跨越绩效与信息鸿沟

术语汇编（原文）

Access and Service: A measure of how well a health plan provides its members with access to care with good customer service.

Access to Care: Provision for timely and appropriate healthcare.

Accident: An event that involves damage to a defined system that disrupts the ongoing or future output of the system.

Accounts Payable: Total of all monies owed by the organization.

Accounts Receivable: Monies owed to the organization but not yet collected.

Accreditation: A decision awarded to a healthcare organization that is in compliance with established standards.

Accruals: Taxes or wages accumulated against current profits but not yet due to be paid.

Accuracy: The extent to which data are free of identifiable errors.

ACE Inhibitor: A drug that acts to widen the blood vessels and make it easier for the heart to pump blood through the body. Captopril, ramipril, and enalapril are commonly used angiotensin-converting enzyme inhibitors.

Active Error: An error at the level of the frontline operator whose effects are felt almost immediately.

Activity-Based Costing: An accounting method used to estimate costs of a service or product by measuring the costs of the activities it takes to produce that service or product.

Acuity: The degree of psychosocial risk of health treatment or the degree of dependency or functional status of the patient.

Acute Care Hospital: A hospital that provides acute care services. Excludes discharges to longterm and rehabilitation hospitals.

Acute Myocardial Infarction (AMI): Death of heart muscle resulting from insufficient blood supply to the heart.

Added Value: The additional tangible benefit derived by an organization through carrying out a business function or process.

Adjusted Average per Capita Cost (AAPCC): The amount of funding a managed care plan receives from the Health Care Financing Administration to cover costs.

Administrative/Billing Data: Patient demographics; information about the episode of care such as admission source, length of stay, charges, discharge status, and diagnostic and procedural codes.

Administrative/Financial Measures: Performance measures that address the organizational structure for coordinating and integrating services, functions, or activities across operational components, including financial management.

Admission–Discharge–Transfer (ADT) System: A computer-based system used to track the gross movement of patients from their arrival to their departure within a medical enterprise. ADT systems are concerned primarily with patient demographics and provider information.

Adult Day Care Program: A program providing supervision, medical and psychological care, and social activities for older adults who live at home or in another family setting, but cannot be alone or prefer to be with others during the day.

Adult Smoking Cessation Advice/Counseling: A measure that reports what percent of adult heart attack/heart failure/pneumonia patients are provided advice and/or counseling to quit smoking.

Advanced Practice Nurses: Graduates of an accredited school of nursing and licensed by state law to practice nursing, especially nurse administrators, nurse anesthetists, nurse clinicians, nurse practitioners, nurse psychotherapists, and nurse midwives.

Adverse Event: An injury resulting from a medical intervention.

Affordable Care Act (ACA): Also known as Obamacare, is the federal statute signed into law on March 2010 that is part of the healthcare reform agenda of the Obama administration.

Agency for Healthcare Research and Quality (AHRQ): The health services research arm of the US Department of Health and Human Services.

Aggregate: Measurement data collected and reported by organizations as a sum or total over a given time period or for certain groupings.

Algorithm: An ordered sequence of data element retrieval and aggregation through which numerator and denominator events or continuous variable values are identified by a measure.

Allied Health Personnel: Healthcare workers specially trained and licensed to assist and support the work of health professionals, such as dental assistants, dental technicians, medical record administrators, pharmacists’ aides, and radiology technicians.

Allowable Value: The predefined range of alphanumeric values that are valid for a data element in a database.

Allowance for Doubtful Accounts: An estimated amount of bad debt subtracted from a balance sheet’s accounts receivable. This is a reserve for doubtful and bad accounts.

Ambulatory Care: Healthcare services provided to patients on an ambulatory basis, rather than by admission to a hospital or other healthcare facility. Also called outpatient care.

Ambulatory Payment Classification (APC): A payment group under the Hospital Outpatient Prospective Payment System composed of procedures that are clinically similar and associated with similar resource requirements.

American Hospital Quest for Quality Prize: An American Hospital Association award that honors leadership and innovation in quality, safety, and commitment to patient care by hospitals and/or multi-hospital health systems.

American National Standards Institute (ANSI): A nonprofit organization that helps establish electronic data standards.

American Recovery and Reinvestment Act (ARRA): An economic stimulus package enacted in 2009 that included the HITECH Act.

Amortization: The gradual elimination of a liability in regular payments over a specified period of time. Alternatively, writing off an intangible asset investment over the projected life of the asset.

Ancillary Services: Tests, procedures, imaging, and support services provided in a healthcare setting.

Angioplasty: The reconstruction or restructuring of a blood vessel by operative means or by nonsurgical techniques such as balloon dilation or laser.

Antibiotic Timing: Length of time from arrival at the hospital until antibiotics are given. This measure reports how long a pneumonia patient was in the hospital before they were given antibiotics.

Appropriateness: The degree to which the care provided is relevant to the patient’s clinical needs, given the current state of knowledge.

Aspirin at Arrival: Heart attack patients receiving aspirin when arriving at the hospital. This measure reports what percentage of heart attack patients receive aspirin within 24 hours before or after they arrive at the hospital.

Aspirin Prescribed at Discharge: Heart attack patients who receive a prescription for aspirin when being discharged from the hospital. This measure reports how often aspirin was prescribed to heart attack patients when they are leaving a hospital.

Assets: Money, merchandise, land, buildings, and equipment that the organization owns and that have monetary value.

Assisted Living: A special combination of housing, supportive services, personalized assistance, and healthcare designed to respond to the individual needs of those who need help in activities of daily living and instrumental activities of daily living.

Assisted Living Facility: Assisted living residencies that provide or coordinate personal services, 24-hour supervision and assistance, activities, and health-related services.

Attestation: The part of the process to secure CMS EMR Incentive Program reimbursements that requires providers to prove (attest to) that they are meaningfully using a certified 

EMR.

Audit Trail: A software tracking system used for data security. An audit trail is attached to a file each time it is opened so an operator can trace who has accessed a file and when.

Auditability: Performance measure data obtained from enrolled healthcare organizations are traceable at the individual case level so that performance measurement systems can adequately assess the quality of data.

Authentication: Proving, with some degree of certainty, a user’s identity.

Average Daily Census: The average number of inpatients, excluding newborns, receiving care each day during a reporting period.

Average Length of Service (ALOS): Number of years in continuous, full-time employment, or equivalent.

Backend Process: A process that doesn’t represent a healthcare institution’s unique skills, knowledge, or processes. Typical backend processes include payroll, billing, and accounts payable.

Bad Debt: Accounts receivable that will likely remain uncollectible and written off. Bad debts appear as an expense on the hospital’s income statement, thus reducing net income.

Bad Debt Expense: Provision for actual or expected uncollectibles resulting from the extension of credit.

Bad Outcome: Failure to achieve a desired outcome of care.

Balance Sheet: A statement of the financial position of the enterprise at a particular time.

Balanced Scorecard: An integrated framework for describing strategy through the use of linked performance measures in four, balanced perspectives—Financial, Customer, Internal Process, and Employee Learning and Growth.

Baseline: The starting point for defining needs.

Behavioral Healthcare: Healthcare services organized to provide mental healthcare.

Benchmarking: The comparison of similar processes across organizations and industries to identify best practices, set improvement targets, and measure progress.

Beneficiary: A person eligible for coverage of healthcare services by either a public or private health insurance program.

Best of Breed: The service provider that is best in its class of services.

Best Practice: The most effective and desirable method of carrying out a function or process.

Beta Blocker at Arrival: Quality measure that assesses the percentage of heart attack patients who receive a beta blocker when they arrive at the hospital.

Beta Blocker Prescribed at Discharge: Quality measure that assesses the percentage of heart attack patients who have a beta blocker prescribed when they are discharged from the hospital.

Binary: A system of expressing numerical values as 0s and 1s.

Binary Outcome: Events or conditions that occur in one or two possible states, that is, 0 or 1. Such data are frequently encountered in medical research.

Bioinformatics: The use of computer-based methods, including large databases and related tools, to acquire, store, manage, and analyze biological data.

Biometrics: A method of verifying the identity of a user based on their fingerprints, facial features, retinal pattern, voice, or other personal characteristic.

Blood Cultures: A blood test for the presence of bacteria in the blood.

Boxplot: A graph in which thin lines connect the highest and lowest data points to boxes that represent the two center quartiles on the graph.

Break-Even Analysis: A calculation of the approximate sales volume required to just cover costs, below which production would be unprofitable and above which it would be profitable.

Browser: A software program that interprets documents on the Web.

Business Intelligence (BI): Information technology practices and products concerned with gathering and analyzing financial and operational indicators.

Business Process Management (BPM): A business improvement strategy based on documenting, analyzing, and redesigning processes for greater performance.

Bylaws: Self-imposed rules that constitute a contract between a corporation and its members to conduct business in a particular way.

CAHPS: A comprehensive and evolving family of surveys, funded and managed by AHRQ, that ask consumers and patients to evaluate the interpersonal aspects of healthcare. CAHPS initially stood for the Consumer Assessment of Health Plans Study, but as the products have evolved beyond health plans, the acronym now stands alone as a registered brand name.

Capital Budget: A summary of the anticipated purchases for the year.

Capital Expenditure: An expenditure on tangible and intangible assets that will benefit more than one year of account.

Capitation: A payment structure where a caregiver is paid a set amount per patient in advance, regardless of how many procedures are performed.

Cardiac Catheterization Laboratory: Facilities offering special diagnostic procedures for cardiac patients.

Cascading: The process of developing aligned scorecards throughout an organization.

Case Finding: The procedure for determining whether a case is potentially eligible for inclusion in the denominator of a measure.

Case Management: A system of assessment, treatment planning, referral, and follow-up that ensures the provision of comprehensive and continuous services and the coordination of payment and reimbursement for care.

Case Mix: The collective pool of patients in a health system, including data on age, gender and health status.

Case Mix Index (CMI): A severity statistic used as a weight for Medicare patients. CMI varies from 0.4 to over 16.0, with an average of 1.0.

Cash: Money the organization has control of and access to.

Cash Flow: A measure of a hospital’s financial health, equal to cash receipts minus cash payments over a given period of time. Alternatively, net profit plus amounts charged off for depreciation, depletion, and amortization.

