comp3 unit14 lecture slides

Terminology in Healthcare and Public Health SettingsWhat is Health Information Management and Technology?This material Comp3_Unit14 was developed by The University of Alabama Birmingham, funded by the Department of Health and Human Services, Office of the National Coordinator for Health Information Technology under Award Number 1U24OC000023

Terminology in Healthcare and Public Health Settings What is Health Information Management and Technology?

What is Health Information Management and Technology?Learning ObjectivesDefine and explain terms and concepts Understand terms that frame HIM and HIT practiceDescribe health IT hardware and softwareDefine acronyms and abbreviations

*Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings What is Health Information Management and Technology?


Electronic Health Information ManagementeHIMA term and trademark used by AHIMA to identify the transition from paper based health information management to electronic health information management (eHIM)

Source:(AHIMA, 2012)*Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings What is Health Information Management and Technology?


eHIMA term and trademark used by AHIMA to identify the transition from paper based health information management to electronic health information management (eHIM)Electronic Health Record (EHR) ManagementA process where the management of electronic health data is created or received for legal or business purposesSource:(AHIMA, 2012)*Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings What is Health Information Management and Technology? Electronic Health Information Management


Health Information Technology: Hardware and Software*Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings What is Health Information Management and Technology?


SoftwareLegacyOff-the-shelfVanilla systemsHome grownBest of breed*Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings What is Health Information Management and Technology?


Types of NetworksA network is a system of multiple computers that share information virtuallyInformation is stored and retrieved from data repositories on computers called serversSmart terminals

Dumb terminals

Wireless *Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings What is Health Information Management and Technology?


Data EntryDevicesCentral Processing Units (CPU)Secured TabletsSlim ClientsSecured Personal Digital Assistants (PDA)LocationsPoint-of-careNurses StationComputers on Wheels



Commonly Used HIT Acronyms*Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings What is Health Information Management and Technology?

Professional organizations supporting HIT

AHIMAAmerican Health InformationManagement AssociationAMIAAmerican Medical Informatics AssociationHIMSSHealthcare Information and Management Systems SocietyEHRAHIMSS Electronic Health Record Association


Commonly Used HIT Acronyms


National agencies supporting HIT

AHRQ Agency for Healthcare Research and QualityHHSDepartment of Health and Human ServicesNIHNational Institutes of HealthNLMNational Library of MedicineIOMInstitute of Medicine



US governmental oversight for HITECH

ONCHIT Office of the National Coordinator for Health Information Technology ONC Office of the National CoordinatorONC HIT (Health IT) Standards CommitteeONC HIT (Health IT) Policy Committee


Commonly Used HIT Acronyms


CDCCenters for Disease Control and PreventionCMSCenters for Medicare and Medicaid ServicesFDAFood and Drug AdministrationHRSAHealth Resources and Services AdministrationCAHCritical Access HospitalSource(HRSA, 2012)



Organizations supporting HIT standardsCCHITCertification Commission for Health Information TechnologyATCBAuthorized Testing and Certification BodyATLAccredited Testing LaboratoryACBAuthorized Certification BodySDOStandards Development OrganizationHITSPHealth Information Technology Standards PanelHL7Health Level 7ISOInternational Organization for Standardization



CIOChief Information OfficerCMIOChief Medical Information OfficerCNIOChief Nursing Information Officer



CIOChief Information OfficerCMIOChief Medical Information OfficerCNIOChief Nursing Information OfficerSNOMEDSystematized Nomenclature of MedicineVHAVeterans Health AdministrationVistAVeterans Health Information Systems and Technology Architecture


Commonly Used HIPAA Acronyms


CECovered EntityHIPAAHealth Insurance Portability and Accountability Act of 1996BABusiness AssociateBAABusiness Associate Agreement

Source: (AHIMA, 2012)


Commonly Used HIPAA Acronyms


CFRCode of Federal RegulationsIFRInterim Final RuleNPRMNotice of Proposed RulemakingOCROffice for Civil RightsPHIProtected Health Information

Source: (AHIMA, 2012)


What is Health Information Management and Technology?SummaryUnderstand the terms and concepts used in the fieldUnderstand the terms that frame HIM and HIT practiceDescribe health IT hardware and softwareRecognize commonly used acronyms and abbreviations



What is Health Information Management and Technology?References*Health IT Workforce Curriculum Version 3.0/Spring 2012 Terminology in Healthcare and Public Health Settings What is Health Information Management and Technology? ReferencesAHIMA. ARRA acronyms. Available from: http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_047273.hcsp?dDocName=bok1_047273Amatayakul MK. Electronic health records: a practical guide for professionals and organizations. Chicago (IL): AHIMA; 2009.AHIMA. eHIM. Electronic health information management. Available from: http://www.ahima.org/ehim/default.aspxAHIMA. HIM role in EHR management and the legal EHR. Available from http://www.ahima.org/resources/ehrroles.aspxHRSA. About HRSA. Available from: http://www.hrsa.gov/about/ Relationship of terminologies and classifications. American Health Information Management Association. Available from: http://www.ahima.org/resources/termclass.aspxONC. Acronyms. Available from: http://healthit.hhs.gov/portal/server.pt/community/health_it_hhs_gov__acronyms/1217

ImagesSlides 5, 6: Microsoft clip art; Used with permission from Microsoft.


