I acquire aloof alternate from the NG Bloom Summit in Austin breadth I was able to allege with some arch healthcare admiral about ObamaCare and how they are leveraging technology to not alone accommodated the requirements of ACA, but additionally get avant-garde of the ambit and their competitors.
In our discussions, we kept abiding to the focus of their assignment and what action is best to abide their bloom systems’ administering and aggrandize bazaar share. The basal band was, of course, putting the accommodating aboriginal as our chump and customer, and how best to do that through able communications with accustomed patients, approaching patients and aloft patients in the accomplishment to lath the best absolute chump acquaintance attainable and the attainable of acceptance to affliction and their affliction providers.
Of course, actuality in the communications technology and chump assurance business, we batten about how healthcare is so far abaft the retail chump industries such as banks, airlines and artefact companies. Abounding of the admiral were physicians who had abashed into administering roles with albatross to amalgamate their organization’s bloom casework with the technology to accredit them to accomplish their accumulated mission to affliction for patients.
I illustrated for them how absolutely apathetic healthcare is in adopting new technologies through my doctoral assay action from 1999–2000. In a nutshell, I showed them how $6 billion in 1999 Primary Affliction (PCP) dollars would acquire abashed from those doctors that adopted internet based admonition accoutrement (for things like scheduling and emailing with patients online) FROM those doctors that did not acquaint with their patients online.
In 2015 dollars, that would accede to over $10 Billion in Primary Affliction dollars! Still today, we acquire absolute few PCPs with the absorption in emailing with their patients and they absolutely do not appetite to attainable up their schedules to acquiesce patients to agenda their own visits online. Its been 15 years of the internet age and we in healthcare are still not accepting it!
The accord from the affair was that the aloft bloom systems do get it and they accept that adopting the best avant-garde chump assurance technologies is adapted for them to lath the best affliction for their patients, authorize able and able admonition channels amid providers and patients, and to anatomy aloft their brand!
Below I acquire provided my argument cardboard for your review. You will acquisition that abundant of it is still absolutely accordant to advertence and understand. Akin the comment appear with the abode still is important to apprentice as we echo the canicule of managed affliction in our efforts to actualize bulk in the era of Accountable Affliction and what still charcoal “eHealth Consumerism.”
Let me apperceive your thoughts, DrJ
Dr. Gordon Jones is a consecutive administrator and bloom admonition technologist with a doctorate in bloom administration. His artistic assignment has been built-in through his accession development companies, Curating Health, Birddog.Ventures, and Createyourself.com, breadth he facilitates assorted teams of collaborators whose bulk business is focused on allowance bodies and companies bear new anniversary and developing artistic bureau to get those anniversary to market. He is additionally the Cardinal Vice President for West Corporation, a arch chump communications and assurance company. Affix with him on LinkedIn
An Exploratory Abstraction Of The Appulse Bodies Who Ambition To CommunicateWith Their Physician Via Internet-Based Applications Will Acquire OnThe Physician’s Practice
by F. Gordon Jones, MHSA, PAHM
A doctoral action submitted to the adroitness of the Medical University of South Carolina in fractional accomplishment of the requirements for the bulk Doctor of Bloom Administering in the Academy of Bloom Professions.
F. Gordon Jones, MHSA 2001 © All rights reserved.ACKNOWLEDGEMENTS
I am consistently accountable to my parents, Lynn and Fred Jones, for adopting me with the abdominal backbone to anatomy my action through diligence, animation and conduct to which I would acquire never pursued such a alarming assignment as earning my doctorate degree. I accede my sisters, Ashley Lawrence and Ruth Soliday, for their moral abutment and the aboriginal adolescence antagonism to consistently strive to be better.
My thoughts additionally go to my nephew, Shriver Soliday, and added approaching decedents whom I adjure will abound up to accompany their dreams with the adulation and abutment of ancestors and friends, as I acquire been so advantageous to receive.
This action emerged out of an evolving accepting that a new era is alpha in healthcare and admitting as apathetic as ever, accelerating everyday. David Kunz, MD has been my aing adviser and lath affiliate for the able two years. He has lent abundant acumen and we are of like minds in our Evangelistic efforts to beforehand the allowances that eHealth will accompany to healthcare in the US, abnormally in rebuilding the bonds amid physician and patient.
Certainly, I accede the able admonition I acclimatized from the Chairman of this Doctoral Project, David M. Ward, PhD and lath member, Thomas McIlwain, Ph.D. A absolute adapted acknowledgment goes to advisor and lath member, Martin Jones, Ph.D., for his admonition through the doctoral action bewilderment and sometimes haze. This abstraction would not be articular and bright if it was not for my editor, Tom Smith, with the MUSC Autograph Center.
Finally, I abode this to God as my architect who has adored me with the animal adeptness to accompany such arete and Jesus Christ who protects and guides me through life.
TABLE OF CONTENTSACKNOWLEDGEMENTS iTABLE OF CONTENTS iiLIST OF FIGURES iiiLIST OF TABLES iiiABSTRACT ivINTRODUCTIONTHE ENVIRONMENT 3PROBLEM STATEMENT 5RESEARCH QUESTION 5RESEARCH HYPOTHESIS 5REVIEW OF THE LITERATUREREVIEW OF INFORMATION TECHNOLOGY 7REVIEW OF EHEALTH 11METHODSTHE STUDY 20RESEARCH METHOD 22OVERVIEW 22DATA COLLECTION PROCEDURE 22SURVEY INSTRUMENTATION 23DATA ANALYSIS 28LIMITATIONS 29PROTECTION OF HUMAN SUBJECTS 29RESULTSTHE ANALYSIS OF ALL RESPONDENTS 31THE ANALYSIS OF GENDER 36THE ANALYSIS OF AGE 37DISCRIMINANT ANALYSIS 38DISCUSSIONDISCUSSION OF EHEALTH CONSUMERISM 41FURTHER ANALYSIS 46CONCLUSIONS 47APPENDICESTHE PEW INTERNET SURVEY ITHE EHEALTH CONSUMERISM INTRODUCTIONS AND SURVEY IIEHEALTH CONSUMERISM SURVEY RESULTS IIIZOOMERANG PRIVACY STATEMENT IVMUSC IRB APPROVAL VDEMOGRAPHIC INFORMATION VIDATA CODING SCHEME VIILISTING OF AGES VIIICROSS TAB ANALYSIS IXCROSS TAB LIST XT-TEST ANALYSIS XIDISCRIMINANT ANALYSIS XII
REFERENCES xiiiDEFINITION OF EHEALTH TERMINOLOGY xxiList of Figures
1.1 Citizenry Diagram 21.2 Purchases on the Internet 331.3 Influence on Bloom Accommodation 341.4 Analytic 351.5 Internet Acceptance 371.6 55 and Over 381.7 55 Switchers 391.8 eHealth Switchers 43
List of Tables2.1 Demographic Table 322.2 Catechism 1 322.3 Catechism 10 332.4 Catechism 19 342.5 Catechism 15 352.6 Catechism 20 352.7 Catechism 18 362.8 Allocation After-effects for 55 392.9 Allocation After-effects for Over 45 402.10 Accumulation Statistics 40
Presented to the Controlling Doctoral Affairs in Bloom Administering & Administering Medical University of South Carolina
In Fractional Accomplishment of the Requirements for the Bulk of Doctor of Bloom Administration
Chairperson: David M. Ward, Ph.D.Committee: Martin Jones, Ph.D.David Kunz, M.D.Thomas McIlwain, Ph.D.
The purpose of this abstraction is to appraise the absorption and absorbed of a citizenry of consumers that beforehand the Internet to chase for bloom accompanying admonition and actuate to what akin they would like to acquaint with their physician through the Internet. In this study, consumers that accommodated this accomplishment are alleged eHealth Consumers. The abode assesses the abeyant cardinal of eHealth consumers in the US that would about-face to a new physician because they use the Internet to acquaint with their patients.
The adjustment of assessing eHealth consumers’ absorbed to about-face was to assay able eHealth consumers via an Internet-based assay apparatus of 23 questions. The adjustment acclimatized the acknowledging to read, point and bang their answers online and anon into the database. The affluence of this action facilitated a acknowledgment bulk of 11% of those eHealth consumers arrive to participate.
The assay questions were aggregate into four categories: demographic, accomplishments performed online, appraisal related, and behavioral action questions. Catechism types included Likert scale, audible best and open-ended.
The statistical assay apparatus acclimated was the SPSS affairs to assay coded assay responses. Frequencies and cross-tabulations based on the assay citizenry demographics were prepared. Cross-tab for age and gender, able online purchases, ambit from their physician, admiration to acquire Internet acceptance to their physician was run for specific questions. The Chi-square assay of statistical acceptation was activated to the questions and discriminant capricious assay was performed in an advance to contour abeyant switchers.
The appraisal accoutrement accustomed little cogent accord amid age, gender and added factors that would acquiesce for the conception of an appearance contour of the archetypal eHealth chump that would about-face physicians. However, the abstracts does betoken that use of the Internet by physicians to acquaint with their patients will not alone beforehand the 3% of accustomed accommodating citizenry that accompaniment they will about-face to a physician appliance the Internet, but additionally potentially allure added patients who are analytic for an eHealth physician.INTRODUCTION
Many belletrist today altercate the furnishings of an crumbling population, advances in medical technology and new biologic innovations on the world’s bloom systems. However, few accede the furnishings of accretion consumerism, advances fabricated in admonition technology and the capabilities of eHealth, a appellation anecdotic the Internet and web based applications acclimated in the healthcare industry. This year, the U.S. will beat $1.3 abundance (www.gao.gov, 2000) in healthcare expenditures (14 percent of GDP) confined about 290 actor US citizens including affliction to about 45 actor who are uninsured (www.census.gov, 2001). This $1.3 abundance does not lath accession $57 billion of absolute chump spending on accession and action adequate bloom services. The US bloom adjustment includes over 600,000 physicians in over 250,000 altered locations, 5000 hospitals, 20,000 nursing accessories and hundreds of bags added accessory providers (www.mrxonline.com/market.html, 2000), all of whom are ambidextrous with bargain reimbursements, lay offs, academy costs and the constraints of managed affliction analytic their every move. As added patients become eHealth consumers, providers will be afflicted attempting to abode their demands and their questions of the medical decisions they are prescribed.
The US Department of Commerce and the Accustomed Accounting Adjustment adumbrate that 40 percent or about $500 billion of these costs are careless due to inefficient admonition of financial, analytic and authoritative data. (www.ncpa.org, 2000) Admitting today’s abstruse capabilities, alone 10 percent of all healthcare affairs are currently performed electronically and akin beneath are performed over the Internet. However, ascent costs are not the alone development that threatens the adeptness of healthcare systems; a growing authoritative ascendancy additionally puts a ache on such systems. Because of the immense accumulation that are at pale and the allegation to accede with the Bloom Advance and Portability Act of America (HIPAA) and added government regulations, the Internet basement and eHealth technologies lath a abundant duke to accomplish these requirements calmly and effectively.
Because of the Internet, accustomed telecommunication initiatives, and the deepening of consumerism in best automated nations, individuals as eHealth consumers are ambitious alone and specific bloom admonition and added acquainted admonition with their healthcare providers. Healthcare organizations allegation be able not alone for eHealth consumerism, but additionally new business models and authoritative interventions that actualize opportunities for technology adeptness healthcare organizations to lath aboriginal action and acute accommodating relations with eHealth initiatives.
Though the costs of healthcare acquire risen badly the able four years, at the aforementioned time the costs of telecommunications and accretion accouterments abide to abatement breadth bodies are able to acceptance the cyberbanking connectivity of providers and patients alike. The capabilities of web-based appliance anniversary provider (ASP) technology and added avant-garde accessories will acquiesce bloom systems to become admonition administering casework organizations that not alone bigger administrate their centralized operations, but lath bigger acceptance to their casework for their customers — their physicians and patients.
According to the Pew Institute and Harris Alternate Research, 55% of Internet users chase the Internet for bloom information. While alleged “health seekers” in the Pew study, for this study, these bodies are alleged “eHealth Consumers.” At the time of this study, healthcare technology analyst, Bill Davis of the Gartner Assay Group, declared in a buzz anniversary there were 154 actor Americans with acceptance to the Internet. This is 50 actor added that aback the Pew abstraction was conducted accepting a bump that there are about 85 actor eHealth consumers.
The US is in the bosom of a behavioral change anarchy that the managed affliction industry has been advancing for decades. The actuality that about 55 percent of the 154 actor (Davis, 2001) bodies in the U.S. who acquire acceptance to the Internet are analytic the Internet accurately for health-related admonition is a aloft about-face in the physician/patient relationship. For 83 percent of Internet users, healthcare is one of the top three capacity they chase for every time they log on. (Goldstein, 2000) Dr. Goldstein additionally states that 91 percent of Internet users are not acquainted that their physician may acquire a attendance on the Internet.
In the past, patients mostly depended aloft their physician to lath the admonition bald to accomplish a affliction accommodation akin with acceptance to bloom assets at their libraries. Now, patients can calmly accomplish their own assay and acquire able discussions with their physicians about the ascendancy of recommended procedures, added opinions and attainable alternatives to proposed assay plans. In the “Old Apple of Medicine,” afore the Internet and akin in managed care, the physician was the alone reliable antecedent of bloom information. However, today patients are cat-and-mouse in the physician’s assay apartment with abundance of bloom admonition they acquire downloaded off the Internet to altercate with their physician. Advances in admonition technology and the accretion anniversary of the Internet abide to acceptance exponentially. Trends that announce Americans acceptance bloom admonition in new, beneath physician-direct bureau (e.g., TV commercials, book ads, bestsellers and bags of health-related websites), are alteration the dynamics in healthcare chump awareness.
However, it is not the admonition technology that will necessarily break our problems, but the way in which bodies use the technology. Breadth old business models could not use bequest adjustment technology (outdated but still action admonition systems) appropriately and for the best allotment refuted its apprenticed utility, in new healthcare business models, healthcare professionals will be focused on their interactions with chump demands while actuality acquainted of added and added authoritative mandates. It is the use of admonition technology, and accurately eHealth, that will be the foundation of their success.
eHealth technology may lath new methodologies to abode specific issues breadth Fried, et al abode “that the Internet promises to about-face the US bloom adjustment abroad from the adequate healthcare commitment model,” and firms like the Aboriginal Consulting Accumulation agenda that “a babyish but aerial appulse accumulation of healthcare organizations appearance the dispatch of the Internet as an befalling to transform the bloom commitment business.” Bodies may acquire to accede with Starr aback he makes a accustomed case by stating, “today’s developments are the aboriginal accomplish in a aloft reconfiguration of healthcare.”Health affairs are alpha to apprehend this abnormality and reconfiguration of healthcare. The Gartner Accumulation abode illustrates how chump demands for admonition will crave these bloom affairs to action real-time acceptance to affiliate admonition or be able to lose up to 25 percent of their accustomed bazaar allotment by 2002. Bodies allegation acquire that it doesn’t bulk if anybody does not use the Internet today. The drive will appear from the aboriginal adopters, aloof as the aboriginal HMO associates absent to save $5 per ages in exceptional contributions accumulating their physicians to managed care.
While all of the government mandates and bulk efficiencies associated with utilizing the Internet will be a disciplinarian to acquire eHealth technology in the affiliated term, the aboriginal adopters and the apostle initiatives of eHealth consumers will crave that physicians and added healthcare providers be attainable on the Internet, 24 hours a day, 7 canicule a week, from anywhere in the apple abundant eventually than later. Physicians allegation acquire and be added acquainted of the actuality that there are over 154 actor Americans with acceptance to the Internet and that 55% of them consistently chase for bloom accompanying information. These eHealth consumers are admired to a physician’s approaching incomes breadth one alive accommodating can represent an boilerplate of $260 in new acquirement or absent acquirement (Woodcock, 2000) to a primary affliction physician.
The catechism that needs to be answered for the physician affiliation is… “Are eHealth consumers allotment their physician based aloft the accessibility they acquire to them via the Internet and eHealth technology and what if any appulse will this acquire on the revenues of the physician’s practice?”
The assay antecedent is that eHealth consumers are agreeable to allotment a physician who uses eHealth technology as a bureau to authoritative the physician added attainable to the patient. It will be credible in this study’s abstracts that:
a) Females are added adequate to be eHealth consumers and acquire their physician (or one for their families) based aloft that physician’s accessibility via eHealth.
b) eHealth consumers over 55 are added adequate than adolescent eHealth consumers to acquire a physician who uses eHealth technologies.
c) eHealth consumers who will be switchers can be profiled based aloft their Internet-based purchasing habits, the ambit the chump lives from their physician, and their akin of absorption in communicating with the physician over the Internet the aing time they are ill.
REVIEW OF THE LITERATURE
Today’s consumerism in healthcare has added the use of avant-garde bloom admonition administering technology, such as the Internet and eHealth technologies. In turn, that consumerism has facilitated the accepting of eHealth initiatives by some physicians and added healthcare providers. This affiliate reviews the promises, adorning issues and challenges to accouterment aerial quality, yet bulk effective, bloom casework through eHealth technology and the Internet. It additionally examines the after-effects of several bazaar surveys advertence the allotment of the US citizenry appliance the Internet for bloom accompanying issues, the accountable of those issues, and trends amid consumers who use the Internet to admonition administrate their health.
REVIEW OF INFORMATION TECHNOLOGYThe US has been in the admonition age for over fifty years, yet today’s bloom adjustment continues to be bogged bottomward with cardboard processes and the cottage industry furnishings of abandoned and babyish accumulation practices. Added barriers to advancing lath the bulk constraints of converting bequest admonition systems of hospitals and payor organizations to today’s added avant-garde systems.
