Massachusetts Medical Society: ARRA Glossary

ARRA Glossary

Chapter 224 of the General Laws of Massachusetts:  A 2012 Massachusetts  law requiring all physicians to demonstrate proficiency in the use of electronic health records at the level of Meaningful Use as a condition of relicensure, starting in 2015. Read more details here.

ACO (Accountable Care Organization): A movement to reduce costs and improve healthcare quality by changing incentives and workflow.

ARRA (American Recovery and Reinvestment Act):  a $787 billion stimulus measure signed by President Obama in February 2009 to provide aid to states and cities, funding for transportation and infrastructure projects, expansion of the Medicaid program to cover more unemployed workers and health IT funding.

ASP (Application Service Provider): A software system running remotely from the user and typically accessed over the Internet.  (also called hosted or SaaS  [software as a service]). Can reduce capital and support costs for EMR’s.

AUI (Adopt, Upgrade, Implement): During the first year of the Medicaid-track incentive program, providers do not have to measure meaningful use, simply provide proof of commitment to purchasing a certified EMR or upgrading to a certified EMR. During the second year, practices must achieve meaningful use measures.

CCHIT (Certification Commission for Health Information Technology):  a recognized certification body for electronic health records and their networks. It is an independent, voluntary, private-sector initiative established by the Health Care Information Management Association, the Healthcare Information and Management Systems Society (HIMSS) and the National Alliance for Health Information Technology.

Certified EMR: An Electronic Medical Record system capable of fulfilling some or all of the criteria of meaningful use as defined under ARRA. (see also CCHIT)

CMS (Centers for Medicare and Medicaid Services): The Federal agency responsible for ARRA-HITECH incentive payments (among other things)

CPOE (Computerized Physician Order Entry):  a process of electronic entry of medical practitioner instructions for the treatment of patients under care. These orders are communicated over a computer network to the entities responsible for fulfilling the order.

DIRECT Project: A 2010 Federal project to implement simple, point-to-point HIPPA-secure Internet-based transfers of health information. Direct should enable existing electronic exchanges to become more standardized and convenient.

Drummond Group: Drummond Group Inc. is an ARRA approved interoperability test lab providing a variety of testing services. Founded in 1999, DGI has tested over a thousand international software products used in vertical industries such as automotive, consumer product goods, healthcare, energy, financial services, government, petroleum, pharmaceutical and retail.

EHR and EMR: Electronic Health Record (EHR) software and Electronic Medical Record (EMR) software are used interchangeably these days. Prior to integration and interoperability, an Electronic Medical Record (EMR) was a standalone software system that physicians and clinicians interacted with to electronically capture and document past medical history, clinical assessment, care provided to and responses of the patient, and note the plan of care for the patient, post discharge. The EMR is a clinical software record of care provided a patient. In contrast, integration of two or more systems providing data into a patient’s clinical record is an Electronic Health Record (EHR), documenting a patient’s encounter of care. The EHR contains clinical content and data from multiple medical sources, such as labs.

EOHHS: Executive Office for Health and Human Services, the Massachusetts state agency responsible for the development of the State Health Information Exchange (among other things).

EP (Eligible Provider): Any physician not working primarily in a hospital setting seeking reimbursement under ARRA. You do NOT qualify if you furnish 90% of your services in a hospital setting, either inpatient or outpatient or emergency department during a calendar year.

FHIR (Fast Healthcare Interoperability Resources): An HL7 standard for secure interchange of data using modern, web-based technologies.

HIE (Health Information Exchange): the system for the electronic movement of health-related information among organizations according to nationally recognized standards.

HIMSS: The Healthcare Information and Management Systems Society (HIMSS) is a not-for-profit organization dedicated to improving the quality, safety, cost-effectiveness, and access to healthcare, through the best use of information technology and management systems. Originally founded in 1961 as the Hospital Management Systems Society, it is now headquartered in Chicago, Illinois. The society includes more than 35,000 individual members, over 520 corporate members, and more than 120 not-for-profit organizations. HIMSS’ annual conference draws upward of 35,000 attendees and provides extensive educations sessions in addition to a massive expo.

HIPAA (Health Insurance Portability and Accountability Act): enacted by Congress in 1996. Title I of HIPPA protects health insurance coverage for workers and their families when they change or lose their jobs. Title II of HIPA, known as the administrative simplification provisions, requires the establishment of national standards for electronic healthcare transactions and national identifiers for providers, health insurance plans, and employers. Provisions also address the security and privacy of health data. The standards are meant to improve the efficiency and effectiveness of the nation’s health care system by encouraging the widespread use of electronic data interchange.

