Chapter 11 Health Information Technology: An Applied Approach

accountable care organizations (ACOs)
an organization of healthcare providers accountable for the quality, cost, and overall care, of Medicare beneficiaries who are assigned and enrolled in the traditional fee for service program
allied health professional
a credentialed healthcare worker who is not a physician, nurse, psychologist, or pharmacist
american association of medical colleges (AAMC)
the organization establishedin 1876 to standardize the curriculum for medical schools in the United States and to promote the licensure of physicians
american college of healthcare executive (ACHE)
the national professional organization of healthcare administrators that provides certification services for its members and promotes excellence in the field
american hospital association (AHA)
the national trade organization that provides education, conducts research, and represents the hospital industry’s interests in nataion llegislative matters; membership includes individual healthcare organizations as well as inidivdual healthcare professionals working in specialized areas of hospitals, such as risk management
american medical association (AMA)
the national professional mambership organization for physicians that distributes scientific inforamtino to its members and the public, informs members oflegislation related to health and medicine, and represents the medical profession’s interests in national legislative matters
american nurses association (ANA)
the national professional mambership association of nurses that works for the improvement of health standards and the availability of health care services, fosters high professional standards for the nursing profession, and advances the economic and general welfare of nurses
american recovery and reinvestment act (ARRA)
previously known as the stimulus bill or HR 1. the actions related to health information technolgoy are spread throughout the law; howeve,r the bulk of the items are in Title XIII health information technology
average length of stay (ALOS)
the mean length of stay for hospital inpatients discharges during a given period of time
case management
the ongoing, concurrent review performed by clinical professinals to ensure the necessity and effectiveness of the clincial services being provided to a patient 2. a process that integrates and coordinates pateitn care over time and across multiple sites and providers, especially in complex and high cost cases 3. the process of developing a specific care plan for a patient that serves as a communication tool to improve quality of care and reduce cost
chief executive officer (CEO)
the senior manager appointed by a governing board to direct anorganiztaion’s overall management
chief information officer (CIO)
teh senior management responsible for the overall management of information resources in an organization
chief nursing officer (CNO)
the senior manager (usually a registered nurse with advanced education and extensive experience) responsible for administering patient care services
chief operating officer (COO)
individual who oversees the healthcare organization’s internal operations, usually including direct patient care services, but not financial or information related services
clinical privileges
the authorization granted by a healthcare organization’s governing board to a member of the medical staff that enables the physician to provide patient services in the organization within specific practice limits
commission on accreditation for health informatics and information management education (CAHIIM)
the accrediting organization for educatinal programs in health informatics and information management
commission on certification for health informatics and information management (CHIIM)
an independent body within AHIMA that serves the public and the profession by establishing and enforcing standards for the initial certification and certification maintenance of health informatics and information manaegment professionals
continuous quality improvement (CQI)
a management philosophy that emphasizes the importance of knowing and meeting customer expectations, reducing variation within processes, and relying on data to build knowledge for process improvement. 2. a ocntinuous cycle of planning, measuring, and monitoring performance and making knowledge based improvement
continuum of care
the range of healthcare services provided to patiens, form routine ambulatory care to intensive acute care
extended care facility
a healthcare faicilty licensed by applicable state or local law to offer room and board, skilled nursing by a full tiem registered nurse, intyermediate care, or a combination of levels on a 24 hour basis over a long period of time
health savings accounts
savings accounts designed to help people save for future medical an dretiree health costs ona tax free basis;
health systems agency (HSA)
a type of organization called for by the Health Planning and Resources Development Act of 1974 to have broad representation of healthcare providers and consumers on governing boards and committees
hill-burton act
the federal legislation enacted in 1946 as the Hospital Survey and Construction Act to authorize grants for states to construct new hosptials an dlater to modernize old ones
home healthcare
the medical and/or personal care provided to individuals and families in their place of residence with the goal of promoting, amintaining, or restoring health or minimizing the effects of disabilities and illneses, including terminal illnesses
hospice care
the medical caer provided to persons with life expectancies of six months or less who elect to forgo standard treatment of their illness and to receive only palliative care
integreated delivery network (IDN)
a system that combines the financial an dclinical aspects of healthcare and uses a group of heatlhcare providers, selected on the basis of quality and cost management criteria, to funish com[prehensive health services across the continuum of care
integrated delivery system (IDS)
system that combines the financial an dclinical aspects of healthcare and uses a group of heatlhcare providers, selected on the basis of quality and cost management criteria, to funish com[prehensive health services across the continuum of care
investor owned hospital chain
group of for profit healthcare facilities owned by stockholders
managed care organization (MCO)
a type of healthcare organization that delivers medical care and manages all apsects of the care or the payment for care by limiting providers of care, discounting payment to providers of care, and/or limiting access to care
medical staff bylaws
a collection of guidelines adopted by a hospital’s medical staff to govern its business conduct and the rights and resonsibilities of its members
medical staff classifications
the organization of physicians in a healthcare facility and typically include active, provisional, honoroary, consulting, courtesy, and medical resident assignments
mission
the defined purpose for which a group of people or an organization joins forces to accomploish specific goals
national instituties of health (NIH)
federal agency of the department of health and human services comprising a nubmer of institutues that carry out research and [programs related to certain types of diseases, such as cancer
national practitioner data bank (NPBD)
a data bank established by the federal government through teh 1986 Health Care Quality Improvement Act that conains information ion professional review actions taken against physicians and other licensed healthcare practitioners, which healthcare organizations are required to check as part of the credentialing process
peer reveiw organization (PRO)
until 2002, a medical organization that performs a professional review of medical necessity, quality and appropriateness of healthcare services provided to Medicare beneficiaries
public health services (PHS)
services concerned primarily with the health of populations in geopolitical areas, such as states and counties
quality improvement organization (QIO)
an organization that perfomrs medical peer review of Medicare and Medicaid claims, including review of validity of nhosptial diagnosis and procedure coding information; completeness, adequacy, and quality of care, and appropriateness ofprospective payments for outlier cases and nonemergent use of the emergency room
reengineering
fundamental rethinking and radical redisign of business processes to achieve significatn p[erformance improvements
rehabilitation services
health services provided to assist patients in achieving and maintaining their optimal level of function, self-care, and independence after some type of disability
skilled nursing facility (SNF)
a long term nursing facility with an organizaed professinal staff and permanent facilities (including inpatient beds) that provides continous nursing and other health related, psychosocial, and personal services to patients who are not inan acute phase of illness but who primarily require continued care on an inpatient basis
subacute care
a type of step down care provided after a patient is released form an acute care hospital (including nursing homes and other facilities that provide medical care, but not surgical or emergency care
utilization review act
the federal legislation that requires hospitals to conduct continued stay reviews for Medicare and Medicaid patients