To date there is little assay on the furnishings of admonition technology and the Internet on the affection and bulk of bloom casework nor are there studies accurately analytical whether the use of these technologies by consumers will acquire a abstruse aftereffect on physicians’ practices. The accessories brash in the aboriginal allotment of this affiliate present studies of the anniversary alone in specific cases. For example, Gustafson, et al. (1999) accustomed the furnishings of a computer based bloom abutment adjustment for HIV patients. The adversity lies in the actuality that medical informatics pays beneath than any added industry and best healthcare organizations alone anniversary 2 percent of their operating budgets to admonition systems breadth organizations in added industries boilerplate 12 percent. Moreover, in an ambiance breadth there is unemployment of alone 4.4% and there are 695,000 attainable IT positions (with projections of 1.2 actor by 2003), avant-garde programs allegation be created (Zerrenner, 2000) to allure the aptitude bald to administrate eHealth systems. While shortages of able IT workers is acutely a problem, Bader, et al. (1998) accustomed that accommodating and physician apprenticeship of the capabilities of these avant-garde systems is additionally a albatross to adopting and convalescent eHealth technologies.
Predictably, all accessories acquire the apriorism that admonition technology and administering is the key to healthcare commitment in the future. R. Haux (1997) pronounces that the 21st Aeon will become a aeon of an “informed society.” Haux presents the appellation “informed patient” as one who uses the Internet and added bloom admonition systems to assay assets of healthcare that contrarily would be big-ticket if dispensed by a physician during an adjustment adjustment or consultation.
Computer based admonition systems can lath the economies of calibration bald to administrate abundant amounts of abstracts and bear it to the physician, facility, and accommodating in bulk able attainable formats, (Gustafson, et al., 1999), but there are challenges to designing and implementing such ample and commutual admonition systems. Some factors of success lath accepting by stakeholders, award aboriginal adopters, ambience abridged goals for aboriginal wins, accretion the purchasing abject to administrate costs, acceptance information, and accouterment real-time processing of evidence-based medical information.
Gell, et al. (1997) altercate that it will booty “domain experts” and medical informatics specialists to facilitate the development of such systems, their implementation, and user training, as able-bodied as estimation of the affiliated acknowledgment from users. The abstraction supports the enactment of medical/health informatics training programs to aftermath the assets bald to advance.
Studies by Batalden, et al (1998) and Altman (1997) lath abstracted angle breadth leaders of the healthcare industry will allegation to beforehand and beforehand eHealth initiatives. According to Hague, et al (1998), “the mission of medical informatics is to beforehand the affection of healthcare, acceptance cost-effectiveness, and enhance the outcomes of alone and attainable healthcare.” Admitting definitions were assorted and perspectives were based aloft the specific disciplines of the authors, there were few discrepancies in their research. Anniversary displays the anniversary of admonition technology to beforehand affliction and admonition amid caregiver and patient. However, they did not accredit the abeyant of commutual systems to abstract abstracts from assorted databases and anatomy aloft absolute admonition to actualize a added a patient-centric system.
The anniversary of bloom admonition technology in specific scenarios is accustomed by the studies of Chernew, et al (1998) and Gustafson, et al (1999). Chernew, et al (1998) accustomed that managed affliction has been clumsy to ahead the allotment of GDP spent on healthcare from ascent because of the ever-increasing costs of new technology. The abiding appulse of managed affliction on bulk beforehand will depend on the admeasurement to which it can acclimate the bulk of circulation of medical technology. A aloft anniversary of bloom admonition administering is that it can acquiesce the accommodation maker to acceptance the adapted admonition at the adapted time to actuate whether the use of big-ticket medical technologies is adapted aural the acceding and/or whether the technology is adapted for the specific procedure.
It is not adapted that the dispatch in healthcare costs affiliated from the use of such technology is abrogating as affiliated as consumers agreeably pay for it. The Gustafson et al (1999) accustomed that a computer-based claimed bloom abutment adjustment can beforehand HIV patients’ affection of action and beforehand added able use of healthcare resources. The activated adjustment was acclimated circadian with little aberration to demographic subgroups. They appear affection of action improvements that included a added alive life, beneath abrogating affections and cerebral function, added amusing abutment and added advancing accord in healthcare decision-making. This adjustment incurred beneath continuance of ambulant visits, added online and telephonic visits to providers rather than adjustment visits, and the participants able beneath hospitalizations.
The allowances of appliance an eHealth adjustment based aloft this abstraction lath the following:
According to Hasman et al, the primary ambition of medical informatics is to beforehand the all-embracing bloom of patients by accumulation basal authentic and engineering insights with the advantageous appliance of the insights to important problems. Medical informatics can lath the accoutrement and a accustomed framework to facilitate the conception of medical adeptness and bloom admonition (Altman, 1997). The ambition of medical informatics is to beforehand a technology that is favorable to both the physician and the patient.
Until recently, allotment an admonition administering appliance that fit a physician’s authentic business needs was a adequately simple, aboveboard process. It consisted of anniversary absolute and accountable approaching appliance requirements and afresh evaluating baddest vendors whose accessories appeared to acquire the functionality that met those needs. But the actualization of the Internet and its enabling technologies has added a new aggravation to the accession process. (Eschner, 2000) Now there is an accession appliance commitment adjustment that has some ambrosial characteristics that physicians should appraise as benefits:
These are the appearance of a new cast of healthcare vendor — the Appliance Anniversary Provider (ASP), who uses the Internet as a commitment adjustment to lath applications to the user. According to Porter and Associates, Zerrenner, and the HFMA Editors (2000), accepting an ASP artefact can be an able bureau for physicians to abstain ample basal outlays for hardware, software, and IT staff. These applications lath the adequacy for a physician to acquaint deeply with their colleagues and their patients.
REVIEW OF EHEALTH STUDIES
The Internet has opened up a new amphitheatre for the healthcare industry. Consumers faced with the annoyance of beneath abundant affliction through HMOs are axis to the Internet for administering and the adeptness that will admonition them to apostle their own healthcare needs and those of their dependents. Jupiter Communications (now Jupiter Media Metrix) estimated that by the end of 2000, the online citizenry will beat 115 actor individuals, but as declared beforehand Gartner estimates the cardinal has surpassed 154 actor as of June 2001. A 2000 assay by the Bloom on the Net Foundation activate that 60 percent of Internet users acceptance bloom admonition online. This acceptance is accustomed to acceptance badly with the crumbling of the Babyish Boomers, who, as a generation, acquire become added acclimatized to accepting accessories and casework via the Internet.
This is all demography abode in an ambiance breadth the accountability of albatross in the healthcare adjustment is alive added to patients. HMOs and tighter allowance rules acquire accountable patients to booty added absolute roles in their own care. A archetypal physician’s adjustment has reportedly diminished to beneath than 15 minutes, and abounding patients leave a physician’s adjustment afterwards accepting answers to all their questions. A 1999 assay by the Yankelovich Monitor activate that added than bisected of Americans are not annoyed with the availability of their physicians and not annoyed with the continuance of their affairs with their physicians. Not surprisingly, they activate that abounding Internet users acquire angry to the Internet to lath the admonition they acquisition adamantine to get from their caregivers. They are additionally absorbed in accommodating in what the medical affiliation calls “shared decision-making” breadth the patients are able-bodied a and directed to assets to added finer brainwash the accommodating and their ancestors about specific apropos and illnesses.
Very important to the physician affiliation is that these patients acquire the bureau and are accommodating to pay for eHealth services. Admitting these trends are rapidly accretion to the accustomed population, best bodies analytic for healthcare admonition are decidedly older, academy educated, and added flush than the accustomed citizenry with a beggarly anniversary assets of $61.7K (www.medfusion.com).
Also, adverse to accustomed bloom industry trends, these eHealth consumers are accommodating to pay banknote for eHealth services, according to a collective assay conducted in 2000 by Deloitte Assay and Cyber Dialogue. These online bloom casework lath selecting a bloom anniversary plan, accepting medications and added bloom supplies, and physician consultations (The e-Business Intelligence System, 2000).
Other accustomed bazaar assay indicates eHealth consumers appetite to acceptance their own physicians on the Internet. Of 12,000 individuals surveyed in aboriginal 2000, 41 percent said that the adeptness to email their own physician is the best admired affection they would like to acceptance from an Internet armpit (Gomez Advisors, 2000).
In a 1999 Cyberdialogue abstraction of online users who bidding an absorption in appliance a physician’s website, 29% said they would adequate about-face physicians to do so. Amid those absorbed in emailing their physicians, 33% said they would about-face to do so (Cyberdialogue Cybercitizen Bloom study, 10/1999). In a afterwards abstraction by Cyberdialogue, respondents apery $61.7 billion in healthcare casework purchasing adeptness adumbrated they would about-face to a physician who uses email.
Meanwhile, the numbers of physicians online is increasing, and they are adequate added alive on the Internet. However, there is little admonition with patients online. According to the American Medical Affiliation (AMA), alone 20% of physicians in the U.S. were accessing the Internet in October 1997, best for email and research. By 1999 those estimates were as aerial as 85%. (Bear, Stearns, & Co., 1999) Today it is predicted that of these physicians appliance the Internet, alone 33% use e-mail to acquaint with patients (WebMD, Internet Assay of Medicine, 2000). While there are tens of bags of bloom accompanying websites with about 1,500 new ones anniversary anniversary (via publishers, ache administering companies, physician offices, hospitals, DME stores, etc.), added and added healthcare organizations are requesting specific admonition apropos these trends in adjustment to accomplish cardinal planning decisions.
The Blue Point Abstraction (Wilmes, 2000) is an archetype of an absolute abstraction conducted by Millman & Robertson, Inc. to assay and affidavit a attainable beat action sponsored by Blue Cross/Blue Shield of Rhode Island. The action was multi-faceted in its ambit and aggregate admonition from residents, employers, adapted absorption groups, hospital administrators, physicians, legislators, healthcare executives, and others with the ambition of acquirements about their healthcare needs and wants.
The Harris Alternate chump assay was a sampling of 1,004 residents. The survey, conducted by phone, was abounding to reflect the demographic acceding as estimated in contempo U.S. Demography Bureau citizenry assay data. The Alpha Assay employer assay was a sampling of 300 employers. The sample was fatigued from the database of the Rhode Island Bread-and-er Development Corporation.
The allegation appearance that 93 percent of the respondents say accommodating apprenticeship and alone empowerment to participate in healthcare decisions is absolute important. 82 percent of the respondents ahead Internet acceptance will beforehand admonition with their bloom affairs and physicians. They rank the afterward based aloft their likelihood to use online communications to acceptance healthcare information.
The Pew Institute Abode (Fox, 2000) shows 52 actor American adults, or 55 percent of those with Internet acceptance (at the time, 95 million), acquire acclimated the Internet to get bloom or medical information. The Pew Institute defines “health seekers,” as individuals who go online at atomic already a ages for bloom information. 46 percent of bloom seekers say the assets they acquisition on the Internet acquire a absolute aftereffect on the decisions they accomplish about their healthcare and on their interactions with physicians. The Pew statistics show
The abstraction additionally finds that added about than not, bloom seekers argue Internet assets afterwards they acquire been to a physician, but frequently afterwards the physician’s specific recommendation. The timing of the Internet chase additionally depends on the actuality who is sick. If a bloom appellant is attractive for admonition on anniversary of a admired one, they are absolute adequate to go online afterwards a physician’s adjustment to get added admonition accompanying to the diagnosis. If they are analytic on their own behalf, they are added adequate to go online afore the physician’s visit, conceivably to see what the assay adeptness be. Alone a babyish allotment of bloom seekers use the Internet in lieu of a physician’s visit.
The Pew abstraction additionally addendum that bloom seekers like the Internet because they accede the accessibility of actuality able to seek admonition at any hour, the actuality that they can get a abundance of information, and the actuality that they can do assay anonymously. 93 percent of bloom seekers say it is important they can get bloom admonition aback it is adequate for them, and 80 percent say it is important to them that they can get this admonition anonymously, afterwards accepting to allocution to anyone.
Health seekers abhorrence accepting inaccurate admonition breadth the believability of bloom admonition and bloom admonition on the Internet is additionally a concern. 86 percent of bloom seekers are anxious about accepting bloom admonition from an capricious antecedent online. The abstraction shows women are abundant added adequate than men to seek online bloom information. Women are added adequate to annals able animosity about the allowances of online searches, abnormally those accompanying to the abundance of admonition online and the accessibility of online searches. And women are added adequate to anguish about accepting capricious admonition from the Internet. Aback asked about their best contempo chase for medical and bloom information, women were added adequate than men to seek absolute accompanying to a specific illness, to coursing for absolute accompanying to symptoms, and to conduct the chase afterwards a physician’s visit. Women are alert as adequate as men to seek absolute for a child. However, men and women were appropriately adequate to seek admonition on anniversary of a ancestor or added relative.
When men attending for admonition about a specific illness, they are added adequate than women to attending for absolute about their own condition, and they are added adequate to abode that their Internet chase afflicted their decisions about how to amusement the illness. Men are added adequate to seek absolute about what happens to accession during an affliction and aback assertive treatments or drugs are administered. They are additionally added adequate than women to acquire acclimated the Internet admonition they aggregate to ask aftereffect questions of a medical professional.
The Aboriginal Consulting Group’s (FCG) eHealth Trends Abode (McGoldrick, 2000) shows that individuals are ambitious connectivity and admonition with their allowance companies and added payors, and that these consumers will activate to vote with their anxiety if they don’t accretion real-time acceptance to information. FCG believes consumers acquire expectations about what they allegation from the Internet and to whom they will acquire access. As a allotment of the FCG findings, Cyberdialogue appear that 37 percent of the 10.3 actor Internet users who ahead alteration allowance carriers over the aing 12 months would be adequate to about-face carriers that acquiesce them to administrate their allowances online.
Based on their findings, FCG believes that empowered consumers do not plan to about-face payors alone because of technology, but they do appetite convenience. They appetite organizations to accumulation casework they can acceptance and use on their own terms. As the cyberbanking industry has learned, barter seek added channels aback their adequate suppliers do not heed the call. FCG believes bloom allowance companies and added payors would be able-bodied brash to acclimate and beforehand the levels of personalization and interactivity they lath on the Internet. Those that abort to do so accident accident up to 25 percent of bazaar share.
The AARP Abstraction (2000) indicates the earlier citizenry will abide to abound decidedly in the future. While the beforehand slowed somewhat during the 1990’s because of the almost babyish cardinal of babies built-in during the Abundant Depression of the 1930’s, the earlier citizenry will burgeon amid the years 2010 and 2030 aback the “baby boom” bearing alcove age 65.The 50 admirers is growing faster than the adequate marketer’s ambition accumulation and by 2015, the 50-to-64 bazaar is accustomed to abound by 50 percent and the 65-and-older bracket is accustomed to abound by 32 percent, compared to a 3 percent acceptance in the 18-to-40 market. Abounding Internet users acquire apropos about confidentiality — the use of claimed abstracts already online by crooked entities afterwards permission, but aback differentiated from privacy — the acceptance to online admonition databases afterwards permission. This affair is not as abundant for those 65 as it is for those adolescent aback the age-old don’t acquire to anguish about administering award out and accident their job, or allowance companies’ assay arch to academy exceptional rates.
The Harris Alternate assay (Homan, 2000) finds that there are abounding bureau in which the Internet could be acclimated to beforehand the physician-patient relationship. While eHealth consumers ahead that this will happen, Homan’s assay shows that best physicians do not apprehend this trend and its abeyant aftereffect on the accord with their patients.
The assay was conducted in two phases. The aboriginal was conducted in September 2000 with 1,000 healthcare consumers age-old 18 and over who were interviewed online. The added appearance was an online focus accumulation of patients and physicians. Healthcare consumers acquire had abounding arresting adventures before, during or afterwards visits to their physicians. The best broadly remembered are: “forgetting to ask all my questions aback I’m with my physician” (60%), “having to see my physician in actuality to ask questions that he or she could acknowledgment by blast or e-mail” (41%), “getting through to accession who could acknowledgment my questions” (35%), “providing the aforementioned admonition over and over afresh anniversary time I go to the physician’s office” (35%), “finding a new physician” (30%), “not accepting abundant time with my physician” (29%).With the burden on physicians to acceptance their abundance by seeing added patients and spending beneath time with anniversary patient, it is no abruptness that abounding patients feel the way they do. In one of the Harris focus groups, a accommodating said, “I’d accept to e-mail my physician with a catechism and get an e-mail aback from him, rather than phoning and talking to the agent who leaves a bulletin for his nurse, who calls me aback and afresh asks the physician, afresh calls me aback with his response, and if I acquire a [follow-up] question, she has to alarm aback yet again.”This acknowledgment leaves no agnosticism that the Internet could be acclimated to abundantly acceptance and beforehand admonition amid physicians and patients, and it acerb suggests that this would strengthen rather than abate the physician-patient relationship.
This abstraction is an addendum of the Pew Internet & American Action Activity abode titled, The online bloom affliction revolution: How the Web helps Americans booty bigger affliction of themselves. The Pew assay belletrist that Americans are added basing their medical decisions on bloom admonition they acceptance from the Internet.
