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This glossary includes terms and acronyms that are used in relation to health care information technology and data standards.

If there are terms or acronyms that should be included on this page, please email the term, definition and URL to the Gravity Project Team.

Term/Title

Description

Source

Assessment/
Diagnosis
These include activities where providers (clinical and community-based)
and health plans analyze the data obtained through screening to determine a patient’s social risks and needs.
Gravity Project Use Case Package (section 3.1 - health care activities)
CCDSCommon Clinical Data Sets:  specific medical codes, to represent concepts such as race, ethnicity, and preferred languagehttps://www.healthit.gov/sites/default/files/ccds_reference_document_v1_1.pdf

CMS Promoting Interoperability Program

To continue its commitment to promoting and prioritizing interoperability of health care data, the Centers for Medicare and Medicaid (CMS) renamed the “EHR Incentive Programs” to “Promoting Interoperability Programs” in April 2018. This change moves beyond meaningful use requirements and increases the focus on interoperability and patient access to health information.

https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Medicare_FactSheetFY2019IPPS.pdf

Coded DataData concepts that use a value set to describe the range of concepts relevant to the definition. The concepts are organized in such a way that encompasses the essential aspects of the concepts and assigned a code to represent the meaning. The Gravity Project recognizes five nationally recognized code systems—LOINC, Standard Nomenclature of Medicine, Clinical Terms (SNOMED CT), International Classification of Diseases Version 10 (ICD-10), Current Procedural Terminology (CPT), and Healthcare Common Procedure System (HCPCS)—used to represent data across the four clinical activities of screening, diagnosis, goal setting, and interventions.Gravity Project Use Case Package

Consensus Building

Consensus building is a process that aims to maximize team agreement. Major steps involved in consensus building include: brainstorming, combining similar concepts based on group discussion, and further refining options per discussion. If consensus among the team members cannot be reached, a voting process can be utilized. In addition, it is useful to inform the team that consensus is the primary decision process, with voting being the fall back process if agreement cannot be reached.

https://www.isixsigma.com/implementation/change-management-implementation/building-team-consensus/

Data Element

According to the National Library of Medicine, a data element (DE) is information that describes the kind of data to be collected in a study. The DE does not include the data themselves.

[GL1]I know this comes from the webpage, but “piece” is not a helpful word. I think they mean “kind” so that it wouldn’t include the data themselves. I would change.

https://www.nlm.nih.gov/cde/glossary.html#cdedefinition

Data Set

As commonly used a data set is a database (or, sometimes, data bank or data file) is ''a large collection of data, organized so that it can be expanded, updated, and retrieved rapidly for various uses." (Webster's New World Dictionary, 2nd ed.)

https://www.ncbi.nlm.nih.gov/books/NBK236556/#_ddd00051_

Food Security/Insecurity

Food security is defined as access to enough food for an active, healthy life. Food insecurity,is a household-level economic and social condition that reflects limited or uncertain access to adequate food.

https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/definitions-of-food-security/

GoalsThese refer to the intention of care—the “why” of treatment/intervention. Goals can be both patient and population specific. Patient goals are best made collaboratively with the patient and care team aligned with principles of person-centered care.Gravity Project Use Case Package (section 3.1 - health care activities)

HL7® FHIR®

FHIR is an interoperability standard intended to facilitate the exchange of healthcare information between organizations. It consists of 2 main parts: a content model in the form of ‘resources,’ and a specification for the exchange of these resources in the form of real-time interfaces as well as messaging and documents.

HL7 FHIR® R4 may also go by the following names or acronyms: "HL7 Fast Healthcare Interoperability Resources Specification (FHIR), R1,” FHIR

http://www.hl7.org/implement/standards/product_brief.cfm?product_id=491

Housing Stability/ Instability

Though there are no standard definitions for housing stability/instability, housing instability is generally used as an umbrella term that reflects concepts such as trouble paying rent, overcrowding, moving frequently, staying with relatives, and/or spending more than 1/3 of household income on housing.1, 2 These experiences may negatively affect physical health and make it harder to access health care.1, 3, 4. (Citations appear on the linked source page.)

https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health/interventions-resources/housing-instability

InterventionsThese refer to actions undertaken by providers (clinical and community-based)
and health plans to help address identified social needs. These include referrals, case management, care planning, counseling and education, and provision of services and orders.
Gravity Project Use Case Package (section 3.1 - health care activities)

ONC Health IT Certification Program

The Office of the National Coordinator for Health Information Technology (ONC) Health IT Certification Program (Program) is a voluntary certification program established by the Office of the National Coordinator for Health IT. Requirements for certification are established by standards, implementation specifications, and certification criteria adopted by the Secretary. The Program supports the availability of certified health IT for its encouraged and required use under other federal, state and private programs

https://www.healthit.gov/topic/certification-ehrs/about-onc-health-it-certification-program

Patient Story

A patient story is used in use case development to provide a longitudinal view of a person receiving care. It describes at a high-level how a patient’s needs, preferences, and risks are impacted by the interactions the patient has with the health system across the life course.

