CPHIMS flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

HIPAA Privacy Rule

Governs use and disclosure of protected health information by covered entities; permits treatment, payment, and operations without authorization, requires minimum necessary use, and grants patients access rights.

HITECH Act

Two thousand nine federal law that expanded HIPAA enforcement, added breach notification duties, extended security rules to business associates, and funded EHR adoption through incentive payments.

Meaningful Use

CMS incentive program requiring eligible professionals and hospitals to use certified EHR technology for data capture, interoperability, and quality reporting; it continues today as Promoting Interoperability.

Value-based care

Payment model that rewards providers for quality, outcomes, and cost savings rather than volume of services; examples include accountable care organizations, bundled payments, and readmission penalties.

DRG

Diagnosis-related group, the prospective payment classification CMS uses to pay hospitals a fixed amount per inpatient discharge based on diagnosis and resource consumption.

Medicare versus Medicaid

Medicare is federal coverage for people aged sixty-five and older or with disability; Medicaid is jointly funded federal-state coverage for low-income people under state-set eligibility rules.

Anti-Kickback Statute

Federal criminal law barring remuneration intended to induce referrals of items or services paid by federal programs; civil penalties apply, and safe harbors protect certain arrangements.

The Joint Commission

Independent accrediting organization that surveys hospitals against quality and safety standards; CMS deems its accreditation as meeting the Medicare Conditions of Participation.

HL7 v2 message

Pipe-delimited messaging standard for healthcare interfaces; segments such as MSH, PID, and OBX carry trigger events like admissions, orders, and results between systems.

FHIR

HL7 standard using RESTful application programming interfaces and modular resources such as Patient and Observation to exchange healthcare data, now expected by US patient access rules.

DICOM

Standard governing storage, transmission, and display of medical images; it defines image file formats plus the network services used by picture archiving and communication systems.

ADT feed

Admission-discharge-transfer messages that update downstream systems when a patient's location or status changes; they drive master patient index updates and order routing.

RTO versus RPO

Recovery time objective is the maximum acceptable system downtime after a disruption; recovery point objective is the maximum tolerable data loss, expressed as an amount of time.

Single sign-on

Authentication method letting a user log in once to reach multiple applications; it is typically implemented with SAML or OpenID Connect and reduces password fatigue.

Interface engine

Middleware that translates, routes, queues, and monitors messages between disparate systems; it converts protocols and alerts support staff when transmissions fail.

Master patient index

System that links records belonging to the same person across applications; it uses deterministic or probabilistic matching and underpins health information exchange accuracy.

CPOE

Computerized provider order entry lets clinicians enter orders directly; it removes transcription steps and enables decision support at the moment an order is placed.

Five Rights of CDS

Framework for clinical decision support covering the right information, right person, right intervention format, right channel, and right time in the clinical workflow.

Alert fatigue

Desensitization caused by too many or low-value alerts, leading clinicians to override or ignore warnings; it is reduced by tiering, filtering, and tracking override rates.

BCMA

Bar-code medication administration scans the patient wristband and drug label before a dose is given; it prevents wrong-patient and wrong-drug errors when workflow is followed.

LOINC

Standard terminology for laboratory tests and clinical observations; it enables interoperable result exchange, quality reporting, and mapping across laboratory information systems.

SNOMED CT

Comprehensive clinical terminology covering findings, procedures, and body sites; it is used in problem lists and mapped to ICD-10 codes for billing and reporting.

RxNorm

Normalized naming system for clinical drugs that links brand and generic products with strengths and dose forms; it supports e-prescribing and medication reconciliation.

Medication reconciliation

Structured comparison of a patient's pre-visit medication list with current orders at transitions of care; it reduces omissions, duplications, and dosing discrepancies.

Triple constraint

Project management principle that scope, schedule, and cost are interdependent; changing one requires adjusting the others, with quality as the balancing outcome.

Critical path

Longest sequence of dependent tasks through a project network; it determines the shortest possible project duration, and any delay on it delays completion.

RACI matrix

Chart assigning who is responsible, accountable, consulted, and informed for each project task; exactly one person should hold accountability per item.

Kotter's eight steps

Change model sequenced as urgency, coalition, vision, communication, empowerment, short-term wins, consolidation, and anchoring; it is widely applied to EHR adoption efforts.

ADKAR model

Prosci change framework describing individual transition through awareness, desire, knowledge, ability, and reinforcement; a change succeeds only when every element is present.

Net present value

Sum of discounted future cash flows minus the initial investment; a positive result means the project returns more than the required rate of return.

Service level agreement

Contract or internal document specifying measurable service expectations such as uptime percentage, response time, and resolution targets, with remedies for missed targets.

Steering committee

Senior governance group that prioritizes information technology projects, allocates resources, sets policy, and resolves escalated issues across the organization's project portfolio.