Medical Terms Flashcards

1
Q

Providers

A

Providers: Those who give care. Physicians, nurses, and almost any other licensed clinical professional you can think of. Synonym: clinicians.

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2
Q

Payers?

A

Payers: Those who foot the bill for care. Health insurance companies, essentially. Sometimes patients pay for themselves, but that scenario is excluded here. Payers always refers to insurance companies. Synonym: insurers.

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3
Q

PolicyMakers

A

Policymakers: Those who make the rules relevant to care. This theoretically includes our elected representatives, but usually refers to the government agencies like CMS (Center for Medicare and Medicaid Services) which are responsible for health policy and programs. Other terms that you may encounter

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4
Q

Inpatient

A

Inpatient: Refers to hospitals and similar facilities where a formal admission is required and stays last longer than 24 hours.

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5
Q

Outpatient

A

Outpatient: Refers to clinic-like settings. Compared to Inpatient facilities, they provide shorter visits (less than 24 hours), treat simpler conditions, and generally cost less.

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6
Q

Health organization

A

Health Organization: An overarching term that encompasses both inpatient and outpatient facilities. It basically means a place where clinical professionals work to deliver healthcare services. Insurance companies are excluded. Synonyms: Care Delivery Organization (CDO), Health Delivery Organization (HDO).

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7
Q

Health System

A

Health Organization: An overarching term that encompasses both inpatient and outpatient facilities. It basically means a place where clinical professionals work to deliver healthcare services. Insurance companies are excluded. Synonyms: Care Delivery Organization (CDO), Health Delivery Organization (HDO).

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8
Q

ACA?

A

ACA: The Affordable Care Act. It was signed into law in March 2010, and is discussed further in section 2.4. Policy. Synonyms: Patient Protection and Affordable Care Act (PPACA), Obamacare.

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9
Q

ACO

A

ACO: Accountable Care Organization, a new format for health organizations promoted by the ACA.

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10
Q

EHR?

A

EHR: See section 3. Electronic Health Records. Synonyms: Electronic Medical Records (EMR), Electronic Patient Records.

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11
Q

PHR?

A

PHR: See section 3.6. Personal Health Records.

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12
Q

HIE?

A

HIE: See section 4. Health Information Exchanges.

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13
Q

HHS?

A

HHS: Department of Health and Human Services. The U.S. government office overseeing all federal regulations and programming for enhancing and protecting the health and well-being of all Americans. Nearly 80,000 employees and over 1.1 trillion

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14
Q

CMS

A

CMS: Centers for Medicare and Medicaid Services. The part of HHS that oversees the federal Medicare program and works in partnership with state governments to administer other social healthcare programs like Medicaid.

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15
Q

ONC?

A

ONC: Office of the National Coordinator for Health Information Technology. The part of HHS that leads all Health IT efforts, including grants, policies, and standards.

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16
Q

MU?

A

MU: Meaningful Use. The financial incentive program started by CMS to promote adoption of certified EHR technology, under direction of the American Recovery

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17
Q

CPOE?

A

CPOE: See section 3.4 Computerized Provider Order Entry. Synonyms: Order Entry, Computerized Physician Order Entry.

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18
Q

PCP?

A

PCP: Primary Care Provider. Synonyms: Primary Care Physician, Family Physician, General Practitioner.

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19
Q

Epic?

A

Epic: One of the major Electronic Health Record vendors. www.Epic.com.

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20
Q

Cerner?

A

Cerner: Another major Electronic Health Record vendor. www.Cerner.com.

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21
Q

HealthTech

A

Those in the venture capital community have long used “Health Tech” as an overarching term for everything at the intersection of technology and healthcare. “Tech,” in this case, is generic enough that it goes beyond just software to include medical devices (hardware)

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22
Q

HealthIT?

A

“Health IT” qualifies Health Tech with an information-only context. It has grown to be associated with enterprise-focused, traditional companies that deal with regulated hospital and clinic workflows. Blogs like Histalk and Chilmark Research are good places to learn about the Health IT space. Despite its enterprise skew, Health IT is both sufficiently overarching and not too vague. The moniker can also accommodate the new developments that arise in the health software domain. For all those reasons, it’s used throughout this book.

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23
Q

Digital Health

A

It’s the newest term on the block. Thanks to overzealous and ill-informed media publications, there is an unspoken association between Digital Health and sparkling startups. Anything in health that is massively funded or espouses new-age tech paradigms (like SaaS, mobile, sensor, cloud and social) gets shuffled into this category. For example, Theranos (lab company), Oscar (health insurer) and Jawbone (consumer electronics) are all considered Digital Health companies by prominent industry publications like Rock Health. For an emerging term, Digital Health has managed to find obscurity before viability.

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24
Q

Digital Medicine

A

“Digital Medicine” is the sister term to Digital Health, describing tech-driven changes in the medical profession. A few years ago, the term “Health 2.0” gained mainstream traction as a way to point out next-generation technologies and startups.

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25
Q

Healthtech landscape categorized into 2 high level segments?

A

We can categorize the health tech landscape into two broad, high-level segments: Enterprise and Consumer.