Cash Flow Statement: A report on the impact of an organization’s operating, investing, and financing activities on the cash flow over an accounting period.

Categorical Variable: A categorical variable groups items into predefined discrete, noncontinuous classes.

Cause and Effect: A linkage between items on a Balanced Scorecard. Cause and Effect may be hypothetical.

Census Day: A period of service between the census-taking hours on two successive calendar days, the day of discharge being counted only when the patient was admitted the same day.

Central Tendency: A property of the distribution of a variable, usually measured by statistics such as the mean, median, and mode.

Change Management: The set of structures, procedures, and rules governing the adoption and implementation of changes in the relationship between the customer and the service provider.

Charity Care: Health services that were never expected to result in cash inflows.

Cheers Award: An award presented by the Institute for Safe Medication Practices (ISMP) that recognizes individuals, healthcare organizations, regulatory agencies, professional organizations, researchers, pharmaceutical, and other healthcare-related businesses that have set a superlative standard of excellence to following the prevention of medication errors during the award year.

Children: Individuals who have not reached the legal age for consent.

Children Wellness Program: A program that encourages improved health status and a healthful 

lifestyle of children through health education, exercise, nutrition, and health promotion.

Children’s Online Privacy Protection Act (COPPA): The Federal law that regulates the Webbased collection and use of personal information gathered from or about children under age 13.

Chiropractors: Individuals specially trained and licensed to practice chiropractic.

Chi-square: A test for statistical significance, typically applied to data in contingency tables.

Choice Board: A Web-based, multi-user ordering system in which a customer’s order is sent to suppliers along the entire supply chain.

Claim: A bill for healthcare service.

Clearinghouse: A service that manages the claims and other electronic data from providers, verifies the information, and forwards the proper forms to the payers.

Client-Server: A computer architecture in which the workload is split between desktop PCs or handheld wireless devices (clients) and more powerful or higher-capacity computers (servers) that are connected via a network such as the Internet.

Clinic Visit: A visit to a specialized medical unit that is responsible for the diagnosis and treatment of patients on an outpatient, nonemergency basis.

Clinical Data–Based Severity Adjustment Methods: Techniques that quantify risks of shortterm outcomes based on clinical data.

Clinical Laboratory Improvement Amendments (CLIA): A congressional amendment passed in 1988 that established quality standards for all laboratory testing.

Clinical Laboratory Personnel: Those healthcare professionals, technicians, and assistants staffing a healthcare facility where specimens are grown, tested, or evaluated and the results of such are recorded.

Clinical Measures: Indicators designed to evaluate the processes or outcomes of care associated with the delivery of clinical services.

Clinical Outcome: A change in signs or symptoms as a result of clinical intervention.

Clinical Performance Measure: A quality measure reflecting the degree to which a provider competently and safely delivers clinical services that are appropriate for the patient in the optimal time period.

Clinical Performance: The degree of accomplishment of desired health objectives by a clinician or healthcare organization.

Clinical Survey: A tool used to collect data from clinicians who provide care.

Closed Formulary: A list of branded and generic prescription drugs that are approved for insurance coverage. Patients are required to pay more when they insist on brand-name drugs instead of less expensive generic drugs.

Closed Physician–Hospital Organization (PHO): A PHO that restricts physician membership to those practitioners who meet criteria for cost-effectiveness and/or high quality.

Cluster Analysis: One of several computationally efficient techniques that can be used to identify patterns and relationships in large amounts of patient data.

Cognitive Ergonomics: The applied science of equipment design, as for the workplace, intended to maximize productivity by reducing operator fatigue and discomfort.

Coinsurance: The portion of a covered claim that a patient must pay.

COLA: A nonprofit, physician-directed organization promoting quality and excellence in medicine and patient care through programs of voluntary education, achievement, and accreditation. COLA was established as a private alternative for physician office laboratories complying with the Clinical Laboratory Improvement Amendments of 1988.

Collusion: A fraudulent arrangement between two or more parties.

Commission: A type of finder’s fee set by insurance brokers or agents for selling health plans.

Commission for Health Improvement (CHI): The National Health Service (NHS) inspectorate, responsible for reviewing clinical governance arrangements in NHS organizations.

Common Carrier: Licensed utilities that provide communications services for a fee, under nondiscriminatory terms.

Common Cause Variation: Random variation inherent in every process.

Communications Protocol: A set of standards designed to allow computers to exchange data.

Community Healthcare: Diagnostic, therapeutic, and preventive healthcare services provided for individuals or families in the community for the purpose of promoting, maintaining, or restoring health or minimizing the effects of illness and disability.

Community Health Information Network (CHIN): Providers and payers within a specific area who are networked to exchange medical and administrative information among them, eliminating redundant data collection and reducing paperwork.

Community of Practice: Groups whose members regularly engage in sharing and learning, based on common interests.

Comorbidities: Preexisting diseases or conditions.

Comparison Group: The group of healthcare organizations to which an individual healthcare organization is compared.

Comparison Level Data: Aggregation of healthcare organization level data to provide a standardized norm by which participating organizations can compare their performance.

Competitive Insourcing: A process where internal employees may engage in bidding to compete with competitive, third-party bidders for a defined scope of work.

Competitive Reward Model: A program that rewards relative performance.

Complications: Conditions arising after the beginning of healthcare observation and treatment that modifies the course of the patient’s health or illness and the intervention/care required.

Composite Measure: A measure that combines the results of all process measures with a set into a single rating.

Computerized Physician Order Entry (CPOE): An electronic prescribing system that enables a physician to order through a computer rather than on paper.

Confidence Interval: A range of values containing the true value of the parameter being estimated with a certain degree of confidence.

Configuration: The operational characteristics of a performance measurement system.

Confounding Factors: Intervening variables that distort the true relationship between/among the variables of interest.

Consumer Informatics: Computer-based information available to the general public.

Continuity: The degree to which the care for the patient is coordinated among practitioners, among organizations, and over time.

Continuous Variable: A measure in which each individual value for the measure can fall anywhere along a continuous scale.

Contract: A binding agreement made between two or more parties, which is enforceable at law.

Contract Managed: General day-to-day management of an entire organization by another organization under a formal contract.

Contractor: A firm or person who has entered into a contract to supply goods and/or services.

Control Chart: A form of line chart that includes control limits based on plus or minus three standard deviations or sigma’s from the centerline. There are heuristics for determining when an observed variation is statistically significant.

Controlled Vocabulary: A terminology system unambiguously mapped to concepts.

Convergence: The merging of all data and all media into a single digital form.

Coordination of Benefits (COB): A verification system used to make sure a claim is not paid twice.

Co-payment: The flat fee that a patient pays, usually at the time of service.

Core Competency: The healthcare organization’s unique skills, knowledge, and processes.

Core Measure Set: A grouping of performance measures carefully selected to provide, when viewed together, a robust picture of the care provided in a given area.

Cost–Benefit Analysis: A technique designed to determine the feasibility of a project or plan by quantifying its costs and benefits.

Cost Shifting: A leveling method where one patient group is charged more to make up for another group’s underpayment or inability to pay.

Cost-to-Charge Ratio: The ratio of hospital cost to what is charged to patients and third-party payers for services. Medicare has explicit guidelines for establishing cost-to-charge ratios.

Credentialing: The examination of a healthcare professional’s credentials, practice history and medical certification or license.

Criteria: Expected levels of achievement or specifications against which performance or quality may be compared.

Critical Access Hospital: Hospitals with a patient census of less than 25 and that are located more than 35 miles from a hospital or another critical access hospital, or are certified by the state as being a necessary provider of healthcare services to residents in the area.

Critical Path: The shortest path to the final product or service in resource scheduling. The critical path represents the minimum length of time in which a project can be completed.

Current Assets: Cash, short-term investment, accounts receivable, inventory, prepaid expenses, and other assets that can be converted into cash within a year.

Current Liabilities: Liability that must be paid within a year, including accounts payable, wages and salaries, taxes, and mortgage payments.

Current Procedural Terminology (CPT): A uniform coding system for healthcare procedures developed by the American Medical Association (AMA) and used when submitting claims for healthcare to third-party payers. CPT coding assigns a five-digit code to each service or procedure provided by a physician.

Current Status of Development: The amount of work completed to date relative to the final implementation of a particular measure.

Current Use of the Measure: A measure is considered to be in current use if at least one healthcare organization has used the measure to evaluate or report on the quality of care within the last three years.

Customer Perspective: One of the four standard perspectives used with the Balanced Scorecard.

Customer Relationship Management (CRM): The dynamic process of managing a patient– healthcare organization relationship. Patients are encouraged to continue mutually beneficial commercial exchanges and are dissuaded from participating in exchanges that are unprofitable to the organization.

Customer Segment: A homogeneous group of similar patients with similar needs, wants, lifestyle, interaction opportunities, profile, and purchase cycle.

Cycle Time: The time it takes to convert an idea into a new product or service or to improve an existing product or service.

Dashboard: A graphical user interface to key performance indicator data.

Data Collection: The act or process of capturing raw or primary data from a single or number of sources.

Data Editing: The process of correcting erroneous or incomplete existing data, exclusive of data entry input edits.

Data Element: A discrete piece of data, such as patient birth date or principal diagnosis.

Data Entry: The process by which data are transcribed or transferred into an electronic format.

Data Maintenance: The efforts required to keep database files and supporting documentation accurate.

Data Mart: An organized, searchable database system, organized according to the user’s likely needs.

Data Mining: The process of studying the contents of large databases in order to discover new data relationships that may produce new insights on outcomes, alternate treatments, or effects of treatment.

Data Point: The representation of a value for a set of observations or measurements at a specific time interval.

Data Quality: The accuracy and completeness of measure data on performance in the context of the analytic purposes for which they will be used.

Data Repository: A database acting as an information storage facility. A repository does not have the analysis or querying functionality of a warehouse.

Data Sources: The primary source documents used for data collection.

Data Transmission: The process by which data are electronically sent from one organization to another.

Data Warehouse: A central database, frequently very large, that can provide authorized users with access to a cleaned, organized subset of the organizations data. A data warehouse is usually provided with data from a variety of noncompatible sources.

Database: An organized, comprehensive collection of variables and their values.

