for music reproduction, etc.

Soundex search:  A method of encoding patient names phonetically, so entrance of a name would bring back all names that phonetically sound the same.  Same as “Russell-Soundex coding scheme”.

source document repository:  A database to store detailed patient care documents created at the point of care.

specialist:  A physician who works in a department not providing primary care, also known as a “specialty care provider”.

specialty:  A classification of specialized fields of medical services, such as dermatology, urology, orthopedics, etc.

speech recognition system:  Computer software that understands a user’s voice so he / she does not have to type.

sponsor:  A person who sees the usefulness of a project and who agrees to take ownership of the project.

spooling:  See “printer spooling”.

sporadic:  Neither endemic nor epidemic; occurring occasionally in a random or isolated manner.

stage:  The natural high level breakpoints in a project life cycle.

staging:  Transferring patient clinical data from a remote to a local computer before it is needed, instead of at the time needed, so it will be there when it is needed, e.g., at the time of an encounter.

stakeholder:  Any person or group who has an interest in a project. Typically some support the project, some are neutral and some are antagonists.

standard:  A set of guidelines and rules for a particular subject area set up by a committee whose members are authorities in the subject area in order to establish a commonality of computer software or hardware systems, healthcare procedures, etc., so that computer systems or people can communicate.

standard of care:  The minimum level of performance accepted to ensure high quality of care to patients. Standards of care define the types of therapies typically administered to patients with defined problems or needs.

standard development organization (SDO):   Organizations working on healthcare standards.

standing order:  A type of medication order that is carried out until the physician cancels it.

STAT:  Needed immediately.

STAT order:   A type of medication order where the medication is given immediately and only once.

stateless:  A method by which the server treats each request as a separate transaction. A World Wide Web server is a stateless server and thus it does not remember the caller of the previous request.

stay:  Encounter(s) leading up to an inpatient admission (e.g., an ED visit where the patient is discharged to the hospital) together with the inpatient admission.

storage:  A method of retaining data, text or graphics by preserving the information on hard drives, within the computer, floppy disks or other media.

store-and-forward:  A communications approach wherein messages are transmitted to another node where they can be stored and forwarded at a later time to the recipient.

stored procedure:  A set of procedural code stored in a database that is executed by the database software either on demand by an application program or when an associated database trigger is activated.

strategy:  A change in direction of an organization that is presumed to result in an objective or objectives of the organization being fulfilled. See “objective”.

striping:   A method of fault tolerance for information stored on disks that involves using three or more disks and controllers and keeping the data on one disk and parity data on another disk. If data is lost, it can be reconstructed from data on the other disks.

structure chart:  A hierarchical diagram that breaks a system into subsystems, subsystems into modules and modules into other modules and routines, which might also identify data flow.

structured design:  A way of designing an application system where the system program code if broken into subsystems, subsystems are broken into modules, and modules are broken into additional modules or routines.

Structured Query Language (SQL):  A language that provides a user or program interface to relational database systems. It was developed by IBM in the 1970s and is an ISO and ANSI standard. It is often embedded in programs in other computer languages.

sublingual: Located beneath the tongue. May pertain to a medication and mean a “route”.

subjective: Information given by the patient. See section 3.4.3.1.

subroutine: A series of instructions that together complete a specific task.  A subroutine is named so that it can be called from many different program locations by name. A subroutine may have parameters to pass data to the subroutine or from the subroutine.

subspecialty:  A specialty area within a particular medical discipline. For example, subspecialties within pediatrics might be the following: adolescent medicine, pediatric cardiology, pediatric critical care medicine, pediatric emergency medicine, pediatric endocrinology, pediatric gastroenterology, pediatric hematology-oncology, pediatric infectious diseases, neonatal-perinatal medicine, pediatric nephrology, pediatric pulmonology, and pediatric rheumatology.

