Healthcare Interoperability Glossary
Find industry terminologies for healthcare interfacing, HL7 and interoperability right here.
A | B | C | D | E | F | G | H | I | J | K | L | M|
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N | O | P | Q | R | S | T | U | V | W | X | Y | Z
A
ACK - Acknowledgment
Acknowledgment is often used to "pace" connections between trading partners. Also see What is An ACK?
ADT - Admit-Discharge-Transfer
ADT are HL7 messages which carry patient demographics information. ADT are often sent by the HIS or registration application and broadcast to many other applications in a typical hospital. Also see What is An ADT Message?
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C
Cardinality
Limits how many times an element must/may appear in a HL7 message. Represented as minimum and maximum instance counts, e.g., 0-to-n or 1-to-1.
Also see What is Cardinality in HL7?
| Field or Segment |
Rule | Cardinality |
Patient address field (PID-11) |
optional and repeating |
0 to n |
Patient primary language field (PID-15) |
optional and non-repeating |
0 to 1 |
Patient class field (PV1-2) |
required and non-repeating |
1 to 1 |
The Patient Identification (PID) segment in the Patient Admission message (ADT-A01) |
required and non-repeating |
1 to 1 |
CCHIT - Certification Commission for Healthcare IT
Serves as the recognized US certification authority for electronic health records (EHR) and their networks. In September 2005, CCHIT was awarded a 3-year contract by the U.S. Department of Health and Human Services to develop and evaluate the certification criteria and inspection process for EHRs and the networks through which they interoperate.
CCOW - Clinical Context Management Specification
Allows clinical applications to share information at the point of care.
CDR - Clinical Document Repository
Clinical document repository enables hospitals to build a life-long health record environment using stored health records for the purpose of better treatment, clinical research and health statistics for policy making.
CCD - Continuity of Care Document
The HL7 Continuity of Care Document (CCD) is the result of a collaborative effort between the Health Level Seven and ASTM organizations to “harmonize” the data format between ASTM’s Continuity of Care Record (CCR) and HL7’s Clinical Document Architecture (CDA) specifications. Also see HL7 and Continuity of Care Document
CCR - Continuity of Care Record
The Continuity of Care Record (CCR) is an XML-based standard for the movement of “documents” between clinical applications. Furthermore, it responds to the need to organize and make transportable a set of basic information about a patient’s health care that is accessible to clinicians and patients.
| White Paper | Understanding The Continuity of Care Record |
| Blog Posts | What Is the Continuity of Care Record (CCR)? |
CDA - Clinical Document Architecture
Stores or moves clinical documents between medical systems. Documents are things like discharge summaries, progress notes, history and physical reports, prior lab results, etc. The CDA uses XML for encoding of the documents and breaks down the document in generic, unnamed, and non-templated sections. Also see How do CCR and CDA Compare
Clinical Interface Specialist
Clinical Interface Specialist is responsible for moving clinical data between applications or between healthcare providers. They also create tools to move data, or create clinical applications that need to share or exchange data with other systems.
Conformance Checking
Conformance checking or Gap Analysis for HL7 messages is a logical process used to determine whether a message from one particular medical device or application is compatible to the standard HL7 messaging format, or a custom format adopted by another device or application.
Coord of Ben Priority
If the insurance works in conjunction with other insurance plans, this field contains priority sequence.
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D
DFT - Detailed Financial Transaction
HL7 messages that carry billing information.
DICOM - Digital Imaging and Communications in Medicine
Digital Imaging and Communications in Medicine is a common format for image storage. Provides for handling, storing, printing, and transmitting information in medical imaging.
E
EHR - Electronic Health Record
Electronic Health Record (EHR) is the consolidation of a patient's medical records. An EHR may be made up of multiple electronic medical records (EMRs) from many locations and/or sources.
EMR - Electronic Medical Record
A computer-based record containing health care information regarding a patient. EMR systems are used in doctor's offices, clinics, hospitals, etc. and are used for the assisting a physician with a patient's clinical matters.
ELINCS - EHR-Lab Interoperability and Connectivity Standards
The EHR-Lab Interoperability and Connectivity Specification (ELINCS) specification provides a profile that refines (or constrains) “standard” HL7 messages to moving lab results from reference labs to physician offices. Also see ELINCS.
Diagram Source: California HealthCare Foundation
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H
Healthcare Interoperability
The ability to exchange data among a variety of clinical platforms in a seamless manner.
| Read | 7 Habits for Healthcare Interoperability |
HIE - Health Information Exchange
The mobilization of healthcare information electronically across organizations within a region or community.