Database Management System (DBMS): A system to store, process, and manage data in a systematic way.

Day of Care: A period of service between the census-taking hours on two successive calendar days, the day of discharge being counted only when the patient was admitted the same day.  

Days Hold: Number of accounts still within the specified number of days after discharge before billing.

Debt Service: The series of payments of interest and principal required on a debt over a given period of time.

Decision Effective Date: The date of the accreditation decision awarded to an organization following an accreditation survey.

Decision Support System (DSS): An application for analyzing large quantities of data and performing a wide variety of calculations and projections.

Decision-Tree Analysis: A graphical process used to select the best course of action in cases of uncertainty.

Defined Allowable Value: The predefined range of alphanumeric values that are valid for a data element in a database.

Defined Measure: A structured measure with defined populations that measure specific events or values.

Demand Management: A program administered by managed care organizations or provider organizations to monitor and process initial member requests for clinical information and services.

Denominator: The lower part of a fraction used to calculate a rate, proportion, or ratio.

Denominator Data Elements: Those data elements required to construct the denominator.

Denominator Event: The event or state that defines a case as eligible for inclusion in the denominator.

Denominator Excluded Populations: Detailed information describing the populations that should not be included in the denominator.

Denominator Included Populations: Detailed information describing the population(s) that the denominator intends to measure.

Denominator Sampling Frame: The list of all cases potentially eligible for inclusion in the denominator, from which a more highly specified selection of cases will be made.

Denominator Statement: A statement that depicts the population evaluated by the performance measure.

Denominator Time Window: The time period in which cases are reviewed for inclusion in the denominator.

Denominator Verification: The extent to which the entire population of interest, and only the population of interest, is identified through data collection.

Dentist: Individuals licensed to practice dentistry.

Depreciation: The decline in the value of a fixed asset over its useful life.

Diagnosis Hold: Number of accounts not yet coded in Medical Records.

Diagnosis-Related Group (DRG): A system of reimbursement by the Health Care Financing Administration based on a patient’s primary diagnosis, length of stay, secondary diagnosis, surgical procedure, age, and types of services required. This case mix classification system is used primarily in the United States as a method of funding hospitals.

Diagnostic Mammography: The x-ray imaging of breast tissue in symptomatic women who are considered to have a substantial likelihood of having breast cancer already.

Dietitians: Individuals with a legally recognized qualification in nutrition and dietetics who apply the science of nutrition to the feeding and education of groups of people and individuals in health and disease.

Digital Signature: An encrypted digital tag added to an electronic communication to verify the identity of a customer. Also known as an electronic signature.

Direct Cost: That portion of cost that is directly expended in providing a service.

Disabled: Persons with physical or mental disabilities that affect or limit their activities of daily living and that may require special accommodations.

Discharge Instructions: A quality measure that reflects the percentage of patients with heart failure who are given information about their condition and care when they leave the hospital.

Discount Rate: The rate at which member banks may borrow short-term funds directly from a Federal Reserve Bank.

Discriminatory Capability: The extent to which an indicator demonstrates variation across multiple healthcare organizations.

Disease Management: A management approach that focuses on specific diseases, looking at what creates the costs, what treatment plan works, educating patients and providers, and coordinating care at all levels.

Disease Management: The development of an integrated treatment plan for patients with longterm illnesses or recurring conditions instead of viewing each physician visit as a separate event.

Disease-Specific Care: A certification program for disease management services, such as asthma or diabetes.

Disenrollment: The act of terminating the membership of a person or group in a health plan.

Disruptive Technology: A technology that causes a major shift in the normal way of doing things and that improves with time. The PC, digital camera, and cell phones are disruptive technologies.

DMADV: A Six Sigma strategy divided into five phases: Define, Measure, Analyze, Design, and Verify.

DMAIC: A Six Sigma quality improvement strategy described by five phases: Define, Measure, Analyze, Improve, and Control.

Downsizing: Reduction in employee headcount.

Drug Price Review (DPR): A monthly report that lists the average wholesale prices of prescription drugs.

Due Diligence: A thorough effort to intercept potential problems before they occur.

Ease of Use: Regarding a user interface, the ease or efficiency with which the interface can be used.

Economic Darwinism: Survival of the fittest; the most economically successful companies in the marketplace.

Economic Value Added (EVA): The after-tax cash flow generated by a business minus the cost of the capital it has deployed to generate that cash flow.

Economies of Scale: Reduction in the costs of production due to increasing production capacity.

Efficacy: The degree to which the care of the patient has been shown to accomplish the desired or projected outcome(s).

Electronic Data Interchange (EDI): An instance of data being sent electronically between parties, normally according to predefined industry standards.

Electronic Health Record (EHR): An electronic record of a patient’s medical history, medications, and other pertinent health data. Need not be hospital-centric, as is the case with an EMR.

Electronic Medical Record (EMR): A hospital-centric, electronic record of a patient’s hospital chart. This typically includes medical, social, and family histories, medications, lab results, and other data collected at the hospital.

Electronic Submission: The process whereby performance measure data are transferred electronically between information systems.

Eligibility: The ability to be part of a healthcare plan, with specific benefits for which a member qualifies and the time frame of coverage.

Emergency Care Research Institute (ECRI): An independent nonprofit health services research agency.

Emergency Medical Services: Clinical services specifically designed, staffed, and equipped for the emergency care of patients.

Emergency Medical Technicians/Paramedics: Personnel trained and certified to provide basic emergency care and life support under the supervision of physicians and/or nurses. Emergency Room Visit: A visit to the emergency unit.

Employee Benefits: Social security, group insurance, retirement benefits, workman’s compensation, and unemployment insurance.

Employee Contribution: The portion of health plan premiums paid by an employee to the company’s contracted payer.

Employee Learning and Growth Perspective: One of the four standard perspectives used with the Balanced Scorecard. Employee skills, availability of information, and organizational climate are often measured in this perspective.

Employee Relationship Management (ERM): A dynamic process of managing the relationship between knowledge worker and enterprise such that knowledge workers elect to continue a mutually beneficial exchange of intellectual assets for compensation in a way that provides value to the enterprise and are dissuaded from participating in activities that are unprofitable to the enterprise.

Employee Retirement Income Security Act (ERISA): A federal outline for regulating employee benefit plans, including healthcare plans sponsored and/or insured by an employer.

Employer Mandate: For companies that provide health insurance for their employees, this stipulation forces the company to pay for at least part of the insurance premium for each employee.

Encryption: The process of encoding data to prevent someone without the proper key from understanding the data, even though they may have access to the data.

End-of-Life Care: Patient care related to those not expected to survive more than 6 months.

Enforceability: The conditions under which the terms, conditions, and obligations of the parties under an agreement will be adopted and confirmed by a court of competent jurisdiction.

Enrolled Organization: An organization contractually committed to participation in a performance measurement system.

Enrollee: A member of a health plan or a member’s qualifying dependent.

Enrollment: In the context of the Affordable Care Act, enrollment is the act of selecting a particular coverage plan with a healthcare insurance provider.

Enrollment Assistance Services: A program that provides enrollment assistance for patients who are potentially eligible for public health insurance programs such as Medicaid, State Children’s Health Insurance, or local/state indigent care programs.

Enterprise Resource Planning (ERP): The activities supported by software that helps an enterprise manage product planning, parts purchasing, maintaining inventories, interacting with suppliers, providing customer service, and tracking orders.

Episode of Care (EOC): Healthcare services provided for a specific illness during a set time period.

Equipment Management: The selection, delivery, setup, and maintenance of equipment to meet patients’ needs, as well as the education of patients in its use.

Ernest A. Codman Award: An award given to organizations and individuals in the use of process and outcomes measures to improve organization performance and quality of care.

Error: Failure of a planned action to be completed as intended or use of a wrong plan to achieve an aim; the accumulation of errors results in accidents.

Established Patient: A patient who had received professional services within the past 3 years.

Excluded Populations: Detailed information describing the populations that should not be included in the indicator.

Executive Information System: A system that allows executives to analyze company data and reach management conclusions through decision-making tools, much as a physician might use a decision support system to narrow diagnosis options.

Expense: The cost of doing business. 

Experience Rating: A method of determining a company’s health insurance premiums by estimating the future healthcare risks of its employees.

Explanation of Benefits (EOB): A document that defines the portions of the service paid by insurance and the amount the patient has to pay.

External Comparison at a Point in Time: A comparison using the same measure for multiple comparable entities.

External Comparison of Time Trends: A comparison using the same measure for multiple comparable entities tracking change over time.

External Data Source: A repository for data that exists outside of the measurement system’s control.

External Standards: Performance measurement systems developed by government entities, accrediting bodies, or any regulatory entities so that performance data are comparable across measurement systems.

Extracorporeal Shock Wave Lithotripter (ESWL): A device used for treating stones in the kidney or ureter through the transmission of acoustic shock waves directed at the stones.

Extranet: A private network using the Internet protocol to share business information or operations with vendors, customers, and/or other businesses.

Food and Drug Administration Safety and Innovation Act (FDASIA): Section 618 of the act directed development of risk-based regulatory framework for health IT.

Fee Schedule: A list of maximum fees, per service, a provider will be reimbursed within a fee-for service payment system.

Fee-for-Service: A traditional method of paying for medical services. A physician charges a fee for each service provided, and the insurer or patient pay all or part of that fee.

Fertility Counseling: A service that counsels and educates on infertility problems and includes laboratory and surgical workup and management for individuals having problems conceiving children.

Financial Perspective: One of the four standard perspectives used with a Balanced Scorecard, often viewed as constraints within which the organization must operate.

Financial Statement: A written report that quantitatively describes the financial health of a company. This includes an income statement and a balance sheet, and often also includes a cash flow statement.

Firewall: A software and/or hardware security system that allows or denies access to information and the transfer of information from one network to another based on predefined access rules.

Fisher’s Exact Test: A statistical test used on contingency tables, more accurate than the chisquare test.

Fixed Assets: Land and physical properties used in the creation of economic activity by the enterprise.

Fixed Cost: A cost that does not vary depending on production or sales levels, such as rent, property tax, insurance, or interest expense.

Focus: The activity or area on which a performance measure centers attention.

Forecasting: A mathematical method of extrapolating historical performance data to aid in planning. As with weather forecasting, the further into the future the forecast, the less certain the results.