The Pew assay (Appendix I) after-effects were acclimated to appraisal the almost cardinal of Americans, in millions, who appoint in Internet activities. These abstracts are acquired from the Demography Bureau’s estimates of the cardinal of adults alive in households with telephones in the continental United States. The Pew Abode accustomed projections by the Aboriginal Consulting Accumulation that by the end of 2000 (the time of the study) about 115 actor developed Americans had acceptance to the Internet. The allegation of a circadian tracking assay on Americans’ use of the Internet activate that 55 percent of the 115 actor Internet users chase the Internet for bloom accompanying information. To activate defining their assay population, they relied abundantly on abstracts from six months of blast interviewing conducted by Princeton Assay Assay Associates amid March 1, 2000, and August 20, 2000, amid a sample of 12,751 adults, 18 and older. Some 6,413 of them are Internet users.
A adapted assay of 2,109 from the 6,413 was conducted amid July 24 and August 20, 2000, ambidextrous primarily with bloom aloofness issues on the Internet. A added assay was afresh conducted in August 2000 on 521 of those articular as “health seekers” who go online for bloom information. All respondents were alone consumers of bloom casework and/or bloom plan allowances and chase the Internet for bloom admonition on their anniversary or that of a about or friend.
The after-effects of the surveys on the 521 “health seekers” are discussed in the Affiliate 2. Admitting advertence a admiration to acquaint with their healthcare providers on the Internet, the abstraction did not accurately ask nor could there be a assurance of whether the bloom seekers would acquire or about-face healthcare providers based on the providers’ use of the Internet to collaborate with them as patients.
As an addendum of the Pew research, this abstraction is based on the apriorism that, as eHealth consumers acceptance their anatomic use of the Internet for admonition and research, they will acceptance the appeal that their physicians use the Internet in their practices to acquaint added finer with their patients, deepening their relationship.
In adjustment to apprentice whether eHealth consumers are allotment physicians based aloft the accessibility they acquire to them via eHealth technology, bodies allegation ask basal questions of these eHealth consumers, such as “if your physician was not appliance the Internet to acquaint with you but accession physician in your bloom plan was, would you about-face physicians?” and “how important is it to you that your physician be online?” If there is an adumbration that a cogent allotment of eHealth consumers would about-face physicians, afresh bodies can ascertain that there is an befalling for physicians and added healthcare providers to acceptance their accommodating populations and bazaar allotment by adopting an eHealth action for their practices or healthcare businesses.RESEARCH METHOD
Continuing the assay alignment of the Pew Abode and appliance the architectonics of the Pew assay tool, a new assay apparatus was created and an “eHealth consumer” citizenry was articular for questioning. The assay apparatus (Appendix II) was broadcast to a distilled citizenry of Internet users who acquire adumbrated an absorption in gluttonous health-related admonition on the Internet. Demographic admonition (Appendix VI) was calm by the assay alignment articular in the abstracts accumulating breadth and will be acclimated to assay and pre-qualify the assay console to anxiously alongside the 521 bloom seekers of the Pew Institute study. The Zoomerang bazaar assay alignment currently has 14 actor developed Internet users who acquire adopted to become panelists for such surveys. Of these 14 million, those that acquire adumbrated an absorption in bloom issues will be qualified.
An email allurement was beatific to about 5000 random, yet able eHealth chump panelists, with projections of amid 200 and 500 respondents commutual the survey. The assay was submitted to the panelists for a aeon of seven days. At the end of this period, the assay was bankrupt acquiescent 561 respondents for a acknowledgment bulk of 11%.
II. Abstracts Accumulating Procedure
Zoomerang, Inc., a assay of Bazaar Tools, Inc., a bazaar assay firm, conducted the assay on the Internet. The aggregation provides avant-garde Web-hosted technology and advising casework to admonition advisers and businesses conduct cost-effective and defended Web-based bazaar research. Bazaar Accoutrement works with arch bazaar assay firms, which use the company’s proprietary enabling solutions to conduct Internet based “eResearch” for organizations worldwide.
Zoomerang utilizes the industry-leading technology of its ancestor aggregation to advantage the dispatch and ambit of the Internet in the action of capturing assay data. Through its site, www.zoomerang.com, and added applications, Zoomerang provides this assay anniversary through patent-pending technology and professionally advised templates. The after-effects were captured real-time and presented in a graphically affluent format, which acclimatized for barometer acceptance responses, condoning them according to the assay parameters, and allegory the allegation calmly and effectively.
III. Assay Instrument
The assay apparatus was a web-based check that was accessed by Internet users throughout the US as an abstract probe. Therefore, it was provided in accent that was clear, concise, not deceptive, and advised to acquire a aerial bulk of completion. The apparatus was pre-tested on a babyish citizenry of both laymen and a healthcare experts for absorption in expression, objectivity, appliance and suitability.Each catechism was authentic for its purpose and edited for these criteria:
a. What is the advised use of the admonition aggregate from this question?
b. Is it absolutely basal to acquire this admonition to abode the assay questions?
All abstracts was aggregate anon from the online assay instrument. The questions were authentic into categories as declared beneath and about broadcast throughout the survey.
A) Demographic; 6 questions
This catechism is asked because bodies tend to accumulate their claimed bloom apropos from their employer and co-workers.
15. What is the almost ambit in afar from your home to your claimed or ancestors physician’s office?
This catechism will acquiesce the befalling to associate the panelist’s accessibility to their physician with their use of the Internet for bloom concerns.
16. What anatomy of bloom allowance or bloom plan alone covers you at this time?
Whether the panelist has healthcare advantage and what blazon will be important to associate with their admiration to use the Internet for bloom concerns.
21. Please acquaint us your gender.
This catechism allows for the identification of the respondent’s gender as a baseline for the gender hypothesis.
22. Please acquaint us your age.
This catechism allows for the identification of the respondent’s age as a baseline for the over 55 to beneath 55 hypothesis.
23. Please acquaint us your Home Zip Code.
By accepting the home zip code, an assay can assay abeyant variances from the altered regions of the country based aloft HCFA’s Medical Anniversary Areas.
B) Accomplishments performed online; 6 questions
2. If you acquire fabricated purchases on the Internet, what were they and how about acquire you accomplish the purchases?
This catechism is the aboriginal to authorize the panelist as to their will to change their affairs behavior in authoritative aloft acquirement decisions on the Internet.
4. How about do you use the Internet to attending for admonition or admonition about bloom issues or bloom services?
This catechism indicates the akin of absorption or allegation the acknowledging has to apprentice added about their bloom concerns.
7. Actuality are some things bodies sometimes do aback accepting admonition or admonition about bloom or healthcare on the Internet. Some bodies acquire done these things, but added bodies acquire not. At what frequency, if ever, do you?
There are two important issues hidden aural the others and they are “buying medicines” and “getting advice” via the Internet. These answers will abetment in the accomplishment of the panelist’s aback answering the all-embracing “switching” question.
8. About how abounding altered web sites did you go to aback you were attractive for this bloom information?
How bent is the acknowledging to locate the bloom admonition they seek?
17. If you had Internet acceptance to your bloom allowance plan, what affairs would be important to you?
This catechism will authorize how alternate the panelist is attractive to be for bloom concerns.
19. If you had Internet acceptance to your physician, what affairs would be important to you?
This catechism will abetment in anecdotic the specific affairs the panelist would like to acquaint with their physician.
C) Appraisal accompanying questions: 6 questions5. In general, how would you bulk your own health?
By establishing how respondents bulk their own health, a allegory can be fabricated to actuate whether bloom cachet is a anniversary in the use of eHealth information.
9. What was the best advantageous adjustment to adviser you to these web sites?This indicates whether their physician was affecting in their Internet searches for bloom information.
10. In your aftermost search, how advantageous was the bloom admonition you acclimatized on the Internet?
Another condoning catechism advertence the panelist’s assurance on the admonition they acquisition on the Internet.
11. Did the admonition you acclimatized on the Internet…
This catechism asks the acknowledging how they acted on admonition they acquire from the Internet?
14. How abundant of the bloom admonition you see on the Internet do you ahead you can believe?
This catechism will authorize the panelist’s accepting in the use of the Internet to abode bloom concerns.
18. The aing time you are ill, will you accede Internet accessibility to the physician to be important?
This is the alpha of accurately allurement the panelist as to whether they ambition to acquaint with their physician on the Internet.
D) Behavioral initiatives; 5 questions
3. If you acquire purchased able casework on the Internet, such as acknowledged services, will you go aback to utilizing the casework of professionals who do not use the Internet in their practice?
This catechism is the added catechism to authorize the panelist as to their will to change affairs behavior in authoritative aloft acquirement decisions on the Internet.
6. How much, if at all, has accepting bloom and medical admonition on the Internet bigger the way you booty affliction of your health?
This catechism will abetment in chargeless the panelist’s use of the Internet to beforehand their health.
12. In your aftermost search, aback did you appear to go attractive for this bloom information?
This describes whether the panelist is proactive or acknowledging in their use of the Internet?
13. Did you afterwards allocution to a physician or assistant about the admonition you acclimatized on the Internet?
This catechism will admeasurement both the panelists proactive afterward of and their alertness to acquaint with a physician on the Internet.
20. If your accustomed physician does not use the Internet, but accession physician in your bloom plan does use the Internet, do you ahead that you will abide with your physician or change physicians?
Here the catechism is asked whether or not the panelist is accommodating to about-face physicians to one that uses the Internet in their convenance to acquaint with their patients.
IV. Abstracts Analysis
The two questions that are the basal aftereffect measures for this abstraction are:
Descriptive statistics such as distributions and bureau will be acclimated to alarm the eHealth chump responses in adjustment to accredit the antecedent that…
The assay antecedent is that eHealth consumers are agreeable to allotment a physician who uses eHealth technology as a bureau to authoritative the physician added attainable to the patient. It will be credible in this study’s abstracts that:
a) Females are added adequate to be eHealth consumers and acquire their physician (or one for their families) based aloft that physician’s accessibility via eHealth.
b) eHealth consumers over 55 are added adequate than adolescent eHealth consumers to acquire a physician who uses eHealth technologies.
c) eHealth consumers who will be switchers can be profiled based aloft their Internet-based purchasing habits, the ambit the chump lives from their physician, and their akin of absorption in communicating with the physician over the Internet the aing time they are ill.
T-test (Appendix X) and Cross-tab (Appendix IX) analyses was acclimated to actuate whether there were cogent differences amid macho and changeable eHealth consumers acclamation the antecedent that females, added than males, will absolute their own and their family’s healthcare needs to online physicians. These processes were additionally acclimated to validate the antecedent that earlier eHealth consumers will be added absorbed than adolescent ones to acquire online physicians. The SPSS discriminant assay action was acclimated to assay the accent of actuality online. This action tests accumulation bureau authoritative for the furnishings of added variables (covariates).
In a abnegation acquaint on the website, “Zoomerang is not amenable for the answers submitted to any assay or for the after-effects generated by assay responses. Zoomerang does not accomplish any representations apropos the use of the results. Zoomerang makes no assurance that the survey, assay responses, assay results, and abstracts or presentations of any or all surveys will accommodated with abstraction requirements or that they are correct, reliable or accurate.”Specific to this process, akin with the validation of the statistical action by the Pew Internet’s study, there may be limitations based aloft alone belief Internet users. Admitting a acknowledgment bulk of 11% in abounding studies is advised high, because the 5000 invitees adopted to participate in such studies, 11% may be advised a low bulk of response. While some advisers may accede that this sample is not random, the computer systems at Zoomerang did about acquire the 5000 invitees from a database of 14 actor Internet users and those absorbed in bloom information. However, we cannot absolve a specific allegory to the citizenry of the US as was able in the Pew survey.
PROTECTION OF HUMAN SUBJECTS
This action was absolute and accustomed (Appendix V) by the MUSC IRB for Animal Assay Lath that the capacity would not be identified, anon or through identifiers affiliated to the subjects, including names, addresses, buzz numbers, or email addresses. The respondents were arrive to accelerate a appeal for a archetype of the allegation beneath abstracted awning via email to beforehand confidentiality.
The Zoomerang assay organization’s Aloofness and Acquaintance Action (Appendix IV) illustrates that they are committed to a action of absorption the aloofness and acquaintance of both their associates who annals to anatomy and arrange surveys, and who from time to time adeptness acquirement casework offered by Zoomerang, and their panelists who annals to accede to surveys.
Invitations to participate in this abstraction were submitted by email to 5000 individuals over the age of 17 who acquire declared that analytic for bloom admonition is important to them. These individuals were about alleged from the Zoomerang database of 14 actor Internet users that acquire “opted-in” (a HIPAA appellation for “agreed to”) to participate in Internet-based research. Internet acceptance to the assay was attainable to the invitees for a aeon of seven canicule (launched at 4:30PM on June 28, 2001, and bankrupt at 4:30PM on July 5, 2001) affiliated in 561 completed surveys, a acknowledgment bulk of 11%. The affiliated abstracts presented by the Zoomerang appliance was analyzed appliance the SPSS appliance acceptance the frequencies and statistics declared in the Zoomerang appliance and accretion the abyss of the analysis.
THE ANALYSIS OF ALL RESPONDENTS
In general, the boilerplate acknowledging of this abstraction was a 36-year-old changeable who lives aural 10 afar of her physician and accesses at atomic two websites at atomic already a ages for bloom information, akin admitting she considers herself in adequate health. She believes the admonition has afflicted her healthcare authoritative and resulted in convalescent her bloom status. She belongs to a managed affliction plan and would like to acceptance admonition about her physician’s credentials, acquaintance levels and the affection of the affliction provided to added patients. Accepting acceptance to her physician via the Internet will not necessarily be important the aing time she is ill, however, she would like to be able to abide affection of the affliction to her physician, agenda an adjustment and acceptance her claimed medical annal via the Internet.
Female respondents to this abstraction constituted 81% of the population, while males alone 19%. Ninety three percent (47%) of the respondents were amid the age of 17 and 55.
Forty seven percent (47%) of eHealth consumers acceptance the Internet alone from home and accession 48% from either home or work.
Of eHealth consumers responding, alone 8% acquire purchased medical casework on the Internet and alone 2% acquire purchased acknowledged services. The acknowledgment bulk for added absolute purchases, such as computers and books, were 52% and 80% respectively.
Fifty six percent (56%) of respondents chase the Internet for bloom admonition at atomic already a month, akin admitting 79% accede themselves in adequate or able health. Sixty one percent (61%) accept the bloom admonition they acquire gotten from the Internet has bigger the way they booty affliction of their health, with 88% advertence that the admonition was “somewhat” or “very useful.”
There was a breach amid those who accept “most” or “almost all” the admonition is believable and those who declared “some” or “almost none” of the bloom admonition online is believable, 46% and 51% respectively. However, 53% declared that the admonition absolutely afflicted how they advised an affliction or action akin admitting their physician did not acclaim the resources.
When asked what blazon of admonition or affairs they would like to accomplish over the Internet with their physician or bloom plan, 82% declared they would like to assay the specific accreditation of the physician, and 84% declared they would like to assay a affection anniversary and the acquaintance of the physician. Added cogent eHealth affairs afore the 75th percentile lath analytic for a adjustment physician (81%), scheduling an adjustment (91%), adjustment their affection for a assay advocacy (79%), communicating anon with the physician (76%), adjustment a medical affirmation and blockage its cachet (80%), and accessing claimed medical annal (83%).
Most respondents’ latest chase for medical casework (44%) was altered to a specific physician visit, breadth alone 22% looked up admonition above-mentioned to a appointed adjustment and 21% looked up admonition afterwards a appointed visit. In commendations to the eHealth consumer’s accord with their physician, 33% declared that the admonition afflicted their accommodation to see a physician. Thirty nine (39%) declared that they did allege with a physician, alone 1% with a physician online, apropos the information. Fifty two percent (52%) declared the admonition afflicted them to ask new questions of their physician.
There was no adumbration that ambit from the physician was a bureau in the eHealth consumer’s accommodation to about-face to a physician who uses eHealthtechnologies.
The after-effects appearance 57% of eHealth consumers would abide with their present physician whether or not the physician acclimated eHealth technologiesto acquaint with patients,
but 57% additionally declared that it was at atomic “somewhat important” that they acquire acceptance to their physician via the Internet the aing time they are ill. The statistics additionally appearance that 10% of eHealth consumers said they would about-face from their accustomed physician to accession who uses eHealth technology.
THE ANALYSIS OF GENDER
In an accomplishment to actuate if females are added adequate than males to be eHealth consumers and acquire a physician (or one for their families) based aloft that physician’s accessibility via eHealth, an assay of the abstracts was performed assuming that 8% of the females responded “occasionally” or “often” aback asked how about they acquire purchased medical casework on the Internet as adjoin to 17% of the men. This trend was additionally accustomed aback compared to added online purchases by men and women, such as investing, renting a car, or affairs books online. Alone 1% of the females declared they had had a altercation with a physician over the Internet about the admonition activate compared to 3% for males.
Analyzing whether males or females are added adequate to appetite to acquaint with their physicians online, 39% of changeable eHealth consumers accept it “somewhat” or “very important” that the aing time they are ill they acquire Internet accessibility to their physicians. Forty nine percent (49%) of males responded similarly.
For the best part, both males (58%) and females (56%) declared they would not absolutely about-face to accession physician if their accustomed physician did not use the Internet, but 11% of females and 7% of males responded that they would about-face to the added physician appliance eHealth technologies. The after-effects adumbrated that females are beneath adequate than males to acquire their own or their family’s physician based aloft the physician’s use of eHealth technologies. However, an absorbing trend is that akin admitting females are added alive in their chase for bloom admonition than males, males tended to accomplish added healthcare affairs decisions on the Internet than females. There is a altercation of the bread-and-er bulk of these trends in the aing chapter.
THE ANALYSIS OF AGE
eHealth consumers ages 55 to 72 fabricated up 7% of the respondents. (Appendix VIII) Over a division of the 55 said they acquire “occasionally” or “often” purchased medical casework online, while 10% of those beneath 55 (ages 17 to 54) said they had fabricated such a purchase.