subsystem:  A major, largely independent, portion of code that defines an application that works in coordination with other applications to produce a coherent and complete major software system; a set of functions that are logically grouped together.

supervision:  Designating or prescribing a course of action, or giving procedural guidance, initial direction, and periodic evaluation for individuals to whom tasks are delegated.

supervision, direct:  Being physically present and immediately accessible to designate or prescribe a course of action or to give procedural guidance, direction and periodic evaluation.

symptom:  Any subjective evidence of disease or of a patient’s condition, i.e. such evidence as perceived by the patient; a change in a patient’s condition indicative of some bodily or mental state.

synchronous:  Two or more processes dependent upon specific events occurring at the same time or in the same order.

synchronous transmission:  Data communications in which characters or bits are sent at a fixed rate, with the transmitting and receiving devices synchronized; this eliminates the need for start and stop bits basic to asynchronous transmission and significantly increases data throughput rates.

synopsis:  See “encounter synopsis”.

system:  Unit made up of separate parts or elements, where the parts rely on each other, are interrelated, have a common purpose, and together form a collective whole.

systems analysis:  The process of assessing whether a particular task is suitable for computerization and determining the type of hardware and software required.

Systems Application Architecture (SAA) Common User Access (CUA):  A definition and description of user interface standards developed by IBM for character-based systems, most using IBM’s CICS. There are also equivalent GUI standards.

system architecture:  The computers, the networks, the operating systems, the telecommunications, the database management systems and hardware, and other software and hardware necessary to support the applications.

system requirement:  A required characteristic of a new or changed automated system due to a project.

system software:  Any program that provides support to run the computer as opposed to an application program. See “application”.

table:  Information organized in rows and columns used for storing and retrieving data items in a relational database. Equivalent to a file.

tablet computer:   A pen computer about the width and length of a standard, 8 ½” x 11”, sheet of paper.

tape:  See “magnetic tape”.

task:   (1) Portions of code that can run concurrently, where these portions of code together make up a larger program; for example, a program can consist of a screen handling program and another program to do calculations when the screen handling program is not running. (2) A piece or work to be done.

TCP (transmission control protocol):  Divides a message into packets and then reassembles the packets when they all arrive at the destination. TCP also checks that the packets of a message arrived error free.

TCP/IP (transmission control protocol/Internet protocol):  A set of standards for communicating among dissimilar computers, developed and supported by ARPA (Advanced Projects Research Agency) of the U.S. Department of Defense. This is the communications protocol for transferring data from one computer to another over the Internet.

telecommunications:  The electronic transmission of information, including voice, data, video, image facsimile, telemetry, where there is a source that originates and encodes a message, a transmission medium, and a receiver that receives and decodes the message.

telemedicine:  The use of interactive audio and visual links to enable remote healthcare practitioners to consult in “real time” with specialists in distant medical centers.

temperature:   A measure of heat associated with the metabolism of the human body.

template:  A document that provides the basic framework for another document.

tera- (e.g., terabytes):   A prefix meaning one trillion. For example, a terabyte is one trillion bytes.

testbed:  A smaller scale hardware and software system that mimics the automated system.

testing:   Evaluation of  a computer software system to determine if it meets the requirements for the system. Requirements to be tested are user requirements determined by talking to users and software requirements determined during the design of the system.

therapy:  The treatment of disease.

therapeutic substitution:  The replacement of a prescribed medication with an entirely different medication of the same pharmacological or therapeutic class.

thread:  Equivalent to a  “task”.

three-tier data architecture:  A three tiered system is partitioned into three separate processes:  the user interface, business processing and database management. As opposed to a two-tiered system, the business processing is removed from the client and is placed on a separate application server. Each tier may have its own hardware and software architecture. Many companies use transaction processing (TP) monitors to distribute requests among multiple servers.

