Frequently Asked Questions And Healthcare Glossary of Terms

Transcription

1 Frequently Asked Questions And Healthcare Glossary of Terms Kno2 FAQs What is Kno2? Kno2 enables care providers to securely send and receive patient information via standards-based formats and methods to connect the healthcare continuum on the Surescripts Clinical Interoperability network or any trusted Direct network. How does Kno2 work? Kno2 connects with the systems and tools used every day for exchanging clinical documents to enable any healthcare provider to securely share patient information. Kno2 creates a common link for all members of the care continuum through existing resources, from HISP networks to healthcare information systems to multi-function devices. Who can use Kno2? Kno2 technology enables secure, structured, interoperable exchange of information across all patient care environments, from acute to ambulatory to post-acute and other partners involved with care. When can I use Kno2? Whenever you need to exchange patient information with external care partners, Kno2 provides a simple, standards-based method to ensure safe and effective care. Where does Kno2 fit within the healthcare environment? Kno2 seamlessly integrates with existing processes and workflows to simplify the sharing of patient information, regardless of setting. As secure and structured exchange of patient information becomes standard, Kno2 connects the healthcare community with a lightweight solution that complements existing processes while replacing inefficient communication methods such as fax and fax services. Why is Kno2 effective for healthcare? Kno2 was designed specifically for healthcare, using standards-based technology that connects those who serve patients in a simple, secure and affordable way. Kno2 provides a simple, lightweight, and standards-based solution designed to connect with any healthcare setting through multiple points of access, from devices to healthcare networks to EMRs. How is Kno2 different than other Direct Messaging portals? Kno2 is designed to fit into your existing workflows and system, despite what levels of technology you have adopted or if you don t have a Direct-compatible EMR. From paper-based charts to proprietary clinical systems, Kno2 enables the sending and receiving of Direct messages and the attachments to be easily incorporated into your existing workflows. Coming in 2015, Kno2 will be expanded to include the automation of fax, scanned documentation and virtually any other source where clinical documents may be originating! Streamline your document exchange and filing process overnight!

2 Why use Kno2? Kno2 provides a set of tools specifically designed for moving patient information across your system of healthcare partners using the Surescripts Clinical Interoperability Network. Kno2 creates a common link for all members of the care continuum to securely exchange patient information without requiring disruptive changes in process or heavy investments in technology. Kno2 improves and expands the exchange of patient information with a simple, affordable solution designed to replace the limitations of traditional fax communication. Kno2 functionality enables you to transform unstructured and paper-based content into interoperable patient information to complete the patient record, enhance patient safety and improve quality of care. Kno2 integrates with existing processes and patient workflows while providing the ability to replace outdated methods of communication for improved efficiency. Kno2 is very affordable. Surescripts FAQ Who is Surescripts? The Surescripts network supports the most comprehensive ecosystem of healthcare organizations nationwide. Pharmacies, payers, pharmacy benefit managers, physicians, hospitals, health information exchanges and health technology firms rely on Surescripts to more easily and securely share health information. Guided by the principles of neutrality, transparency, physician and patient choice, open standards, collaboration and privacy, Surescripts operates the nation's largest health information network. By providing information for routine, recurring and emergency care, Surescripts is committed to saving lives, improving efficiency and reducing the cost of healthcare for all. For more information, go to and follow them at twitter.com/surescripts. Direct FAQs What is Direct? Direct is a protocol for encrypted messaging that supports the secure electronic exchange of health information between trusted entities (i.e., physicians, nurses, nursing homes, hospitals). Direct messages can include any type of file attachment. Both the message and the attachments are encrypted. What is the Direct Project? When healthcare organizations, providers, and patients exchange information today, they're likely sending paper through the mail or fax. The Direct Project aims to improve this process, making it faster, less expensive and more secure. How? The Direct Project establishes standards and documentation to support simple scenarios of pushing data from where it is to where it's needed, in a way that will support more sophisticated interoperability in the future. For more information you can consult:

3 What is DirectTrust? DirectTrust is an independent non-profit association whose mission is to develop and promote rules and best practices around security and trust in electronic health information exchange. DirectTrust defines the Trust Framework as a set of technical, legal, and business standards, expressed as policies and best practices recommendations, which members of the trust community agree to follow, uphold and enforce. What is meant by Direct exchange? Direct exchange describes the push of health information from a sender to a known receiver, similar to a how an or fax is pushed from one endpoint to another. What is a Direct address? Similar to a fax number or address, but much more secure, a Direct address is a uniquely assigned healthcare address that is used for sending information to and from. Direct addresses are commonly assigned to providers of all types, departments, workflows, medical record areas, devices, or wherever you want documents to be exchanged. Meaningful Use & Health Information Exchange FAQs What is meaningful use? Electronic health records can provide many benefits for providers and their patients, but the benefits depend on how they're used. Meaningful use (MU) is the set of standards defined by the Centers for Medicare & Medicaid Services (CMS) Incentive Programs that governs the use of electronic health records and allows eligible providers and hospitals to earn incentive payments by meeting specific criteria. For details about the incentive programs, visit the cms website. The goal of meaningful use is to promote the spread of electronic health records to improve health care in the United States. The benefits of the meaningful use of EHRs include: Complete and accurate information. With electronic health records, providers have the information they need to provide the best possible care. Providers will know more about their patients and their health history before they walk into the examination room. Better access to information. Electronic health records facilitate greater access to the information providers need to diagnose health problems earlier and improve the health outcomes of their patients. Electronic health records also allow information to be shared more easily among doctors' offices, hospitals, and across health systems, leading to better coordination of care. Patient empowerment. Electronic health records will help empower patients to take a more active role in their health and in the health of their families. Patients can receive electronic copies of their medical records and share their health information securely over the Internet with their families.

4 How does Direct help in achieving meaningful use? Under Meaningful Use Stage 2, providers that qualify for reimbursement must demonstrate the exchange of clinical information using a secure messaging or network exchange. Direct-compatible networks are strongly recommended and endorsed as the network of choice based upon the acceptance of the Direct protocol across the continuum. The Surescripts Clinical Interoperability Network has been approved and accredited as the leading clinical Direct network. What does attestation mean with respect to meaningful use in healthcare? Meaningful use attestation, in a healthcare information technology (HIT) context, is a process that documents that an organization or an individual has successfully demonstrated meaningful use and is successfully fulfilling the requirements for electronic health records (EHR) and related technology. According to the provisions of the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, organizations eligible for the Medicare EHR incentive program must attest to Meaningful Use Stage 1 for two years before moving on to Meaningful Use Stage 2 for two years, before tackling Meaningful Use Stage 3. The Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC) establish all criteria. Those eligible for the Medicaid program must demonstrate Meaningful Use by 2016 in order to receive payment. What if I don t attest to meaningful use, why do I care? If you participate in patient care, you will be affected. The transfer of patient care and records happens across all care settings, including post-acute and the extended care markets. Hospitals and leading providers will be encouraged to send patient referrals to your organization based upon your ability to send and receive Direct communications. Kno2 will easily enable your organization to do this without heavy investments in technology and infrastructure. What if I am on a different health information exchange? No worries. Speak with your Health Information Exchange provider and find out if they are Direct compliant and a trusted network. If so, you can stay right where you are. If not, we will assist you in enabling your office to utilize Kno2 while maintaining your existing HIE connections. Other Sources of Information on Direct plus.com/filedownloads/2013%20ehealth%20direct%20connect%20- %20Ambulatory%20HIE%20FAQ.pdf

5 Glossary Acute Care Acute care is a branch of secondary healthcare where a patient receives active, but short-term treatment for a severe injury or episode of illness, typically a short-term stay in a hospital not usually exceeding a few days. Advance Directive An advance directive, also known as a living will, personal directive, advance decision, or an advance healthcare directive, is a set of written instructions that a person gives that specifies what actions should be taken for their health if they are no longer able to make decisions due to illness or incapacity. Ambulatory Care Ambulatory care is a personal healthcare consultation, treatment or intervention using advanced medical technology or procedures delivered on an outpatient basis (i.e., where the patient s stay at the hospital or clinic, from the time of registration to discharge, occurs on a single calendar day). Analytics Healthcare analytics is a product category used in the marketing of business software and consulting services. It makes extensive use of data, statistical and qualitative analysis, explanatory and predictive modeling. The U.S. healthcare industry is undergoing three major overlapping developments in the evolution of data management and information technology utilization: Data Collection: characterized by the adoption and meaningful use of electronic medical records. Data Sharing: characterized by the adoption of health information exchanges Data Analysis: characterized by the adoption of enterprise data warehouses and analytic tools. In 2004, the Healthcare Information Management Systems Society (HIMSS) published the seven-stage EMR adoption model (EMRAM), creating a pivotal framework for measuring the industry s advancement towards the use of computerized medical records. Ancillary Services Ancillary services refer to the healthcare services provided exclusive of room and board. Supplies and lab tests provided under home care, audiology, durable medical equipment (DME), ambulatory surgical centers (ASC), home infusion, cardiac testing, hospice care, fitness center, radiology, sleep centers and skilled nursing facilities are just some examples of ancillary services.