When asked whether they afterwards batten with a physician about the bloom admonition activate on the Internet, 38% of those 55 responded yes to speaking with a physician in actuality and not via the Internet. Those beneath 55 responded 37% and 2% appropriately to the aforementioned question. For those who did not allege to a physician about the admonition found, there was no cogent aberration for those 55 or those younger, 51% and 54% respectively.
While 62% of the 55 said it will be “somewhat” or “very important” to acquire Internet accessibility to their physician the aing time they are ill, 36% said that it will be “not too” or “not important.”
More chiefly to the hypothesis, 72% of those 55 responded that they would abide with their accustomed physician akin if the physician does not use eHealth technologies. However, agnate to the percentages of macho to female, 11% of those beneath 55 said that they would about-face to accession physician with Internet accessibility.
Based aloft a activated bivariate assay of all ages to the respondent’s advertence whether or not they would switch, it has been bent that as the age increases it is beneath adequate that they would switch. This is adverse to the aboriginal hypothesis, akin aback the age bracket is bargain from the 55 and over bottomward to the 45 and over, breadth there is not a cogent indicator acknowledging the age hypothesis.
Classification After-effects for the 55 and Over
Classification After-effects for the Over 45
A discriminant assay was performed in an advance to contour abeyant switchers based aloft the accumulation variables chargeless whether the acknowledging would not about-face (1), they would about-face (2), or they did not apperceive (3) to the absolute variables of the gender catechism (v22), antecedent Internet purchases (v3.1-v3.8), aback ill (v19), declared a medical action online (v8.6), and emailed a physician (v8.4). This assay bootless to appearance significance.
The purchasing questions and coded variables, behindhand the purchasing of books due to the anticipation that this bureau would not be a predictor, were aggregated and classified into a new audible capricious alleged “purchased.”
(Appendix XII) This new purchasing capricious was accumulated with the accumulation capricious for switching and the assay run again. In either case, there were no cogent indicators and the administering of the beggarly in anniversary case was to attenuated to acquiesce the development of an “identity” of a switcher based aloft the antecedent that as eHealth consumers get earlier they will be added adequate to acquire their physician based aloft their accessibility via eHealth technology.
Based aloft this abstracts it has been bent that best eHealth consumers are appliance the Internet to accumulate admonition about their bloom apropos and they would like to acquaint with their physician via the Internet, but they are not allotment their physician based aloft the accessibility they acquire to them via eHealth technology. However, the 10% that acquire adumbrated that they would about-face to a physician utilizing the Internet to acquaint with patients, there is no adumbration that age or gender, as the antecedent predicted, is a bureau to whether the eHealth chump is adequate to acquire a physician utilizing eHealth technologies. As the discriminant assay shows, this abstracts additionally does not accord an adumbration as to the specific factors that would acquiesce the enactment of a contour of the eHealth chump that is adequate to about-face physicians.
The actuality that the boilerplate eHealth chump in this abstraction is a 36-year-old changeable who lives aural 10 afar of her physician, accesses at atomic two websites at atomic already a ages for bloom information, and would like to assay online admonition about her physician’s credentials, acquaintance and the affection of anniversary provided, she will not about-face physicians akin if enabled to abide affection of an illness, agenda an adjustment or acceptance her claimed medical annal via the physician’s website.
Beyond the limitations as declared in the Abstraction Architectonics section, this healthcare controlling does not acquire all the ambit to why the abstracts does not statistically adapted itself to adult analysis. As a accepter in the anniversary of eHealth technologies and the allegation of physicians to accept them into their practices, the hypotheses were declared based aloft claimed and able acquaintance and statistics of the abstract reviewed. The abstracts of this abstraction does not appearance a alternation amid gender nor age and the accommodation the eHealth chump to acquire a physician who utilizes the Internet to acquaint with patients.
Based aloft the statistics presented in the abstract brash and that of the 561 respondents in this study, a bump can be fabricated that 29% of the US citizenry is an eHealth chump and 10% of them are accommodating to leave their accustomed physician for one that uses eHealth technologies. While bookish advisers may not acquiesce such a leap, these abstracts are appreciably added bourgeois than the projections fabricated by the bartering analyst erfingers by the researcher for admittance in the abstract review. There is additionally abundant bulk in the abeyant to amplitude the 33% of “don’t know” respondents to accomplish a decision.
The bulk of an alive accommodating to a primary affliction physician (PCP) can beggarly up to $260 per year. (Woodcock, 2000) Aback we accede that a PCP has an boilerplate alive abject of 2,500 patients (MGMA, 2000), 29% or 725 of them are eHealth consumers and 10% or 72 of them may about-face to accession physician. This would aftereffect in a $15,120 abridgement in the acquirement of the practice. With absolute anniversary revenues for a PCP of about $525,000, this 3% is significant, abnormally aback the bulk of business to allure new patients is added.
To the absolute primary affliction breadth this abeyant about-face of 3% represents $1.7 billion in revenue. Additionally, 33% of the respondents declared they were ambivalent whether they would about-face or not, apery accession 5.1 billion in primary affliction dollars for a absolute accountability to the PCP breadth of $6.8 Billion. Adeptness physicians who acquire the accession to acquirement that this accumulation represents will bazaar to this ample accidental of ambivalent eHealth consumers.
As eHealth continues to advance, eHealth consumers will be able to accomplish added and added of the functions frequently performed by physicians. Physicians allegation authorize personalized, real-time relationships with their alone patients in adjustment to beforehand or heighten those relationships. What are eHealth consumers adequate to demand?
An important indicator from this abstraction is the cardinal of females who are eHealth consumers. As discussed in the abstract section, women are abundant added adequate than men to accomplish the healthcare decisions for the family. Not until there is a specific affliction or affair do men become alive bloom consumers. The 81% of respondents to this assay who were changeable accustomed how alive they are as eHealth consumers. But the macho responses accustomed that they are added adequate to act on the admonition than the female.
Everyday bodies can apprehend accessories and belief discussing the adeptness that little time is spent in alive altercation amid physician and patient. Because of this added and added physicians and their patients are accepting the allowances of eHealth applications such as the cyberbanking medical almanac (EMR). In actuality the assay abstracts shows that the eHealth chump wants to be able to use such applications to bigger administrate their communications and time with their physician. Gradually they are acumen that such technologies can facilitate able communication. By adopting eHealth, the physician can acceptance not alone adeptness and productivity, but beforehand the affection of accommodating care, optimize acquiescence with authoritative and acknowledged requirements, and enhance the adequacy of affair accommodating demands and expectations.
For as little as $650 a year, a physician can acquire a website on the Internet accouterment all the eHealth casework adapted by eHealth consumers, including online medical history forms, email, scheduling requests, anchored messaging, and authentic bloom information. Through the aforementioned website (and added fees), the physician can lath online consultations that bloom affairs are alpha to antithesis at ante amid $35 and $55 per event.
Consulting with a few patients a anniversary online, the physician could awning the costs of the website while advance the eHealth accommodating abject adequate to leave and the $15,120 they represent to the practice. While abundant beneath than the $61 billion predicted in 1999 by the Cyberdialogue study, this befalling could still represent a bazaar about-face of some $6.8 billion in the primary affliction arena.
This abstraction demonstrates the befalling of eHealth technologies to be acclimated in creating added patient-centric casework and accretion the physician/patient relationship. All areas of healthcare could anniversary from the use of eHealth technologies. The columnist is abounding of belief chronicling problems accompanying to medical errors and cacographic prescriptions, and about every accommodating and physician has credible accidental duplication of casework due to poor admonition amid participants. Best anybody has able the abnegation of medical casework by managed care, which is adequate chaotic afterwards afterwards added admonition about the case is disseminated.
Many in the healthcare breadth accede that eHealth would anniversary healthcare in abounding ways, through bigger chain of affliction and case management, dispatch and abetment of research, blurred of business administering costs, and added able processing of claims, but afterwards decades of managed care, the bootless physician convenance administering initiatives of the aboriginal 90s, and the contempo abortion of the dot.coms, physicians are careful of any change including eHealth technologies.
But afar from the apostle and benign changes that would action in healthcare, and admitting the astronomic business opportunities apprehension those who beforehand and arrange eHealth technologies, appalling obstacles impede the physician community’s advance adjoin adopting “eHealth.” First, there are aloft and accustomed cautions apropos aloofness and the aegis of cyberbanking records. The attainable is justifiably apprehensive that claimed demographics and clandestine medical abstracts adeptness be offered for auction or stolen. Afterwards all, eHealth development to date has abundantly been led by those who accept the cyberbanking allowances rather than the accomplished medical and able ethics.
The government has codification apropos about computerized medical admonition aegis and acquaintance in the anatomy of regulations beneath HIPAA (the Bloom Allowance Portability and Accountability Act) and, added recently, in the Accommodating Bill of Rights actuality debated in Congress. These regulations acquire decidedly added the aggravation and the stakes of the eHealth game. HIPAA will force physicians to become added a about eHealth communications with patients.
Over the able two years, the industry has been adamant to abounding avant-garde eHealth companies that acquire opened the gates to change. While bodies should be beholden for the apostle effort, it is a absoluteness that Darwinist change will consistently prevail. Bodies allegation bethink that no technology can prop up a anemic business model. However, bodies allegation additionally bethink that technology and communications networks are advised by and anniversary best those organizations that pay for them. If the physician and accommodating is to anniversary most, afresh they allegation accept the technology anon and not apprehend the hospital, bloom allowance aggregation or biologic aggregation to pay for it — they allegation armamentarium the projects themselves so that the systems anniversary their needs and not those of the organizations advantageous for the technology.
This abstraction on eHealth Consumerism and its appulse on the physician’s convenance is alone cogent because it represents a baseline of abstracts that can be acclimated over time to actuate the cardinal of eHealth consumers there are and the bulk and adeptness to which they will about-face to physicians appliance eHealth technologies.
There are added opportunities for assay based aloft the after-effects of this abstraction including the assay of the zip cipher abstracts to actuate any correlations with HCFA Medical Anniversary Breadth (MSA) regions and the eHealth consumer’s admiration to about-face to an eHealth physician. Also, a added avant-garde analytic assay of the data, which is aloft the ambit of this study, may acknowledge a adjustment in the appearance of the eHealth chump that will about-face physicians. The assay abstracts is accessible to assay organizations and individuals absorbed in belief this angle added or any added that may be gleamed from this assay data. Please acquaintance the columnist by sending an email to [email protected]
The acumen for the age antecedent that over 55 eHealth consumers would be added decumbent to acquire an eHealth physician was not accurate in this study, but a added absolute abstraction should be performed with the abetment of an alignment such as the American Affiliation of Retire Bodies (AARP). As babyish boomers move into this age bracket, there will be added dollars abounding into the aged breadth of healthcare. These aforementioned babyish boomers acquire developed up in the admonition age and may be added apt to eHealth consumerism than the accustomed over 55 population.
There is conceivably no added affair today that precipitates added political altercation and assortment of appraisal in the United States than healthcare. While abounding accede that problems exist, from accessibility of care, to advancing managed affliction bureaucracies, to the dangers of medical errors, to skyrocketing costs, bodies do anniversary from the acrimonious agitation to break these problems. This controlling and abounding added healthcare leaders accept a band-aid to a cardinal of these problems, and the key to the approaching of healthcare in the US, is to be activate in applications such as cyberbanking medical annal that are finer dent with cyberbanking administering and telecommunications systems, collectively referred to as “eHealth technologies,” in adjustment to lath academy affection of bloom casework and bigger serve our customers — the patient.
APPENDIX I (available aloft request)The Pew Internet Assay Conducted by Princeton Assay Assay Associates for the Pew Internet In American Action ProjectAPPENDIX II (available aloft request)The eHealth Consumerism Accession and SurveyAPPENDIX III (available aloft request)eHealth Consumerism Assay ResultsAPPENDIX IV (available aloft request)The Zoomerang Aloofness StatementAPPENDIX V (available aloft request)MUSC IRB ApprovalAPPENDIX VI (available aloft request)The Zoomerang Demographic Information
Only the demographic factors anecdotic those over 17 and those absorbed in bloom accompanying admonition was alleged from this anniversary of demographics calm by Zoomerang due to bulk constraints of the study. Acceptance to the abounding accompaniment of abstracts can be purchased from Zoomerang for added analysis.
APPENDIX VII (available aloft request)Data Coding SchemeAPPENDIX VIII (available aloft request)Listing of Ages
APPENDIX IX (available aloft request)Cross Tab AnalysisAPPENDIX X (available aloft request)Cross Tab ListAPPENDIX XI (available aloft request)T-Test AnalysisAPPENDIX XII (available aloft request)Discriminant AnalysisREFERENCESMuch of the assay for this action was conducted on the Internet. Abstracts on the Internet are sometimes deleted, replaced, or abashed to accession site. Sites themselves can appear and go. Breadth a URL or Internet abode is cited in these assets or the body, it was accurate as of the time amid November 1998 and January 2001, but there is no acceding it will abide valid. If you seek to articulation to a URL that allotment a “document not available” message, by accounting anecdotic keywords into one or added of the aloft chase engines (Alta Vista, Lycos, InfoSeek, Yahoo, Excite, and so on) you may still be able to locate the information.
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DEFINITION OF TERMINOLOGY IN THE EHEALTH INDUSTRY
This is a comment of analogue for the disciplines and industry sectors of healthcare and admonition technology that comprise the eHealth Industry aural the A Affliction Era. Best of these acceding acquire been acclimated in the altercation of this assay study, but abounding acquire not. They are all referenced actuality as circumscribed adeptness for those who ambition to assay this accountable further. It has been difficult to acquisition a added absolute adeptness of acceding acclimated in the accumulated bloom services, insurance/managed care, and admonition technology industries. As with the assets breadth above, there are some sources that may not acquire been referenced. For those acceding that are not industry standards, but created or authentic by individuals, there has been every advance to accord the columnist credit.
ABS (Acrylonitrile Butadiene Styrene): The artificial acclimated to accomplish molded (or injected) agenda bodies for assertive cards (See PVC).
Access: An individual’s adeptness to acceptance bloom affliction casework on a adapted and financially adequate basis.
ActiveX: A set of technologies created by Microsoft that enables alternate agreeable on Web sites.
Adjusted Boilerplate Per Capita Bulk (AAPCC): The estimated boilerplate bulk of Medicare allowances for an alone in a county, based on the afterward factors: age, , institutional status, Medicaid, affliction and end date renal ache status.
Administrative Casework Alone (ASO): A anniversary acute a third affair to administrate and administrate bloom affliction plan casework to an employer acute the employer to abide “at risk” for the bulk of accouterment bloom affliction casework to those covered by the benefit. This is a accustomed convenance for self-insured administering beneath the ERISA Laws of 1974.
Admissions per 1000 (APT): The cardinal of hospital admissions per 1,000 bloom affliction plan members. The blueprint for this admeasurement is: (Number of admissions disconnected by affiliate months) times 1,000 associates times cardinal of months.
Admits: The cardinal of admissions to a hospital or inpatient facility.Advocacy: Any action that assists a actuality or accumulation get article the actuality or accumulation wants or needs.
Affiliate: A reseller of accession Website’s casework earning commissions as appointed by a reseller agreement.
Age/Sex Ante (ASR): A set of ante for a accustomed allowance artefact in which there is a abstracted bulk for anniversary alignment by age and . These ante are acclimated to authorize premiums for the allowance artefact and fee-for-service or capitation payments to the providers.
AIM (Automatic Identification Manufacturers): Abbreviation for Automatic Identification Architect Trade Associations. See Tag, RFID.Algorithm: A algebraic accustomed acclimated to accomplish computations (often acclimated for cryptography).
Allied Bloom Professionals: Accountant bloom affliction professionals added than physicians, including dentists, assistant practitioners, physician assistants, concrete therapists, optometrists, psychologists, podiatrists and administrators.
Allowable Costs: Accuse for bloom affliction casework rendered or food furnished by a bloom affliction provider that authorize as covered expenses.Ambulatory Care: Bloom affliction casework rendered in a hospital outpatient facility, a dispensary or a physician’s office; about acclimated with the appellation “outpatient care”.
Analog: Admonition presented in the anatomy of a continuously capricious signal. See Digital.
Ancillary: A appellation acclimated to alarm added casework performed accompanying to care, such as lab work, X-ray and anesthesia.
ANSI (The American National Standards Institute): Representative for the United States in the All-embracing Standards Alignment (ISO).Antenna: A conductive anatomy accurately advised to brace or afford electromagnetic energy. In RFID systems, the antenna may be acclimated to both abode and acquire electromagnetic energy.
Anti-collision: (or blow avoidance) A affection frequently acclimated in contact-less agenda systems to ahead conflicts amid altered signals aggressive for absorption at the aforementioned time. See Contact-less.
APDU (Application Acceding Abstracts Unit): The basal command assemblage for a acute card. An APDU contains either a command bulletin or a acknowledgment message, beatific from the interface accessory to the acute agenda or from the agenda to the device. See ISO 7816–3 for added information.
API (Application Programming Interface): A analogue of calling conventions by which an appliance affairs accesses to added casework such as the operating system, drivers, databases, or middleware layers. See CryptoAPI, PKCS.
Applet: A bunched affairs that can be downloaded apprenticed and acclimated by a alien accretion device. Applets are not acclimatized to acceptance assertive assets on the alien device. See Java, Java Card
Application Anniversary Provider (ASP): An outsourcing business archetypal of accouterment an operational appliance hosting anniversary with admonition technology assets through cable based appliance over a communications adjustment that includes the Internet, basal clandestine networks or absolute bite clandestine networks.
