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Suggested Citation:"Appendix F: Glossary." National Research Council. 2012. Strategies and Priorities for Information Technology at the Centers for Medicare and Medicaid Services. Washington, DC: The National Academies Press. doi: 10.17226/13281.
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F

Glossary

Accountable care organization—A recognized legal entity under state law, composed of a group of participants (providers of services and suppliers) that have established a mechanism for shared governance and work together to coordinate care for Medicare fee-for-service beneficiaries.

applications architecture—Descriptive term encompassing the structure (e.g., logical organization), properties, and behavior (e.g., interactions) of the applications (e.g., functionality) needed to support a business process.

business ecosystem—The people, processes, services, and information required to operate and meet all business requirements of a specific business role that is independent of other business roles.

business glossary—A compendium of standard definitions, terminology, and representations regarding data to be shared across all the target business systems.

enterprise architecture—Descriptive term encompassing the structure, properties, and behavior of the components of an information system, including architectural layers such as process architecture, applications architecture, information architecture, and infrastructure architecture.

global business ecosystem—The union of all of the business ecosystems bearing on the business.

Suggested Citation:"Appendix F: Glossary." National Research Council. 2012. Strategies and Priorities for Information Technology at the Centers for Medicare and Medicaid Services. Washington, DC: The National Academies Press. doi: 10.17226/13281.
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global information ecosystem—The union of all of the information ecosystems in the enterprise.

health information model—An authoritative set of policies and practices that define the health data objects within an enterprise that will be commonly used by business services; it determines a standard terminology regarding health data objects that is defined in the business glossary.

informatics—Used in the present report as a generic term to refer to both biomedical informatics (the core discipline) and health informatics (its application in clinical care and public health). The field deals with data, information, and knowledge for scientific inquiry, problem solving, and decision making—motivated by efforts to improve human health.

information architecture—Descriptive term encompassing the structure, properties (e.g., formats), and behavior (e.g., flows) of the storage and management of information within a specific information system, with emphasis on information exchange among applications and processes.

information ecosystem—The information technology components and their interactions, automated and manual, required to build, develop, operate, and evolve one or perhaps multiple business functions; the term includes the people who design, build, maintain, and operate the systems.

information system families—Term used internally by the Centers for Medicare and Medicaid Services for groupings of information systems used to accomplish a specific business role; essentially synonymous with the present report’s use of “information ecosystem,” absent the focus on the humans who design, build, maintain, and operate the systems.

infrastructure architecture—Descriptive term encompassing the structure, properties, and behavior of the technology infrastructure (i.e., hardware and software) components of an information system; does not include information or applications in the information or applications architectures.

modernization, systems modernization—Refers to modest or evolutionary transitions of components and subcomponents of an information system.

process architecture—Descriptive term encompassing the structure, properties, and behavior of the processes in an information system.

Suggested Citation:"Appendix F: Glossary." National Research Council. 2012. Strategies and Priorities for Information Technology at the Centers for Medicare and Medicaid Services. Washington, DC: The National Academies Press. doi: 10.17226/13281.
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software service—An abstraction that represents the execution of some set of actions as part of a process in an information ecosystem. Such services are implemented in modern enterprise architectures by means of remotely invoked procedures and service-level agreements with business units.

transformation, systems transformation—Refers to significant or revolutionary transitions of components and subcomponents of an information technology system.

Suggested Citation:"Appendix F: Glossary." National Research Council. 2012. Strategies and Priorities for Information Technology at the Centers for Medicare and Medicaid Services. Washington, DC: The National Academies Press. doi: 10.17226/13281.
×
Page 172
Suggested Citation:"Appendix F: Glossary." National Research Council. 2012. Strategies and Priorities for Information Technology at the Centers for Medicare and Medicaid Services. Washington, DC: The National Academies Press. doi: 10.17226/13281.
×
Page 173
Suggested Citation:"Appendix F: Glossary." National Research Council. 2012. Strategies and Priorities for Information Technology at the Centers for Medicare and Medicaid Services. Washington, DC: The National Academies Press. doi: 10.17226/13281.
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Page 174
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The Centers for Medicare and Medicaid Services (CMS) is the agency in the Department of Health and Human Services responsible for providing health coverage for seniors and people with disabilities, for limited-income individuals and families, and for children--totaling almost 100 million beneficiaries. The agency's core mission was established more than four decades ago with a mandate to focus on the prompt payment of claims, which now total more than 1.2 billion annually. With CMS's mission expanding from its original focus on prompt claims payment come new requirements for the agency's information technology (IT) systems.

Strategies and Priorities for Information Technology at the Centers for Medicare and Medicaid Services reviews CMS plans for its IT capabilities in light of these challenges and to make recommendations to CMS on how its business processes, practices, and information systems can best be developed to meet today's and tomorrow's demands. The report's recommendations and conclusions offered cluster around the following themes: (1) the need for a comprehensive strategic technology plan; (2) the application of an appropriate metamethodology to guide an iterative, incremental, and phased transition of business and information systems; (3) the criticality of IT to high-level strategic planning and its implications for CMS's internal organization and culture; and (4) the increasing importance of data and analytical efforts to stakeholders inside and outside CMS. Given the complexity of CMS's IT systems, there will be no simple solution.

Although external contractors and advisory organizations will play important roles, CMS needs to assert well-informed technical and strategic leadership. The report argues that the only way for CMS to succeed in these efforts is for the agency, with its stakeholders and Congress, to recognize resolutely that action must be taken, to begin the needed cultural and organizational transformations, and to develop the appropriate internal expertise to lead the initiative with a comprehensive, incremental, iterative, and integrated approach that effectively and strategically integrates business requirements and IT capabilities.

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