6 CDA The HL7 CDA (clinical document architecture) is an XML-based markup standard intended to specify the encoding, structure and semantics of clinical documents for exchange. CDA is an ANSI-certified standard from health level seven. CDA specifies the syntax and supplies a framework for specifying the full semantics of a clinical document. It defines a clinical document as having the following six characteristics: persistence, stewardship, potential for authentication, context, wholeness and human readability. A CDA can contain any type of clinic content. Typical CDA documents would be a patient discharge summary, imaging report, pathology report, admission physical, etc. Even though CDA typically uses XML, it allows for a non-xml body (pdf, Word, jpg and so on) for simple implementations. CMS A federal agency within the U.S. Department of Health and Human Services that administers the Medicare program and works in partnership with state governments to administer Medicaid (known as Medi-Cal in California), the State Children s Health Insurance Program (SCHIP), and health insurance portability standards. Direct Direct is a protocol for encrypted messaging that supports the secure electronic exchange of health information between trusted entities (i.e., physicians, nurses, nursing homes, hospitals). Direct messages can include any type of file attachment. Both the message and the attachments are encrypted. DME DME (Durable Medical Equipment) is any medical equipment used in the home to aid in a better quality of living. Some examples include nebulizers, CPAP machines, catheters, hospital beds, wheelchairs (which may include a motorized mechanism), iron lungs and oxygen tents. EMR/EHR An EMR is an electronic medical record whereas an EHR is an electronic health record. HIE HIE (Health Information Exchange) is the mobilization of healthcare information electronically across organizations within a region, community or hospital system. HIE provides the capability to electronically move clinical information among disparate healthcare information systems while maintaining the meaning of the information being exchanged. The goal of the HIE is to facilitate access to and retrieval of clinical data to provide safer and more timely, efficient, effective and equitable patient-centered care. HIM HIM stands for Health Information Management. HIM is the practice of maintenance and care of health records by traditional (paper-based) and electronic means in hospitals, doctors offices, health departments, health insurance companies, and other facilities that provide healthcare or maintenance of health records.

7 HIMSS HIMSS (Healthcare Information Management Systems Society) is a global, cause-based, not-for-profit organization focused on better health through information technology (IT). HIMSS leads efforts to optimize health engagements and care outcomes using information technology to improve healthcare quality, safety, cost-effectiveness, and access through the best use of information technology and management systems. HIPAA HIPAA (Health Insurance Portability and Accountability Act) was enacted into law in August, 1996 to uphold privacy standards for health insurance plans, to combat waste, fraud, and abuse in health insurance and healthcare delivery, to promote the use of medical savings accounts, to improve access to long term care services and coverage, and to simplify the administration of health insurance. Title 1 of HIPAA protects health insurance coverage for workers and their families when they change or lose their jobs. Title 2 of HIPAA, known as the administrative simplification (AS) provisions, requires the establishment of national standards for electronic healthcare transactions and national identifiers for providers, health insurance plans and employers. This act gives the right to privacy to individuals from age 12 through age 18. The provider must have a signed disclosure from the affected before giving out any information on provided healthcare to anyone, including parents. Ultimately HIPAA is intended to improve the efficiency and effectiveness of the nation s healthcare system by encouraging the widespread use of electronic data interchange in the U.S. healthcare system. HISP A HISP (Health Information Systems Program) is an organization that provides security and transport services for directed exchange based on the Direct protocol. A HISP provides: Assurance: of identity of participant (entities and individuals) and justification for participation in the trust community. A HISP also issues and maintains direct addresses to participants (entities and individuals) Security: associate each address with at least one security certificate and assure directcompliant payload encryption as specified by each addressee maintain a keystore of public keys discoverable to other HISPs through industry-standard protocols (i.e., DNS, LDAP) Standards: process direct-compliant messages to and from assigned addressees using SMTP/SMIME, signed and encrypted using X509 certificates. HITECH HITECH, the Health Information Technology for Economic and Clinical Health Act, abbreviated HITECH Act, was enacted under Title XIII of the American Recovery and Reinvestment Act of Under the HITECH Act, the Department of Health and Human Services is spending $25.9 billion to promote and expand the adoption of health information technology. The Washington Post reported the inclusion of as much as $36.5 billion in spending to create a nationwide network of electronic health records. At the time it was enacted, it was considered the most important piece of healthcare legislation to be passed in the last 20 to 30 years, and the foundation for healthcare reform.

