Procuring Interoperability: Achieving High-Quality, Connected, and Person-Centered Care (2018)
Chapter: Appendix D: Glossary
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Appendix D
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Suggested Citation:
"Appendix D: Glossary." National Academy of Medicine. 2018. Procuring Interoperability: Achieving High-Quality, Connected, and Person-Centered Care. Washington, DC: The National Academies Press.
doi: 10.17226/27114.
Appendix D
GLOSSARY
| TERM | DEFINITION |
|---|---|
| Application Programming Interface (API) | A set of clearly defined specifications that detail how software components should interact. In health care, APIs established a standardized approach to sharing data between connected devices and systems. |
| Argonaut Project | A private-sector initiative to advance industry adoption of modern, open interoperability standards. The purpose of the Argonaut Project is to accelerate time to market by developing a first-generation FHIR-based API and Core Data Services specification to enable expanded information sharing for EHRs and other health IT. |
| Clinical Document Architecture (CDA) | A framework for clinical documents to be structured in a way through which they can be read by both humans and computers (Oemig and Snelick, 2016). |
| Consolidated-Clinical Document Architecture (C-CDA) | “The HL7 Consolidated CDA is an Implementation Guide which specifies a library of templates and prescribes their use for a set of specific document types” (Duteau and Madra, 2016). |
| Core Data Services (CDS) | Fundamental, standards-based data services that implementations of the public API are expected to provide. The CDS read/write access to both clinical documents (e.g., discharge summary) and discrete clinical data elements (e.g., allergies). |
| Digital Imaging and Communications in Medicine (DICOM) | An “international standard to transmit, store, retrieve, print, process, and display imaging information” (DICOM, 2018). |
| Health Information Exchange (HIE) | HIE allows clinicians and patients to appropriately access and securely share a patient’s medical information electronically to inform timely clinical decisions. There are currently three key forms of HIE: direct exchange, query-based exchange, and consumer-mediated exchange (ONC, 2018). |
| Health Information Technology for Economics and Clinical Health Act (HITECH) | Enacted as part of the American Recovery and Reinvestment Act of 2009, HITECH aims to promote the adoption and meaningful use of health IT. A section of the HITECH Act also addresses the privacy and security concerns associated with the electronic transmission of health information, in part through several provisions that strengthen the civil and criminal enforcement of the HIPAA rules. |
| Health Level Seven International (HL7) | Founded in 1987, HL7 is a not-for-profit, standards-developing organization dedicated to “providing comprehensive framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information that supports clinical practice and the management, delivery, and evaluation of health services” (HL7, 2018). |
Suggested Citation:
"Appendix D: Glossary." National Academy of Medicine. 2018. Procuring Interoperability: Achieving High-Quality, Connected, and Person-Centered Care. Washington, DC: The National Academies Press.
doi: 10.17226/27114.
| TERM | |
| Integration Profiles/Implementation Guides | Guidelines that prescribe to developers how to apply data exchange standards for specific types of needs (i.e., use cases) to result in more common (open) interface implementations. |
| Interface Control Documents (ICDs) | “Details the physical interface between two system elements, including the number and types of connectors, electrical parameters, mechanical properties, and environmental constraints” (NASA, 2007). |
| Integrating the Healthcare Enterprise (IHE) | An initiative started in 1997 by health care industry professionals with the initial goal of improving the integration of imaging data into hospital IT infrastructure. Since then, IHE has expanded its scope to include multiple functional domains (e.g., laboratory, cardiology, and pathology) that create specific integration profile documents and provide guidance on the coordinated use of established standards such as DICOM and HL7 (Rhoads, Cooper et al., 2009). |
| Interoperability | “the ability of two or more systems or components to exchange information and to use the information that has been exchanged” (IEEE Computer Society, 1991). |
| JASON (advisory group) | JASON is an independent group of elite scientists which advises the United States government on matters of science and technology. |
| JavaScript Object Notation (JSON) | An open-standard file format that uses human-readable text to transmit data objects consisting of attribute-value pairs and array data types. |
| Macro-Tier | A tier within the health care interoperability ecosystem that represents inter-facility information exchange. |
| Meaningful Use/Medicare EHR Incentive Program | An effort initiated under the HITECH Act of 2009, led by CMS and ONC, to incentivize the adoption and “meaningful use” of certified EHR technology. |
| Meso-Tier | A tier within the health care interoperability ecosystem that represents intra-facility information exchange. |
| Micro-Tier | A tier within the health care interoperability ecosystem that represents information exchange between individual actors at the point of care. |
| Middleware | “Middleware is software that lies between an operating system and the applications running on it. Essentially functioning as hidden translation layer, middleware enables communication and data management for distributed applications” (Microsoft, 2017). |
| National Evaluation System for health Technology (NEST) | Created by the FDA to “efficiently generate better evidence for medical device evaluation and regulatory decision-making” by “strategically and systematically leveraging real-world evidence and applying advanced analytics to data tailored to the unique data needs and innovation cycles of medical devices” (FDA, 2018). |
| N-Squared Diagram | A systems engineering tool used to identify interactions between multiple systems. |
| Open Architecture (OA) | A system designed so that one subsystem can be replaced with another subsystem with minimal effect on the performance of the overall system. This means both subsystems have to meet detailed specifications. |
| Open Business Model | A business model structured to enable organizations to compete based on the performance of their individual products (or subsystems) rather than on how information is exchanged between subsystems. |
| ONC Interoperability Standards Advisory | First established in 2015 and updated annually, the ONC interoperability standards advisory provides guidance on “best-of-breed” data exchange standards, integration profiles, and implementation guides based on intended purpose (i.e., use cases), maturity, and degree of adoption. |
Suggested Citation:
"Appendix D: Glossary." National Academy of Medicine. 2018. Procuring Interoperability: Achieving High-Quality, Connected, and Person-Centered Care. Washington, DC: The National Academies Press.
doi: 10.17226/27114.
| TERM | |
| Organizational Interoperability | “Standardized process (workflow) elements using business process modeling tools” (Taylor and Snelick, 2016). |
| Personal Connected Health Alliance | A nonprofit organization formed by the Health Information and Management Systems Society (HIMSS) that aims to mobilize a coalition of stakeholders in technology and life sciences around personal connected health. The alliance publishes and promotes adoption of the Continua Design Guidelines, an international standard for the exchange of data to and from personal health devices. |
| Representational state transfer (REST) and RESTful | RESTful is an API that uses HTTP requests to get, put, post, and delete data. A RESTful API is based on representational state transfer (REST) technology, an architectural style and approach to communications often used in web services development. |
| Semantic Interoperability | “Standardized terms/vocabulary for data interpretation,(e.g., LOINC, ICD-10CM)” (Taylor and Snelick, 2016). |
| Syntactic Interoperability | “Standardized data exchange formats, (e.g., HL7, XML)” (Taylor and Snelick, 2016). |
| Technical Interoperability | “Signals using standard protocols for technically secure data transfer, (e.g., TCP/IP)” (Taylor and Snelick, 2016). |
| Trusted Exchange Framework | The Trusted Exchange Framework, released by ONC in draft form in January 2018, outlines a common set of principles for trusted exchange minimum terms and conditions for trusted exchange. It is designed to bridge the gap between providers’ and patients’ information systems and enable interoperability across disparate health information networks (ONC, 2018). |
Suggested Citation:
"Appendix D: Glossary." National Academy of Medicine. 2018. Procuring Interoperability: Achieving High-Quality, Connected, and Person-Centered Care. Washington, DC: The National Academies Press.
doi: 10.17226/27114.
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