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Chapter 3 Terms

Principal and Ancillary Functions of the Healthcare Record

TermDefinition
e-discovery Is the method used to describe the discovery of information that is stored electronically pg.95
Clinical privileges Allows a doctor to only perform services that are in their area of expertise in a hospital. pg.91
National Practitioner Data Bank (NPDB) is a database used to view if a physician or licensed practitioner has had any professional review actions taken against them and it is a part of the requirements a provider must pass during the credentialing process pg. 91
Continuous Quality Improvement (CQI) A philosophy used by managers to continually asses the performance of there employees and use that data to provide further improvements to meet the expectation of customers and provide better quality service pg.80
Advanced decision support Is a clinical support system that is integrated into an EHR and provides automated guidelines to facilitate decision making for the physician pg.77
Patient Centered Medical Home (PCMH) A programs that allows patients and their families to have access to better quality primary care and build stronger patient-doctor relationships and improves outcomes pg.75
Health Level 7 (HL7) An organization that works in establishing guidelines for the exchange, management, and integration of electronic information and is made up of healthcare professionals. pg.74
Case-mix Analysis Is mainly used for medicare reimbursements, patients with similar sets of characteristics are split into groups and analyzed pg.78
Clinical Practice Guidelines Is a tool used by healthcare providers to make the best decisions for a patient based on clinical knowledge pg.78
Medical Necessity Is a measure used to determine if a service or procedure is necessary and if it will be beneficial for the patient's health, it must meet certain criteria or have a certain diagnosis in order to be considered medically necessary pg. 81
Utilization Management A set of processes used to measure that as a provider we are utilizing our resources to the best of out ability and providing the the most consistent effective care possible pg.81
Created by: 616773291