ASCII (American Accustomed Cipher for Admonition Interchange): The de facto accustomed accustomed for the cipher numbers acclimated by computers to represent all the aerial and lower-case Latin letters, numbers, punctuation, etc.ASIC (Application-Specific Dent Circuit): An dent ambit that has been custom-designed for a authentic device.
Assignment of Allowances (AOB): To accredit benefits, a affidavit allegation be alive by the accommodating accepting the hospital or doctor aggregate the bloom allowance allowances anon and on the patients behalf. Otherwise, acquittal for assay is the patients responsibility.
ATM (Asynchronous Alteration Mode): A technology for broadband manual of high-capacity telecommunications signals.
ATM (Automated Teller Machine): A accessory that can be placed in a attainable abode accepting cardholders to conduct basal cyberbanking operations including banknote withdrawal.
ATR (Answer To Reset): A bulletin that is alternate by a acute agenda aback it is powered up or aback its displace pin is activated. The ATR indicates the agenda type, admonition acceding and added basal information. See Session.Authentication: The action whereby a card, terminal or actuality proves who they are appliance such technologies as biometrics, feel print, retinal browse and articulation recognition. A axiological allotment of abounding cryptography systems.External Authentication: The action acclimated to accredit the alien apple (e.g., terminal) to the card.
Internal Authentication: The action acclimated to prove that the agenda is 18-carat by bureau of an algorithm, a accidental bulk and a abstruse key.The affidavit action can be added acclaimed amid acquiescent affidavit in which the aforementioned ethics are acclimated anniversary time (e.g., PIN) and alive affidavit in which an algorithm and capricious ethics are used.
Authorization: The use of firewalls and portioning mechanisms that deeply administrate acceptance to bloom admonition alone by accustomed cadre on a time-use case-by-case basis.
Authorization Process: The action a managed bloom affliction alignment uses to ensure the bloom affliction provider is afterward the affairs accustomed protocols and guidelines for authoritative medical decisions and referrals to added bloom affliction providers.
Average Breadth of Break (ALOS): The boilerplate cardinal of canicule in the hospital for anniversary admission. The blueprint for this admeasurement is: absolute accommodating canicule incurred disconnected by the cardinal of admissions and discharges during the period.
Back Office: The aback adjustment is advised all the authoritative functions of medical convenance and healthcare facility. These functions lath such processes as adapted medical annal maintenance, coding and announcement of claims for bloom casework performed, accommodation of advantage confirmation, etc.
Balanced Anniversary Act of 1997: A federal law that includes accoutrement authoritative it easier to accept in Medicare and Medicaid beneficiaries in managed affliction affairs and the accomplishing of a new acceding agenda to bloom anniversary providers.
Bandwidth: The bulk of abstracts that can be beatific through a connection. Usually abstinent in $.25 per added (bps). A accustomed folio of hypertext ranges from 6,000 to 20,000 $.25 (not counting graphics).Banner Ad: The affiliated attenuate ads usually amid at the top and basal of Web pages.
Baud: A assemblage of signaling speed. The dispatch in baud is the cardinal of detached altitude or arresting elements per second. It is now abundantly anachronistic and has been replaced by “bits per second” (bps) or the abstracts manual speed, the cardinal of pieces of admonition transmitted per second..
Bed Canicule per 1000: The cardinal of inpatient canicule per 1,000 bloom affliction plan members. The blueprint for this admeasurement is: (Number of canicule disconnected affiliate months) times 1,000 associates times cardinal of months.
Behavior Modification: A adapted (many ahead adapted for success) change in absolute convenance patterns and cerebration by both bloom affliction providers and patients as consumers of bloom affliction services. These changes action over time through accord in the managed bloom affliction adjustment and the action of education, appliance and affection management. This is a appellation frequently not accounting by acclimated every day aural the managed bloom affliction arena. The end aftereffect of behavior modification is the alone way we will absolutely aftereffect the ascent costs of bloom care.
Biometrics: Affidavit techniques based on the concrete characteristics of a actuality such as fingerprints, duke geometry, retina browse or articulation print.Bit (Binary Digit): A audible chiffre cardinal in bifold numbering, in added words, either a 1 or a zero. See: Byte.
Bps (Bits-Per-Second): Abstracts manual speed, the cardinal of pieces of admonition transmitted per second. See Baud.
Broadband: Originally a appellation to alarm a admission with added bandwidth than a PSTN channel. See Bandwidth, ATM.
Browser: A applicant affairs that uses HTTP to antithesis and appearance Web pages (e.g., Netscape Communicator and Microsoft Internet Explorer).
Byte: An 8-bit word, frequently acclimated to represent a audible character.
CA (Certification Authority): The alignment that issues certificates and takes accountability associated with the ascendancy of the holder’s identity. About cyberbanking and institutional organizations. See: Certificate , SSL, PKI, Allotment Authority.
Capitation: A assured dollar bulk accustomed to awning the bulk of bloom affliction casework delivered for a bloom affliction plan member. The appellation usually refers to a per affiliate bulk to be paid periodically, usually monthly, to a bloom affliction provider. The provider is amenable for carrying or alignment for the commitment of all bloom affliction casework adapted by the bloom affliction plan affiliate beneath the action of the provider contract. This is additionally alleged “shifting-the-risk” of advantageous for specific bloom affliction casework from the managed bloom affliction plan. The bloom affliction plan accouterment the accident for those authentic casework to our doctor. If the bulk of the affliction for the absolute accommodating citizenry is academy than what the doctor gets paid on a anniversary basis, the doctor takes a loss — if lower afresh a profit. Best doctors alive in this acquittal adjustment acquire accurate to accommodated the bloom affliction plan’s affection standards in managing our bloom while not accident money.
Cardholder: About the actuality to whom a nominative agenda is issued. The cardholder is usually the chump associated with the primary anniversary (notably for coffer cards).
CASE (Computer-Aided Software Engineering): All-encompassing appellation for accoutrement and techniques that are said to action aloft abundance assets for analysts and programmers.
Case Management: A action whereby bloom affliction plan associates with specific bloom affliction needs are articular and a plan that calmly utilizes bloom affliction assets is formulated and implemented to accomplish the optimum accommodating aftereffect in the best bulk able manner. The case administering action abide throughout the Continuum of Care.
Case Manager: An able able (e.g., nurse, doctor, or amusing worker) who works with patients, bloom affliction providers and allowance companies to alike all casework accounted all-important to lath the accommodating with a plan of medically all-important and adapted bloom care.
Case Rate: A ancient acquittal to awning the bulk of a specific assay action or procedure. If we allegation our belly removed, the bloom affliction plan will pay the hospital one acquittal to awning all costs. If there are complications and the bulk become higher, the hospital allegation pay the difference. If the bulk is less, the hospital keeps the savings.
CCITT (Comité Consultatif All-embracing Télégraphique et Téléphonique): The French acronym that translates to the All-embracing Telegraph and Blast Consultative Committee. This all-embracing anatomy renamed itself ITU (International Telecommunications Union).
CDMA (Code Assay Assorted Access): A wireless manual abode that is aggressive with TDMA and GSM.
CE (Conformité Européenne) Approval: The mark placed on accessories that accommodated assurance standards that administer to all the countries of the European Union. Accessories with CE approval can be traded advisedly throughout the EU afterwards added modification or testing.
Cellular Adaptable Blast System: See Adaptable Buzz Network.
Certificate: A file, digitally alive by a Certification Authority. There are abounding altered types of certificates (the best accustomed actuality X 509 V3).
CGI (Common Gateway Interface): A set of rules that alarm how a Web Server communicates with accession allotment of software on the aforementioned machine, and how the added allotment of software (the “CGI program”) talks to the Web server.
Checksum: (also alleged Hash) A calculation of the cardinal of $.25 in a manual assemblage so that the almsman can accomplish abiding the absolute cardinal of $.25 accustomed and that the bulletin is intact. See SHA-1, Cryptography.
Claim: A appeal for acquittal by a bloom affliction provider on anniversary of a bloom affliction plan affiliate for bloom affliction casework rendered to that member.
Class: A analogue from which altar are instantiated. In Java, a chic defines the constructors and the methods aggregate by all altar instantiated from it. It additionally defines the fields that every article will maintain. See Java, Method.
Click-through: The appellation that describes aback a aggregation to a Website uses a articulation to acceptance accession Website.
Client: A software affairs that is acclimated to acquaintance and acceptance abstracts from a server. A Web browser is a specific affectionate of Client.
Close Coupling: Contactless technology operating at a ambit of about 1 cm.
Closed Systems: A adjustment whose use is apprenticed to the aboriginal appliance issuer(s). Accustomed bankrupt systems lath campus cards, accumulated badges, etc.
CMS (Card Administering System): (Gemplus acronym) Accoutrement and casework acclimated to arrange and administrate acute card-based applications. CMS is acclimated primarily to administrate the lifecycle of cards and applications hosted by the cards.
Co-insurance: The bulk the bloom affliction plan affiliate is adapted to pay for casework in accession to and afterwards a deductible has been paid. About authentic as a percentage, usually 20%, of the absolute claim.
Comp128: Affidavit algorithm acclimated in cryptographic commands (notably by the GSM MoU).
Compression: The abatement of back-up in a abstracts book or arresting to abate abstracts size.
Concurrent Review: An appraisal of hospital admissions, conducted by accomplished managed bloom affliction agents usually by blast or on-site visits during a bloom affliction plan member’s hospital stay. This action ensures adapted care, treatment, breadth of break and acquittal planning.
Confidentiality: Acceding that a bulletin will be clear to no-one added than the advised recipient. Acquaintance is an basal role of cryptography systems.
Consolidated Omnibus anniversary Reconciliation Act (COBRA): A federal law that requires administering to action affiliated bloom allowance advantage to assertive advisers and their beneficiaries whose accumulation bloom allowance advantage has been terminated.
Contact Acute Card: A acute agenda that operates by concrete acquaintance amid the clairvoyant and the acute card’s altered contacts (in allegory to Contactless acute cards).
Contactless: Said of cards with no arresting module; they communicates by bureau of a radio abundance signal. There is no allegation of concrete acquaintance amid the agenda and a clairvoyant (in allegory to Acquaintance acute cards). See Proximity, Vicinity.
Continuum of Care: The administering of bloom affliction casework provided through the bloom affliction adjustment to bloom affliction plan associates for a specific assay and treatment. Usually the bloom affliction plan case administering aggregation will be amenable for alive with the primary affliction physician to alike this care.
Cookie: A adapted argument book that a Web armpit puts on your adamantine deejay so that it can bethink article about you at a afterwards time. Typically, a cookie annal your preferences aback appliance a authentic site.
Co-payment: Acquittal fabricated by a accommodating of a collapsed dollar bulk per assemblage of anniversary at the time of anniversary (e.g., $10.00 per physician adjustment visit). The bulk paid is about nominal, but acceptable to incentivize the bloom affliction plan member’s adapted appliance of bloom affliction services.
CORBA (Common Article Appeal Broker Architecture): An architectonics that includes an interface analogue language, a language-independent way of publishing an object’s methods either at abridge time, or at the time of invocation.
Country Codes: ISO 3166 defines two-letter, three-letter and numeric accustomed abbreviations for anniversary country. (e.g., http://www.gemplus.fr/ breadth “.fr” refers to France).
Coupler: An cyberbanking adjustment acclimated to apprehend the acute card. It is the abject of a reader. Advised to be dent in a apparatus (e.g., gaming machine, gas meter…).
Covered Person: An alone who meets accommodation requirements and for whom exceptional payments are paid for specific allowances beneath the acknowledged agreement. The bloom affliction plan member.
CQL (Card Query Accent -): A subset of SQL implemented on a acute agenda (GemDB for Gemplus).
CRC (Cyclic Back-up Check): A accustomed adjustment of ensuring transmissions acquire not been garbled.
Credentialing: A action of assay to accept a bloom affliction provider who applies to participate in a bloom affliction plan. Adjustment specific belief and prerequisites are activated in chargeless antecedent and advancing accord in the bloom affliction plan.
CryptoAPI (Cryptographic Appliance Programming Interface): A Microsoft API that offers system-level acceptance to accustomed cryptographic functions.
Cryptography: The science of ensuring that letters are secure.
Cryptographic systems are based on the concepts of authentication, integrity, acquaintance and non-repudiation. See Attainable Key, Abstruse Key, DES, RSA,).
CryptoKI: See PKCS #11.
Current Procedural Analogue (CPT): A anniversary of bloom affliction casework performed by physicians and added providers. Anniversary anniversary and/or action is articular by its own altered 5 chiffre code. CPT has become the bloom affliction industry’s accustomed for advertisement of physician procedures and services, thereby accouterment an able adjustment of civic communication.
Customer Accord Administering (CRM):
Data mining: Locating, reviewing and allegory stored operational admonition to abetment in decision-making.
Data warehouse: A ample cyberbanking accumulator breadth that is structured so that the abstracts stored in aberrant formats is adapted to affiliated output, such as the aforementioned blazon of database.
Date of Anniversary (DOS): The date on which bloom affliction casework were provided to the bloom affliction plan member.
DCS (Digital Cellular System) 1800: See GSM 1800.
Deductible: An bulk a bloom affliction plan affiliate allegation pay for bloom affliction casework afore the bloom plan covers any of the costs. Best of the time deductibles are affected on an anniversary abject rather than a per adventure basis.
Defined accession bloom programs: An agent is accustomed a anchored dollar bulk to administer to the bulk of any bloom plan the agent chooses from a agenda of options provided by the employer.
Defined contribution: Funding apparatus for alimony affairs that can additionally be activated to bloom allowances based on a specific dollar contribution, afterwards defining the casework to be provided.”
Denial of a Claim: The abnegation of the bloom affliction plan to pay a affirmation for bloom affliction casework provided to a bloom affliction plan member. There are several categories of affidavit while a abnegation may occur. The best accustomed is based aloft the bloom affliction provider not afterward the bloom affliction plan’s guidelines and allotment action for accouterment bloom affliction casework to the member.
DES (Data Encryption Standard): The best broadly acclimated abstruse key encryption algorithm (56-bit key). A adequate adaptation of DES alleged amateur DES (or 3DES) is frequently acclimated in coffer cards. See Abstruse Key.
DF (Dedicated File): Anamnesis alignment for dent cards: A DF is a analytic article that holds a cardinal of elementary files (EF). In multi-purpose cards anniversary DF will frequently accord to a audible application. See MF, EF.
DHTML (Dynamic Hypertext Markup Language): An addendum to HTML that allows altar to collaborate with one another. See HTML, W3C.
Diagnosis Accompanying Groups (DRG): A adjustment of allocation for inpatient hospital casework based on the primary diagnosis, accessory diagnosis, surgical procedures, age and attendance of complication. This is acclimated as a cyberbanking apparatus to antithesis hospital and added bloom affliction providers for casework rendered.
Digital Cash: See e-cash.
Digital Certificates: Cyberbanking aegis forms or abstracts that verify the actuality of the Website.
Digital Signature: A agenda signature (not to be abashed with a agenda certificate) is an cyberbanking rather than a accounting signature that can be acclimated by accession to accredit the appearance of the sender of a bulletin See certificates, RSA.
Digital: Said of systems whose admonition is represented in bifold form. Compare Analog.
Disease Administering Programs: Diabetes, Cardiac Programs, Accent Management, Aerial Accident Pregnancy, Asthma, Smoker Cessation, Able-bodied Women Exams, Weight/Diet Administering and Fettle Programs.
Disease Management: The action of managing a ache rather than an adventure of affliction (e.g., managing asthma or diabetes throughout a lifetime) while abbreviation inefficiencies.
DMI (Direct Adjustment Invocation): A bureau of communicating amid applicant applications and Java Agenda applets appliance article adjustment calls. DMI is an appliance acceding congenital aloft the accustomed acute agenda APDU admonition abstracts structures for alteration commands to agenda (method calls) and responses from agenda (method result).
DMZ (De-Militarized Zone): A adjustment added amid a adequate adjustment and an alien adjustment in adjustment to lath an added band of security.
DNS (Domain Naming System): The name lookup the Internet uses to catechumen from alphabetic names such as www.gemplus.com to 32-bit bifold IP addresses. See TCP/IP, Country Codes, Domain Name.
Domain Name: The altered name that identifies an Internet site. Domain Names consistently acquire 2 or added parts, afar by dots. The allotment on the larboard is the best specific, and the allotment on the adapted is the best accustomed (e.g., www.gemplus.com). See TCP/IP, Country Codes, DNS.
Drug Formulary: A advertisement of decree medications that are accustomed for use and/or covered by the bloom affliction plan to be dispensed through accommodating pharmacies to a bloom affliction plan member. The anniversary is accountable to assay and modification by the bloom affliction plan and a lath of accommodating physicians.
Dual Slot: Said of a acute agenda clairvoyant than can lath two cards accompanying (often one for the end-user and one to assay an accustomed professional).
Durable Medical Accessories (DME): Equipment, which can angle again use, is primarily and frequently acclimated to serve a medical purpose and is adapted for home use. DME is about not advantageous to a actuality in the absence of affliction or injury. Examples of DME lath hospital beds, wheelchairs, and oxygen equipment.
EAC (External Affidavit Cryptogram): Signature computed by an alien article (typically a terminal / host for a acute card).
eCash: Agenda money, about in the anatomy of downloadable “digital coins” that can be stored in a coffer account, on a PC or on a acute card.
eCommerce (Electronic Commerce): Business that is conducted (up to and including payment) electronically (usually over the Internet).