HIE provides the capability to electronically move clinical information between disparate health care information systems while maintaining the meaning of the information being exchanged. The goal of HIE is to facilitate access to and retrieval of clinical data to provide safe, and efficient patient-centered care.
HITSP - Healthcare Information Technology Standards Panel
The panel serves as a cooperative partnership between the public and private sectors for the purpose of achieving a widely accepted and useful set of standards specifically to enable and support widespread interoperability among healthcare software applications, as they will interact in a local, regional and national health information network for the United States.
HL7
HL7(Health Level Seven) is a Standards Developing Organization accredited by the American National Standards Institute to author consensus-based standards representing a board view from healthcare system stakeholders.
HL7 has compiled a collection of message formats and related clinical standards that loosely define an ideal presentation of clinical information, and together the standards provide a framework in which data may be exchanged.HL7 CDA
Clinical Document Architecture – provides an exchange model (XML-based) for clinical documents (such as discharge summaries and progress notes); recently known as the Patient Record Architecture (PRA).
HIS - Hospital Information System
The "main" system in a hospital used by most caregivers. Sends ADT broadcasts to all ancillary applications. The HIS is typically the patient administrative system and order entry system for a hospital.
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I
Interface Engine
An interface engine can transform or map the data to the receiving application’s requirements while the message is in transit so that it can be accepted by the receiving application.
Essentially, the import and export module from the sending application is built in a very comprehensive manner, capturing all potential data to be used in one interface.
The application interface is built with a one-to-many concept in mind. These import/export modules then are connected to an interface engine so that the mapping, routing, and monitoring are managed by this system.
IHE - Integrating the Healthcare Enterprise
IHE is an initiative by healthcare professionals and industry to improve the way computer systems in healthcare share information.
L
LIS - Laboratory Information System
A lab information system (LIS), is an information system that receives, processes, and stores information generated by a medical laboratory processes. LIS often interfaced with HIS (Hospital Information Systems) and, today, EMR applications.
LOINC - Logical Observation Identifiers Names and Codes
Applies universal code names and identifiers to medical terminology related to the EHR (Electronic Health Record) and assists in the electronic exchange and gathering of clinical results (such as laboratory tests, clinical observations, outcomes management and research). Also see What are LOINC Codes?
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M
Medical Informatists
Medical Informatists work in the field of health informatics, which is the study of the logic of healthcare and how clinical knowledge is created. Informatists seek to create or adopt a clinical ontology--a hierarchical structure of healthcare knowledge (a data model), terminology (a vocabulary), and workflow (how things get done).
Message
The basic unit of HL7 communications. Built of segments and groups of segments.
MLP - Minimal Layer Protocol
Minimal Layer Protocol (MLP) is how you wrap an HL7 message with a header and footer to insure you know where a message starts, where a message stops, and where the next message starts.
These headers and trailers are usually non-printable characters that would not typically be in the content of HL7 messages.
The header is a vertical tab character <VT> its hex value is 0×0b.
The trailer is a field separator character <FS> (hex 0×1c) immediately followed by a carriage return <CR> (hex 0×0d)
<VT> |
HL7 Message goes here |
<FS> |
<CR> |
Modality
A "machine" typically in the lab or radiology departments used to collect patient data, such as a film scanner, CAT scan machine, blood gas analyzer, mass spectrometer, etc.
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N
NIST - National Institute of Standards and Technology
Founded in 1901, NIST is a non-regulatory federal agency within the U.S. Department of Commerce. NIST's mission is to promote U.S. innovation and industrial competitiveness by advancing measurement science, standards, and technology in ways that enhance economic security and improve our quality of life. NIST have made solid contributions to image processing.
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O
OBR - Observation Request Segment
Used in ORM and ORU messages.
OBX
the OBX is a segment used to transmit a single observation or observation fragment. It represents the smallest indivisible unit of a report. The principal mission of an OBX is to carry information about observations and results in HL7 standard report messages (i.e., ORU or MDM)
ONCHIT - Office of the National Coordinator for Health Information Technology
The Office of the National Coordinator for Health Information Technology provides leadership for the development and implementation of a nationwide health IT infrastructure allowing secure and seamless exchange of data and records.
ORM - General Order Message
Used to order "anything" In the HL7 Standard, an order (ORM) is any request for materials such as supplies, lab test, procedure, etc. Orders are usually for a particular patient, but they can also be for a department (e.g., floor stock) or for a non-patient (e.g., an environment study where no specific patient is involved.)
The transmission of clinical orders occurs between the application placing the order (the placer) and the clinical application filling the order (the filler).