Format: The specification of the character length of a specific data element.

Formulary: A list of pharmaceutical products and dosages deemed by a healthcare organization to be the best, most economical treatments.

Frail Elderly: Older adults or aged individuals who are lacking in general strength and are unusually susceptible to disease or to other infirmity.

Franklin Award of Distinction: Award for a case management system that demonstrates excellence in building collaboration among the various professional and technical staff in the hospital to focus on case management and performance measurement results having a positive effect on patient care.

Frequency Distribution: The division of a sample of observations into a number of classes, together with the number of observations in each class.

Full-Time Equivalent (FTE): A measure of employee time devoted to work, typically 8 hours per day.

Functional Specification: A document that incorporates and crystallizes the requirement specifications and specifies exactly what a software and/or hardware system will deliver.

Functional Status: A measure of an individual’s ability to perform normal activities of life.

Gantt Chart: A graphical production scheduling method that shows lengths of various production stages.

Gatekeeper: A physician who manages a patient’s various healthcare services, coordinates referrals, and helps control healthcare costs by screening out unnecessary services.

General Data Elements: The group of data elements used to link healthcare organization level to comparison group data.

Generally Accepted Accounting Principles (GAAP): The conventions, rules, and procedures that define accepted accounting practice, as defined by the Financial Accounting Standards Board.

Genetic Algorithms: Programs designed to mutate, breed, and spawn new, more fit algorithms, based on their success in solving a particular problem.

Geographically Defined: Persons located within a specified boundary.

Geriatric Services: The branch of medicine dealing with the physiology of aging and the diagnosis and treatment of disease affecting the aged.

Getting Better: Care related to acute illness or injury.

Governance: Activities and policies extended on behalf of senior management of the parent corporation.

Government Performance and Results Act (GPRA): Legislation that requires federally funded agencies to develop and implement an accountability system based on performance measurement.

Gross Profit: A financial indicator equal to profit before expenses, interest, and taxes have been deducted.

Gross Revenue: Total revenue less cost of goods sold.

Gross Sales: Total invoice value of sales, before deducting for customer discounts, allowances, or returns.

Group Model HMO: A form of HMO where a partnership or company provides services and pays for the facility and salaries.

Group Purchasing Organization: An organization whose primary function is to negotiate contracts for the purpose of purchasing for members of the group or has a central supply site for its members.

Half-Life: The time in which half of the devices or applications in a given population fail or become useless because of obsolescence.

Hamilton Depression Rating Scale: A 17-item scale that evaluates depressed mood, vegetative and cognitive symptoms of depression, and comorbid anxiety symptoms.

HCPCS: The HCFA Common Procedural Coding System.

Health Care Financing Administration (HCFA): The branch of the US Department of Health and Human Services that administers Medicare and the federal portion of Medicaid.

Health Care Network: An entity that provides, or provides for, integrated health services to a defined population or individuals.

Health Care Organization (HCO): Entity that provides, coordinates, and/or insures health and medical services for people.

Health Care System: A corporate body that owns, leases, religiously sponsors, and/or manages health provider facilities.

Health Episode Statistics (HES): A database containing details of all patients admitted to NHS hospitals in England.

Health Information Technology for Economic and Clinical Health (HITECH) Act: A component of the American Recovery and Reinvestment Act (ARRA) of 2009 that promotes the adoption and meaningful use of health information technology.

Health Maintenance Organization (HMO): An affiliation of independent practitioners that contracts with patients to provide comprehensive healthcare for a fixed periodic payment specified in advance.

Health Plan: A person’s specific health benefits package or the organization that provides such a package.

Health Plan Employer Data and Information Set (HEDIS): NCQA’s tool used by health plans to collect data about the quality of care and service they provide.

Health Risk State: Behavior associated with negative medical consequences.

Health Status Measures: Indicators that assess the functional well-being of specific populations, both in general and in relation to specific conditions.

Healthcare Informatics: The use of computer-based tools, applications, and communications to interact with and manage health-related data.

Healthcare Insurance Portability and Accountability Act (HIPAA): The US Government regulation that holds healthcare facilities responsible for bringing legacy IT systems into stringent compliance and ensuring the security of patient records.

Hemodialysis: Provision of equipment and personnel for the treatment of renal insufficiency on an inpatient or outpatient basis.

Heuristic: A rule of thumb.

HL7: A standard interface for exchanging and translating data between computer systems.

Holding Company: A corporation organized for the purpose of owning stock in and managing one or more corporations.

Home Care: Community health and nursing services providing coordinated multiple service home care to the patient.

Home Health Service Visit: A visit by home health personnel to a patient’s home.

Home Health Services: Service providing nursing, therapy, and health-related homemaker or social services in the patient’s home.

Home Healthcare Agency: An organization that arranges for and provides necessary healthcare services in a patient’s home.

Homeless: Persons who have no permanent residence, including children and adolescents with no fixed place of residence.

Horizontal Analysis: The percentage change in indicator value from a previous year, that is, [(subsequent − previous)/previous] × 100.

Hospice Program: A recognized clinical program with specific eligibility criteria that provides palliative medical care focused on relief of pain and symptom control and other services that address the emotional, social, financial, and spiritual needs of terminally ill patients and their families.

Hospices: Facilities or services, which are especially devoted to providing palliative and supportive care to the patient with a terminal illness and to the patient’s family.

Hospital: A healthcare organization that has a governing body, an organized medical staff and professional staff, and inpatient facilities and provides medical, nursing, and related services for ill and injured patients 24 hours per day, 7 days per week.

Hospital Alliance: Hospital groups that agree to buy equipment and services jointly rather than incurring the costs separately.

Hospital Information System (HIS): A computer-based system that usually includes patient tracking, billing and administrative programs and also may include clinical features.

Human Capital: Employee knowledge, skills, and relationships.

Human Factors: The study of the interrelationships between humans, the tools they use, and the environment in which they live and work.

Illiterate/Low-Literate Populations: Persons with low levels of education.

Immigrants: Persons coming into a country of which he or she is not a native for the purpose of setting up residence.

In Process: Indicates NCQA has reviewed the health plan for the first time and is in the process of making a decision on the accreditation outcome.

In Vitro Fertilization: Program providing for the induction of fertilization of a surgically removed ovum by donated sperm in a culture medium.

Incentive and Reward Program: A program that rewards and encourages providers to improve quality and efficiency.

Incidence: A rate, showing how many new cases of a disease occurred in a population during a specified interval of time, usually expressed as the number of new cases per unit time per fixed number of people.

Incident to Services: Those services furnished as an integral, although incidental, part of the physician’s personal professional services in the course of diagnosis or treatment of an injury or illness.

Included Populations: Detailed information describing the population(s) that the indicator intends to measure.

Income Statement: An accounting of sales, expenses, and net profit for a given period.

Incurred but Not Reported (IBNR): When services have been delivered but the insurer has not processed the claim.

Indemnification: A method of shifting legal liability from one party to another by contract.

Indemnity insurer: An insurance company that pays for the medical care of its insured but does not deliver healthcare.

Independent Practice Association (IPA): A type of HMO that contracts with a group of associated physicians for services to its members.

Index: A type of composite measure that adds up individual scores on several items for an individual and divides this sum by the number of items scored.

Indicator: A measure used to determine performance of functions, processes, and outcomes over time.

Indirect Cost: A cost that is indirectly expended in providing a service.

Individually Identifiable Health Information (IIHI): Health information that can be associated with an individual.

Infrastructure: The system of servers, cables, and other hardware, together with the software that ties it together, for the purpose of supporting the operation of devices on a network.

Inhouse: Number of accounts for patients that have not been discharged.

Initiatives: The specific programs, activities, projects, or actions an organization will undertake in an effort to meet performance targets.

Inpatient Care: Services delivered to a patient who needs physician care for at least 24 hours, usually in a hospital.

Inpatient Day: A period of service between the census-taking hours on two successive calendar days, the day of discharge being counted only when the patient was admitted the same day.

Inpatient Mortality: Death of a patient with a heart attack during a hospital stay.

Inpatient Neonatal Mortality: A report of how often infants died before 28 days of birth, adjusted to reflect the fact that some babies are sicker than others at or shortly after birth.

Insourcing: The transfer of an outsourced function to an internal department of the customer, to be managed entirely by employees.

Institute of Medicine (IOM): A private, nonprofit institution that provides information and advice concerning health and science policy under a congressional charter.

Institutionalization: The care delivered in a hospital, rehabilitation hospital, nursing home, from admission to discharge.

Institutionalized Adults: Persons in long-term care or nursing homes.

Insurance Hold: Number of accounts waiting for insurance verification.

Intangible Asset: Something of value that cannot be physically touched, such as a brand, franchise, trademark, or patent.

Integrated Delivery System (IDS): A unified healthcare system that provides physician, hospital, and ambulatory care services for its members by contracting with several provider sites and health plans.

Integration: The process of bringing together related data from different sources to arrange it by customer.

Intellectual Property: Know-how, trade secrets, copyrights, patents, trademarks, and service marks.

Interface: The procedures, codes, and protocols that enable two systems to interact for a meaningful exchange of information.

Intermediate Care Facility: A place that provides medical care to patients who don’t need to be in a hospital.

Internal Process Perspective: One of the four standard perspectives used with a Balanced Scorecard, used to monitor the effectiveness of key processes the organization must excel at in order to continue adding value for patients and shareholders.

Internal Standards: Performance measurement quality standards tailored to a specific healthcare organization.

Internal Time Comparison: A comparison using the same measure in the same organization at two or more points in time to evaluate present or prior performance.

International Classification of Diseases, 9th Revision, with Clinical Modifications (ICD9-CM): A coding system developed in the United States, based on the ICD-9 code developed by the World Health Organization. ICD-9-CM codes provide a standard for comparison of birth, death, and disease data.

International Classification of Diseases, 10th Revision (ICD-10): A list that assigns codes to types of illnesses or conditions. Whereas CPT codes represent procedures and other services, ICD-10 codes represent diagnoses.

International Organization for Standardization (ISO): An international organization that establishes standards in a variety of areas, including quality management (see ISO 9000).

