Unit 1: The National Health IT Landscape

3. Minicomputers

(Often) Stand-alone system that can be cheaper/smaller/more powerful than a mainframe computer - does not integrate well with other systems within the organization

3. Microcomputers

(Personal computer)

3. Computerized provider order entry (CPOE)

A computer application that accepts provider orders electronically, replacing handwritten or verbal orders and prescriptions

1. Commonwell Health Alliance

A consortium of HIT vendors and other organizations that are committed to achieving interoperability

1. The Sequoia Projects

A non profit organization to advance the implementation of secure, interoperable nationwide HIE

1. Health Level Seven International (HL7)

A not-for-profit, ANSI-accredited standards developing organization focused on technical standards for HIE

1. American National Standards Institute (ANSI)

A private, non-profit organization that coordinates the development and use of a voluntary consensus standards in the United States.

3. Patient Portals

A secure website through which patients may communicate with their provider, request refill on prescriptions, schedule appointments, review test results, or pay bills

3. Health IT Safety

A shared responsibility between vendors and health care organizations (Requirements on page 91)

1. Nationwide Interoperability Roadmap

A ten year plan for achieving HIT interoperability in the US

1. Patient-centered medical homes (PCMHs)

APMs that are rooted in the private sector

1. Bundled payments

Aim to incentivize providers to improve care coordination, promote teamwork, and lower costs

1. Health Insurance Portability and Accountability Act (HIPAA)

An act designed to make health insurance more affordable and accessible and also includes important provisions to simplify administrative processes and to protect the security and confidentiality of personal health information

1. American Recovery and Reinvestment Act

An economic stimulus bill passed in 2009, in response to the Great Recession, that provided $787 billion to state and local governments for schools, hospitals, and transportation projects. It was one of the largest single packages of government spending in American history. - (promoted HIE and HITECH)

1. Computer-based patient record (CPR)

An electronic patient record system that resides in a system specifically designed to support users by providing accessibility to complete and accurate data, alerts, reminders, clinical decision support systems, links to medical knowledge, and other aids

3. Electronic Health Record (EHR)

An electronic record of a patient's entire health history

3. Administrative information system

Contains primarily administrative or financial data and general used to support the management functions and general operations of the healthcare organization

3. HIMSS Analytics EMR Adoption Model (EMRAM)

Defines the stages of EMR adoption (0-7)

3. Clinical Information Systems

Departmental systems or clinical decision support, medication administration, computerized provider order entry, EHR systems, etc.

1. HIT interoperability

Encompasses any electronic sources with information needed to provide the best possible care

1. Strategic Health IT Advanced Research Projects (SHARP)

Establish by the ONC to support innovative research and to address well-documented problems that impede the adoption and use of health IT

1. Medicare Modernization Act

Expanded HIT program to include prescriptions and mandated the use of e-prescribing

3. Best of Breed (systems)

Individual clinical departments would select the best application or system for meeting their unique unit's needs and attempt to get the "systems to talk to each other" using interface engines

3. Mainframe Computers

Large central system of computer data, hard for small community hospitals to obtain/maintain

1. Office of the National Coordinator for Health Information Technology (ONC)

Located within the HHS that provides leadership for the development and nationwide implementation of an interoperable HIT infrastructure to improve the quality and efficiency of health care

3. Personal Health Records (PHR)

Managed by the patient, may include health and wellness information

1. Health Information Technology for Economic and Clinical Health (HITECH) Act

Mandated it to provide leadership and oversight of the national efforts to support the adoption of EHRs and HIE

1. Accountable Care Organization (ACO)

Networks of health care providers that share responsibility for coordinating care and meeting meeting healthcare quality and cost metrics for a defined patient population

1. Alternate Payment Methods (APM)

Providers receive bonus payments and are exempt from MIPS. Kinds that are currently popular (ACOs, bundled payments, PCMHs)

1. Beacon Community Program

Provides funding to selected communities to build and strengthen their health information technology infrastructure and exchange capabilities. The program supports these communities at the cutting edge of EHR adoption and health information exchange to push them to a new level of sustainable healthcare quality and efficiency

1. eHealth Exchange

Supported by the Sequoia Project, it is a group of government and nongovernment organizations devoted to improving patient care through interoperable HIE

1. Regional Extension Centers (RECs)

Supported rural health providers in adopting and becoming meaningful users of EHRs

3. Interoperability

The ability of a system to exchange electronic health information with and use electronic health information from other systems without special effort on the part of the user

1. Coordination of Care

The deliberate organization of patient care activities between two or more participants involved in a patient's care to facilitate the appropriate delivery of health care services

3. Usability

The effectiveness, efficiency, and satisfaction with which the intended users can achieve their tasks in the intended context of produce use

1. Fast Healthcare Interoperability Resources (FHIR) standards

Under HL7, these standards were introduced in 2012 to improve the exchange of EHR data

1. Meaningful Use (MU) of EHRs

Used to promote the use of HIT, and also determined incentive payments for promotion

1. Merit-based Incentive Payment System (MIPS)

Uses a set of performance measures, divided into categories to calculate a score (0-100) for eligible professionals

1. Pay for Performance (P4P)

Value-based purchasing pilot program

1. Affordable Care Act (ACA)

Widespread healthcare reform legislation

1. Electronic Health Record (EHR)

a computerized lifelong health care record for an individual that incorporates data from providers who treat the individual

1. Centers for Medicare and Medicaid Services (CMS)

a federal agency within the U.S. Department of Health and Human Services that is responsible for Medicare and Medicaid, among many other responsibilities.

1. Health Information Exchange (HIE)

a network that enables the sharing of health-related information among provider organizations according to nationally recognized standards

1. e-prescribing

electronic generation, transmission, and filling of a medical prescription

1. Value-based payment

paying health care providers for the quality of care they provide to Medicare patients

1. Health Information Technology (HIT)

technology that is used to record, store, and manage patient health care information

1. Patient Safety

the avoidance and prevention of patient injuries, adverse events, and compromise of patient health information (PHI) resulting from the processes of health care delivery.

1. Health Information blocking

when persons or entities knowingly and unreasonably interfere with the exchange or use of electronic health information