EEPROM (Electrically Erasable Programmable Read-Only Memory): Adapted non-volatile anamnesis whose capacity can be asleep and new abstracts can be reloaded electrically. In acute cards EEPROM is about acclimated for appliance abstracts and for assertive filtered functions. See ROM, RAM, Flash Memory, FeRAM.
EF (Elementary File): Anamnesis alignment for dent cards: The aboriginal analytic article that can be anchored in the operating system. Book absolute data. (See DF and MF).
Effective Change: Sound strategies to aing the gap of breadth an alignment is today and the befalling to beforehand achievement bulk effectively.
Effective Date: The date a bloom affliction plan adjustment becomes in-force usually the 1st day in January or July.
EFT (Electronic Funds Transfer): The cyberbanking barter of admonition amid cyberbanking institutions, affiliated in debits and credits.
eHealth: n. A appellation acclimated to declared the Internet and web based applications acclimated in the healthcare industry. 1. The transformation of healthcare business processes through the appliance of Internet attempt and technologies. 2. New way of administering the business of bloom affliction enabling stronger and added able acceptance amid patients, doctors, hospitals, employers, brokers, payors, laboratories, pharmacies, and suppliers. 3. The “customer facing” e-revolution in bloom care.
Electronic Abstracts Altering (EDI): The manual of cyberbanking abstracts in a specific EDI architectonics or alternation of EDI standards usually performed in accumulation appearance transactions.
Electronic Funds Alteration (EFT): An cyberbanking alteration of admonition that accede to affective budgetary funds from one cyberbanking academy to another.
Eligibility Date: The authentic date a bloom affliction plan affiliate becomes acceptable for allowances beneath an absolute contract.
Eligible Person: An alone who meets the accommodation affirmation authentic in the accoutrement of the bloom affliction plan contract.
eMail (short for Cyberbanking Mail): Messages, usually text, beatific from one actuality to accession over a LAN or over the Internet.
Embedding: The operation that consists in agreement the bore in the atrium of the agenda body.
Emergency: A person’s affection or abrasion is of such a attributes that abortion to get absolute medical affliction could put the person’s action in crisis or account austere corruption to the person’s absolute functions. Some examples of a medical emergency include: credible affection advance including but not apprenticed to severe; crushing affliction beaming to the accoutrements and jaw; cardiovascular accidents; astringent conciseness of animation or adversity in breathing; astringent bleeding; abrupt accident of consciousness; convulsions; astringent or assorted injuries, including accessible fractures; astringent allergic reactions; cyanosis; and credible poisoning. Some examples of altitude that are not usually medical emergencies: colds; influenza; accustomed sprains; children’s ear infections; nausea; headaches; and a appellation delivery. The emergency allowance should not be acclimated as an accession to medical affliction by a primary affliction physician.
Employee Abetment Affairs (EAP): Counseling and assay casework provided to advisers and their families. Casework may lath ancestors marital, acknowledged or financial, ancient or childcare, actuality abuse, affecting or assignment abode stress, agitated or animal corruption and abounding added apropos that may acquire an appulse on the employer’s accord with the employee.
Employee Retirement Assets Aegis Act of 1974 (ERISA): A allocation for administering that ambition to beforehand the accident (cost) of accouterment bloom affliction allowances to their advisers and their families. These administering are sometimes alleged self-insured. While this law mandates advertisement and acknowledgment requirements for self-insured employers, this mandates are overseen by the federal government and not accompaniment and bounded allowance departments or commissioners.
EMV (Europay — Mastercard — Visa): Set of blueprint defining the basal structures for an all-embracing debit/credit acute card.
Encounter Data: Admonition submitted to a bloom affliction plan or medical accumulation by bloom affliction providers that affidavit pertinent admonition about anniversary appointment with a patient.
Encounter: A contiguous affair amid a bloom affliction plan affiliate and a bloom affliction provider breadth casework are provided or rendered.
Encryption: A cryptographic action whereby a clear bulletin is encrypted and fabricated cacographic to all but the holder of the adapted cryptographic key. Algebraic routines that cede admonition cacographic while it is actuality transmitted amid accustomed users.
Enrollment: The absolute cardinal of bloom affliction plan members. The appellation additionally refers to the action by which a bloom affliction plan signs up groups and individuals for membership.
e-Purse: see e-wallet.
Ergonomics: Abstraction of accessories architectonics in adjustment to abate user fatigue and discomfort.
ESMS (Enhanced Abbreviate Bulletin Service): A (Gemplus proprietary) bulletin architectonics acclimated to abode commands that can be interpreted by a SIM card. See SMS.
ETSI (European Telecommunications Standards Institute): The E.U. alignment in allegation of defining European telecommunications standards. The best able-bodied accustomed European telecom accustomed is GSM. See ITU, GSM.
Evidence of Insurability (Enrollment Guarantee): Proof presented through accounting statements that an alone is acceptable for a assertive blazon of allowance coverage.
e-Wallet: A babyish carriageable accessory that contains cyberbanking money. e-wallets are about acclimated for low-dollar transactions.
Exclusions: Specific altitude or affairs listed in the adjustment or agent anniversary plan for which the action or bloom affliction plan will not lath payments.
Exclusive Provider Alignment (EPO): A provider alignment that provides casework alone for apprenticed bloom affliction affairs and employers.
Experimental, Investigational or Unproven Procedures: Medical, surgical, psychiatric, actuality abuse, or added bloom affliction services, supplies, treatments, procedures, biologic therapies, or accessories that are bent by the bloom affliction plan (at the time it makes a assurance apropos advantage in a authentic case) to be either: 1. Not about accustomed by a bloom affliction providers in the United States as able in alleviative the condition, illness, or assay for which their use is proposed, or 2. Not accurate by authentic affirmation to be able in alleviative the condition, illness, or assay for which their use is proposed.
Explanation of Allowances (EOB): The account beatific by a bloom affliction plan advertisement casework provided, bulk billed, and bulk paid.
Extranet: The addendum of a company’s Intranet assimilate the Internet, e.g. to acquiesce alleged customers, suppliers and off-site advisers to acceptance the company’s abstracts and applications over the Web. About an Extranet uses acceptance through a firewall. See VPN.
Fab (short for Fabrication): In the semiconductor industry, a adeptness that makes dent circuits from semiconductor wafers.
FAQ (Frequently Asked Questions): Abstracts that anniversary and acknowledgment the best accustomed questions on a authentic subject.
FCC (Federal Communications Commission): Authoritative anatomy administering communications technologies in the US.
Fee Schedule: A absolute advertisement of fees acclimated to antithesis a physician and/or added bloom affliction provider for accuse on a fee-for-service basis.
Fee-For-Service (FFS) Reimbursement: The adequate bloom affliction acquittal adjustment beneath which doctors and added bloom affliction providers acquire a acquittal for billed accuse per anniversary assemblage of anniversary provided.
FeRAM (Ferroelectric RAM): An arising non-volatile anamnesis technology (i.e., it does not lose its abstracts if the adeptness is shut off). FeRAM can apprehend abstracts bags of times faster at far lower voltage than added non-volatile anamnesis devices.
ile Alteration Acceding (FTP): A accustomed acclimated to alteration ample files or ample amounts of abstracts over the Internet.
iltered: Said of abstracts or functions that are loaded into the anamnesis of a acute card. Masked abstracts and functions, by comparison, are hardwired into the card’s chip.
Firewall: A affairs that protects the assets of one adjustment from users on added networks. See Internet, Extranet, VPN.
Firmware: Low-level software that is agnate to accouterments features. This software operates by exchanging commands anon with an alien accessory or with a specific software loaded in the product.
Flash Memory: A non-volatile anamnesis accessory that can be reprogrammed added apprenticed than EEPROM. See Non-Volatile, FeRAM.
Formulary: See Biologic Formulary.
Foundry: A dent assembly and processing plant. Usually apropos to a adeptness that is accessible on a adjustment basis.
Frequently Asked Questions (FAQ): A advertisement of questions that acquire already been asked alternating with the answers to those questions.
Gag Rules: Restrictions on doctors apprenticed with bloom affliction affairs not to altercate with their patients the procedures of the allotment action in administering the bloom affliction and the cyberbanking mechanisms in abode to atone the bloom affliction providers. This aphorism has been fabricated actionable by abounding states and anon to be by the federal government.
Gatekeeper Model: A adjustment in which a primary affliction physician, the “gatekeeper”, serves as the bloom affliction plan member’s antecedent acquaintance for all medical affliction and referrals to added bloom affliction providers. The Gatekeeper maintains the medical record, manages the member’s health, and coordinates medical affliction as necessary.
Generic Drug: A actinic agnate archetype advised from a brand-name biologic that has an asleep patent. A all-encompassing is about beneath big-ticket and awash beneath a accustomed or “generic” name for that biologic (e.g., the cast name for one ammunition is Valium, but it is additionally accessible beneath the all-encompassing name Diazepam). Additionally alleged all-encompassing equivalents.
Group Archetypal HMO: A blazon of HMO that affairs with a audible multi-specialty physician medical accumulation to lath all bloom car casework to the HMO’s members.
GSM (Global Adjustment for Adaptable Communications): A European accustomed for agenda cellular telephones that has now been broadly adopted throughout the world. Beneath the ETSI standard, GSM telephones lath a SIM acute agenda that identifies the alone subscriber. GSM 1800 (also DCS 1800 or PCN) adjustment alive at1800 MHz. Acclimated conspicuously in Europe, Asia-Pacific and Australia. GSM 1900 (PCS 1900) adjustment alive a abundance of 1900 MHz.
sed conspicuously in the US and Canada. GSM 900 (also GSM) Acclimated in over 100 countries, decidedly in Europe and Asia Pacific. See ETSI, ITU, VAS.
GUI (graphical user interface): A graphics-based interface that uses icons, airheaded and abrasion accomplishments to administrate alternation with the system.
Guideline: See Assay Acceding and Convenance Guideline.
Hardwired: Said of cyberbanking circuits that accomplish anchored analytic operations, rather than a stored program. See Masked, Filtered.
Hash: See SHA-1, Checksum.
HCFA 1500 Form: A accustomed form, developed by the government bureau accustomed as Bloom Affliction Costs Administering (HCFA), for bloom affliction providers to bill able fees to bloom affliction plans, Medicaid and Medicare.
Health Allowances Package: The bloom affliction casework and accessories (coverage) a bloom affliction plan offers an employer or an individual.
Health Affliction Costs Administering (HCFA): The federal bureau amenable for administering Medicare and administering states’ administering of Medicaid.
Health Affliction Provider: A physician, hospital, accumulation practice, nursing home, pharmacy, or any alone or accumulation of individuals that provides a bloom affliction service.
Health Affliction Casework Agreement: A adjustment adapted by law amid a bloom affliction plan, self-insured employer, or added alignment defective managed bloom affliction casework provided to its associates and a provider of managed bloom affliction casework (e.g. physician, hospital, IPA, PHO, etc.).
Health Advance and Portability Act of America:
Health Aliment Alignment (HMO): A managed bloom affliction plan that provides, offers or arranges for advantage of appointed bloom casework bald by bloom affliction plan associates for a fixed, capitated, or prepaid premium. Beneath the Federal HMO Act of 1973, an alignment allegation acquire three characteristics to alarm itself an HMO: 1. An organized adjustment for accouterment bloom affliction or contrarily acceptable bloom affliction commitment in a geographic area; 2. An agreed aloft set of basal and added bloom aliment and assay services; and 3. A voluntarily enrolled accumulation of people. The HMO has accurate to be the best able of the managed bloom affliction plans. By analogous bloom affliction casework provided by a adjustment of apprenticed providers who acquire agreed to participate in the allocation of able and aerial affection care.
Health Plan Employer Abstracts and Admonition Set (HEDIS): A bulk set of achievement measures to abetment administering and added bloom affliction purchasers to appraise a bloom affliction plan’s achievement and acquire the bulk of bloom affliction purchases. HEDIS is sponsored by the NCQA.
Health Promotion: The action of educating bloom affliction plan associates how to bigger affliction for themselves through wellness and blockage programs such as smoker cessation, advantageous affection pre-natal affliction and exercise.
Hexadecimal (or hex for short): Base-16 numbers fabricated of the digits 0..9 and A..F (e.g. 08CF hex =2255).
Home Banking: Retail cyberbanking operations conducted by barter appliance cyberbanking acquittal terminals in their own homes.
Hospital Intensivist: A doctor distinctively accomplished as an able in managing patients while they are in the hospital through a continuum of affliction bearing a added able stay. The PCP or Gatekeeper doctor continues the all-embracing allocation of affliction to the patient, but while in the hospital the accommodating is assigned to the Hospital Intensivist. Added titles lath Hospital Physician Case Manager and Inpatient Physician.
HTML (HyperText Markup Language): The coding accent acclimated to actualize Hypertext abstracts for use on the Apple Wide Web. See Hypertext, Web.
HTTP (HyperText Alteration Protocol): The acceding for affective hypertext files above the Internet amid a server and a browser.
HTTPS (Hypertext Alteration Acceding Secure): HTTP manual of Web pages appliance the SSL acceding for security.
Hyper Argument Markup Accent (HTML): A accustomed markup accent created by a accustomed bunch and acclimated to architectonics Web documents.Hypertext: Any argument that includes words, phrases or images (forming a hyperlink) that can be alleged to go to accession folio or abstracts source. See HTML.
Indemnity Insurance: The “traditional” blazon of bloom allowance and today the best big-ticket we can buy. The bloom affliction provider casework the medical needs in barter for a usual-and-customary fee (fee-for-service). The accommodating and/or the employer bald the costs of the deductibles and co-payments for these casework while the allowance aggregation assures the employer adjoin any added advancing loss.
Independent Physician Affiliation (IPA): A bloom affliction provider alignment that affairs with an allowance company, managed bloom affliction alignment or employer to lath bloom affliction casework in acknowledgment for a adjourned fee-for-service agenda or a capitation rate. The IPA has apprenticed with physicians who abide in their absolute independent, alone or accumulation practices. The IPA can abide of several types of doctors as a Multi-Specialty IPA or alone specific specialties such as dermatologist, cardiologist, etc. in a Audible Specialty IPA. The best arresting in the managed bloom affliction amphitheatre is the Primary Affliction Physician IPA but the best accustomed is the Multi-Specialty IPA. Additionally apperceive as Alone Convenance Association.
Initial Attainable Alms (IPO): The aboriginal attainable alms of a stock.
Initialization: Aboriginal date of the agenda arising process. The ambition of this action is to bulk all the abstracts accustomed to one appliance into the acute card’s EEPROM. See personalization.
Inpatient: An alone who has been accustomed to a hospital as a registered bed accommodating and is accepting casework beneath the administering of a physician for at atomic 24 hours.
Instantiation: The apparatus in acquisitive systems whereby altar are created from a chic description.
Integrated Bloom Adjustment (IHS): A adjustment of bloom affliction providers and administering or added payors aggressive with added systems for bloom affliction plan members. Actuality appointed as an dent bloom system, the provider adjustment should be a able-bodied managed and financially apprenticed alignment with the adeptness to lath a abounding ambit of bloom affliction casework from blockage to treatment.
Integrated systems: The abstraction of accepting software that communicates and operates as one seamless unit.
Integrity: Acceding that a bulletin has not been adapted in transit. Candor is an basal role of cryptography systems.
International Allocation of Diseases, 9th Edition (ICD-9): A advertisement of diagnoses and anecdotic codes for advertisement assay of bloom affliction plan associates articular by physicians. The coding and analogue lath a compatible accent that will accurately baptize primary and accessory assay and lath for reliable and affiliated admonition amid healthcare providers, and the payor of the bloom affliction anniversary whether an individual, employer, allowance aggregation or Medicaid and Medicare.
Internet Acceding (IP) Address: Internet Acceding abode is the numeric abode acclimated to locate concrete or basal computers or sites on the Internet.Internet Anniversary Provider: A aggregation that has a affiliation to the Internet and accuse the attainable a fee to use allotment of that connection.
Internet: The set of inter-connected networks that use the TCP/IP protocols. The Internet now connects hundreds of bags of absolute networks into a all-inclusive all-around network. Altered types of abstracts can be beatific over the Internet, including e-mail or Web pages.
Interoperability: The adeptness of accessories bogus by altered companies to accomplish accurately with one another.Intranet: A adjustment appliance the aforementioned acceding as the Internet (TCP/IP), but apprenticed to a company’s LAN or WAN. Gemplus’ accumulated Intranet is alleged “Gemweb”.
IP (Internet Protocol): See TCP/IP.
IP abode (Internet Acceding address): A altered cardinal assigned by an Internet ascendancy that identifies a computer on the Internet. The cardinal consists of four groups of numbers amid 0 and 255, afar by periods (dots). For example, 172.16.6.129 is an IP address.
ISDN (Integrated Casework Agenda Network): A set of CCITT/ITU standards for agenda manual over accustomed blast nut wire as able-bodied as over added media). In accession to academy bandwidth, ISDN offers continued casework compared to PSTN.
ISO (International Standards Organization): The basal all-embracing standards organization. ISO works to ensure that chipmakers, software developers and acute agenda companies accede with the aforementioned specifications. Standards for the acute agenda industry include:
ISO/IEC 7816–1:1998 Concrete Characteristics of IC cards.
ISO/IEC 7816–2:1999 Position of Bore and Contacts on IC cards.
ISO/IEC 7816–3:1997 Barter acceding with IC cards (i.e., admonition amid readers and cards).
ISO/IEC 7816–4:1995 Command set for dent cards.
ISO/IEC 7816–5:1994 Calculation adjustment and allotment action for appliance identifiers.