Invalid Data: Values for data elements that are required for calculating and/or risk adjusting a core measure that falls outside of the acceptable range of values defined for that data element. Inventory: The stock of goods on hand that is for sale.

ISO 9000: The family of ISO standards concerned with quality management.

John M. Eisenberg Award for Patient Safety and Quality: An award that recognizes major achievements of individuals and organizations in improving patient safety and quality.

Joint Commission on Accreditation of Healthcare Organizations (JCAHO): A commission that defines standards concerning the content and quality of medical records, as well as requirements for organization-wide information-management processes that must be followed to qualify for participation in the Medicare and Medicaid programs.

Joint Venture: A contractual arrangement between two or more parties forming an unincorporated business.

Just in Time (JIT): A manufacturing philosophy in which raw materials arrive no earlier than they are required to reduce costs and inefficiencies associated with large inventory.

Kaizen: A Japanese quality improvement philosophy named after the phrase “continuous improvement.”

Karnofsky Performance Score (KPS): A score used to quantify a patient’s general well-being, often used to determine whether a cancer patient can receive chemotherapy. The score ranges from 0% (death) to 100% (normal, no complaints, no signs of disease).

Key Performance Indicators (KPIs): Core measures that gauge the performance of an organization in a particular area, in terms of how the organization has performed in the past and how it is currently performing.

Knowledge Engineering: The process of extracting knowledge from an expert with enough detail and completeness that the knowledge can be imparted to others or to an information system.

Knowledge Management: A deliberate, systematic business optimization strategy that selects, distills, stores, organizes, packages, and communicates information essential to the business of a company in a manner that improves employee performance and corporate competitiveness.

Knowledge Organization: An organization that creates, acquires, transfers, and retains information.

Knowledge Repository: A central location of information on best practices.

Knowledge Workers: Employees hired primarily for what they know.

Knowledgebase: A database that contains information about other data contained in the database.

Laboratory: Hospital-based main laboratories or Point of Care Testing, free-standing laboratories, embryology laboratories, reference laboratories, blood banks, and donor centers.

Lagging Indicator: A performance measure that represents the consequences of actions previously taken.

Latency: The delay inherent in a system.

Latent Error: An error in the design, organization, training, or maintenance that lead to operator errors and whose effects typically lie dormant in the system for lengthy periods of time.

Leading Indicators: Measures considered drivers of future performance. A predictive measure.

Lean Manufacturing: A quality methodology focused on eliminating all waste from the manufacturing process.

Legacy System: An existing information system in which an enterprise has invested considerable time and money.

Leverage: The degree to which an organization assumes a larger proportion of debt than the amount invested by its owners.

Liabilities: Everything a company owes a creditor. The sum of current liabilities and short-term debt.

Liquidity: Capacity to pay debts as they come due.

Living with Illness: Care related to chronic or recurrent illness.

Local Area Network (LAN): A network of computer and peripherals in close proximity, usually in the same building.

Localization: The process of adapting a website to a particular country or region.

Logical Observation Identifiers Names and Codes (LOINC): Universal identifiers for laboratory and other clinical observations.

Logistic Regression: A form of regression analysis used when the response variable is a binary variable.

Long-Term Care: The health and personal care services provided to chronically ill, aged, disabled, or retarded persons in an institution or in the place of residence.

Long-Term Care Pharmacy: Services that include the procurement, preparation, dispensing, and distribution of pharmaceutical products, and ongoing monitoring and assistance in managing the resident’s clinical status and outcomes-related drug therapy.

Long-Term Debt: Financial obligations that come due more than 1 year from the date of the balance sheet statement.

Lost Opportunity Cost: The cost of not applying resources to toward an alternative investment.

Loyalty: A positive inner feeling or emotional bond between a patient and healthcare organization or provider.

LVF Assessment: A measure of the percentage of patients with heart failure who receive an evaluation of left ventricular function.

Magnet Hospital: An award presented by the American Nurses Credentialing Center (ANCC) to organized nursing services.

Magnetic Resonance Imaging (MRI): The use of a uniform magnetic field and radio frequencies to study tissue and structure of the body.

Malcolm Baldrige National Quality Award: An award established by Congress to promote quality awareness, to recognize quality and business achievements of US organizations, and to publicize the award winners’ successful performance strategies.

Mammography Screening: The use of breast x-ray to detect unsuspected breast cancer in asymptomatic women.

Managed Behavioral Health (MBHO): A delivery system for behavioral health concerns that includes managed care services.

Managed Behavioral Healthcare Organization (MBHO): A system of behavioral healthcare delivery that manages quality, utilization and cost of services, and which measures performance in the area of mental and substance abuse disorders.

Managed Care: A healthcare system and ideology based on prepaid membership instead of feefor-service payment each time service is delivered.

Managed Care: The assumption of responsibility and accountability for the health of a defined population and the simultaneous acceptance of financial risk.

Managed Care Organization (MCO): An insurer that provides both healthcare services and payment for services.

Managed Care Organization: A general term for health plans that provide healthcare in return for preset monthly payments and coordinate care through a defined network of primary care physicians and hospitals.

Managed Care Plans: Health insurance plans intended to reduce healthcare costs through a variety of mechanisms.

Management Services Organization (MSO): A corporation, owned by the hospital or a physician /hospital joint venture that provides management services to one or more medical group practices.

Margin of Safety: An excess of intrinsic value over market price.

Marginal Cost: The change in cost as the result of one more or less unit of output.

Marketing: The process associated with promoting products or services for sale, traditionally involving product, price, place, and promotion.

Mass Customization: Providing products as per customer specifications using traditional manufacturing techniques.

Master Patient Index: A database that collects a patient’s various hospital identification numbers, perhaps from the blood lab, radiology, admission, and so on, and keeps them under a single, enterprise-wide identification number.

Material Requirements Planning (MRP): A strategy to increase manufacturing efficiency by managing the production schedule, reducing inventory, increasing cash flow, and delivering products in a timely manner. Mean: The average value of a sample.

Meaningful Use: A Medicare and Medicaid program that awards incentives for using certified electronic health records (EHRs) to improve patient care.

Measure: A standard used to evaluate and communicate performance against expected results.

Measure Information Form: A tool used to provide specific clinical and technical information on a measure.

Measure-Related Feedback: Measure-related information on performance that is available, on a timely basis, to organizations actively participating in the performance measurement system for use in the organization’s ongoing efforts to improve patient care and organization performance.

Median: The middle value when the numbers are arranged in order of magnitude.

Medicaid: A joint federal and state healthcare program for low-income or disabled persons.

Medical Informatics: The use of computer-based tools to assist with core clinical functions, decision support, and research functions.

Medical Record: Data obtained from the records or documentation maintained on a patient in any healthcare setting.

Medical Record Hold: Number of accounts not yet abstracted in Medical Records.

Medical Savings Account: A private equity fund, much like an individual retirement account, set up to help cover future healthcare expenses, forming medical financial security regardless of workplace health plans.

Medically Uninsured: Individuals or groups with no or inadequate health insurance coverage.

Medicare: The federal government’s healthcare program for all persons over the age of 65 and for younger persons who have disabilities and cannot work.

Mentally Ill: Persons diagnosed as having a syndrome of emotional, cognitive, and/or perceptual problems leading to significant impairment of functioning or behavior.

Metadata: Data about data. How the structures and calculation rules are stored, information on data sources, definitions, quality, transformations, date of last update, and user access privileges.

Microsystems: The multiple small units of caregivers, administrators, and other staff who deliver care and services.

Minority Groups: A subgroup having special characteristics within a larger group, often bound together by special ties that distinguish it from the larger group.

Mirroring: Two identical files or databases created and updated simultaneously so an exact duplicate exists at all times.

Missing Data: When there are no values present for one or more data elements that are required for calculating and/or risk adjusting a core measure.

Mission Critical: Data relating to essential business operations.

Mission Statement: A mission statement defines the core purpose of the organization.

Mode: The most frequently occurring value for a data element.

Model-Based Approach for Risk Adjustment: A statistical technique that uses a mathematical model to describe the relationship between an outcome and a set of explanatory variables that are used to study and characterize the data.

Morbidity: A measurement of illness or accident risk, based on categories of age, region, occupation, and others.

Mortality: Statistical death rates, usually broken down by age or gender.

Mortgage: A legal document that pledges property to cover debt.

Multivariate Analysis: The analysis of the simultaneous relationships among variables.

Myocardial Infarction (MI): Heart attack.

National Committee for Quality Assurance (NCQA): A nonprofit organization that acts as a watchdog for the quality of care delivered managed care plans and physician organizations. Its accreditation process includes HEDIS and patient satisfaction surveys.

National Institute of Standards and Technology (NIST): A federal agency within the Commerce Department’s Technology Administration whose primary mission is to develop and promote measurement, standards, and technology to enhance productivity, facilitate trade, and improve the quality of life.

National Library of Medicine (NLM): The largest medical library and a branch of the National Institutes of Health (NIH).

National Patient Safety Goals: The National Patient Safety Goals are a series of specified actions that accredited organizations are expected to take in order to prevent medical errors.

National Quality Forum (NQF): The independent, voluntary, consensus-based member organization that endorses standardized quality measures.

National Quality Improvement Goals: Standardized performance measures that can be applied across accredited healthcare organizations.

National Quality Measures Clearinghouse (NQMC): A public repository for evidence-based quality measures and measure sets sponsored by the Agency for Healthcare Research and Quality, US Department of Health and Human Services.

Neonate: A child under 28 days of age.

Net Earnings: The amount left over after deducting all due bills for the accounting period and paying off all due interest and federal taxes.

Net Income: Revenues less expenses.

Net Patient Revenue: Net revenue from patients, third-party payers, and others for services rendered.

Net Present Value (NPV): The total present value of all cash flows, discounted to present day dollars. Enables managers to evaluate investments in today’s dollars.

Net Profit: Revenues minus taxes, interest, depreciation, and other expenses.

Net Revenue: Gross revenue adjusted for deductions and expenses.

Net Worth: Total assets minus total liabilities of an individual or company. Also called owner’s equity, shareholders’ equity, or net assets.

Network: A group of hospitals, physicians, other providers, insurers, and/or community agencies that voluntarily work together to coordinate and deliver health services.

Network Model HMO: A health maintenance organization that contracts with multiple groups of physicians for care delivery.