Token Ring:  A networking architecture in the shape of a ring, where access to write to the network is controlled by a token that passes from station to station. The competing architecture is Ethernet, which is much more common.

tomography:  The recording of internal body images at a predetermined plane by means of the tomograph; called also body section roentgenography.

tool bar or toolbar:  In a GUI, a graphical strip appearing across the top of the screen, side of the screen or bottom of the screen containing icons on buttons that represent functions the user frequently invokes.

topical:  Pertaining to a drug or treatment applied to the surface of a part of the body.

toxicity:  The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison.

traceability:  The ability to trace a requirement, project objective or organizational business requirement through the entire systems life cycle, e.g., to source code, data on databases, etc.  See “requirements traceability”.

trade-name: Proprietary names that are registered to protect the name for the sole use of the manufacturer holding the trademark (e.g., for drugs). Trade-name drugs are usually capitalized.

Trading Partners:  Commercial entities that do business with each other using EDI.

trailer:  The ending data segment of a set of data segments.

transaction:  (1) A logical update that takes a database from one consistent state to another. (2) A module that performs a logical update of a database through an on-line transaction processing system.

transcription:  A process of transforming dictated or otherwise documented information into an electronic format.

transfer:  Change in medical care unit, hospital, medical staff, or responsible physician of an inpatient after hospitalization.

treatment:  To provide care to cure, improve or mitigate a medical condition.

treatment (management) case:   In this book a case to track a treatment for a particular patient and usually non-chronic medical condition over a number of encounters where the condition is not likely to require long term continuing care.

trend document:  In this book, a document that automatically records a value or values that a caregiver wants to track over time as the value(s) are input via other source documents. A trend document may include mean, minimum and maximum expected values and report out of bounds values to identified caregivers. See “control chart”.

treatment decision point:  A point in time either occurring or predicted before which it is most advantageous to treat a disease.

treatment plan:  An organized and documented  approach to selecting care activities to treat a patient for an presumed or identified medical condition.

triage:  Assessment of patients’ medical problems to determine urgency and priority of care in the Emergency Department to determine which patient is to be seen next.

triage nurse:   A nurse in the Emergency Department who triages patients.

Trustworthy Health Telematics (TrustHealth): An approach for caregiver security developed in Europe for the European Commission to provide personal smart cards (computer chips imbedded in credit cards) to caregivers to gain access to healthcare systems using RSA encryption algorithms.

two-phase commit protocol:  An update approach in databases that results either in all database changes associated with a transaction being successfully made or all changes being successfully rolled back.

two-tier architecture:  A user component and a database-server component. Most of the application—especially the user interface—runs on a desktop. The primary function of the server is to access databases. Two-tier systems usually have limited scalability—few applications can support more than 100 simultaneous users.

tunneling:  A technology that enables one network to send its data via another network’s connections. Tunneling works by encapsulating a network protocol with packets carried by the second network. For example, tunneling technology enables organizations to use the Internet to transmit data across a virtual private network (VPN).

ultrasound: Ultrasound is a technique by which sound waves are bounced into a person’s body, and their reflections captured by a machine that transforms them into an image that can be read.

unified messaging: Allowing messages to be text, fax, voice, graphics, picture, Internet page, or video, or any combination of these. See “messaging”.

Uniform Resource Locator (URL):  An address uniquely identifying a home page within the World Wide Web on the Internet.

uninterruptible power supply (UPS):  A (battery powered) power supply that is guaranteed to provide working voltage to a computer regardless of interruptions in the incoming electrical power.

Unique Healthcare Identifier (UHID):   An ASTM term for a unique patient identifier.

Unique Physician Identifier Number (UPIN): A number to identify providers for Medicare billing purposes.  The UPIN identifier will soon be replaced by the National Patient Identifier (NPI identifier).  See “National Patient Identifier”.

