2011-2012 DATA CAPTURE AND SHARING

Electronically capturing health information in a standardized format

Using that information to track key clinical conditions

Communicating that information for care coordination processes Initiating the reporting of clinical quality measures and public health information

Using information to engage patients and their families in their care

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Patient Protection and Affordable Care Act (ACA)

The Affordable Care Act (ACA) gives Americans the ability to make informed choices about their health, including the following components of the Patient’s Bill of Rights:

• Coverage—ends pre-existing condition exclusions for children, keeps adults under 26 covered, ends arbitrary withdrawals of insurance coverage, and guarantees the right to appeal

• Costs—ends lifetime limits on coverage, reviews premium increases, helps maximize premium dollars

• Care—covers preventive care at no cost, protects choice of doctors and removes insurance company barriers to emergency services

Personal Health Record (PHR)

A Personal Health Record (PHR) is an electronic application patients use to maintain and manage their health information in a private, secure, and confidential environment. PHRs can include information from a variety of sources, including health care providers and patients themselves and help patients securely and confidentially store and monitor health information, such as diet plans or data from home monitoring systems, as well as patient contact information, diagnosis lists, medication lists, allergy lists, immunization histories, and much more. PHRs are separate from, and do not replace, the legal record of any health care provider. They are distinct from portals that simply allow patients to view provider information or communicate with providers.

Regional Extension Center (REC)

Regional Extension Centers (RECs), located in every region of the country, serve as a support and resource center to assist providers in EHR implementation and Health IT needs. RECs bridge the technology gap by helping providers navigate the EHR adoption process from vendor selection and workflow analysis to implementation and meaningful use. Through ARRA, ONC established 62 RECs that assist primary care providers in the adoption and meaningful use of electronic health records. The REC program was designed to leverage local expertise to provide practical, customized support to meet the needs of local health care providers. RECs are part of working groups on emerging business lines in support of practice transformation including: privacy and security, accountable care organizations, patient centered medical home, health information exchange, and patient engagement.

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Rural Health Clinic (RHC)

A Rural Health Clinic (RHC) must be located in a Medically Underserved Area (MUA) or Health Professional Shortage Area (HPSA) and defined by the U.S. Department of Commerce, Census Bureau as non-urbanized (fewer than 50,000 people.) Its corporate structure can be unincorporated, public, nonprofit or for profit. An RHC is required to employ a mid-level provider (MLP) at least 50 percent of the time the practice is open to see patients. The importance of whether a clinic is designated urban or rural is due to the difference in payment caps that exist for rural versus urban FQHCs.

Safety Net Providers

Health care Safety Net Providers are institutions that are critical in providing care and services to vulnerable populations in low-income, medically underserved, immigrant and communities of color. These facilities are most often located in these communities, or nearby, and are serving the community. Most have limited health care resources available forcing residents to go without care or having to travel outside of their own community for services. Safety net providers are distinguished by their commitment to provide access to care for people with limited or no access to health care due to their financial circumstances, insurance status, or health condition.

SNOMED

SNOMED CT (Systematized Nomenclature of Medicine -- Clinical Terms) is a standardized, multilingual vocabulary of clinical terminology that is used by physicians and other health care providers for HIE. SNOMED CT contains more than 300,000 medical concepts, divided into hierarchies from body structure, clinical findings, geographic location to pharmaceutical/biological product. Each concept is represented by an individual number and several concepts can be used simultaneously to describe a complex condition. By using numbers to represent medical concepts, SNOMED CT provides a standard by which medical conditions and symptoms can be referred, eliminating the confusion that may result from the use of regional or colloquial terms. The numerical reference system also facilitates the exchange of clinical information among disparate health care providers and EHRs.

Telehealth

Telehealth uses telecommunications technology to provide health care to patients who are not in the same physical location as the provider. Telehealth includes activities, also called telemedicine, such as patient consultations using video conferencing, remote or

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home monitoring of vital signs, and store and forward transmission of still images or data. In addition to clinical applications, telehealth also includes remote non-clinical services, such as provider training, administrative meetings, and continuing medical education, in addition to clinical services. Telemedicine, and telehealth in general, offers an important tool to rural primary care physicians who can offer patients access to specialty medicine, for example, without having to travel long distances. As a category, telehealth is expanding with a variety of new applications that use wireless technologies, email and smart phones, to name a few examples.

Triple Aim

The Triple Aim is a framework developed by the Institute for Healthcare Improvement (IHI) that describes an approach to optimizing health system performance. The Triple Aim recommends that new designs must be developed to simultaneously accomplish three critical objectives, improve the health of the population; enhance the patient experience of care (including quality, access, and reliability); and reduce, or at least control, the per capita cost of care.

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