Chapter 10-11 (Consumer Informatics/Health Information Exchange)

Question 1

Blue Button

Answer 1

a movement toward an improved healthcare system in which patients and providers use information technology to collaborate and improve health. The Blue Button logo signifies that you—as an individual consumer or patient–can get easy, secure access to your own health information in a format you can use. To “Blue Button” is a verb, meaning, for a consumer, “download my health data so I can use it.”

Question 2

digital divide

Answer 2

the growing gap between the underprivileged members of society, especially the poor, rural, elderly, and handicapped portion of the population who do not have access to computers or the Internet; and the wealthy, middle-class, and young Americans living in urban and suburban areas who have access

Question 3

Ask Me 3

Answer 3

Ask Me 3 is an educational program that encourages patients and families to ask three specific questions of their providers to better understand their health conditions and what they need to do to stay healthy.

What is my main problem?
What do I need to do?
Why is it important for me to do this?

Question 4

personal health record

Answer 4

a health record where health data and other information related to the care of a patient is maintained by the patient

Question 5

bring your own device (BYOD)

Answer 5

a trend involving healthcare practitioners using their personal smartphones or other devices rather than devices provided by the healthcare organization. While acceptable, the personal device must meet specific encryption and other security protocols to protect PHI as required by the healthcare organization.

Question 6

consent management

Answer 6

a system, process, or set of policies that enables patients to choose what health information they are willing to permit their healthcare providers to access and share. Consent management allows patients to affirm their participation in electronic health initiatives such as patient portals, personal health records (PHR), and health information exchange (HIE)

Question 7

consolidated model (centralized)

Answer 7

one of the three models of health information exchange architecture
Many independent healthcare organizations connect with the HIE and aggregate data is stored and shared within a central repository managed by the HIE. This centralized data has a master patient index or a record locator service (RLS).

Question 8

consumer-mediated exchange

Answer 8

a type of health information exchange that is controlled by patients who want to control the use and access of their health information. According to the ONC, “consumer-mediated exchange provides patients with access to their health information, allowing them to manage their health care online in a similar fashion to how they might manage their finances through online banking. When in control of their own health information, patients can actively participate in their care”

Question 9

directed exchange

Answer 9

frequently referred to as a “push exchange” because it pushes authorized and secure information from one healthcare organization to another. For example, if a patient is being transferred from one hospital to another, the patient’s health information would be “pushed” to the receiving hospital in order to provide the background health information to help the transition to continued care

Question 10

federated model (decentralized)

Answer 10

one of the three models of health information exchange architecture
There is no centralized database of patient information. The federated model is more common than the consolidated model because it works much like the Internet. With the advent of cloud computing, the federated model may become the more common HIE model.

Question 11

health information organization (HIO)

Answer 11

a public–private partnership organization that oversees, governs, and facilitates the transmission of health data between different types of healthcare organizations that have various EHR systems, according to nationally recognized standards. Many HIOs started as a local health information organization (LHIO) or regional health information organization (RHIO)

Question 12

hybrid model

Answer 12

combines the advantages of centralized and decentralized models. It has an record locator service, and some data are stored in a central repository while the remainder stays with the other healthcare organizations within the HIE. The hybrid model also has a patient portal to itself, and not to a specific healthcare organization

Question 13

identity management

Answer 13

security measures that ensure that the individual who has been identified in a health information organization system is who they say they are, that they have the authority to do what they want to do, and that their actions are tracked

Question 14

identity matching

Answer 14

(also known as patient matching) the process in which the health information organization identifies the right person within the database to exchange information between healthcare organizations. The process examines different demographic elements from different health information technology (health IT) systems to determine if they refer to the same patient.

From an interoperability perspective, the ability to complete patient matching efficiently, accurately, and at scale has long been identified as a key element of the nation’s health IT infrastructure. Patient matching is almost universally needed to enable the interoperability of health data for all kinds of purposes. Patient matching also requires careful consideration with respect to its effect on patient safety and administrative costs

Question 15

local health information organization (LHIO)

Answer 15

a small-scale, local version of an RHIO

Question 16

Meaningful Use (MU)

Answer 16

a regulation that was issued by the Centers for Medicare and Medicaid (CMS) on July 28, 2010, outlining an incentive program for eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) participating in Medicare and Medicaid programs that adopt and successfully demonstrate meaningful use of certified EHR technology

Question 17

eHealth Exchange

Answer 17

formerly called nationwide health information network (NwHIN); it is a set of standards, specifications and policies that enable the secure exchange of health information over the Internet. This program provides a foundation for the exchange of health information across diverse entities, within communities and across the country, helping to achieve the goals of the HITECH Act. The Nationwide Health Information Network Exchange is the first community that implemented these standards, specifications and policies in production

Question 18

opt-in or opt-out consent

Answer 18

an option in a health information organization system (HIO) that sets the default for health information of patients to be included in the HIO automatically (opt-in), but the patient can choose not to be included (opt-out)

A variation on this consent is the OPT-OUT WITH EXCEPTIONS model that sets the default for health information for patients to be included, but the patient can opt-out completely or allow only select data to be included

Question 19

query-based exchange

Answer 19

a find-and-seek request for information that is sent through the health information organization to find any available health information on a specified individual. It is the opposite of the “push exchange,” so it is thought of as a “pull exchange.” This type of exchange is typically used in urgent and emergency care to seek information that would be relevant for the encounter at hand.

For example, a Medicare patient is brought to the Emergency Department of a local hospital. The Emergency physician requests the patients’ most recent EKG and bloodwork results from her cardiologist. The cardiologist’s EHR is queried and it sends the EKG and labwork to the Emergency Department in response. The Emergency Physician is then able to compare the last EKG and bloodwork with the ones being done currently in order to make an informed decision about the patient’s treatment

Question 20

record locator service (RLS)

Answer 20

a software tool that provides the ability to identify where records are located based upon criteria such as a Person ID and/or record data type, as well as providing functionality for the ongoing maintenance of this location information

Question 21

regional health information organization (RHIO)

Answer 21

a group of organizations with a business stake in improving the quality, safety and efficiency of healthcare delivery that comes together to exchange information for these purposes. The terms RHIO and Health Information Exchange, or ‘HIE’, are often used interchangeably

Question 22

value-based healthcare

Answer 22

an evolving concept focused on three areas:

1. better care for the individual
2. better health for the community
3. lower cost of healthcare through improvement of services and delivery methods

Question 23

vetting

Answer 23

the process of critically appraising the abilities of an organization or person to determine if they meet the stated criteria

Question 24

infrastructure

Answer 24

the basic physical and organizational structures and facilities (e.g. buildings, roads, power supplies) needed for the operation of a society or enterprise

Question 25

syndromic

Answer 25

occurring as a syndrome or part of a syndrome

Question 26

advent

Answer 26

the arrival of a notable person, thing, or event