Unique Product Number (UPN): Part of a uniform bar code labeling standard for products shipped to hospitals developed by the HIBCC. Two Universal Product Number (UPN) codes, HIBC-LIC codes and UCC/EAN codes, are used for product bar codes to identify med/surg products and manufacturers.

unit:  See “nursing unit”.

unit assistant: a healthcare professional who performs a variety of clinical, clerical and administrative duties within a unit, or section, of the hospital

Unit Census:  A patient list that identifies all admitted patients in a nursing unit.

United Medical Language System (UMLS):  A system linking together various medical vocabularies using semantic relationships, developed by the National Library of Medicine.

United Modeling Language (UML):  An object modeling language for designing and describing application systems.

universal patient record:   In this book, a possibly distributed patient medical record that electronically combines and summarizes all of a patient’s charts, that is available to caregivers and healthcare, government and insurance organizations via a network. It consists of the combination of all patient clinical information in CPR repositories and source document repositories, and all paper chart information in chart rooms, for a patient, any of which can be located through the CPR repositories, and then ordered.

universal patient medical record: Same as “universal patient record”.

universal precautions:  The recommendations published by the Center for Disease Control, Atlanta, Georgia, for preventing transmission of infectious disease by blood or body fluids.

UNIX:  Operating system developed by Bell Laboratories in the 1970s, now widely used in mini-computers and workstations.

UPC format (Universal Product Code for identification at point of sale):  A bar code used for product identification. The code is sensed by laser / optical scanners.

urgent care clinic:  A facility that provides care for problems that need to be treated outside routine business hours but that are not serious enough to require Emergency Department care.

urgent condition:  A condition that needs treatment within 24 hours.

usability:  The extent to which a computer system is easy to learn and effective to use for the given business tasks and users.

use case: User workflow in terms of his or her task environment.

user:  Someone who uses an automated system.

utilization review:   The necessity, quality, effectiveness, or efficiency of medical services, procedures, and facilities.

vaccination:  The introduction of vaccine into the body for the purpose of inducing immunity. Coined originally to apply to the injection of smallpox vaccine, the term has come to mean any immunizing procedure in which vaccine is injected.

validity:  The extent to which data corresponds to the actual state of affairs or measures what it purports to measure.

validation: Testing an automated system at the end of development to determine if the system or component works as determined by the program specifications, vendor systems customization specifications or business policies specifications.

VAN (value added network):  Generally commercial networks that transmit, receive, and store EDI transactions on behalf of their customers.

variance:  The differences between an expected outcome and an actual outcome of a care activity, either positive or negative.

verification: “Human” examination of an automated system to compare it against system requirements or business requirements, including user interface requirements, to determine if the requirements are being fulfilled. See “validation”.

version:  A software system version is an instance of a system that differs in some way from other instances. Usually each version is identified by a decimal number “x.y” where “x” is an integer representing a “release” number that changes when there is a major new version, and “y” is an integer representing a minor change within the identified release.

version control:  Another term for the “release process”.

VGA (Video Graphics Array):  Color graphic format for monitors developed by IBM for PC compatible systems. The basic resolution is 640 x 480 pixels with 16 colors. Super VGA is an extension to the standard supporting resolutions of 1024 x 768 with 256 colors and 1280 x  1024 with 16 colors.

virtual private network (VPN):  A network that utilizes a public network such as the Internet as a secure channel for communicating private data. A VPN can be created using “tunneling”.

virtual system:  In this book, a local system that stores remote patient clinical information from CPR repositories and source document repositories so it can be staged.

visibility:  The functionality in an application system provided to a person.

vision:  A healthcare organization management’s intelligent foresight into how the healthcare organization can best be improved to meet the future needs of its members, employees and outside organizations it does business with.

vital signs:  A patient’s temperature, pulse, respiration and blood pressure. Some medical people consider pain to be a fifth vital sign.

voice recognition system:  See speech recognition system.

voice response unit (VRU):  Same technology as “interactive voice recognition (IVR)”.

