Fostering Rapid Advances in Health Care: Learning from System Demonstrations (2003)

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i Glossary and Acronym List GLOSSARY Chronic condition. A condition that requires ongoing medical care, including monitoring, treatment, and coordination among multiple providers; limits what one can do; and is likely to last longer than 1 year. Examples include diabetes, cancer, and cardiovascular disease (Partnership for Solutions, 2002~. Clinicians. individual health care providers, such as physicians, nurse practitioners, nurses, physician assistants, and others. Providers. Refers to both institutional providers of health care services (e.g., health plans, health maintenance organizations tHMOs], hospitals, nursing homes) and clinicians (e.g., physicians, nurse practitioners, nurses, physician assistants). Quality. The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge (Institute of Medi- cine, 1990~. 91

~ Glossary and Acronym List Quality aims. Six dimensions of quality that constitute the goals of the health system (Institute of Medicine, 2001)0 · Safe—avoiding injuries to patients from the care that is intended to help them. · Effective providing services based on scientific knowledge to all who could benefit and refrain- ing from providing services to those not likely to benefit (avoiding underuse and overuse, respec- tively). Patient-centered—providing care that is respectful of and responsive to individual patient prefer- ences, needs, and values and ensuring that patient values guide all clinical decisions. T'mel~reducing waits and sometimes harmful delays for both those who receive and those who give care. Efficient avoiding waste, including waste of equipment, supplies, ideas, and energy. Equitable~providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status. Quality (or performance) measures. These include measures of patient perspectives on care, clini- cal quality, and patient outcomes: . Measures of patient perspectives include patients' assessment of and satisfaction with their access to and interactions with the care delivery system (e.g., waiting times, information received from providers, choice of providers). Measures of clinical quality are specific quantitative indicators designated to identify whether the care provided conforms to established treatment goals and care processes for specific clinical presentations. Clinical quality measures generally consist of a descriptive statement or indicator (e.g., the rate of beta blocker usage after heart attack, the 30-day mortality rate following coro- nary artery bypass graft surgery), a list of data elements that are necessary to construct and/or re- port the measure, detailed specifications that direct how the data elements are to be collected (including the source of data), the population on whom the measure is constructed, the timing of data collection and reporting, the analytic models used to construct the measure, and the format in which the results will be presented. Measures may also include thresholds, standards, or other benchmarks of performance (McGlynn, 2002~. Measures of patient outcomes include mortality, morbidity, and physical and mental functioning. : - ~1

Glossary and Acronym List ACRONYM LIST ACEs avoidable classes of events or accelerated compensation events AHRQ Agency for Healthcare Research and Quality BPHC Bureau of Primary Health Care CHC Community Health Center CHEF} Consolidated Health Informatics Initiative CMS Centers for Medicare and Medicaid Services DHHS U. S. Department of Health and Human Services DICOM Digital Unaging and Communications in Medicine FFS fee-for-service FPL federal poverty level FQHC Federally-Qualified Health Center HI:PAA Health Insurance and Portability Act of 1996 HL7 Health Level 7 HMO health maintenance organization HRSA Health Resources and Services Administration ICT information and communications technology IEEE Institute of Electrical and Electronics Engineers INPC Indiana Network for Patient Care TOM Institute of Medicine ISDI Integrated Service Development Initiative NCPDP National Council for Prescription Drug Programs NEHEN New England Healthcare ED:[ [electronic data interchange] Network NEM National Library of Medicine PSI Patient Safety Initiative REP request for proposals S CHIP State Children's Health Insurance Program VHA Veterans Health Administration