Typically, the caregiver (e.g., physician) is entering orders on the HIS application which acts as the placer application in HL7 messaging parlance. The system to which the order is targeted (e.g., the lab in the case of a complete blood count order) is the filler of the order.
ORU - Observation Result (Unsolicited) Message
In HL7 messaging, ORU messages provide structured patient-oriented clinical data between systems (e.g., EKG results to a physician’s office). ORU messages also can be used for linking orders and results to clinical trials (e.g., new drugs or new devices).
Clinical observations can include:
- Clinical laboratory results
- Imaging studies (i.e., text)
- EKG pulmonary function studies
- Interpretation
| Slides | Results (ORU) Messages – The Breakdown |
Video |
Results (ORU) Messages – The Breakdown |
P
PACS - Picture Archiving Communication System
Picture Archiving and Communication Systems are devoted to the storage, retrieval, distribution, and presentation of images. The medical images are stored in an independent format, most commonly DICOM.
PID - Patient ID Segment
Patient ID Segment is used by all applications as the primary means of communicating patient identification information. This segment contains permanent patient identifying and demographic information that, for the most part, is not likely to change frequently.
PMS - Practice Management System
Practice Management Systems (PMS) facilitate the day-to-day operations of a medical practice. PMS software enables users to capture patient demographics, schedule appointments, maintain lists of insurance payers, perform billing tasks, and generate reports. It handles the administrative and financial matters for a practice.
Point-To-Point Interfaces
A point-to-point interface is one in which the receiving vendor provides a specification on what data it can receive and in what format it needs to be in. The sending application then builds an interface to that specification for that application. It is a one-to-one relationship. For each application requiring an interface, there is a new request and point-to- point interface developed.
| Read | What is Your Healthcare Interface Method? |
| Video |
Point-to-point Interfaces vs. Interface Engine. |
R
RHIO - Regional Health Information Organization
The terms “RHIO” and “Health Information Exchange” or “HIE” are often used interchangeably. RHIO (regional health information organization) is a group of organizations with a business stake in improving the quality, safety and efficiency of healthcare delivery.
RHIOs are the building blocks of the proposed National Health Information Network (NHIN) initiative proposed by David Brailer, MD, and his team at the Office of the National Coordinator for Health Information Technology (ONCHIT).
To build a national network of interoperable health records, the effort must first develop at the local and state levels. The concept of NHIN requires extensive collaboration by a diverse set of stake holders. The challenges are many to achieve success for a health information exchange or a RHIO.
RIS - Radiology Information System
The "main"application in an imaging center. RIS used by radiology departments to store, manipulate and distribute patient radiological data and imagery. RIS are used for patient scheduling and tracking and image tracking.
| Read | Radiology Workflow - Integrated |
| Video |
Radiology Workflow: What Role Does HL7 Play? |
S
Separator Character Codes
| \E\ = Insert Escape Char \F\ = Insert Escape Char \R\ =Insert Repetition Sep Char \S\ =Insert Component Sep Char \T\ =Insert Sub-Component Sep |
SIU - Scheduling Information Unsolicited
Scheduling Information Unsolicited (SIU) messages are used to communicate information about a patient’s appointment from the hospital scheduling system to a physician or clinic’s practice management system. SIU messages are a part of the HL7 Standard. An SIU message can contain the following information:
- Notification of new appointment booking
- Notification of appointment rescheduling
- Notification of cancellation
- Notification of addition, modification, cancellation, discontinuation, or deletion of service or resource on appointment
The SIU messages are generated by the hospital scheduling system and let a physician know that outpatient services are being requested. It is important for the patient’s medical record to be updated to contain appointment information.
SNOMED - Systematized Nomenclature of Medicine
Provides comprehensive computerized clinical terminology covering clinical data for diseases, clinical findings, and procedures.
T
TCP/IP - Transmission control Protocol/Internet Protocol
Low level communications protocols used to connect hosts on the Internet. Sockets are created between clients and servers over TCP/IP. TCP/IP is stream oriented meaning it deposits bits in one end and they show up at the other end.
TCP/IP Basics:
- Socket is "communication endpoint"
- Server = wait for connection
- Client = initiate connection
- Sequenced, reliable transport
- Bi-directional by definition
- Sometimes/often used uni-directionally
X
X12
Provides for electronic exchange of business transactions-electronic data interchange (EDI). The American National Standards Institute (ANSI) chartered the Accredited Standards Committee (ASC) X12 to develop uniform standards.
Z
Z Segment
Z segments contain clinical or patient data that the HL7 Standard may not have defined in other areas. Essentially, it is the catch all for data that does not fit into the HL7 Standard message definitions.
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