Acronyms, Abbreviations & Other Definitions
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Brief definitions are listed below. If there is more detailed information available or needed about a particular item, then there will be a link either from the acronym or form the real term to a page with that information.
- AHIMA- American Health Information Management Association
- ACI - Add Clinical Item
- ADT - Admission, Discharge, Transfer
- AMA -American Medical Association
- BW - Build Workbook. Allscripts terminology; is a workbook provided to clients to assist and organize v11 data collection and build activities.
- CCD - Continuity of Care Document
- CDA - Clinical Document Architecture
- CCR - Continuity of Care Record
- CED - Clinical Exchange Document
- CCI- Correct Coding Initiative
- CG CareGuides - A large set of templates created by Allscripts for Touchworks for common medical conditions including diseases, injuries and health maintenance.
- CIS - Clinical Information System, industry word. Generic term used to describe the software programs designed to capture manage and analyze health care data.
- CLR - Common Language Runtime. It is Microsoft's implementation of the Common Language Infrastructure (CLI) standard, which defines an execution environment for program code. http://en.wikipedia.org/wiki/Common_Language_Runtime
- CPOE - Computerized Physician Order Entry, industry term. The electronic entry by a physician of treatment instructions for patients under his or her care. These orders are communicated over a computer network to medical staff or departments responsible for fulfilling the order. http://en.wikipedia.org/wiki/CPOE
- CMS - Centers for Medicare and Medicaid. Their home page http://www.cms.hhs.gov/ and more information http://en.wikipedia.org/wiki/Centers_for_Medicare_and_Medicaid_Services
- CPT4 - Current Procedural Terminology, 4th Edition, medical term. A standardized set of codes established by the American Medical Association to identify medical procedures performed and for billing purposes.
- CDT - Clinical Desktop
- DEA - Drug Enforcement Agency
- DUR - Drug Utilization Review-
- EHR – Electronic Health Record, industry term. A patient’s medical record in a digital format. Owned and controlled by the provider.
- EMAR - Electronic Medication Administration Record
- EMR – Electronic Medical Record, industry term. A patient’s medical record in a digital format.
- ETL - Extract, Transform, Load
- FTP – File Transfer Protocol, computer term. A network protocol for transferring files over the internet. http://en.wikipedia.org/wiki/Ftp
- GUI- Graphic User Interface
- HCPCS- Healthcare procedural coding system.
- HEDIS- The Healthcare Effectiveness Data and Information Set-Tool used to measure performance on important dimensions of care and services.
- HIE Health Information Exchange
- HIPAA – Health Insurance Portability and Accountability Act, legal and medical term. Relates to the legal act of 1996.
- HIT- Health Information Technology-used to improve the efficiency and quality of health care that patients receive. System where medical professionals store information ususally contained in a patients chart on a computer, rather than on paper
- HMP – Health Management Plan, Allscripts Term – this is a component of the Clinical Desktop within Touchworks. It is a workspace for reviewing current orders, meds, order reminders, alerts and results for active problems
- HL7- Health Level Seven - a standard development organization that supports the development and maintenance of a health data exchange protocol.
- HTB – Horizontal Tool Bar the menu bar that appears horizontally across the screen.
- Hx - is used in medical shorthand to mean "history"
- ICD9 - International Statistical Classification of Diseases and Related Health Problems
- IHE Integrating the Healthcare Enterprise
- ISO- International Organization for Standarization
- IPA- Independent Practice Association-consists of a network of physicians in a region or community who agree to participate in an association to contract with health maintenance organizations, other managed care plans, and also vendors for the benefit of each of the physicians in the IPA.
- KB – Allscripts Knowledge Base, Allscripts term – the knowledge base is an online resource created by Allscripts as a resource tool to support Touchworks users.
- KPI - Key Performance Indicator; business term. Can include common measures and statistics aggregated from the EHR in order to assess compliance, meaningful use, or work flow consistency.
- LAN-Local Area Network
- LIS - Laboratory Information System. A general term often used to reference an internal or external laboratory system.
- LMRP - Local Medical Review Policy
- MAR - Medication Administration Record
- MDM - Medical Document Management
- MPI - Master Patient Index - Used Interchangeably with Patient Master Index (PMI). An index that contains a unique identifier for every patient in the enterprise
- MSO - Managed Services Organization or Medical Services Organization
- NAW - Note Authoring Workspace
- NCQA - National Committee for Quality Assurance
- NDC-National Drug Code
- NPI - National Provider Identifier
- OBR - Observation Request Segment
- OCD – Orderable Concept Dictionary, Allscripts term – This is a dictionary that comes with Touchworks that is a consistent dictionary of orders and results. This was created to deal with differences in medical terminology in different locations and with different vendors.
- OID – Orderable Item Dictionary, Allscripts term – This is the dictionary of things that can be ordered, received or recorded as results. These terms can vary from hospital to hospital, and are therefore mapped to items in the orderable concept dictionary for consistency.
- ORM - Observation Result Messages
- ORU - Observation Result Unsolicited
- PACS – Picture Archiving and Communication System – used to exchange medical images over a network (X-rays, ultrasound etc.)
- PAT – Physician Administration tool
- PBM - Pharmacy Benefit Manager
- PCP- Primary Care Provider
- PHI-Personally Identifiable Health Information
- PHR –Personal Health Record –owned and controlled by the patient
- PM - Practice Management
- PMS - Practice Management System
- PQRI- Physician Quality Reporting Initiative-for 2009 consists of 153 quality measures and 7 measure groups
- RIS - Radiology Information System
- RLS -Record Locator Service - An index that lets clinicians find out where the patient information they seek is stored so that they can request it directly from its source.
- RTI- Real Time Intervention
- ROI – Return on Investment or Release of Information, when used by medical records staff
- RX+ – a module of Touchworks that allows clinical staff to manage their patients' medications, as well as provides tools for prescribing utilizing DUR checking and plan-specific formularies
- SIG – From the Latin “Signa”, meaning to write. This is a medical abbreviation used when writing prescriptions meant to mean “write the following instructions on the label”
- SIU - Schedule Information Unsolicited (message)
- SQL - Structured Query Language; technical term. The primary DBMS and programming language for Enterprise EHR.
- SSMT – Starter Set Migration Tool – this is a tool used to move items from test to live
- TIU - Text Input Utility - this is the Word integrated transcription tool for typing and submitted transcriptions in the EHR
- TW – Touchworks
- TWPM – Touchworks Practice Management
- VPN –Virtual Private Network
- VTB – Vertical Tool Bar – The tool Bar that runs up and down the screen, usually on the left hand side
- WAD - Working As Designed
- XML - Extensible Markup Language, a computer term.