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26
Q

What are the 2 main building blocks in HealthTech Enterprise?

A

Records and Exchanges.

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27
Q

What is epics care anywhere product

A

Epic’s “Care Anywhere” product is basically an HIE that can connect disparate Epic customers.

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28
Q

Consumer health tech?

A

Retail side of health it such as fitbit and other devices? Software startups that help consumers find the right doctor, price-shop for care, understand their health bills, and get health coaching are some non-hardware examples.

29
Q

CPOE?

A

Computerized Provider Order Entry

30
Q

What is an HIE?

A

To summarize, HIEs are focused on facilitating information exchange between participating care organizations (and not inside an organization, like EHRs). The information exchange can be thought of in two ways: a data push or a data pull.

31
Q

What is HITECH for medical

A

“Health Information Technology for Economic and Clinical Health”, or HITECH

32
Q

What is meaningful use?

A

What is Meaningful Use?Stage 1, started in 2011, aimed at seeding data capture and sharing capabilities
Stage 2, started in 2014, focused on advancing clinical processes using information technology Stage 3, currently expected in 2017, should put the spotlight on improved outcomes

33
Q

What are the MU certifications?

A

Those who pass Stage 1 tests get the marketing label of “2011 Edition Certified.” Likewise, Stage 2 test survivors get “2014 Edition Certified.”
list of vendors and their certified product( s) is available as the “Certified Health IT Product List” (CHPL

34
Q

What is happening with MU3?

A

The MU program will be folded into another, bigger initiative called the Merit-Based Incentive Payment System (MIPS), starting January 1, 2017.

35
Q

But the real disruption of an ACO, business-wise, is in the financial incentives that the organization gives its care providers.

A

Participating providers in an ACO become eligible for bonuses when they demonstrate that quality care has been delivered more efficiently to a population within their network.

36
Q

What is Value Based PURCHASING?

A

VBP programs adjust insurance payments to reward hospitals based on the quality of care provided.

37
Q

What is MEDICAL Loss Ratio? MLR

A

Under the new MLR rules, large group plans (more than 100 insured) must spend at least 85% of their premiums on non-administrative functions (80% for small group plans).

38
Q

What four factors are permitted to be the basis of premium calculations?

A

age, tobacco use, geographic area and individual vs. family status

39
Q

What are the 2 types of EHR modules?

A

Clinical and Administrative

40
Q

What are the 2 major contexts for EHR systems?

A

Inpatient and outpatient

41
Q

What is Revenue Cycle Management?

A

Revenue Cycle Management (RCM) focuses on inpatient billing and has become a mature field in the last 15 years.

42
Q

What is ICD?

A

ICD (International Classification of Diseases) used to codify bills and release payments.

43
Q

What are FlowSheets?

A

These are almost exclusively used for nursing documentation. Nursing workflow tends to involve repeated tedious tasks and multiple handoffs. For example, three shifts of nursing staff could be giving medications every 4 hours, changing wound dressings twice daily, or taking vitals every hour in the Intensive Care Unit (ICU).

44
Q

What is Clinical Decision Support?

A

The CDSS part of a CPOE system generates alerts during an ordering session to notify of potential errors like contraindicated medications, duplicate orders, drug-drug interactions, and conflicting allergies.

45
Q

What is EMAR?

A

eMAR does what the name says: serves as the legal record of what drugs are given to a patient at the point of care. (Electronic medical admin record)

46
Q

What is eprescribing?

A

ePrescribing (or eRx) is the workflow of generating an electronic prescription and transmitting it through a special network to the information systems of insurers and dispensing pharmacies. In other words, eRx is what connects your prescribing physician’s CPOE module to

47
Q

What is a practice management system?

A

Practice Management (PM) systems help run the business functions of outpatient healthcare organizations. It is categorically not used as the EHR system or by the clinician. Instead, the main user is the office manager or front-desk staff. Relies on integration with ehr

48
Q

What is PHR?

A

We defined PHRs as the patient’s view of their health information at the beginning of this section. If the health information in question doesn’t include the patient’s self-gathered data then it should be called a “Patient Portal,” not a PHR. Portals are just a patient-accessible view of a subset of their EHR’s content.

49
Q

curious fact about standalone PHRs is that they may fall outside the scope of the HIPAA Privacy Rule.

A

curious fact about standalone PHRs is that they may fall outside the scope of the HIPAA Privacy Rule.

50
Q

What is RIS?

A

“Radiology Information Systems” (RIS) RIS to facilitate scheduling, documenting procedures, managing results, and handling billing.

51
Q

What is PACS?

A

software category for creating and managing images called “Picture Archiving and Communication System” (PACS) had emerged.

52
Q

What is pathology?

A

Pathology is a unique clinical field that exclusively deals with diagnosis of disease.

53
Q

What is LIS?

A

Laboratory Information Systems, lab workflow

54
Q

Perioperative care spans three phases in relation to surgery: before (preoperative), during (intraoperative) and after (postoperative).

A

Perioperative care spans three phases in relation to surgery: before (preoperative), during (intraoperative) and after (postoperative).