New Patient: One who has not received professional services from the physician, or another physician of the same specialty who belongs to the same group practice, within the past 3 years.

Non-Competitive Reward Model: A program that rewards absolute performance based on fixed targets or benchmarks.

Non-Operating Revenue: Investment income, extraordinary gains, and other non-operating gains.

Non-Weighted Score: A combination of the values of several items into a single summary value for each case.

Normalization: The process of reducing a complex data structure into its simplest, most stable structure. Normalization is often a prerequisite for an efficient relational database design.

Notes Payable: Money borrowed by the organization that is to be repaid within 1 year.

Numerator: The upper portion of a fraction used to calculate a rate, proportion, or ratio.

Numerator Data Elements: Those data elements necessary or required to construct the numerator.

Numerator Excluded Populations: Detailed information describing the populations that should not be included in the numerator.

Numerator Statement: A statement that depicts the portion of the denominator population that satisfies the conditions of the performance measure to be an indicator event.

Numerator Time Window: The time period in which cases are reviewed for inclusion in the numerator.

Objective: A concise statement describing the specific things an organization must do well in order to execute its strategy.

Observation Service: A service furnished on a hospital’s premises that is reasonable and necessary to evaluate an outpatient’s condition or determine the need for a possible admission to the hospital as an inpatient.

Occupied Bed Day: A period of service between the census-taking hours on two successive calendar days, the day of discharge being counted only when the patient was admitted the same day.

Office-Based Surgery: Small organizations or practices composed of four or fewer physicians performing surgical procedures.

Oncology Services: An organized program for the treatment of cancer by the use of drugs or chemicals.

Ongoing Data Quality Review Process: A data quality review process in operation and that is intended to continue for as long as data are accepted into the database.

Open Architecture: A network design that allows integration of various different types of computers and databases.

Open Heart Surgery: Heart surgery where the chest is opened and the blood is recirculated and oxygenated with equipment and the necessary staff to perform the surgery.

Open Physician–Hospital Organization (PHO): A joint venture between the hospital and all members of the medical staff who wish to participate.

Outcome Measure: A measure that indicates the result of the performance of a function or process. Outcome of Care: A health state of a patient resulting from healthcare.

Outcomes: An assessment of a treatment’s effectiveness by considering its success as a care solution as well as its cost, side effects and risk.

Outcomes Management: A program used to determine the clinical end results according to defined various categories and then promote the use of those categories that yield improved outcomes.

Outlier: A case in which costs far exceed those of a typical case within a Diagnostic-Related Group (DRG).

Outlier Payments: Supplements to prospective payments to defray some of the expenses in caring for the most costly cases.

Outpatient Prospective Payment System (OPPS): A prospective payment system established by the Balanced Budget Act of 1997 in which all services paid are classified into groups called Ambulatory Payment Classifications or APCs. A payment rate is established for each APC. Services in each APC are similar clinically and in terms of the resources they require.

Outpatient Surgery: Scheduled surgical services provided to patients who do not remain in the hospital overnight.

Outpatient Visit: A visit by a patient who is not lodged in the hospital while receiving medical, dental, or other services.

Outsourcing: Entrusting a business process to an external services provider for a significant period of time.

Out-tasking: A limited form of outsourcing in which a task is contracted out to a consultant or other service provider.

Overhead: The expense of running the business as opposed to the direct costs of personnel and materials used to produce the end result.

Oxygenation Assessment: A performance measure that reports how many patients with pneumonia had their blood/oxygen level measured.

Pain Management Program: A recognized clinical service or program providing specialized medical care, drugs or therapies for the management of acute or chronic pain and other distressing symptoms, administered by specially trained physicians and other clinicians, to patients suffering from an acute illness of diverse causes.

Palliative Care Program: An organized program providing specialized medical care, drugs, or therapies for the management of acute or chronic pain and/or the control of symptoms administered by specially trained physicians and other clinicians, and supportive care services, such as counseling on advanced directives, spiritual care, and social services, to patients with advanced disease and their families.

Parameter: Any characteristic of a population that can be inferred.

Parent Organization: The primary site of care for a healthcare organization. An organization may have multiple locations of care accredited under one parent organization.

Pathology and Clinical Laboratory Services: A service of a healthcare organization that is equipped to examine material derived from the human body to provide information for use in the diagnosis, prevention, or treatment of disease.

Patient Accounting System: Software that records charges to patients, creates billing forms, and maintains payment records.

Patient Day: A period of service between the census-taking hours on two successive calendar days, the day of discharge being counted only when the patient was admitted the same day.

Patient Demographics: Patient age, ethnicity, gender, and geographic location.

Patient Experience of Care: A patient experience is a report by a patient concerning observations of and participation in healthcare.

Patient Factor: A variable describing some characteristic of individual patients that may influence healthcare-related outcomes.

Patient Level Data: Collection of data elements that depict the healthcare services provided to a patient.

Patient Survey: Data obtained from patients and/or their family members/significant others.

Payer: A company or an agency that purchases health services.

Payroll Expenses: Payroll for all personnel including medical and dental residents, interns, and trainees.

Peak Debt Service: The largest annual interest expense and principal payments on existing debt.

Perception of Care: Satisfaction measures that focus on the delivery of clinical care from the patient’s/family’s/caregiver’s perspective.

Percutaneous Coronary Intervention (PCI): Coronary angioplasty, a procedure used to open up a blocked artery of the heart and restore blood flow to the heart muscle.

Performance Management: The skillful accomplishment of business through the effective use of resources.

Performance Measure: A quantitative tool that provides an indication of an organization’s performance in relation to a specified process or outcome.

Performance Measurement System: A system of automated databases that facilitates performance improvement in healthcare organizations through the collection and dissemination of process and/or outcome measures of performance.

Performance Measurements: The collected results of a healthcare organization’s actual performance over a specified time.

Personal Digital Assistant (PDA): A handheld electronic organizer that may have Internet access and e-mail functions.

Perspective: In Balanced Scorecard vernacular, a category of performance measures. The standard four perspectives are Financial, Customer, Internal Process, and Employee Learning and Growth.

PERT Chart: A method for project planning by analyzing the time required for each step.

Pervasive Computing: The anytime, anyplace access of computational power and data, in an unobtrusive form.

Pharmaceutical Services: Those services provided directly or through contract with another organization that procure, prepare, preserve, compound, dispense, or distribute pharmaceutical products, and monitor the patient’s clinical status.

Pharmacists: Those persons legally qualified by education and training to engage in the practice of pharmacy.

Physician Group Practices/Clinics: Any groups of three or more full-time physicians organized in a legally recognized entity for the provision of healthcare services, sharing space, equipment, personnel, and records for both patient care and business management, and who have a predetermined arrangement for the distribution of income.

Physician Hospital Organization (PHO): A system where a hospital and its physician groups jointly own the organization. The PHO as an entity then assumes the responsibility of arranging contracts with managed care plans and care facilities.

Physician Practice Organization (PPO): A system where insurance companies, employers, and other healthcare buyers arrange lower fees with select physicians and facilities.

Physicians: Individuals licensed to practice medicine.

Picture Archiving and Communications System (PACS): A system that uses an image server to exchange x-rays, CT scans, and other medical images over a network.

Pneumococcal Vaccination: A measure that reports how many patients 65 years and older were screened and vaccinated to prevent pneumonia.

Point of Service (POS): An indemnity-type option offered by HMOs in which members can refer themselves outside the plan and still get some coverage.

Point-of-Sale (POS): The device that is the first point in a financial transaction.

Point-of-Service Collections as a Fraction of Goal: Percentage of target monies collected at time of service.

Population: A complete set of actual or potential observations.

Portal: A website that offers a broad array of resources and services, from e-mail to online shopping. Most of the popular search engines have transformed themselves into Web portals to attract a larger audience.

Positron Emission Tomography (PET): A nuclear medicine imaging technology used to produce composite pictures based on metabolic activity or blood flow.

Poverty Populations: Persons living below the standard level of living of the community.

Practice Sanctions: Penalties, ranging from practice limitations to nonrenewal of contract, for failure of contracted providers to perform above minimum standards.

Practitioner: Any individual who is qualified to practice a healthcare profession.

Precision: The ability of an instrument to resolve small differences. Also known as resolution.

Predicted Value: The statistically expected response or outcome for a patient after the risk adjustment model has been applied and the patient’s unique set of risk factors have been taken into account.

Predictive Modeling: The use of a software program to predict, with quantifiable accuracy, future indicator values, based on past data. These past data typically include data not directly related to the data used to calculate the indicator.

Preferred Provider Organization (PPO): A form of managed care that has contracts with physicians, hospitals, and other providers of care who offer medical services to enrollees on a fee-for-service basis.

Prescriptive Standard: A standard set as a goal that ought to be achieved, or as a threshold that defines minimum performance. This standard may be derived from studies using different measurement methods.

Prevalence: The proportion of people in the entire population who have a disease at a certain point in time without regard to when they first got the disease.

Prevention: The degree to which appropriate services are provided for promotion, preservation, and restoration of health and early detection of disease.

Primary Care Department: A unit or clinic within the hospital that provides primary care services through hospital-salaried medical and/or nursing staff, focusing on evaluating and diagnosing medical problems and providing medical treatment on an outpatient basis.

Primary Care Network: A group of primary care physicians who contract among themselves and/or with health plans.

Prisoners: Individuals involuntarily confined in a penal institution.

Process: An interrelated series of events, activities, actions, mechanisms, or steps that transform inputs into outputs.

Process Management: An evaluation and restructuring of system functions to make certain processes are carried out in the most efficient and economical way.

Process Map: A graphic description of a process, showing the sequence of process tasks, which is developed for a specific purpose and from a selected viewpoint.

Process Measure: A measure that focuses on a process that leads to a certain outcome.

Process Optimization: The removal or re-engineering of processes that don’t add significant value to product or service, impede time to market, or result in suboptimal quality.

Profiling: The process of taking a few key customer data points, such as name, occupation, age, and address, and generating best guesses about their other characteristics.

Profit: The positive gain from business operations after subtracting all expenses.

Profit Center: A segment of the healthcare enterprise for which costs, revenues, and profits are separately calculated.