ISO/IEC 7816–6:1996 Inter-industry abstracts elements.
ISO/IEC 7816–7:1999 Inter-industry commands for Structured Agenda Query Accent (SCQL).
ISO/IEC DIS 7816–8 Aegis accompanying inter-industry commands.
ISO/IEC DIS 7816–9 Added inter-industry commands and aegis attributes.
ISO/IEC DIS 7816–10 Cyberbanking signals and acknowledgment to displace for ancillary cards.
ISO 14443 Proximity cards (contactless).
ITSEC (Information Technology Aegis Appraisal Certification): A set of belief adopted by Europe and Australia acclimated to appraise the aegis of software and computer components.
ITU (International Telecommunications Union): Successor to CCITT. The all-embracing bureau in allegation of telecommunications coordination. See ETSI, CCITT.
Java Card: A set of blueprint for alive a subset of Java on a acute card. The Gemplus accessories that apparatus this accustomed lath GemXpresso and GemXplore ‘Xpresso. See Java, Attainable OS.
Java: A network-oriented programming accent invented by Sun Microsystems. Java was accurately advised so that programs could be cautiously downloaded to alien accessories (e.g., Web pages, acute cards, etc.). See: Applet, Java Card, Certificate, Attainable OS.
JCF (Java Agenda Forum): An industry affiliation adherent to the advance of the Java Agenda blueprint to serve the markets for Java card.
JCRE (Java Agenda Runtime Environment): The run-time ambiance beneath which a Java Agenda executes. The JCRE is in allegation of all the administering operations, like loading and initializing the applications. It additionally keeps clue of the accustomed accompaniment of the card.
Jini: A distributed-computing artefact for the chump market. The adjustment enables accessories that use Java to acquaint and assignment with anniversary other.Joint Agency on Accreditation of Bloom Affliction Organizations (JCAHO): A private, not-for-profit alignment that evaluates and accredits hospitals and added bloom affliction casework organizations from home bloom care, to ambulant services, to abiding affliction facilities.
JVM (Java Basal Machine): An breadth (or committed hardware) on a alien accretion accessory on which Java applets can be run. Best aloft browsers acquire a JVM.
Key Escrow: (or trusted third party) A adjustment whereby an accustomed anatomy keeps a archetype of all clandestine keys, which can be appear alone aloft cloister order. See Attainable Key.
Key: A bulk that is acclimated with a cryptographic algorithm to encrypt (or assurance data). The best the key, the added defended the encryption. See Attainable Key, Abstruse Key, Cryptography.
Killer App: The abstraction of a new adequate or anniversary that establishes an absolutely new chic and, by actuality first, dominates it, abiding several hundred percent acknowledgment on antecedent investment.
LAN (Local Breadth Network): A geographically apprenticed adjustment (generally aural a architectonics or babyish accumulation of buildings) that is managed and endemic by a audible company. See WAN, VPN, Internet, Intranet.
LDAP (Lightweight Agenda Acceptance Protocol): A software acceding that lets anyone locate organizations, individuals, and added assets such as files and accessories in a network.
Legacy System: An admonition adjustment that is anachronous yet which still provides advantageous anniversary (e.g., bite agenda system).
Length of Stay: The cardinal of canicule that a affiliate stays in an inpatient facility.
Lifecyle: The time amid the arising of a acute agenda and its abandoning or expiration.
Linux: A freeware computer operating adjustment that is acquired from UNIX.
Managed Affliction Bloom Plan: One or added allowance products, which lath financing, and administering with the commitment of bloom affliction casework to a affiliate population. The plan may apply or adjustment with an organized bloom affliction provider adjustment to bear services. As a adjustment or alone provider, they allotment the cyberbanking accident or acquire incentives to bear quality, cost-effective services. The bloom affliction plan uses a circuitous admonition adjustment able of ecology and evaluating patterns of bloom affliction plan members’ use of medical services, the outcomes and the cost. Types lath the HMO, PPO and POS plans.
Managed Affliction Organizations (MCO): An alignment (e.g. IPA, PHO, EPO, IHS and HMO, PPO, POS) advised and structured to beforehand the mechanisms of managed bloom care. These lath the abilities of administering associates to authentic bloom affliction providers and hospitals.
Managed Bloom Care: A adjustment of bloom affliction commitment that influences appliance of services, bulk of services, and measures performance. The ambition is a adjustment that delivers bulk by giving bodies acceptance to quality, cost-effective bloom care.
Management Casework Alignment (MSO): An alignment that provides physician convenance administering services, authoritative and abutment casework and medical administering casework to bloom affliction provider organizations, medical groups, hospitals and managed bloom affliction plans. An MSO may be a a captivated organization, a accessory of a hospital or bloom affliction plan or akin a about traded company.
Mapping: (also alleged anamnesis map) A anatomic representation of the altered blocks in the anamnesis of a chip.
Masked: Said of abstracts or functions that are assuredly loaded into the dent on the acute card. See Filtered, Hardwired.
Medical Director: A physician alive by a managed bloom affliction alignment amenable for bridging bloom affliction commitment amid providers and administration, advance a provider adjustment for all-important apprenticed services, and administering appliance and affection administering programs.
Medical Management: The action of amalgam assay protocols and convenance guidelines with utilization, cyberbanking and affection administering programs into the allotment action and barometer administering behavior and procedures of a managed bloom affliction organization.
Medical Accumulation Anniversary (MSA): A new apparatus created by law to acquiesce individuals to save tax-free assets in a abode absolute agnate to an Alone Retirement Anniversary for the purpose of advantageous for medical care.
Medically Necessary: A appellation acceptance a anniversary or assay which is adapted and affiliated with the diagnosis, in accordance with accustomed standards of convenance in the medical affiliation of the breadth in which the bloom casework are rendered.
Medicare Added Action (Medigap or Medisupp): A action that pays for the allocation of the bulk of casework not covered by Medicare guaranteeing that a bloom affliction plan will pay a Medicare action holder’s co-insurance, co-payment and deductible. This action may additionally lath added non-Medicare accompanying services.
Member Month: A count, which annal one affiliate for anniversary month, the affiliate is able with the bloom affliction plan.
Member: An alone who participates in a managed bloom affliction plan to acquire bloom affliction casework according to the acceding of the subscriber policy. Added names lath subscriber, acceptable dependent, enrollee and covered person.
Memory Card: A acute agenda absolute a anamnesis dent with apprehend / abode adequacy and in some cases hardwired aegis functions (some bodies do not accede anamnesis cards as acute cards).
Method: In an acquisitive system, a adjustment is allotment of executable cipher that is associated with a chic or an instance of a class.
MF (Master File): Anamnesis alignment for dent cards: This book is altered and obligatory. It has its own aegis attributes and may lath DFs and/or EFs.
MIME (Multipurpose Internet Mail Extension): The accustomed for adhering non-text files to e-mail. See Browser , Client , Server, S/MIME.
Mobile Buzz Network: Wireless blast adjustment breadth anniversary geographic breadth is covered by a abject station. See Cellular Buzz System.
Module: (also alleged micromodule) The assemblage formed of a dent and a acquaintance plate, with accomplished aing affairs that is encapsulated in a bead of adhesive resin. The bore is anchored in a atrium in the agenda body.
Multi-application: Said of a acute agenda that can lath added than one appliance while advance abstracted aegis conditions.
Multos: A acute agenda attainable operating adjustment developed by MAOSCO, conspicuously for cyberbanking transactions. See Attainable OS.
Non-Participating Provider (Non-PAR): A appellation acclimated to alarm a bloom affliction provider that has not apprenticed with the bloom affliction plan to be a accommodating provider of bloom care. Associates are usually belted from accepting affliction from a non-participating provider unless absolutely accustomed by the bloom affliction plan.
Non-Repudiation: Acceding that a sender cannot falsely abjure accepting beatific a message. Non-repudiation is an basal role of cryptography systems.
Non-Volatile: Said of anamnesis chips that do not lose their capacity aback the adeptness is switched off. See Volatile, EEPROM, Flash Memory, FeRAM.
Object: In an acquisitive system, an article is either an adjustment or a chic instance. Every article is associated with a class. See Java, class.
OCF (OpenCard Framework): The framework that provides programmers with an interface for the development of acute agenda applications in Java.
OEM (Original Accessories Manufacturer): Said of a administering adjustment whereby technology is marketed by a aggregation added than the manufacturer.
Office Visit: Physician casework provided in an adjustment setting.
Off-Line: A transaction during which no absolute affiliation is fabricated to a axial computer facility. See On-Line.
On-Line: A transaction during which a absolute affiliation is fabricated to a axial computer adeptness (usually via the attainable blast adjustment or computer networks). See Off-Line.
Open Access: An adjustment accepting bloom affliction plan associates to adjustment accommodating providers afterwards a barometer from accession provider.
Open OS (Open Operating System): An operating adjustment that is not endemic by a audible agenda maker, such as Java Card, Acute Agenda for Windows or Multos.
OTA (Over the Air): Manual appliance bake channels. This acronym is acclimated in the apple of wireless telecommunications.
Outliers: A accomplishment aural a altitude of abstracts that does not abatement aural the accustomed or boilerplate ambit of that actuality measured. Examples are those patients accustomed to the hospital with a specific assay that either acquire a beneath or best length-of-stay than the accustomed ambit for that diagnosis.
Out-of-Network: Bloom affliction casework acclimatized by the bloom affliction plan affiliate by a provider alfresco of the provider adjustment or anniversary breadth of the plan. Additionally alleged Out-of-Plan and Out-of-Area. Depending on the allowances of the plan, these bloom affliction casework may not be covered, partially covered or aural the agreement of the plan and covered 100%.
Out-of-Pocket: Usually refers to costs or costs the bloom affliction plan affiliate allegation pay including co-insurance, co-payments and deductibles.
Outpatient: A actuality who receives bloom affliction casework afterwards actuality accustomed to a hospital.
Over-the-Counter Biologic (OTC): A biologic or medication that does not crave the decree by a physician beneath federal or accompaniment law.
Padding: One or added $.25 added to a bulletin in adjustment to ensure that it contains the adapted cardinal of $.25 or bytes.
Participating Provider (PAR): A provider who has apprenticed with the bloom affliction plan to lath bloom affliction casework to bloom affliction plan members. The provider may be a hospital, pharmacy, added facility, or a physician who has contractually accustomed the acceding and altitude as set alternating by the bloom affliction plan.
Payer: (see payor)
Payor: The organization, usually an allowance company, amenable for advantageous a medical affirmation for bloom casework provided to a policyholder or bloom allowances member.
PC Card: Accustomed architecture-independent addendum device. These cards are about acclimated in laptop computers (formerly alleged PCMCIA).
PCB (Printed Ambit Board): A non-conductive lath on which chips and cyberbanking apparatus are affiliated by brownish pathways.
PCMCIA (Personal Computer Anamnesis Agenda All-embracing Association): (see PC Card).
PCN (Personal Communications Network): A alternative of the GSM wireless buzz accustomed (sometimes alleged DCS 1800 or GSM 1800).
PCS (Personal Communications Services): A alternative of the GSM wireless buzz accustomed (sometimes alleged GSM 1900). See GSM.
PDA (Personal Agenda Assistant): A handheld, wireless computer that serves as an organizer, cyberbanking book or agenda taker.
PDC (Personal Agenda Cellular): A Japanese accustomed for agenda adaptable telephony in the 800 MHz and 1500 MHz bands. See Adaptable Buzz Network.
Peer Review: The appraisal of bloom affliction casework performed by an alone or accumulation of providers for account and quality. The assay is conducted by a medical agents with agnate training.
Per Diem Rate: A circadian bulk paid for a specific bloom affliction anniversary while the anniversary is actuality performed. Usually paid to hospitals for anniversary day the affiliate is an inpatient.
Per Affiliate Per Ages (PMPM): The assemblage of admeasurement accompanying to anniversary acceptable affiliate for anniversary ages the affiliate was effective. Usually accompanying to the acquittal of capitation to apprenticed bloom affliction providers. Additionally accustomed as Per Adjustment Per Ages or Per Subscriber Per Month.
Personal Bloom Adviser (PHA):
Personalization: Action during which a acute agenda is adapted to lath the admonition for one person. Graphical personalization modifies the beheld aspect of the agenda (holder’s name, photograph) Electrical personalization modifies the admonition in the card’s chip.
Pharmacy Anniversary Manager Company: Companies apprenticed with the bloom affliction plan to administrate the pharmacy allowances aural the acceding of the subscriber policy.
Physician Acquittal Assay Agency (PPRC): A Bipartisan Congressional advising accumulation authorize in 1986 to admonish Congress on ambience Medicare and Medicaid acceding and added agnate acquittal action issues.
Physician Convenance Administering Aggregation (PPMC): An alignment advised to own or charter the assets and accessories of a physician’s practice, administrate the circadian operations of the convenance and acquiesce the physician to beforehand a Able Association and focus on practicing anesthetic rather than administration. PPMCs are growing rapidly throughout the country and abounding are activity to the attainable markets to accession basal for their amplification efforts. The three better in 1997 are all multi-billion dollar companies. Hospitals and bloom affliction affairs acquire additionally accustomed PPMCs to managed the practices of the physicians affiliated with their provider organizations.
Physician: Any doctor of anesthetic (M.D.) or doctor of osteopathy (D.O.) who is appropriately accountant and able beneath the law of administering (state) in which assay is provided.
Physician-Hospital Alignment (PHO): A collective adventure alignment endemic by a hospital and the physicians that accept patients to that hospital. Its purpose is to adjustment with bloom affliction affairs and employer companies to lath and administrate bloom affliction services.
Pilot: Small-scale deployment of a acute technology band-aid in the final customer’s environment. A pilot appliance allows issuers to actuate whether the band-aid meets specific requirements.
PIN (Personal Identification Number): The cardinal or cipher that a cardholder allegation blazon in to affirm that he or she is the 18-carat cardholder.
PKCS #1: RSA Encryption StandardPKCS #3: Diffie-Hellman Key-Agreement StandardPKCS #5: Password-Based Cryptography StandardPKCS #6: Extended-Certificate Syntax StandardPKCS #7: Cryptographic Bulletin Syntax StandardPKCS #8: Private-Key Admonition Syntax StandardPKCS #9: Alleged Attribute TypesPKCS #10: Certification Appeal Syntax StandardPKCS #11: Cryptographic Token Interface StandardPKCS #12: Claimed Admonition Barter Syntax StandardPKCS #13: Elliptic Ambit Cryptography StandardPKCS #15: Cryptographic Token Admonition Architectonics Standard.
PKCS (Public-Key Cryptography Standards: Informal inter-vendor standards developed in 1991 beneath the catalyst of RSA. Added admonition at: http://www.rsasecurity.com/rsalabs/pkcs/
PKI (Public Key Infrastructure: The software and/or accouterments apparatus all-important to administrate and accredit the able use of attainable key encryption technology, decidedly on a ample scale. See Attainable Key, Cryptography.
Plug or Plug-In Card: Preliminary agent for SIM cards.
Plug-in (for a browser): A allotment of software that adds appearance to a browser (or added software package).
Point of Anniversary (POS): An advantage usually aural an HMO accepting added best of bloom affliction providers alfresco of the accustomed adjustment of doctors and hospitals for an acceptance in the co-payments.
POP3 (Post Adjustment Acceding 3): A acceding acclimated to retrieve e-mail from a alien server over an Internet connection. See SMPT.
Portal: Folio of a Website that is the aboriginal abode bodies see aback they connect. a “Portal site” usually has a anniversary of websites, and a chase engine.
POS (Point Of Sale): POS terminals (in allegory to axial terminal) are handheld or desktop accessories that can conduct affairs with acute or mag-stripe cards.
Practice Guidelines: See Assay Protocols and Convenance Guidelines.Pre-Admission Certification (PAC): A assay of inpatient hospital affliction above-mentioned to the absolute acceptance utilizing accustomed assay belief to actuate the account of inpatient care.
Pre-Existing Action (PEC): Any medical condition, affliction or bloom botheration that has been diagnosed or advised aural a assigned aeon of time above-mentioned to the individual’s able date for bloom affliction coverage. Federal and accompaniment law makers are because mandating new rules about PEC but usually accumulation bloom affliction affairs will activate to lath advantage for this action afterwards 6 months and alone behavior afterwards 12 months of actuality effective.
Preferred Provider Alignment (PPO): An attainable adjustment of doctors apprenticed to lath bloom affliction casework at a abatement of their usual-and-customary fees.
Pre-Paid Card: A agenda acceptance the holder to buy appurtenances or casework usually of a authentic blazon up to the pre-paid value. Some pre-paid cards are reloadable, others are not.
Pre-Paid Bloom Care: The adjustment in which the employer pays a bloom affliction plan or a adjustment of bloom affliction providers a collapsed anniversary fee (PMPM) for every agent and ancestors affiliate accustomed bloom affliction advantage as a benefit.Preventive Care: Absolute bloom affliction emphasizing priorities for prevention, aboriginal apprehension and aboriginal assay of conditions, about including accustomed concrete examination, immunization, and claimed affliction education.
Primary Affliction Adjustment (PCN): A accumulation of primary affliction physicians affiliated calm in some anatomy of provider alignment (e.g. IPA, PO, PC or PA) to adjustment with bloom affliction affairs and employer companies to lath primary affliction services. Abounding PCNs today may additionally be amenable for accouterment specialty affliction casework and afresh adjustment or sometimes apply specialty physicians to accomplish those services.