55
Q

Surgical Information Systems (SIS),also known as Operating Room Information Systems (ORIS),

A

also known as Operating Room Information Systems (ORIS),

56
Q

The best example for a viable and distinct niche EHR category is Long-term Post Acute Care (LTPAC) EHRs.

A

LTPAC industry provides care to people who have a chronic illness or disability and require extended stays.

57
Q

Example of niche ehrs

A

First responders and emergency workers: Beyond Lucid
Schools and educators: CareDox, CareFlow EMR
Physical therapy: WebPT, Clinicient
Orthopedic: Exscribe, Phoenix Ortho
Dermatology: EZDerm, Encite.us
Chiropractic: WonderDoc, MyChartsOnline
Oncology: Elekta, Flatiron, Oncochart
Gastroenterology: GMed (acquired by ModMed in mid-2015)
Plastic Surgery: Symplast, Cosmetisuite, patientNOW
Pediatrics: PCC, PhysicianXpress
Ophthalmology: MedFlow, EyeMDEMR, Integrity EMR
Urgent care: DocuTap, Practice Velocity, Codonix

58
Q

To summarize, HIEs are focused on facilitating information exchange between participating care organizations (and not inside an organization, like EHRs). The information exchange can be thought of in two ways: a data push or a data pull.

A

To summarize, HIEs are focused on facilitating information exchange between participating care organizations (and not inside an organization, like EHRs). The information exchange can be thought of in two ways: a data push or a data pull.

59
Q

A HISP is responsible for services like digital certificates and trust management that are needed for directed exchange.

A

A HISP is responsible for services like digital certificates and trust management that are needed for directed exchange.

60
Q

By 1986, the unmanageable proliferation prompted the U.S. National Library of Medicine to create a thesaurus called the Unified Medical Language System (UMLS) to help translate amongst terminologies.

A

By 1986, the unmanageable proliferation prompted the U.S. National Library of Medicine to create a thesaurus called the Unified Medical Language System (UMLS) to help translate amongst terminologies.

61
Q

The three most-often-used terminologies are: International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and the Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT).

A

The three most-often-used terminologies are: International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and the Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT).

62
Q

Integrating the Healthcare Enterprise (IHE) is an industry group with the goal of promoting interoperability amongst imaging and healthcare information systems.

A

All HIEs offer services complying with IHE profiles to promote plug-and-play integration. Below are three key IHE profiles:

63
Q

Most notably, Zocdoc has forged the path, turbo-charged by humongous funding ($ 223 million) and legendary backers (Vinod Khosla, Marc Benihoff, and Jeff Bezos). Since 2007 it has allowed patients to directly schedule their own non-emergency visits to clinics and doctor’s offices. Similarly, Wisconsin-based MyHealthDirect provides white-labeled scheduling services for large health systems, insurers, and medical groups.

A

Most notably, Zocdoc has forged the path, turbo-charged by humongous funding ($ 223 million) and legendary backers (Vinod Khosla, Marc Benihoff, and Jeff Bezos). Since 2007 it has allowed patients to directly schedule their own non-emergency visits to clinics and doctor’s offices. Similarly, Wisconsin-based MyHealthDirect provides white-labeled scheduling services for large health systems, insurers, and medical groups.

64
Q

Cloud-based file storage-and-sync is another fundamental infrastructure service much needed in healthcare. Imagine if users could easily store sensitive health information in a HIPAA-compliant platform that is securely accessible from anywhere. That would take away some of the complexity in developing innovative healthcare applications.

A

Cloud-based file storage-and-sync is another fundamental infrastructure service much needed in healthcare. Imagine if users could easily store sensitive health information in a HIPAA-compliant platform that is securely accessible from anywhere. That would take away some of the complexity in developing innovative healthcare applications.

65
Q

Vendors like DataMotion, TigerText, PatientSafe Solutions, Voalte, Vocera, and PerfectServe are creating multi-modal platforms that make it easier for healthcare stakeholders to communicate with each other, both inside and outside clinical settings.

A

Vendors like DataMotion, TigerText, PatientSafe Solutions, Voalte, Vocera, and PerfectServe are creating multi-modal platforms that make it easier for healthcare stakeholders to communicate with each other, both inside and outside clinical settings.

66
Q

Going forward, services that offer comparison shopping, fair price estimates, out-of-pocket cost calculators, marketplaces, and drug price lists are great focus areas for startups. GoodRx, Pokitdok, and HealthSparq are examples of companies already

A

Going forward, services that offer comparison shopping, fair price estimates, out-of-pocket cost calculators, marketplaces, and drug price lists are great focus areas for startups. GoodRx, Pokitdok, and HealthSparq are examples of companies already

67
Q

Population Health Management (PHM, or just Population Health)

A

The central idea of PHM is that care should be about promoting health and preventing disease, rather than adeptly treating sickness.

68
Q

Phm goals

A

three dimensions simultaneously: improving the individual experience of care, improving the health of populations, and reducing the per capita cost of healthcare.

69
Q

When it comes to PHM, most large health systems tend to do everything in-house. But a significant number of them choose to contract PHM activities out to “Disease Management” (DM) companies.

A

Today DM companies run wellness programs, coaching services, and incentive offerings, among many other things.