HISP (Health Information Service Provider): An organization that manages security and transport for health information exchange among health care entities or individuals using the Direct standard for transport. There is no specific legal designation for an HISP, nor are HISPs specifically regulated by Meaningful Use certification rules. The term HISP was coined to describe specific message transport functions that need to be performed to support scaled deployment of the Direct standard in the market. HISP functions can be performed  by existing organizations (such as EHR vendors, hospitals, or HIE organizations) or by standalone organizations specializing in HISP services.

HIT (Health Information Technology): hardware, software, integrated technologies or related licenses, intellectual property, upgrades, or package solutions sold as services that are designed to support the use by health care entities or patience for the electronic creation, maintenance, access, or exchange of health information.

HITECH (Health Information for Economic and Clinical Health Act): refers to the health information technology provisions of ARRA to build a national program to improve patient care and control costs through federal investment in information technology infrastructure: the adoption of Electronic Medical Records (EMR's) capable of interoperability with privacy and security

HITSP (Health Information Technology Standards Panel): A not-for-profit, multi-stakeholder coordinating body designed to provide the process within which stakeholders identify, select, and harmonize standards for communicating and encouraging broad deployment and exchange of health information technology throughout the healthcare Spectrum.
Hosted EMR: see ASP

ICD-10: The International Statistical Classification of Diseases and Related Health Problems 10th Revision, of 1992, is a medical classification list by the World Health Organization  (WHO), for the coding of diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases.  The code set allows more than 14,400 different codes and permits the tracking of many new diagnoses.

IMPACT (Improving Massachusetts Post-Acute Care Transfers): A Regional Extension Center funded, two-year grant to develop and pilot transfer information in electronic form in the Worcester, MA region

Interoperability, syntactic:  The basic capability to communicate and exchange information - summary documents can be exchanged, opened, read, and stored. The data elements in these documents, however, may need to be extracted and manually keyed into the new system if they are to be used independent of the initial document.

Interoperability, semantic:  The ability to automatically interpret data in the information exchanged meaningfully and accurately in order to produce useful results as defined by the end users of both systems.

IOO (Implementation Optimization Organizations): a group of organizations including vendors, consultants, or other private organizations responsible for deploying EHR’s in the nationwide HIE.

KLAS: (acronym stems from founders’ initials) A private independent organization that gathers, analyzes and reports on EMR and other healthcare technology products and services.

Meaningful Use: Adopting and using an EMR system for ePrescribing, electronically capturing health information in a standards-based, structured format; using that information to track key clinical conditions and communicating that information for care coordination purposes; implementing clinical decision support tools; and reporting clinical quality measures and public health information.

MA Broadband 123: The MA program to provide broadband Internet to all areas of the state by June 2013

MeHI (Massachusetts eHealth Institute): A quasi-public state organization set up in 2008 to focus eHealth activities, currently serving as the REC for Massachusetts.

ONC (Office of the National Coordinator): principal adviser to the Secretary of HHS for development, application, and use of health information technologies; coordinates HHS’s health information technology policy and programs internally and with other relevant executive branches; develops, maintains, and directs the implementation of HHS’s strategic plan to guide the nationwide implementation of interoperable health information technology in both the public and private health care sectors.

Patient-Centered Medical Home: an approach to providing comprehensive primary care that integrates patients as active participants in their own health and well-being. Patients are cared for by a physician who leads the medical team that coordinates all aspects of preventative, acute and chronic needs of patients. A website where patients can share in-depth information on treatments, symptoms and outcomes. (

PECOS: An Internet-based Provider Enrollment, Chain and Ownership System which can be used in lieu of the paper Medicare enrollment application to: submit an initial Medicare enrollment application, view or change enrollment information, track an enrollment application through the web submission process, add or change a reassignment of benefits, submit changes to existing Medicare enrollment information, reactivate an existing enrollment record,  or withdraw from the Medicare Program. The PECOS number is one of the items required by the CMS ARRA-HITECH registration website.

PHI (Protected Health Information): any information relating to an individual’s medical records, health plan beneficiary information, physical or mental health information, or provided health services collected during the health services.

PHR (Personal Health Record): an electronic record of individually identifiable information that can be drawn from multiple sources and that is managed, shared, and controlled by an individual.

REC (Regional Extension Center): as set out in the ARRA, regional extension centers provide technical assistance and disseminate best practices and other information to aid health care providers with the adoption of health information technology. REC is to target especially providers in underserved populations, rural health clinics, and small practices.

SaaS (Software as a Service): see ASP

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