Frequently Asked Questions. Inofile FAQs

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1 Frequently Asked Questions

2 FREQUENTLY ASKED QUESTIONS 1. What is unstructured content in a healthcare setting? 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. 2. What is HL7? HL7 is known as Health Level Seven International and was founded in It s a not-for-profit, ANSI-accredited standards developing organization (SDO) 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 7th level of the 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. 3. What is CDA (Clinical Document Architecture)? The HL7 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 clinical content. Typical CDA documents would be a patient discharge summary, imaging report, pathology report, admission and physical, etc. Even though CDA typically uses XML, it allows for a non-xml body (pdf, word, jpg and so on) for simple implementations. 01

3 4. What is 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. 5. What is 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 HIE is to facilitate access to and retrieval of clinical data to provide safer and more timely, efficient, effective and equitable patient-centered care. 6. What is HISP? 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. HISP also issues and maintains direct addresses to participants (entities and individuals), Security: associate each address with at least one security certificate and assure direct-compliant payload encryption as specified by each addressee- -maintain a keystore of public keys discoverable to other HISPs through industry-standard protocols (e.g., DNS, LDAP), Standards: process direct-compliant messages to and from assigned addressees using SMTP/SMIME, signed and encrypted using X509 certificates. 02

4 7. What is HIMSS? HIMSS 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. 8. What is an EMR/EHR? An EMR is an electronic medical record whereas an EHR is an electronic health record. 9. What does intake mean in a healthcare setting? 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. 10. What does release or release of information mean in a healthcare setting? Release of information generally refers to the forms that patients usually sign (granting authorization) authorizing information to be released to another person, healthcare provider, company, etc. 11. What does HIM stand for in a healthcare setting? 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. 03

5 12. What is ICD-9 and ICD-10? The ICD-9 is more formally known as the International Classification of Diseases 9th 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. The ICD-9 was adopted in The ICD-10 will replace the ICD-9 on October 1, The ICD-10 is the 10th revision of the International Statistical Classification of Diseases and related health problems. 13. 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 one for two years before moving onto Meaningful Use stage two for two years before tackling Meaningful Use stage three. 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. 04

6 14. What is acute care? Acute care is a branch of secondary health care 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. 15. What is 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). 16. What is an 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. 17. What is a long term care facility? LTCFs are defined as institutions such as nursing homes, care homes, convalescent homes, skilled nursing facilities, or intermediate care facilities all providing 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. 18. What are ancillary services in healthcare? 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 this. 05

7 19. What is CMS in healthcare? 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. 20. What is Durable Medical Equipment? Durable Medical Equipment (DME) 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. 21. What is a 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 What is Medicaid? In a nutshell, Medicaid is healthcare for the needy or underserved. It is a federally and statefunded program. Medicaid provides free or low-cost health coverage to more than 50 million children, families, pregnant women and people with disabilities. 23. What is Medicare? Medicare is healthcare for the elderly. It is a federally administered system, to persons aged 65 and older, since

8 24. What is 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, an emphasis is placed on humane and compassionate care. Palliative care is medical care provided by physicians, nurses, and social workers that specialize in the relief of the pain, symptoms and stress of serious illness. 25. What is 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, 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. 07

9 26. What is PHI in healthcare? PHI is simply an acronym for Protected Health Information. 27. What does analytics mean and what are they used for? 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 3 major, overlapping developments in the evolution of data management and information technology utilization: 1- Data Collection: characterized by the adoption and meaningful use of electronic medical records; 2- Data Sharing: characterized by the adoption of health information exchanges; and 3- 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. The adoption of enterprise data warehouses, business intelligence and analytics in healthcare is estimated at approximately 10%, with substantial growth anticipated in the next decade (Frost and Sullivan, 2012). 28. What is interoperability in healthcare? 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. 08

10 29. What is HITECH? HITECH is 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. 30. What is Direct Trust in Healthcare? It s an organization that serves over 1,400 healthcare organizations and 45,000 individual users who are exchanging tens of thousands of Direct messages and attachments nationwide each month. With the new federal interoperability requirements for EHRs to be Direct enabled, the network will expand and these numbers exponentially increase during HAVE MORE QUESTIONS? For additional information on Inofile, and to contact us, visit Copyright 2014 Inofile, LLC All rights reserved inofile.com