Clinical preventive services: Immunization, chemoprophylaxis, counseling, and screening with early intervention, provided to individuals to reduce their likelihood of disease, injury, or impairment, or to improve their overall health status and sense of well-being.*
Community: A group of people defined in many ways, such as by geography, culture, disease or condition, occupation, and workplace (IOM, 2012).
Community health programs: Actions sponsored by organizations, groups, or individuals within a community, to improve the status of the community and its most vulnerable citizens with respect to disease, injury, functional capacity, and sense of well-being.*
Continuous health care learning and improvement: The process of ongoing measurement and analysis to inform changes in the delivery of care. Continuous learning occurs both intra- and interinstitutionally and relies on the real-time capture and use of data on patient experience, outcomes, and process measures (IOM, 2012).
Core measures: A parsimonious set of measures that provide a quantitative indication of current status on the most important elements in a given field,
* This glossary entry has changed or was added after the prepublication version of this report.
and that can be used as a standardized and accurate tool for informing, comparing, focusing, monitoring, and reporting change.
Health system: See “Multisectoral health system.”
Learning health care system: A health care system in which science, informatics, incentives, and culture are aligned for continuous improvement and innovation, with best practices being seamlessly embedded in the care process, patients and families being active participants in all elements of care, and new knowledge being captured as an integral by-product of the care experience (Charter, IOM Roundtable on Value & Science-Driven Health Care).
Multisectoral health system: The array of sectors and entities that influence the health of the population through their activities, ideally in a coordinated manner, as a system, but in practice, operating through occasional and not always sustained collaboration. The system comprises public health agencies, health care delivery organizations, and parts of other sectors (e.g., businesses, schools) and the community (IOM, 2011). The report often shortens this term to “health system.”
Patient- and family-centered care: Patient and family-centered care is designed, with patient involvement, to ensure timely, convenient, well-coordinated engagement of a person’s health and health care needs, preferences, and values; it includes explicit and partnered determination of patient goals and care options; and it requires ongoing assessment of the care match with patient goals (IOM, 2015).*
Population health: The health of the public in a geopolitical location (IOM, 2013a).
Population health programs: Environmental, educational, organizational, social, or policy interventions that seek to advance the profile of a population group with respect to the level of disease, injury, functional capacity, and sense of well-being.*
Public health: Governmental action to advance health and safety through health promotion and health protection measures, through measures to ensure the quality and access of basic personal health services, and through enhanced understanding of factors shaping health status.*
Public health system: A complex network of individuals, organizations, and relevant critical infrastructures with the potential to act individually and
together to create conditions of health. The system encompasses communities, health care delivery systems (e.g., home care, ambulatory care, private practices, hospitals, skilled nursing facilities), employers and businesses, the media, homeland security and public safety agencies, academia, and the governmental public health infrastructure (IOM, 2013b).
Safe care: Care that involves making evidence-based clinical decisions to optimize the health outcomes of individuals and minimize the potential for harm. Errors of both commission and omission should be avoided (IOM, 2004).
Value: Assessed using the following heuristic: Value = Outcomes/Cost (IOM, 2012).
IOM (Institute of Medicine). 2004. Patient safety: Achieving a new standard for care. Washington, DC: The National Academies Press.
IOM. 2011. For the public’s health: The role of measurement in action and accountability. Washington, DC: The National Academies Press.
IOM. 2012. Best care at lower cost: The path to continuously learning health care in America. Washington, DC: The National Academies Press.
IOM. 2013a. Toward quality measures for population health and the leading health indicators. Washington, DC: The National Academies Press.
IOM. 2013b. Crisis standards of care: A toolkit for indicators and triggers. Washington, DC: The National Academies Press.
IOM. 2015. Transforming health care scheduling and access: Getting to now. Washington, DC: The National Academies Press.