Glossary of Terms and Acronyms Related to e-Health
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e-Health is the adoption and effective use of Electronic Health Record systems and other health information technology (HIT) to improve health care quality, increase patient safety, reduce health care costs, and enable individuals and communities to make the best possible health decisions.
Active in all 50 states, the eHealth Exchange is the largest query-based, health information network in the country. It is the principal network that connects federal agencies and non-federal organizations, allowing them to work together to improve patient care and public health.
The ability to contact the payer before the patient is seen and get a response that indicates whether the services to be rendered will be covered by the payer.
Reference: eHealth Initiative Foundation. "Second Annual Survey of State, Regional and Community-based Health Information Exchange Initiatives and Organizations." Washington: eHealth Initiative, 2005.
EDI is a direct exchange of data between two computers via the Internet or other network, using shared data formats and standards.
EHR is a real-time patient health record with access to evidence-based decision support tools that can be used to aid clinicians in decision-making. The EHR can automate and streamline a clinician's workflow, ensuring that all clinical information is communicated. It can also prevent delays in response that result in gaps in care. The EHR can also support the collection of data for uses other than clinical care, such as billing, quality management, outcome reporting, and public health disease surveillance and reporting. EHR is considered more comprehensive than the concept of an Electronic Medical Record (EMR).
A longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting.
The Electronic Healthcare Network Accreditation Commission, a federally-recognized standards development organization whose mission is to promote standards-based accreditation within the healthcare data exchange and whose accreditation programs have set benchmarks for assuring security, confidentiality, accountability, and efficiency. The Health Information Exchange Accreditation Program (“HIEAP”) is one of the various accreditation programs offered by EHNAC.
The automated transmission of laboratory-related data from commercial, public health, hospital, and other laboratories to state and local public health departments through an electronic health records (EHR) system or a Laboratory Information Management System (LIMS). ELR helps identify reportable conditions determined by confirmatory testing and supports case reporting at the state or local level.
An electronic record of health-related information on an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within one health care organization.
Reference: The National Alliance for Health Information Technology Report to the Office of the National Coordinator for Health Information Technology on Defining Key Health Information Technology Terms, April 2008.
See Also: HR (Electronic Health Record)
The EMR is the legal record created in hospitals and ambulatory environments that is the source of data for the EHR.
E-prescribing means secure bidirectional electronic information exchange between prescribers (providers), dispensers (pharmacies), Pharmacy Benefits Managers, or health plans, directly or through an intermediary network.
Prior authorization is the process used to request coverage of a specific medication for a specific patient. Generally, the prescriber requests the authorization from a “Payer” (health plan, processor, or Pharmacy Benefit Manager). This process has historically been handled via facsimile exchange of information or telephone call, and only recently via payer-specific web portals. Electronic prior authorization (ePA) is the electronic transmission of information between the prescriber, and payer to determine whether or not the PA is granted.
Some eligible hospitals may receive EHR incentive payments from both Medicare and Medicaid if they meet all eligibility criteria. What is an eligible hospital under the Medicare EHR Incentive Program?
- Subsection (d) hospitals in the 50 states or DC that are paid under the Inpatient Prospective Payment System (IPPS)
- Critical Access Hospitals (CAHs)
- Medicare Advantage (MA-Affiliated) Hospitals
What is an Eligible Hospital under the Medicaid EHR Incentive Program?
- Acute care hospitals (including CAHs and cancer hospitals) with at least 10% Medicaid patient volume
- Children's hospitals (no Medicaid patient volume requirements)
Some hospitals may be eligible for both; see the Centers for Medicare and Medicaid Services Web site for more details.
Some eligible professionals may receive EHR incentive payments from either Medicare and Medicaid if they meet all eligibility criteria. Who is an Eligible Professional under the Medicare EHR Incentive Program?
- Doctor of medicine or osteopathy
- Doctor of dental surgery or dental medicine
- Doctor of podiatry
- Doctor of optometry
Who is an Eligible Professional under the Medicaid EHR Incentive Program?
- Physicians (primarily doctors of medicine and doctors of osteopathy)
- Nurse practitioner
- Certified nurse-midwife
- Physician assistant who furnishes services in a Federally Qualified Health Center or Rural Health Clinic that is led by a physician assistant.
To qualify for an incentive payment under the Medicaid EHR Incentive Program, an eligible professional must meet one of the following criteria:
- Have a minimum 30% Medicaid patient volume*
- Have a minimum 20% Medicaid patient volume, and is a pediatrician*
- Practice predominantly in a Federally Qualified Health Center or Rural Health Center and have a minimum 30% patient volume attributable to needy individuals
* Children's Health Insurance Program (CHIP) patients do not count toward the Medicaid patient volume criteria.