AHM

a leading provider of health management services, including disease management, clinical decision support and personal health records and is a wholly-owned subsidiary of Aetna.

ADT

messages: a group of messages as defined in the HL7 version 2.x messaging standard. The focus of ADT messages is to convey data related to patient demographics and/or to healthcare encounters (visits). ADT messages are implemented by almost all software applications in a hospital setting. This is the format that Relay uses for its patient demographic data.

ASTM

: originally known as the American Society for Testing and Materials, is an international standards organization that develops and publishes voluntary consensus technical standards for a wide range of materials, products, systems, and services.

CCR

: a patient health summary standard standard published by ASTM.

C32:

Standard Clinical Document format for transmission of clinical patient data and histories. The C32 Specification describes how the US Federal Government expects to use the HL7 Clinical Document Architecture in our National Health Information Network.

C80

: The Clinical Document andMessage Terminology Componentdefines the vocabularies and terminologies utilized by HITSP specifications for Clinical Documents and Messages used to support the interoperable transmission of information. View the most current version as HTML.

C83

: Standard CDA Content Modules Component defines the content modules for document based

HITSP

constructs utilizing clinical information. These Content modules are based on IHE PCC Technical FrameworkVolume II, Release 4. That technical framework contains specifications for document sections that are consistent with all implementation guides for clinical documents currently selected for HITSP constructs. View the most current version as HTML.

CDA

: an XML-based markup standard intended to specify the encoding, structure and semantics of clinical documents for exchange. CDA is part of theHL7 3.0 standard. Akin to other parts of the HL7 3.0 standard [pdf] it was developed using the HL7 development Framework HDF and it is based on the HL7 Reference Information Model RIM and theHL7 3.0 Data Types. CDA documents are persistent in nature. The CDA specifies that the content of the document consists of a mandatory textual part (which ensures human interpretation of the document contents) and optional structured parts (for software processing). The structured part relies on coding systems (such as from SNOMED and LOINC) to represent concepts.

(e.g.: CDA, CCD, HL7 V2.x) XML or Pipe-delimited structured data. The XML data utilizes terminology and coding systems like ICD and LOINC.

CCD

: was "developed as a collaborative effort between ASTM and HL7 . CDA is comprehensive, CCR has the most relevant elements required for care delivery, but not as comprehensive. CCD combines the both standards.

CCR

: a health record standard specification developed jointly by ASTM International, the Massachusetts Medical Society (MMS), the HIMSS, the American Academy of Family Physicians AAFP, the American Academy of Pediatrics AAP, and other health informatics vendors. It is intended to foster and improve continuity of care, reduce medical errors, and ensure a minimum standard of secure health information transportability.

CE

: a rules engine at the core of AHM's offerings.

EHR

: an individual patient's medical record in digital format.

ESB

: a software architecture construct which provides fundamental services for complex architectures via an event-driven and standards-based messaging-engine (the bus). Developers typically implement an ESB using technologies found in a category of middleware infrastructure products, usually based on recognized standards. An ESB generally provides an abstraction layer on top of an implementation of an enterprise messaging system, which allows integration architects to exploit the value of messaging without writing code. Unlike the more classical enterprise application integration EAI approach of a monolithic stack in a hub and spoke architecture, an enterprise service bus builds on base functions broken up into their constituent parts, with distributed deployment where needed, working in harmony as necessary. Full presentation from InfoQ, The Role of the Enterprise Service Bus.

EMR

is a medical record in digital format. In health informatics and most contexts, EMR and EHR (electronic health records) are used synonymously, but many people define an EMR as just the physician interface and EHR including both a physician and patient interface. The term has sometimes included other systems which keep track of medical information, such as the practice management system that supports the electronic medical record.

a personal health information centralization service provided by Google. The service allows Google users to volunteer their health records - either manually or by logging into their accounts at partnered health services providers - into the Google Health system, thereby merging potentially separate health records into one centralized Google Health profile. Volunteered information can include "health conditions, medications, allergies, and lab results". Once entered, Google Health uses the information to provide the user with a merged health record, information on conditions, and possible interactions between drugs, conditions, and allergies.

HDMS

: Cleveland based subsidiary of AHM that performs initial ingest and transformation of client data and also provides primarily financial analytics to clients.

HIE

the mobilization of healthcare information electronically across organizations within a region or community. HIE provides the capability to electronically move clinical information among disparate health care information systems, while maintaining the meaning of the information being exchanged. The goal of HIE is to facilitate access to and retrieval of clinical data to provide safer, more timely, efficient, effective, equitable, patient-centered care. HIE is also useful to Public Health authorities to assist in analyses of the overall health of the population. Some prominent Health Information Exchanges in operation today are BHIX, IHIE, WHIE, HIXNY and LARHIX.