8 HL7 HL7 is known as Health Level Seven International and was founded in It s a not-for-profit, ANSIaccredited standards developing organization dedicated to providing a comprehensive framework and related standards for the exchange, integration, sharing and retrieval of electronic health information that supports clinical practice and the management, delivery and evaluation of health services. HL7 s 2,300 plus members include approximately 500 corporate members who represent more than 90% of the information systems vendors serving healthcare. Level Seven refers to the 7 th level of international organization for standardization (ISO) seven-layer communications model for open systems interconnection (OSI) - the application level. HL7 provides standards for interoperability that improve care delivery, optimize workflow, reduce ambiguity and enhance knowledge transfer among all stakeholders, including healthcare providers, government agencies, the vendor community, fellow SDOs and patients. Hospice Care/Palliative Care Hospice care is a type and philosophy of care that focuses on the palliation of a terminally ill or a seriously ill patient s pain and symptoms, and attending to their emotional and spiritual needs. It s typically care for the dying, and emphasis is placed on humane and compassionate care. Palliative care is medical care provided by physicians, nurses and social workers that specializes in the relief of the pain, symptoms and stress of serious illness. ICD-9 and ICD-10 ICD-9 is more formally known as the International Classification of Diseases, 9 th Revision, Clinical Modification. It is the official system used in the United States of America to classify and assign codes to health conditions and related information. The use of standardized codes improves consistency among physicians in documenting patient symptoms and diagnoses. ICD-9 was adopted in ICD-10 replaced ICD-9 on October 1, ICD-10 is the 10 th Revision of the International Statistical Classification of Diseases and related health problems. IHE IHE (Integrating Healthcare Enterprise) is an initiative by healthcare professionals and industry to improve the way computer systems in healthcare share information. IHE promotes the coordinated use of established standards such as DICOM and HL7 to address specific clinical needs in support of optimal patient care. Intake Intake is the process in which a person is admitted to a clinic or hospital, or signed-in for an outpatient (doctor s office) visit. The reason for the visit and various identifying data about the patient are documented. Certain standard/routine procedures may be performed, such as obtaining patient vital signs (blood pressure, temperature, pulse and respirations, height and weight, and possibly a urine specimen. Basic information such as basic health history, medications, reason for visit are typically obtained during the intake appointment.

9 Interoperability Interoperability describes the extent to which systems and devices can exchange data, and interpret that shared data. For two systems to be interoperable, they must be able to exchange data and subsequently present that data such that it can be understood by a user. In healthcare, interoperability is the ability of different information technology systems and software applications to communicate, exchange data, and use the information that has been exchanged. Data exchange schema and standards should permit data to be shared across clinicians, labs, hospital, pharmacy and patient regardless of the application or application vendor. Long Term Care Facility Long term care facilities (LTCFs) are defined as institutions such as nursing homes, care homes, convalescent homes, skilled nursing facilities, intermediate care facilities that all provide a type of residential care. They are a place of residence for people who require continual nursing care and have significant deficiencies with activities of daily living. Managed Care Organization Managed care or managed healthcare is used in the U.S. to describe a variety of techniques intended to reduce the cost of providing health benefits and improve the quality of care, for organizations that use those techniques or provide them as services to other organizations (managed care organization or MCO), to describe systems of financing and deliver healthcare to enrollees organized around managed care techniques and concepts (managed care delivery systems). The growth of managed care in the U.S. was spurred by the enactment of the Health Maintenance Organization Act of Meaningful Use Meaningful use is using certified electronic health record (EHR) technology to: Improve quality, safety, efficiency, and reduce health disparities Engage patients and family Improve care coordination, and population and public health Maintain privacy and security of patient health information Ultimately, it is hoped that the meaningful use compliance will result in: Better clinical outcomes Improved population health outcomes Increased transparency and efficiency Empowered individuals More robust research data on health systems Medicaid In a nutshell, Medicaid is healthcare for the needy or underserved. It is a federally and state-funded program. Medicaid provides free or low-cost health coverage to more than 50 million children, families, pregnant women and people with disabilities. Medicare Medicare is healthcare for the elderly. It is a federally administered system to persons aged 65 and older, since There are also three conditions where a person can be eligible for Medicare if they are under the age of 65. These include younger people with disabilities, amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig s Disease) or End-Stage Renal Disease (permanent kidney failure, also known as ESRD) receiving dialysis or have had a kidney transplant.

10 PHI PHI is simply an acronym for Protected Health Information. Release or Release of Information Release of information (ROI) generally refers to the forms that patients usually sign (granting authorization) authorizing information to be released to another person, healthcare provider, company, etc. Unstructured Content Unstructured content is all of a patient s healthcare information that has yet to be stored in an electronic file. It s a significant problem that a vast majority of healthcare providers are presently faced with.