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”.
Copyright © 2000-2001 Michael R. McGuire
Duplication not permitted without express written permission
Comments? mailto:Michael.McGuire@abac.com