Welcome to Terminology in Healthcare and Public Health Settings, What is Health Information Management and Technology? This unit will focus on terms and concepts associated with health information management and technology. As defined by the Office of the National Coordinator for Health Information Technology, Health Information Technology or HIT (pronounced H-I-T) is the application of information processing involving both computer hardware and software that deals with the storage, retrieval, sharing, and use of healthcare information, data, and knowledge for communication and decision making.

*The objectives for this unit, What is Health Information Management and Technology?, are to: define and explain the terms and concepts used in the field, to understand the terms that frame HIM (pronounced H-I-M) and HIT (pronounced H-I-T) practice, to describe Health IT hardware and software, and to define commonly used acronyms and abbreviations.*In 1928, an organization was formed devoted to identifying standards in clinical records with the aim of improving patient care. While the American Health Information Management Association, known as AHIMA, (pronounced Uh-HEEM-Uh) continues to promote this concept, members are educated to promote the benefits of electronic health records to also include being patient-centered, comprehensive, longitudinal, accessible, and credible. eHIM (pronounced E-H-I-M) refers to this view of the future of electronic health information management.

*EHR Management is a process that encompasses the creation or the receipt of electronic health data and that information becomes the legal or business record for the healthcare organization.

*Health Information Technology is a combination of computer hardware and computer software. We will now describe some of this technology.*First we will discuss software. Health IT software can be developed and acquired from multiple sources.

Legacy systems are those systems that have been in place and used by the organization for a period of time. They may be used alone or in combination with other applications.

When an organization purchases and implements a system with little or no customization this is referred to as an off-the-shelf system or turnkey system.

A system that is more of a framework for the organizations own customization is often referred to as a vanilla system. Think of it like plain vanilla ice cream before adding the extra toppings, that is, the unique features that a particular organization requires.

In some cases, organizations may choose to develop their own systems using system designers and programmers who work for the organization. This is often called a home grown system.

When an organization chooses multiple vendors or manufacturers for various components of the health IT system, this is referred to as going best of breed. For example, to pick the best system to meet the unique needs of each department, a pharmacy system might be purchased from one vendor, a documentation system from another, and a laboratory system from yet another vendor. *Health information systems integrate information from multiple sources and multiple locations. Therefore they must run on some sort of network. The type of network chosen for the information system depends on the type of organization and the purpose of the system. The type of network chosen determines the type of data entry devices used in the system and whether they are directly connected through wires and cables or through a wireless system.

Smart terminals are data entry devices that generally have extensive memory and house (pronounced HOWZ) computer applications directly on the computers themselves.

Dumb terminals have little or no memory and most computer applications are accessed through a connection to network servers where the applications are housed.

Wireless networks can use smart or dumb terminals. The terminals are not connected directly to the system for access but access servers and the network wirelessly.*Multiple types of data entry and access devices are available that can interact with information system networks.

Central processing units or CPUs (pronounced C-P-Us) are stationary computers that are generally directly connected to the network through computer wire or cable.

Tablets are small portable computers that have screens that can be written on with a stylus writing device and are connected to the network wirelessly. Slim clients, also known as thin clients, are also connected small computers. However, slim clients are dumb terminals that do not have any capacity for data storage. The advantage of the slim client is that it assists in maintaining confidentiality and data security.

Smaller devices such as smart phones or PDAs (pronounced P-D-As) are increasingly popular for access to data, information, clinical protocols and references.

Portable devices such as the tablets and PDAs have be prone to breaches, so it is important that the devices used are kept secure. For example, the devices should be password protected and if data are stored on them, the data should be encrypted.

If wireless devices are not used, the locations for data entry include computer stations in the patients room in a hospital or in the exam room in a doctors office, a central location such as the nurses station, or computers on carts that can be wheeled around from room to room. The carts are referred to as COWs (pronounced cows), which is an abbreviation for computers on wheels.*Now lets take a look at some of the most commonly used acronyms (pronounced ack-ro-nims) in the HIT field. There are a lot of them! Some of them refer to the professional organizations that support HIT. We already mentioned the American Health Information Management Association, but other organizations include the American Medical Informatics Association or AMIA (pronounced Aim-ee-uh) and the Healthcare Information and Management Systems Society known as HIMSS (pronounced hims). These organizations and their members are very active in the HIT field. AMIA now just uses its acronym rather than the full name.

The HIMSS Electronic Health Record Association is a trade association of electronic health record companies working nationally to create and support interoperable electronic health records in hospitals and ambulatory care.

*Federal government funding agencies supporting HIT include:

the Agency for Healthcare Research and Quality, sometimes called A-H-R-Q and sometimes called ARC (pronounced ark). AHRQ has provided funding for many HIT implementation projects.

the Department of Health and Human Services, known as HHS (pronounced H-H-S) or DHHS (pronounced D-H-H-S).

the National Institutes of Health, known as NIH (pronounced N-I-H). This is the major government funding source for medical research.

and the National Library of Medicine or NLM (pronounced N-L-M) which is part of NIH. The NLM provided a lot of support for early informatics (pronounced IN-fer-MAT-icks) research. The Institute of Medicine, or IOM (pronounced I-O-M), is part of the National Academies of Sciences. The IOM provides advice to the nation on health. Several of their reports on ways to improve patient safety have advocated the use of Health IT.