Profit Margin: Net profit after taxes divided by sales for a given 12-month period, expressed as a percentage.

Proprietary: Owned, copyrighted, or for which exclusive legal rights are held.

Prospective Payment: Any advance payment to a provider or facility for future healthcare services. Capitation is a form of prospective payment.

Prospective Payment System (PPS): A reimbursement program in which Medicare pays a predetermined amount for each inpatient discharge.

Protected Health Information (PHI): Individually identifiable health information (HIPAA).

Protocol: A way of doing things that has become an agreed-upon convention. Alternatively, a set of standards that defines communications between computers.

Provider Data: Provider-generated data not necessarily contained in the medical record.

Provider Profile: An examination of services provided, claims filed, and benefits allocated by healthcare facilities, physicians, and other providers to assess quality of care and cost management.

Proxy for Outcome: A process of care used as an indicator of health status, such as an admission to hospital used as an indication of increased severity of illness.

Psychologist/Non-Physician Behavioral Health Clinicians: Persons legally qualified by education and training to practice in the field of mental health.

Public Domain: Belonging to the community at large, unprotected by copyright, and subject to appropriation by anyone.

Public Health Professionals: Persons educated in public health or a related discipline who are employed to improve health of populations.

Push Technology: The automatic delivery of Web news and other information without a request from the user.

Qualified Providers: NCQA accreditation measure that verifies each physician in a health plan is licensed and trained to practice medicine and that the health plan’s members are happy with their service.

Quality: A standard of service established by the healthcare enterprise, patients, or credentialing body.

Quality Assurance: An assessment of the delivery portion of healthcare plans to make sure patients are receiving high-quality care when and where they need it.

Quality Bonus: Monies for performance improvement.

Quality Function Deployment (QFD): Prioritizing and translating customer needs into technical requirements and then delivering a quality product or service that aims to satisfy the customer.

Quality Management: The process of ensuring care is accessible and available, delivered within community standards; and that there is a system to identify and correct problems and to monitor ongoing performance.

Quality Measure: A mechanism to assign a quantity to quality of care by comparison to a criterion.

Quality of Care: Degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.

Quality of Life Measure: A score based on a patient’s overall well-being.

Quality Tools: A clearinghouse for quality assessment indicators sponsored by the Agency for Healthcare Research and Quality.

Radiation Therapy: The branch of medicine concerned with radioactive substances and using various techniques of visualization, with the diagnosis and treatment of disease using any of the various sources of radiant energy.

Random Sample: A subset selected in such a way that each member of the population has an equal opportunity to be selected.

Randomization: A technique for selecting or assigning cases such that each case has an equal probability of being selected or assigned.

Range: The difference between the largest and smallest number in a set. A measure of the spread of a data set.

Rate: A score derived by dividing the number of cases that meet a criterion for quality by the number of eligible cases within a given time frame where the numerator cases are a subset of the denominator cases.

Rate of Return: The annual return on an investment, expressed as a percentage of the total amount invested.

Rate-Based: An aggregate data measure in which the value of each measurement is expressed as a proportion or as a ratio.

Ratio: A relationship between two counted sets of data, which may have a value of zero or greater. 

In a ratio, the numerator is not necessarily a subset of the denominator.

Rationale: An explanation of why an indicator is useful in specifying and assessing the process or outcome of care measured by the indicator.

Real Time: Computer communications or processes that are so fast they seem instantaneous.

Receiver Operating Characteristic (ROC): A graph obtained by plotting all sensitivity values on the y axis against their equivalent values for all available thresholds on the x axis.

Re-Engineering: The process of analyzing, modeling, and streamlining internal processes so that a company can deliver better quality products and services.

Referred Visit: A visit to a specialty unit of the hospital established for providing technical aid used in the diagnosis and treatment of patients.

Refined Diagnostic Related Group (RDRG): A version of the DRG program that classifies cases into levels of severity and complexity based on the impact they are likely to have on use of hospital resources.

Registry Data: Those data obtained from local, regional, or national disease or procedure-related registries.

Regression: A mathematical method of forecasting using line equations to explain the relationship between multiple causes and effects.

Regression Coefficient: For a linear relationship, the constant that represents the rate of change of one variable as a function of changes in the other.

Rehabilitation Centers: Facilities that provide programs for rehabilitating individuals with mental illnesses, drug or alcohol addictions, or physical disabilities.

Rehabilitation Service: An organization service providing medical, health-related, social, and vocational services for disabled persons to help them attain or retain their maximum functional capacity.

Reimbursement: Payment for medical services delivered.

Relational Database: A database where all information is arranged in tables containing predefined fields.

Relative Value Unit (RVU): A composite measure of the time, difficulty, and resources associated with a procedure or service, used to establish fees, reimbursement levels, and physician incentives.

Relevance: The applicability and/or pertinence of the indicator to its users and customers.

Reliability: The degree to which the measure is free from random error.

Reliability, Availability, Serviceability (RAS): An evaluation method weighs a system’s performance and maintenance/repair record to determine whether or not the productivity of the system is worth the cost to maintain it.

Remittance Advice: A notice of payment due, either in paper form or as a notice of an electronic data interchange financial transaction.

Repeatability: The ability of an instrument or system to provide consistent results.

Reporting Period: The defined time period that describes the patient’s end of service.

Request for Proposal (RFP): A document that requests prospective service providers to propose the term, conditions, and other elements of an agreement to deliver specified services.

Requirements Specification: A description, in operational terms, of what management expects the vendor’s product or service to do for the company.

Residential Care Facilities: Long-term care facilities, which provide supervision and assistance in activities of daily living with medical and nursing services when required.

Residual Value: The value remaining in a device, as a function of time.  The longer the time from the original purchase date, the lower the residual value.

Resolution: The ability of an instrument to resolve small differences.

Respect and Caring: The degree to which the patient or a designee is involved in his or her own care decisions and to which those providing services do so with sensitivity and respect for the patient’s needs, expectations, and individual differences.

Respiratory Care Practitioners: Individuals trained and certified in the field of respiratory therapy.

Retained Earnings: The portion of an organization’s net earnings not paid to shareholders in the form of dividends.

Retention: The result when members remain on a health plan from 1 year to the next. Alternatively, the percentage of a premium that a health plan keeps for internal costs or profit.

Return on Assets (ROA): The ratio of operating earnings to net operating assets. The ROA is a test of whether a business is earning enough to cover its cost of capital.

Return on Equity (ROE): The ratio of net income to the owner’s equity. The ROE is a measure of the return on investment for an owner’s equity capital invested in the organization.

Return on Investment (ROI): Profit resulting from investing in a process or piece of equipment. 

The profit could be money, time savings, or other positive result.

Revenue: The inflow of assets from providing services to patients.

Risk-Adjusted Measures: Those measures are risk adjusted using statistical modeling or stratification methods.

Risk-Adjusted Rate: A rate that takes into account differences in case mix to enable valid comparisons between groups.

Risk Adjustment: A statistical process for reducing, removing, or clarifying the influences of confounding factors that differ among comparison groups.

Risk Adjustment Data Elements: Those data elements used to risk adjust a performance measure.

Risk Adjustment Model: The statistical algorithm that specifies the numerical values and the sequence of calculations used to risk adjust performance measures.

Risk Factor: A variable describing some characteristic of individual patients that may influence healthcare-related outcomes.

Risk Factor Value: A specific value assigned to a risk factor for a given episode of care (EOC) record.

Risk Model: The statistical algorithm that specifies the numerical values and the sequence of calculations used to risk adjust performance measures.

Risk Sharing: An arrangement that combines the risk of financial losses for all care providers in a business entity such as a hospital or physician group. One provider’s losses are shared by all, but gains also are shared.

Rollout: The process of introducing a new technology-based service.

Root Cause Analysis: A step-by-step approach that leads to the identification of a fault’s first or root cause.

Rural Healthcare: Healthcare services, public or private, in rural areas.

Rural Populations: Persons inhabiting rural areas or small towns classified as rural.

Safety: The degree to which the risk of an intervention and the risk in the care environment are reduced for the patient and others, including the healthcare provider.

Sales: Total dollar amount collected for services provided.

Salvage Value: The estimated price for which a fixed asset can be sold at the end of its useful life.

Sample: A subset of the population selected according to some scheme.

Sample Size: The number of individuals or particular patients included in a study.

Sampling: The process of selecting a group of units, portions of material, or observations from a larger collection of units, quantity of material, or observations that serve to provide information that may be used as a basis for making a decision concerning the larger quantity.

Sampling Design: The procedure for selecting a subset of a population to observe or estimate a characteristic of the entire population.

Sampling Method: The process used to select a sample. Possible approaches to sampling include simple random sampling, cluster sampling, systematic sampling, and judgment sampling.

Satisfaction Measures: Indicators that assess the extent to which the patients/enrollees, practitioners, and/or purchasers perceive their needs to be met.

Satisfaction Survey: A survey sent to members of a health plan to allow feedback on the organization’s service and quality.

Scheduled Survey Date: The date an organization is to begin its full survey.

Score: A rating, usually expressed as a number, and based on the degree to which certain qualities or attributes are present.

Scorecard: A table of the key performance indicators tracked by an organization. A Balanced Scorecard is a particular type of scorecard.

Self-insured: A company that creates and maintains its own health plan for its employees instead of contracting with an outside insurance provider. Also called self-funded.

Sensitivity: In statistics, the percentage of actual positives that are counted as positive.

Sentient Computing: A computing system in which computers, telephones, and everyday objects track the identity, location, and predict the needs of users.

Sentinel Event: Relatively infrequent, clear-cut events that occur independently of a patient’s condition that commonly reflect hospital system and process deficiencies and result in unnecessary outcomes for patients.

Server: A computer that controls access to the network and net-based resources.

Service Level Agreement (SLA): An agreement between the parent corporation or other customer and the shared services unit in which the unit agrees to provide services to a specified performance level.

Service Mix Index (SMI): The average relative weight of the procedures billed for a service.

Severity: The degree of biomedical risk, morbidity, or mortality of medical treatment.

Shared Risk Payment: A payment arrangement in which a hospital and a managed care organization share the risk of adverse claims experience.

Shareholders’ Equity: What the owners of the organization have left when all liabilities have been met. The difference between total assets and total liabilities.