HITSP

: Standards committee to assist in development of the National Health Information Network (NHIN). It leverages standards made by other committees like IHEand HL7.

HL7

is one of several American National Standards Institute (ANSI)-accredited Standards Developing Organizations (SDOs) operating in the healthcare arena. Most SDOs produce standards (sometimes called specifications or protocols) for a particular healthcare domain such as pharmacy, medical devices, imaging or insurance (claims processing) transactions. Health Level Seven's domain is clinical and administrative data.

HL7

CDA

: a document markup standard (type of CDA) that specifies the structure and semantics of clinical documents for the purpose of exchange. It has the most comprehensive clinical reference model developed till date and span an effort of around 10 years. The HL7 Group has several initiatives with respect to developing these standards. One focus is on promoting interoperability with older hospital and departmental systems. HL7 messages can stand alone or be embedded within ANSI ASC X12N transactions. HL7 V2.x is pipe-delimited, HL7 3.0 is XML with metadata. There are currently several efforts underway to help facilitate the migration from v2.x to 3.x

ICD

: a volume published by the World Health Organization that provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. Every health condition can be assigned to a unique category and given a code, up to six characters long. Such categories can include a set of similar diseases. It is used worldwide for morbidity and mortality statistics, reimbursement systems and automated decision support in medicine. This system is designed to promote international comparability in the collection, processing, classification, and presentation of these statistics. The ICD is a core classification of the WHO Family of International Classifications

IHE

: is an initiative by healthcare professionals and industry to improve the way computer systems in healthcare share information. IHE promotes the coordinated use of established standards such as DICOM and HL7 to address specific clinical need in support of optimal patient care. Systems developed in accordance withIHEcommunicate with one another better, are easier to implement, and enable care providers to use information more effectively..

IHE XDS:

A group of standard transaction protocols within IHE that require Document Consumers to constantly poll the Document Registry for new documents or updates to existing documents in cases when there is an expectation that additional documents may become available after an initial query. In many such cases a publish/subscribe method of receiving new information for patients of interest. In addition, the NAV profile assumes some kind of subscription method. Providing a consistent pub/sub framework will benefit various use cases where constant polling is not feasible.

LOINC: a set of universal codes designed to provide a set of names to identify laboratory and other clinical observations in order to facilitate the exchange and pooling of clinical results for clinical care, outcomes management, and research.

a Saas platform from Microsoft that stores and maintains health and fitness information, launched in Fall 2007. The website is accessible at www.healthvault.com and offered to laymen and healthcare professionals.

NHIN

: a federally funded project being developed to provide a secure, nationwide, interoperable health information infrastructure that will connect providers, consumers, and others involved in supporting health and healthcare. This critical part of the national health IT agenda will enable health information to follow the consumer, be available for clinical decision making, and support appropriate use of healthcare information beyond direct patient care so as to improve health.

PDQ

: and Integration Profile that lets applications query a central patient information server and retrieve a patient's demographic and visit information. It is a IHE/HITSP standard transaction

PHR

: a computer or on-line application where end users can view, maintain and govern access to their own health data.

PIX

: an IHE/HITSP standard transaction.

RIM

is the cornerstone of the HL7 3.0 development process. An object model created as part of the HL7 3.0 methodology, the RIM is a large pictorial representation of the clinical data (domains) and identifies the life cycle of events that a message or groups of related messages will carry. It is a shared model between all the domains and as such is the model from which all domains create their messages. Explicitly representing the connections that exist between the information carried in the fields of HL7 messages, the RIM is essential to our ongoing mission of increasing precision and reducing implementation costs.

RHIOs: an organization providing links between area hospitals, physicians, pharmacies, payers and other health care organizations.

(Systematized Nomenclature of Medicine--Clinical Terms) is a comprehensive clinical terminology, originally created by the College of American Pathologists CAP and, as of April 2007, owned, maintained, and distributed by the International Health Terminology Standards Development Organisation IHTSDO, a non-for-profit association in Denmark. The CAP continues to support SNOMED CT operations under contract to the IHTSDO and provides SNOMED-related products and services as a licensee of the terminology.

(e.g.: LOINC, SNOMED, ICD, CPT, NDC) - These provide codified data. i.e.: ICD 9 code 441.4 stands for Aneurysm of Abdominal Aorta or NDC code of 54569-4587 is used for Lipitor 20 mg Tablets.

: a software system designed to support interoperable machine-to-machine interaction over a network. Recent Silvermine Media article on how to decide between a bulk solution and a web service solution for electronic Care Considerations is located here.