Much of what is spoken about in healthcare IT is difficult to visualize. However, sometimes the words and terms used to give meaning to the ideas can be just as abstract and difficult to define.
HIMSS has gone so far as to publish a dictionary of IT terms and acronyms in an attempt to keep up with the growing lexicon. Using health IT lingo properly is a matter of patient safety and it ensures staff that administration is well-read and familiar with the latest talking points in the healthcare IT conversation.
Oftentimes, terms are used in contexts where they are not applicable, which doesn't always mean the user is incorrect — in some instances the industry has yet to conclusively cement a word's meaning. Those who "speak IT" have to choose their words carefully, as using these terms haphazardly could muddle things more.
Here are 10 commonly misused terms in health IT, compiled with help from Chicago-based AHIMA and Naperville, Ill.-based Impact Advisors.
1. Interface vs. integration. Two completely different things; often interchanged and misinterpreted. From a technical standpoint, an interface can be hardware or software that communicates information between users, programs or devices. As a verb it can refer to interactions between organizations, staff or groups. Integration refers to the process of bringing parts of a related system together or combining disparate parts. Considering that both words can crop up in different healthcare contexts with some crossover, they're easily, and sometimes mistakenly, interchanged.
2. Standards. This may be the broadest term in healthcare IT. Standards can exist for certain operating systems and data formats as well as for concepts, such as interoperability. It could refer to structure or content standards like Health Level Seven, a functional EHR standard such as the HL7 EHR System Functional Model, or a Technical and Interoperability Standard such as Digital Imaging and Communications in Medicine. Due to its pervasiveness, it is a hard term to misuse outright, but knowledge of its various applications will aid in making communication more precise.
3. Informatics. There are many different definitions for this term depending on the discipline it refers to, such as clinical informatics vs. applied informatics or pharmaceutical informatics. Informatics itself refers information science, the way data is processed, stored and retrieved. In healthcare, informatics can include behavioral data, medical data or financial trends. Often, informatics is used to refer to computational health informatics, which are calculations performed using algorithms that are specific to health data. Use of this term can veer into buzzword territory if invoked too liberally or in place of simpler terms, such as data or information.
4. Interoperability. This is a big term with different types and interpretations. Interoperability can refer to the capability of systems to talk to one another and effectively move information back and forth in a usable format. It is a complex issue that is both technical and legislative. With its Interoperability Road Map, the ONC is striving to create a landscape where the EHRs and software from different vendors will be able to seamlessly interact with any hardware or software a client uses. It is not uncommon for healthcare executives and administrators to use the term in place of or in reference to information exchange, although the two are different. Interoperability specifies how data is accessed, assimilated and what can be done with it. Another mistake would be to discuss a broad term like interoperability without including the many moving parts that go into defining the complex concept. Achieving interoperability isn't as simple as passing legislation, facilitating it through new developments in hardware and software or fostering it through cultural changes towards openness in sharing health data, but rather requires each of these and more. Be sure not to oversimplify when talking about a very challenging issue in healthcare.
5. Classifications vs. terminologies. Confusion can sometimes arise between what qualifies as a classification, such as ICD-10, a list of international statistical classification of diseases; and what qualifies as a terminology, such as SNOMED-CT, a systemized, electronic comprehensive clinical health terminology. A clinical terminology is a set of terms and their synonyms that standardize the recording of events, circumstances and patient findings to support quality improvement, clinical care and outcomes research, according to the American Medical Informatics Association. A classification system groups similar diseases and procedures, organizing related information for efficient retrieval.
6. Coding nomenclatures. Coding names and systems vary not only between medical disciplines and practices but from country to country. ICD-10, CPT, HCPCS and PCS all have different structures, standards and are used in different places of service. Mistaking one acronym for another is a simple mistake, but can be embarrassing or leave listeners or readers confused.
7. EHR vs. EMR. Electronic medical record and electronic health record are often used interchangeably and in most instances refer to the same thing. There is a slight distinction to be made in that an EMR is most simply a paper chart in an electronic format. It may not contain long-term health information or patient data aggregated from different providers, like an EHR generally aims to do as it compiles prescription information and medical history from various sources. While only the most tech-savvy health IT specialists may likely know the difference between the two, it is still helpful and professional to use these terms as accurately as possible.
8. Information governance vs. data governance. Information Governance is focused on all types of data, both unstructured and structured, whereas data governance is focused on structured data. Structured data has a high degree of organization or resides in a fixed field, whereas unstructured data is not organized in a pre-defined system. Data governance will generally be concerned with quality, security, ownership and how the data is shared. Information governance places a greater emphasis on appropriate use of the data, the value of data to a business, interpreting the information that the raw data represents and ownership of that information. These are tech-heavy terms that are subtly different, but those fluent in the language of information technology and its applications should know the difference.
9. Population health. The definition of population health can change depending on discipline or location. It can be used to describe a model of delivery of care — such as that delivered under accountable care organizations — or it can refer to a type of analytics, big data or a certain group of patients a particular organization is responsible for or in a specific geographic region. The challenge many executives run into is using this term in discussions, presentations or conversations where there may not be enough context to clarify its use. The term can come off sounding more like a buzzword rather than communicating a concept effectively.
10. Optimization. This term is thrown around often after an IT implementation, in reference to the phase of a rollout when the system moves from being operational in workflow to functioning at its peak capacity. One big problem administrators run into is forgetting that IT is merely a tool used to enhance whatever service delivery process or workflow is already in place. After a rollout takes place, the emphasis shifts to the optimization phase, the point where the IT is fine-tuned and adjusted. The problem with the rush to implementation that many organizations fall victim to is relying too heavily on that second phase. This is akin to having body work done on a car to make it look like new, without ever getting under the hood. When taking this approach with IT, organizations run the risk of struggling to fine-tune a system built on top of workflow and service delivery process issues that may never have been addressed. Overuse of this term in reference to the phase following a rollout can shift the focus away from fixing problems on the front end and lead to struggles trying to address them after implementation.
Would you like to submit a health IT term that you have heard misused, one that could use some clarification or one on this list that you've seen used in a different context? Please email mgreen@beckershealthcare.com with any tips or suggestions.