VRML (Virtual Reality Modeling Language):  Language used to represent and utilize three-dimensional objects on the World Wide Web.

wait list:  A list of patients requiring outpatient appointments, which may include recommendations on when the appointment should take place and who the appointment should be with.

walkthrough:  A group of people who meet to verify the correctness and acceptability of controlled documents, and sometimes computer programs.

WAN (Wide Area Network):  A public or private network that covers a wide geographic area.

waveform:  A continuous analog signal recorded as a line on paper, such as an ECG.

WDM (wave length division multiplexing):  A technology which increases the capability of optical fiber by dividing a transmission channel into different wavelengths, each resulting in a separate channel.

well-formed requirement:  “A statement of system functionality (a capability) that can be validated, that must be met or possessed by a system to solve a customer problem or to achieve a customer objective, and that is qualified by measurable conditions and bounded by constraints.”  See section 2.9.5.

white box: With regard to computer software systems, everything seen by the users of the system and everything not seen by the users of the system, including behind the scenes hardware, the software, the databases, and the networks. "White box" is often used to describe testing, where "white box" testing is done with a complete knowledge of the system. See "black box" and "internal workings".

windowing:  A display technique that uses multiple screen segments to display different items of information. The display can take two basic forms:  tiling (breaking up the screen into discrete segments) and overlapping (producing a three-dimensional effect by having a screen segment overlap, and thus partially or fully obscure another segment).

Windows NT (Windows New Technology, NT):   Microsoft's 32-bit operating system designed for workstations, servers and corporate networks.

wireless communications: A term describing a computer network where there is no physical connection (either copper cable or fiber optics) between sender and receiver, but instead they are connected by radio.

word processor:   Software that can be used to produce textual and other documents, including letters, reports, manuals and newsletters.

Work Breakdown Structure (WBS):  A structured hierarchy of groupings of tasks, stages, etc.

workflow:  The sequence of activities of a business, such as the business of providing medical care, often documented in a diagram in order to determine inefficient activities and inefficient usage of resources. See “business process reengineering”.

work list:  A list of orders for an ancillary department to complete.

workstation:  A micro- or minicomputer system with a network attachment that is used for providing information, computation, and/or network services directly to a user.

World Wide Web:  A hypertext system that links together documents over the Internet. Sometimes just called the “Web”.

writing tool interface:  A standard input field with a writing tool button. When the button is tapped by the pen, a writing tool editing window appears with contiguous separate cells for each pen input character.

WYSIWYG:  Stands for “What You See is What You Get”.  A term to use graphical systems to display on the screen exactly what is printed.

XHTML (Extensible Hypertext Markup Language):  The reformulation of HTML as an application of XML.

XML (Extensible Markup Language):  Like HTML, an SGML-based language for defining document structures and elements for documentation management systems. XML supplements HTML in the creation of web sites and serves as a way to define and transmit data. See “HTML”.

XML DTD (Document Type Definition):  A document that describes the structure and data elements of an XML document; data descriptions are more limited than in an XML Schema.  See “XML Schema”.

XML namespace: See “namespace”.

XML Schema:  A W3C-sponsered effort to define an alternative to DTDs for defining the structure and data elements of XML documents; within XML Schemas data elements can be described at a lower level than a DTD: byte, date, integer, user-defined, and others.  See “XML DTD”.

x-ray:  Electromagnetic radiation for medical imaging.

XSL (Extensible Markup Language Stylesheet Language):  Two facilities that facilitate the manipulation and display of information contained in XML documents: XSLT (XSL Transformations) a language for transforming XML documents into other XML documents or HTML documents, and XSL Formatting Objects, an XML vocabulary for formatting XML documents identifying templates for styles such as fonts, colors, and spacing for rendering including into HTML (similar to Cascading Style Sheets). See “Cascading Style Sheets”.

XSLT:  See “XSL”.

X12N:  See “ANSI ASC X12N”.

 

TABLE OF CONTENTS

Copyright © 2000-2001 Michael R. McGuire

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