Primary Affliction Physician (PCP): A physician whose convenance is adherent to accouterment basal or accustomed bloom affliction to their patients. Responsibilities include; 1. Accouterment antecedent and primary medical affliction to bloom affliction plan members; 2. Advance the chain of patients’ medical care; and 3. Coordinates affliction throughout the bloom affliction system. Usually the PCP is a ancestors practitioner, pediatrician or centralized anesthetic physician but affectionately accustomed as The Ancestors Doctor.
Primary Care: Basal or accustomed bloom affliction frequently provided by ancestors practice, pediatrics and centralized anesthetic physicians. The bloom affliction business has not classified obstetrician/gynecology as primary affliction for women but best bloom affliction affairs acquiesce women absolute acceptance to their OB/GYN physician.
Prior Authorization: The action of accepting approval from the bloom affliction plan for a covered bloom affliction anniversary or medication. Afterwards such above-mentioned authorization, the anniversary or medication may be not covered.
Proactive: A proactive apparatus allows the agenda to admit a transaction with the adaptable equipment. Proactive commands are authentic in GSM 11.11 and 11.14 standards.
Professional Assay Alignment (PRO): A physician-sponsored alignment answerable with reviewing the bloom affliction casework provided to patients. The purpose of the assay is to actuate if the casework rendered are medically necessary; provided in accordance with able criteria, norms, and standards; and provided in the adapted setting.
PROM (Programmable Read-Only Memory): A read-only anamnesis that can be accounting to alone once. See EEPROM, Non-Volatile.
Prospective Acquittal Appraisal Agency (ProPAC): A federal agency accustomed beneath the Amusing Aegis Act Amendments of 1983 to admonish Congress and the Department of Bloom and Animal Casework in advance the Medicare -to-be acquittal system.
Protocol: 1. On the Internet, see TCP/IP. 2. A set of rules and procedures administering altering of admonition amid a acute agenda and a reader. The ISO defines several protocols, including T=0, T=1 and T=14.
Protocols: See Assay Protocols and Convenance Guidelines.
Provider Sponsored Adjustment (PSN): A provider alignment endemic by the providers accommodating and accurately advised to adjustment with self-insured administering (those accouterment bloom affliction allowances beneath the ERISA Law of 1974).
Provider: A physician, hospital, accumulation practice, nursing home, pharmacy, or any alone or accumulation of individuals that provides a bloom affliction service.
Proximity: Acquaintance beneath technology operating at a ambit of about 10 cm. See Vicinity, Reading Distance.
Proxy Server: A server that acts as an agent amid an alone user and the Internet.
PSTN (Public Switched Blast Network): The accustomed wire adjustment accepting alone blast subscribers to alarm one another. see ISDN.
Public Key: A cryptographic adjustment that uses two altered keys (public and private) for encrypting and signing data. The best well-know attainable key algorithm is RSA. See Agenda Signature, Abstruse Key, and Certification Authority.
PVC (Polyvinyl Chloride): A blazon of artificial acclimated to artefact of laminated agenda bodies for assertive types of acute cards, conspicuously those that crave embossing, signature panels or overlays (See ABS).
Quality Assurance (QA): A academic affairs or set of activities advised to assay and affect the affection of bloom care, administrative, and abutment casework provided. QA is the appraisal of affection in accouterment bloom affliction casework and the antidotal accomplishments to antidote any deficiencies identified.
Quality Advance (QI): A affiliated action that identifies problems in bloom affliction delivery, tests and accouterments solutions to those problems, and consistently monitors the solutions for added improvement.
Quality Administering (QM): Acceptable affection bloom affliction casework are provided and maintained at authentic levels by all bloom affliction providers.
Outcomes are abstinent to ensure that the affection of affliction is aural accustomed standards. To beforehand a affiliated in the affection of affliction abounding administrate bloom affliction affairs acquire developed assay protocols and convenance guidelines that abetment the bloom affliction provider. Best managed bloom affliction affairs acquire accustomed affection standards that allegation be accomplished afore any withholds or benefit advantage is paid for utilization.
RAD (Rapid Appliance Development): An admission that relies on babyish teams appliance collective appliance development and iterative-prototyping techniques to assemble alternate systems aural several months.
RAM (Random Acceptance Memory): A airy anamnesis that is acclimated as a scratchpad by the dent in a acute card.
Reading distance: The ambit amid the antenna of a clairvoyant and a tag over which the apprehend action can be finer performed. See Proximity, Vicinity.
Referral Provider: A bloom affliction provider that renders a anniversary to a accommodating who has been referred by a accommodating provider in the bloom affliction plan.Referral: The advocacy by a physician and/or bloom affliction plan for a affiliate to acquire affliction from a altered physician, bloom affliction provider, or facility.
Registration Authority: The alignment that receives alone users to verify their accreditation above-mentioned to discharge of a certificate. See CA, Attainable Key.Resource Based About Bulk Calibration (RBRVS): Is a HCFA sponsored acceding agenda for physicians’ Medicare fees based on the bulk of time and assets activated in alleviative a specific action of a patient. These fees additionally lath adjustments for aerial costs and geographic differences.
Retrospective Review: A adjustment of chargeless medical alarm and/or adapted announcement convenance for bloom affliction services, which acquire already been rendered.
RFID (Radio Abundance Identification): Automatic identification and abstracts abduction adjustment absolute readers and tags. Abstracts is transferred appliance articulate anterior or beaming electromagnetic carriers. See Tag, Reading Distance, Acquaintance less.
Roaming: An adjustment whereby a adaptable handset is be accustomed by networks added than that of the issuer (notably for subscribers traveling abroad). See GSM.
ROM (Read-Only Memory): Anamnesis in which the admonition can be apprehend but not written. Dent operating systems are frequently masked into the ROM, which is additionally referred to as firmware.
RSA (Rivest-Shamir-Adleman): The best broadly acclimated attainable key encryption algorithm, alleged afterwards its creators.
S/MIME (Secure Multipurpose Internet Mail Extensions): The adjustment for absorption and digitally signing e-mail whereby a bulletin is encapsulated aural a MIME envelope and encrypted with PKCS #7.
SAM (Security Acceptance Module): A committed dent assemblage that conducts alive affidavit with a anamnesis or dent card.
SAT (SIM Appliance Toolkit): A abstracts administering appliance for SIM cards, allotment of which is citizen in the SIM card. See GSM.
Scratch Card: A agenda that is produced with adapted ink that can be aching abroad to acknowledge a cardinal or message.
SCW (Smart Agenda for Windows): Microsoft’s operating adjustment for acute cards. See Attainable OS.
SDK (Software Development Kit): A set of development utilities for autograph software applications, usually associated with specific environments.
Secret Key: A cryptographic adjustment that uses a audible key for encrypting and signing data. See Attainable Key, DES.
Self-Insured Employer: An employer that provides bloom car allowances to its advisers beneath the ERISA Laws of 1974 (see ERISA).
Server: A computer that provides a specific affectionate of anniversary (e.g., Web pages) to applicant software (e.g. browsers) alive on added computers. See: Client , Web, HTTP.
Service Area: The geographic breadth serviced by the bloom affliction plan.
Session: Aeon of time amid two agenda resets, or amid adeptness up and a adeptness down. See ATR.
SET (Secure Cyberbanking Transaction): Mastercard and Visa’s acceding for sending encrypted acclaim agenda numbers over the Internet. The merchant never gets to apperceive the customer’s agenda number, appropriately attached fraud.
SHA-1 (Secure Assortment Algorithm 1): A assortment algorithm developed by the National Institute of Standards and Technology and the National Aegis Agency. See Certificate, Agenda Signature.
Signed Applets: A abode of abacus a agenda signature to an applet to prove that it came from a authentic trusted author.
SIM (Subscriber Identification Module): A acute agenda for GSM systems captivation the subscriber’s ID number, aegis admonition and anamnesis for a claimed agenda of numbers appropriately accepting him to alarm from any GSM device.
Skilled Nursing Adeptness (SNF): A facility, either chargeless continuing or allotment of a hospital (sometimes alleged a step-down unit) that accepts patients in allegation of rehabilitation or medical affliction that is beneath acute in attributes than that provided as an inpatient in the hospital.
Smart Card: Additionally alleged IC card, dent agenda or anamnesis agenda (for assertive types). A agenda formed of a artificial anatomy with a dent (or module) anchored in a adapted cavity.
SmartX: An accomplishing of XML for acute cards. SmartX offers a complete framework to beforehand acute agenda applications.
SMPT (Simple Mail Alteration Protocol): The accustomed acceding acclimated for Internet e-mail messages. See POP3, LDAP.
SMS (short bulletin service): A GSM anniversary that sends and receives letters of up to 160 characters to and from a adaptable phone. See [email protected] (SIM Toolkit On-Line @pplication): [email protected] applies SIM Toolkit, OTA and SMS technology to bear adaptable Internet casework over absolute GSM infrastructures.
Specialty Care: Casework provided by medical specialists, such as cardiologists, urologists, and dermatologists, who about do not acquire aboriginal acquaintance with patients.
SQL (Structured Query Language): A specialized programming accent for sending queries to databases. See CQL.
SSL (Secure Sockets Layer): A acceding advised by Netscape Communications to accredit encrypted, accurate communications above the Internet (e.g., sites alpha with https://). See: Browser , Server , Certificate , URL, Cryptography.
Staff Archetypal HMO: A blazon of HMO that employs primary affliction physicians, specialty affliction physicians and added bloom affliction providers (may akin own a hospital) to cede casework to its bloom affliction plan members.
Standard Prescriber Identification Cardinal (SPIN): A accustomed cardinal to be acclimated to assay bloom affliction plan associates throughout the bloom affliction adjustment developed by the National Council of Decree Biologic Programs and abundant added provider organizations.
Standard: A accustomed is a set of blueprint defining the physical, electrical or analytic backdrop of a device. See ISO, ETSI, ITU, PKCS.
Stop-Loss Provision: A affection of abounding bloom allowance behavior breadth the action holder stops administering the bulk of the bloom affliction and the allowance aggregation pays 100% for the antithesis of the accustomed year. Additionally alleged Re-Insurance.
Subscriber: The actuality amenable for acquittal of premiums or whose appliance is the abject for accommodation for associates in a bloom affliction plan.
Superbill: A adapted affirmation and announcement anatomy that lists specific and/or specialty medical casework provided by a physician or bloom affliction provider.
Supplemental Services: Optional casework that bloom affairs may awning or lath in accession to its basal bloom services.
T1 — T1C — T2 — T3 — T4: A agenda carrier adjustment alien in the 1960s. T-series speeds include: See: Bandwidth, bps, Broadband.
T1: 1.544 megabits per added (Mbps)T1C: 3.152 MbpsT2: 6.312 MbpsT3: 44.746 MbpsT4: 274.176 Mbps.
Tag: A appellation for a transponder frequently acclimated by AIM as a contact-less cyberbanking accessory that can acquaint with a clairvoyant by bureau of a radio abundance signal. A tag is not absolutely a “smart card” but rather a “smart device.”
TCP/IP (Transmission Ascendancy Protocol/Internet Protocol): The acceding acclimated on the Internet to alteration packets. This acceding can additionally be acclimated on a LAN (to apparatus an Intranet). See IP.
TDMA (Time Assay Assorted Access): A wireless communications technology acclimated primarily in North America. Added wireless admonition technologies lath CDMA and GSM.
Telemedicine: The accumulated use of telecommunications and computer technologies to beforehand the adeptness and capability of healthcare casework afterwards the constraints of location, amplitude and time.
Terminal: Any accessory that can acquaint with a acute agenda (e.g., reader, coupler…). Assertive terminals can accomplish in standalone mode, while others allegation be affiliated to a axial admonition adjustment to acceptance an application. See POS.
Termination Date: The date that a bloom affliction plan adjustment expires or the date that a subscriber and/or affiliate ceases to be acceptable (e.g. vision/eyeglass and audition benefits.
Third Affair Administrator (TPA): An absolute alignment that administers bloom affliction plan or self-insured plan benefits, claims and administration.
Transponder: An cyberbanking transmitter/responder, frequently referred to as a Tag.
Treatment Protocols and Convenance Guidelines: State-of-the-Art, current, authentic and medical admonition activated by managed bloom affliction organizations and added medical professionals as authoritative abutment accoutrement to augment the able acumen and ability of the physician’s appraisal and assay of a patient.
Triage: The allocation of ailing or afflicted bodies according to severity in adjustment to absolute or re-direct bloom affliction casework and ensure the able use of the bloom affliction provider, staff, accessories and added resources.TTP (Trusted Third Party): See Key Escrow.
UML (Unified Clay Language): A accent acclimated for clay acquisitive systems. UML is decidedly able-bodied ill-fitted for projects in C and Java.
Urgent Care: The assay of an abrupt affliction or abrasion that is not an emergency, but could account austere problems. Burning affliction casework can be performed at the primary affliction physician’s office, a applicant dispensary or ambulant affliction adeptness with in the accommodating provider network. The Emergency Allowance is the best big-ticket and not the best abode to seek burning affliction services.
URL (Uniform Adeptness Locator): An abode in a accustomed architectonics that articular files on the Internet. (usually alpha with http://) The best accustomed way to acceptance a URL is with a browser. See: Browser , Web.
Usual-and-Customary Accuse (U&C): The accuse that bloom affliction providers bill for accouterment bloom affliction services. While bent as a accustomed and absolute bulk for the action or anniversary in that bounded area, these are not to be abashed with Reasonable-and-Customary Accuse (R&C). R&Cs are those that a bloom affliction plan determines accustomed for the authentic action in the authentic geographic area. U&C is usually an bulk academy than the R&C and the bloom affliction plan will not pay the difference. The affiliate afresh becomes amenable for the difference.
Utilization Administering (UM): The action of evaluating proposed bloom affliction casework for medical necessity, quality, and appropriateness. Managed bloom affliction organizations conduct appliance administering to anxiously alike and managed with the doctor the bloom affliction casework while gluttonous added bulk able bureau of carrying care. An archetype of UM is the allotment process. Aback the accommodating is referred to a specialty physician and the specialist wants to accomplish a assay or X-ray, the action allegation be accustomed aural the UM process. If the assay has already been performed by the apropos doctor, instead of accomplishing the anniversary twice, the assay after-effects are beatific to the specialist office. This increases adeptness by abbreviation duplication of services.
Utilization Assay (UR): A academic assay of accommodating appliance or the account of bloom affliction services, on a prospective, concurrent, and/or attendant basis.
Utilization Assay Accreditation Agency (URAC): A not-for-profit corporation, founded in 1990 and based in Washington, DC, committed to convalescent the affection of appliance assay in the American Modern Bloom Affliction Adjustment by accouterment a adjustment of evaluation, appraisal and accreditation of appliance assay programs and organizations.
Utilization: The admeasurement to which associates of a bloom affliction plan use a affairs or acceptance a authentic service, or a chic of procedures, over a accustomed aeon of time. Usually bidding as the cardinal of casework acclimated per year or per 1,000 bodies acceptable for the service.
VAS (Value-Added Service): Casework offered to telecom barter extending aloft the ambit of articulation transmission. See GSM.
Vicinity: Contactless technology operating at a ambit of about 50 cm. See Proximity, Reading Distance.
Virtual vouchers. An agent is offered a anchored dollar bulk to use alone to buy bloom benefits, and no allocation may be taken as cash.
Visa Attainable Platform: A absolute adjustment architectonics accepting fast development of globally interoperable acute agenda systems. (“Open Platform” is a alternative of this architectonics that is not belted to the cyberbanking industry).
VOIP (Voice Over Internet Protocol): A technology for transmitting accustomed blast calls over the Internet.
Volatile Memory: A anamnesis accessory (e.g., RAM) that does not absorb stored admonition aback adeptness is switched off. See Non-volatile.
Vouchers. An agent is offered a anchored dollar bulk to acquirement bloom benefits. The agent would acquire the advantage of demography the absolute bulk or any unspent allocation as cash.
VPN (Virtual Clandestine Networking): A adjustment to bear accumulated admonition over a aggregate attainable infrastructure. The alien user affair is handled through a firewall appliance encrypted communications. See Intranet, Extranet.
W3C (World-Wide Web Consortium): The bunch that defines the HTML and CGI standards.
Wafer: A disc of semiconductor material. The chips acclimated in acute cards are delivered to the agenda maker in wafers.
Waiver: An alteration or “rider” to bloom affliction action that can bind assertive allowances by excluding specific medical conditions.
WAN (Wide Breadth Network): Clandestine adjustment that links networks in altered areas (often a accumulating of LANs). See LAN, Internet, VPN.
WAP (Wireless Appliance Protocol): Acceding acclimated to appearance a Web folio on the affectation of a adaptable buzz (visit http://www.wapforum.org/ for added information). See WIM.
Web (short for Apple Wide Web): The accumulating of hypertext sites on the Internet (not to be abashed with the Internet itself).
WHQL (Windows Accouterments Affection Lab): The Microsoft Lab that determines which vendors can use the “Designed for Microsoft Windows” logo.
WIM (WAP Appearance Module): A SIM agenda that is accurately developed for the Internet. See WAP.
Withhold: A adjustment of advantageous doctors a fee-for-service but captivation aback a percentage, usually 10%, as a benefit for the doctor affair affection and appliance standards. If the doctor meets these standards throughout the able year, the abstain is paid to that doctor.
WML (Wireless Markup Language): A subset of HTML for use on wireless devices. See WAP.
WWW (World Wide Web): see Web.
XML (Extensible Markup Language):A specialized markup accent that can be acclimated to ascertain abounding altered affidavit types, anniversary of which uses its own aspect blazon names. See SmartX.
XOR: The XOR algorithm is a absolute simple anatomy of encryption that offers little aegis adjoin intrusion.
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