*The Health Information Technology for Economic and Clinical Health or HITECH Act is legislation that supports the use of health information technology. The major government agency overseeing the HITECH initiatives is the Office of the National Coordinator for Health Information Technology. It is usually referred to as just ONC (pronounced O-N-C). Two committees that advise the National Coordinator are the Health IT Standards Committee and the Health IT Policy Committee.

*There are other government agencies that are frequently involved with health IT issues. These include the Centers for Disease Control and Prevention abbreviated CDC (pronounced C-D-C) and the Centers for Medicare and Medicaid Services or CMS (pronounced C-M-S). Notice that the names of both of these agencies begin with Centers, not Center.

Other agencies are the Food and Drug Administration known as the FDA (pronounced F-D-A), and the Health Resources and Services Administration or HRSA (pronounced HER-suh).

The CDC is the major public health agency in the country. The FDA oversees the safety of drugs and devices. According to its website, HRSA is the primary Federal agency for improving access to health care services for people who are uninsured, isolated or medically vulnerable. CAH (pronounced C-A-H) stands for Critical Access Hospital. Critical access hospitals are usually small rural hospitals that provide services for the medically underserved, that is those people with limited access to medical care. HRSA works with critical access hospitals.

*Establishing standards in health IT is a very important effort right now. Several organizations are involved in these efforts. In addition to the ONC Health IT Standards committee, these organizations include the Certification Commission for Health Information Technology (pronounced C-C-H-I-T), which was the first group recognized by the government for certifying electronic health records. There are also other organizations who have received the designation as an Authorized Testing and Certification Body and ONC Authorized Certification Body. The ONC-ATCBs (pronounced O-N-C-A-T-C-Bs) were testing and certification bodies under the temporary certification program. The Accredited Testing Laboratories test the EHRs and the ONC-ACBs perform the actual certification in the permanent certification program. Other standards development organizations have worked to establish technical standards for electronic health records. These include the Health Information Technology Standards Panel or HITSP (pronounced Hits-pee) and Health Level 7. HITSP has disbanded as the ONC HIT Standards Committee has taken over much of its work. The ISO (pronounced I-S-O) is an international standards setting organization. Notice that although it is abbreviated as ISO, its name is the International Organization for Standardization.

*Other acronyms used in discussing health information technology include CIO (pronounced C-I-O), CMIO pronounced C-M-I-O) and CNIO (pronounced C-N-I-O).

The CIO is the Chief Information Officer. The CIO is responsible for the health information planning, implementing, maintaining and controlling of health information technology in the organization. New related jobs include the CMIO which stands for Chief Medical Information Officer and the CNIO or Chief Nursing Information Officer. These are usually clinicians whose job is to be a liaison (pronounced lay-is-on) between the physicians or nurses and the IT staff.*SNOMED (pronounced snow-med) is the Systematized Nomenclature (pronounced NOME-en-clay-ture) of Medicine. SNOMED is a comprehensive clinical terminology that can be used with electronic health records to encode medical information.

VHA (pronounced V-H-A) is the Veterans Health Administration. Sometimes this is just abbreviated VA (pronounced V-A). The information system in the V-A is known as Vista (pronounced vista).

*Other acronyms used in healthcare include acronyms associated with the federal legislation known as the Health Insurance Portability and Accountability Act of 1996 or HIPAA (pronounced HIP-uh). The acronyms include: CE (pronounced C-E) for Covered Entity. This is an organization that must comply with the HIPAA rules.

BA (pronounced B-A) stands for Business Associate. This is someone who works with a Covered Entity. A BAA (pronounced B-A-A) is used for Business Associate Agreement, which is required to assure that business associates take proper responsibility for protecting health information.*These are more acronyms used in healthcare associated with the HIPAA (pronounced HIPP-Uh) rules and other federal rules.CFR (pronounced C-F-R) is an acronym for the Code of Federal Regulations. These are rules that are published in the federal register.

IFR (pronounced I-F-R) stands for Interim Final Rule, which is a version of a federal rule that is sent out for comments before being finalized.NPRM (pronounced N-P-R-M) stands for Notice of Proposed Rulemaking and represents the first publication that announces that there is going to be a new federal regulation.OCR (pronounced O-C-R) is the acronym for the Office for Civil Rights which has oversight responsibility for the HIPAA Privacy and Security Rules.PHI is the acronym which stands for Protected Health Information which refers to identifying information about the individual that HIPAA protects. *This concludes What is Health Information Management and Technology?

In summary, you should now understand many of the terms and concepts used in the Health Information Management and Health IT field. You should also understand the terms that frame HIM and HIT practice, and you should be able to describe the hardware and software used in health IT systems. Key points to remember are that health IT systems require choices between different types of system networks, application software, and data entry hardware. Finally, you should be able to recognize commonly used acronyms and abbreviations.

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