Sigma: In statistics, the unit of standard deviation.

Simple Random Sample: A process in which a predetermined number of cases from a population as a whole is selected for review.

Single-Photon Emission Computerized Tomography (SPECT): A nuclear medicine imaging technology that combines existing technology of gamma camera imaging with computed tomographic imaging technology to provide a more precise and clear image.

Six Sigma: A statistically driven quality management methodology designed to reduce defects and variation in a business process, thereby increasing customer satisfaction and business profits. The stated goal is to reduce defects to a level equal to six standard deviations (sigma) from the mean.

Skilled Nursing Facility (SNF): An institution primarily engaged in providing skilled nursing 

care and related services for residents who require medical or nursing care, or rehabilitation services for the rehabilitation of injured, disabled, or sick persons, and is not primarily for the care and treatment of mental diseases.

Slack: In the context of project management, the time in which a minor process or activity can be completed in advance of the next major operation or activity that depends on it.

Social Capital: The sum of the resources embedded within, available through, and derived from the network of relationships possessed by an individual or social unit.

Social Workers: Individuals trained and certified in the field of social work.

Sourcing: The process of identifying potential suppliers of specified services or goods.

Special Cause Variation: Variation due to specific factors, and not due to random error.

Special or Unique Data Source: A data source that is unique to an organization and inaccessible to outside entities or persons.

Specificity: The percentage of actual negatives that are rejected.

Speech–Language Pathologists: Individuals trained and certified in the field of speech– language pathology, a field dealing with the diagnosis and treatment of speech or language disorders.

Sports Medicine: Provision of diagnostic screening and assessment and clinical and rehabilitation services for the prevention and treatment of sports-related injuries.

Stability: The ability of an instrument or device to provide repeatable results over time.

Staff Model HMO: A Health Maintenance Organization variation where the staff physicians work only for a single HMO and have no private practices.

Staffing Ratios: Clinical hospital staff to patient ratios.

Standard: A process, format or transmission protocol that has become convention by agreement of a group of users.

Standard Deviation: A measure of dispersion in the sample, calculated by taking the square root of the variance.

Standard Industry Code (SIC): Codes assigned to various industries and jobs.

Standard of Quality: A generally accepted, objective standard of measurement against which an individual’s or organization’s level of performance may be compared.

Standards: Agreed principles of protocol set by government, trade, and international organizations that govern behavior.

Statement of Retained Earnings: A report on how much of the organization’s earnings were not paid out in dividends.

Statistic: A number resulting from the manipulation of sample data according to specific procedures.

Statistical Process Control (SPC): A method of differentiating between acceptable variations from variations that could indicate problems, based on statistical probability.

Staying Healthy: Care related to healthy populations or the general health needs of non-healthy populations.

Strategic Management System: The use of the Balanced Scorecard in aligning an organization’s short-term actions with strategy.

Strategic Resource Allocation: The process of aligning budgets with strategy by using the Balanced Scorecard to make resource allocation decisions.

Strategic Services: Processes that directly affect an enterprise’s ability to compete.

Strategy: The differentiating activities an organization pursues to gain competitive advantage.

Strategy Map: The interrelationships among measures that weave together to describe an organization’s strategy.

Stratification: A form of risk adjustment that involves classifying data into subgroups based on one or more characteristics, variables, or other categories.

Stratified Measure: A performance measure that is classified into a number of subgroups to assist in analysis and interpretation.

Structure Chart: A graphic description of a process that shows the modular structure of a system, the hierarchy into which the modules are arranged, and the data and control interfaces among modules.

Structure Measure: A measure that assesses whether organizational resources and arrangements are in place to deliver healthcare, such as the number, type, and distribution of medical personnel, equipment, and facilities.

Structured Query Language (SQL): A standard command language used to interact with databases.

Subacute Care: Medical and skilled nursing services provided to patients who are not in an acute phase of illness but who require a level of care higher than that provided in a long-term care setting.

Subrogation: An agreement by which the primary insurer can collect funds from a patient’s other benefits sources as reimbursement for claim costs.

Subsidiary: A company that is wholly controlled by another or one that is more than 50% owned by another organization.

Subsidiary Medical Record (SMR): A medical record maintained by a specific department.

Sunk Cost: Investments made in the past that have no bearing on future investment decisions.

Supply Chain: The flow of materials, information, and finances as they move in a process from supplier to manufacturer to wholesaler to retailer to consumer.

Supply Chain Management: Managing the movement of goods from raw materials to the finished product delivered to customers.

Swing Bed: Temporary nursing home care in a hospital setting. Hospitals offering swing beds have fewer than 100 beds, are located in a rural region, and provide 24-hour nursing care.

Synergy: The benefit derived from the cooperation between two business entities.

Syntax: The ordering of and relationship between the words and other structural elements in phrases and sentences.

Systematic Random Sampling: A process in which one case is selected randomly, and the next cases are selected according to a fixed period or interval.

Systematized Nomenclature of Human and Veterinary Medicine (SNOMED): A standardized vocabulary system for medical databases.

Systems Integration: The merging of diverse hardware, software, and communications systems into a consolidated operating unit.

Tacit Knowledge: Unspoken or implied knowledge.

Tangible Asset: Assets having a physical existence, such as cash, equipment, and real estate, as well as accounts receivable.

Target: The desired result of a performance measure. Targets make meaningful the results derived from measurement and provide organizations with feedback regarding performance.

Taxonomy: The classification of concepts and objects into a hierarchically ordered system that indicates relationships.

Telemedicine: A segment of telehealth that focuses on the provider aspects of healthcare telecommunications, especially medical imaging technology.

Telemonitoring: Monitoring patient physiologic parameters, images, or other data from a distance.

Terminally Ill: Persons with an incurable or irreversible illness at the end stage that will result in death within a short time.

Tertiary Care: Care that requires highly specialized skills, technology, and support services.

Test Cases: Fictitious patient-level data composed of clinical data elements that yield an expected result for a specific core measure algorithm.

Third- or Fourth-Degree Laceration: A measure of how often patients have significant vaginal tears during delivery.

Third-Party Administrator: A company independent of a healthcare organization that handles claims and/or other business services.

Third-Party Payer: An insurance company, health maintenance organization, or government agency that pays for medical services for a patient.

Tiering: A cost-sharing model used by purchasers and health plans to encourage selection of better-performing, more effective and efficient providers.

Time to PCI: Length of time before a clogged artery in the heart is opened via percutaneous coronary intervention.

Time to Thrombolysis: Length of time before thrombolytic therapy is initiated.

Timeliness: The degree to which care is provided to the patient at the most beneficial or necessary time.

Tobacco Treatment/Cessation Program: Organized hospital services with the purpose of ending tobacco-use habits of patients addicted to tobacco/nicotine.

Total Cost of Ownership (TCO): The cost of owning a device or technology, including operating expenses.

Total Expenses: All payroll and non-payroll expenses as well as any non-operating losses.

Total Quality Management (TQM): A customer-centric philosophy based on constant improvement to meet customer demands.

Touch Point: The point of contact between a patient and a healthcare enterprise.

Transients/Migrants: Mobile, short-term residents who move, usually to find work.

Transmission Schedule: The schedule of dates on which performance measurement systems are expected to be transmitting data.

Transplant Services: The branch of medicine that transfers an organ or tissue from one person to another or from one body part to another to replace a diseased structure or to restore function or to change appearance.

Trend Analysis: The percentage change in indicator value from a reference or base year, that is, [(subsequent − base year)/base year] × 100.

Trended: The application of trend analysis on a performance indicator.

Triage: A means of guiding patients to proper services by using an intermediary person to gather preliminary information and answer patients’ questions.

Ultrasound: The use of acoustic waves to visualize internal body structures.

Uniform billing code: The procedural rules on patient billing, including what information should appear on the bill and how it should be coded.

Urgent Care Center: A facility that provides care and treatment for problems that are not life threatening but require attention over the short term.

Useful Life: The time, usually expressed in months or years, that a device can perform a useful function.

User Interface: The junction between the user and the computer.

Usual and Customary: An insurance industry term for a charge that is usual and customary and made by persons having similar medical conditions in the county of the policyholder.

Utilization Management: A review process used to make sure a patient’s hospital stay, surgery, tests, or other treatment is necessary.

Vaginal Birth after a Cesarean Delivery (VBAC): A measure that reports how often patients had a vaginal birth after previously having a Cesarean section.

Validity: The degree to which the measure is associated with what it purports to measure.

Value Chain: The sequence of events in the process of delivering healthcare.

Value Proposition: A description of how an organization will differentiate itself to customers, and what particular set of values it will deliver.

Value-Added Network (VAN): An information exchange network between a healthcare site and its business operations such as billing and supply offices.

Values: The deeply held beliefs within the enterprise that are demonstrated through the day-today behaviors of all employees.

Variable: A phenomenon that may take on different values.

Variable Cost: A unit cost that depends on total volume.

Variance: A measure of dispersion in a sample, calculated by taking the average of square differences between observations and their mean.

Virtual Knowledge Management: A Knowledge Management model in which knowledge workers and management work and communicate through the Web and other networks.

Vision: A shared mental framework that helps give form to the often-abstract future that lies ahead.

Vulnerable Populations: Groups of persons who may be compromised in their ability to give informed consent, who are frequently subjected to coercion in their decision making, or whose range of options is severely limited, making them vulnerable to healthcare quality problems.

Wage Index: A measure of the relative differences in the average hourly wage for the hospitals in each labor market area compared to the national average hourly wage.

Warranty: A contractual undertaking given by the supplier, to provide a specified level of product or service support.

Web Service: A tool or capability that can be accessed through the Web, rather than being run locally on a desktop.

Weighted Index: An index adjusted to reflect the differential importance of variables relative to other values.

Weighted Mean: The sum of the mean of each group multiplied by its respective weights, divided by the sum of the weights.

Weighted Score: A combination of the values of several items into a single summary value for each case where each item is differentially weighted.

Women: Adult females, including pregnant women.

Workflow: A process description of how tasks are done, by whom, in what order and how quickly.

Working Capital: The funds available for current operating needs. Computationally, it is current assets less current liabilities.

Zero Defects: A management strategy practice that aims to reduce defects in products or services as a way to increase profits.