A patient story does not describe how the patient interacts with systems.


Personas

Personas, commonly used in User Experience (UX) design, are fictional characters created by developers used to represent a person who is expected to use a site, brand, or product. Personas can be presented in a one or two-page document describing the users’ behavior patterns; goals, skills; attitudes; and background and environment. Personas help providers understand a target audience and thereby inform the development of the product or service. In standards development and harmonization, personas enable stakeholders to prioritize key data capture and exchange features based on how well they address the needs of a primary persona.

https://theblog.adobe.com/putting-personas-to-work-in-ux-design-what-they-are-and-why-theyre-important/

ScreeningThis refers to activities where SDOH data from individual patients are initially
captured, whether through a self-administered, provider-administered, or health plan administered questionnaire. These activities may also be repeated at certain intervals to monitor changes in social risks.
Gravity Project Use Case Package (section 3.1 - health care activities)

Social Determinants of Health

Social determinants of health (SDH) are conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems.

https://www.who.int/social_determinants/en/

Standard Development Organizations

Standards development organizations (SDOs) in health IT are member-supported organizations, often accredited by the American National Standards Institute (ANSI), that develop and maintain standards to meet industry needs. Members include health care providers, insurers, health IT software developers, patients, caregivers, and others. There are at least 40 SDOs that currently develop and maintain standards for the healthcare field, many of which are international organizations with U.S. branches. A single SDO might develop only one standard or may develop hundreds of standards, depending on the mission or interests of the organization.

https://www.healthit.gov/playbook/sdo-education/chapter-2/

Standards Harmonization

Standards harmonization involves a process of minimizing redundant or conflicting standards that may have evolved independently.

The goal of harmonization is to find commonalities across standards, identify critical elements that need to be retained, and develop a common standard. For businesses, harmonization cuts compliance costs and simplifies the process of meeting requirements. It also reduces complexity for those tasked with testing and auditing standards compliance.


Social Needs

Social needs are not always synonymous with social risks (see definition of social risks below). A “need” also depends on people’s individual preferences and priorities. Distinguishing between social risks and social needs emphasizes the patient’s role in identifying and prioritizing interventions. A screening tool may uncover multiple social risks, such as food, housing, and transportation instability, but the patient may only view one of those as a need. (Reference Alderwick HA, Gottlieb LM. Meanings and Misunderstandings: A Social Determinants of Health Lexicon for Health Care Systems. Milbank Q. In press)


Social Risks

Social risk factors are specific adverse social conditions that are associated with poor health, like food insecurity or housing instability. Patients are increasingly being asked about selective social risk factors in clinical settings across the U.S., though risk factors may also be assessed using proxy indicators at the community level. (Reference Alderwick HA, Gottlieb LM. Meanings and Misunderstandings: A Social Determinants of Health Lexicon for Health Care Systems. Milbank Q. In press)


Transportation Access/ Transportation Barriers

Lack of transportation affects access to medical care as well as economic opportunities, healthy food, and other resources needed to be healthy. Transportation barriers can involve personal vehicle ownership/access, public transportation infrastructure and cost, transportation time and distance, and other local, state, or national policies that affect travel. Transportation challenges affect residents in both rural and urban communities.

http://www.hpoe.org/resources/ahahret-guides/3078

Use Case

A use case reflects a request users will make of a given system and describes how the system would respond to that request. In other words, use cases describe conversations between a system and its user(s), known as actors. Although use cases in Health IT systems are usually automated (such as an Order system), use cases can also be used to describe equipment, devices, or business processes.

https://www.pmi.org/learning/library/use-cases-project-manager-know-8262

Value Set

Value sets are coded vocabulary groups that include all possible values or responses related to a given data element.

http://www.qualityforum.org/ProjectDescription.aspx?projectID=78591

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