Bioinformatics
The sum of the computational approaches to analyze, manage, and store biological data. Bioinformatics involves the analysis of biological information using computers and statistical techniques, the science of developing and utilizing computer databases and algorithms to accelerate and enhance biological research.
Data Dictionary
• File that stores detailed information about the
data elements used in a database —
– name
– type (numeric, alphanumeric, logical …)
– storage allocation
– person authorized to change
– date of last change
Health Informatics
is the “scientific field that deals with biomedical information, data, and knowledge – their storage, retrieval, and optimal use for problem solving and decision making. It accordingly touches on all basic and applied fields in biomedical science and is closely tied to modern information technologies, notably in the areas of computing and communication (medical computer science)”
[Stanford Medical Informatics].
HMIS
The management
best practices to provide effective use of Health Information
Technology and ensure Health Information Management.
HIT
The application of information
processing involving both computer hardware and software that
deals with the storage, retrieval, sharing, and use of health care
information, data, and knowledge for communication and decision
making.
HTML
Hypertext Markup Language (HTML) is the predominant markup language for web pages. HTML elements are the basic building-blocks of webpages.
HIM
The practice of
maintenance and care of health records by traditional and electronic
means in hospitals, physician’s office clinics, health
departments, health insurance companies, and other facilities that
provide health care or maintenance of health records.
ICD-9
International Classification of Disease, 9th edition, Clinical Modification
A standardized classification of disease, injuries, and causes of death, by etiology and anatomic localization and codified into a 6-digit number, which allows clinicians, statisticians, politicians, health planners and others to speak a common language, both US and internationally. Cf SNOMED, SNOP.
ICD-10
the ICD-10-CM is based upon the International Classification of Diseases, which is published by the World Health Organization (WHO) and which uses unique alphanumeric codes to identify known diseases and other health problems. According to WHO, the ICD assists in the storage and retrieval of diagnostic information and in the compilation of national mortality and morbidity statistics.

The ICD-10-CM revision includes more than 68,000 diagnostic codes, compared to 13,000 in ICD-9-CM. In addition, ICD-10-CM includes twice as many categories and introduces alphanumeric category classifications for the first time.

Informatics or Information Science
the sciences concerned with gathering, manipulating, storing, retrieving, and classifying recorded information
Normalization
n creating a database, normalization is the process of organizing it into tables in such a way that the results of using the database are always unambiguous and as intended. Normalization may have the effect of duplicating data within the database and often results in the creation of additional tables. (While normalization tends to increase the duplication of data, it does not introduce redundancy, which is unnecessary duplication.) Normalization is typically a refinement process after the initial exercise of identifying the data objects that should be in the database, identifying their relationships, and defining the tables required and the columns within each table.
XML
• Definition:A markup language that describes data in a structured and human-readable text format• Example: Craig Duncanstudent37.3 • Related to HTML, but more powerfulbecause XML can be modified and extended• Has become the de facto standard for representation of information content• Has become the language of choice for information exchange
802.11b
is an amendment to the IEEE 802.11 specification that extended throughput up to 11 Mbit/s using the same 2.4 GHz band. This specification under the marketing name of Wi-Fi has been implemented all over the world. The amendment has been incorporated into the published IEEE 802.11-2007 standard.
802.11 is a set of IEEE standards that govern wireless networking transmission methods. They are commonly used today in their 802.11a, 802.11b, 802.11g and 802.11n versions to provide wireless connectivity in the home, office and some commercial establishments.
Bandwidth
– indicates how much information can be
carried in a given time period (usually a second) over
a wired or wireless communications link.
Broadband
refers to a telecommunications signal or device of greater bandwidth, in some sense, than another standard or usual signal or device (and the broader the band, the greater the capacity for traffic). Different criteria for “broad” have been applied in different contexts and at different times. Its origin is in physics, acoustics and radio systems engineering, where it had been used with a meaning similar to wideband.[1][2] However, the term became popularized through the 1990s as a vague marketing term for Internet access.
Browser
is a software application for retrieving, presenting, and traversing information resources on the World Wide Web. An information resource is identified by a Uniform Resource Identifier (URI) and may be a web page, image, video, or other piece of content.[2] Hyperlinks present in resources enable users easily to navigate their browsers to related resources. A web browser can also be defined as an application software or program designed to enable users to access, retrieve and view documents and other resources on the Internet.
C/C++
is a statically typed, free-form, multi-paradigm, compiled, general-purpose programming language. It is regarded as an intermediate-level language, as it comprises a combination of both high-level and low-level language features.[2] It was developed by Bjarne Stroustrup starting in 1979 at Bell Labs as an enhancement to the C language. Originally named C with Classes, the language was later renamed C++ in 1983.[3]
C++ is one of the most popular programming languages[4][5] with application domains including systems software (such as Microsoft Windows), application software, device drivers, embedded software, high-performance server and client applications, and entertainment software such as video games.[6] Several groups provide both free and proprietary C++ compiler software, including the GNU Project, Microsoft, Intel and Embarcadero Technologies. C++ has greatly influenced many other popular programming languages, most notably C# and Java.
Client
a computer that is designed to request
information from a server
Client/Server
model for applications in
which the bulk of the back-end processing takes
place on a server, while the front-end processing is
handled by the clients
Data Repository
– Master Patient Index (MPI)
– Standardization of Terminology & Data Format
Data Warehouse
enables the collection and
organization of disparate data sources, both
internal and external, to an enterprise
Database
collection of data carefully
organized to be of value to a user
• Database Management System (DBMS) –
software used to manipulate the database
Database Server
is a computer program that provides database services to other computer programs or computers, as defined by the client–server model. The term may also refer to a computer dedicated to running such a program. Database management systems frequently provide database server functionality, and some DBMSs (e.g., MySQL) rely exclusively on the client–server model for database access.
Such a server is accessed either through a “front end” running on the user’s computer which displays requested data or the “back end” which runs on the server and handles tasks such as data analysis and storage.
In a master-slave model, database master servers are central and primary locations of data while database slave servers are synchronized backups of the master acting as proxies.
Some examples of Database servers are Oracle, DB2, Informix, Ingres, SQL Server. Every server uses its own query logic and structure. The SQL query language is more or less the same in all the database servers.
Distributed Computing
– a set of “smaller”
databases into which an organization
might choose to store its data.
– Benefits include: data are closer to user;
multiple copies exist; data access is more
efficient; applications are more
balanced.
– Disadvantages: more complex;
potential for loss of synchronization.
HSC 50031
3 Final Conce
Ethernet
a physical and data layer technology for LAN networking
Extranet
is a computer network that allows controlled access from the outside, for specific business or educational purposes. An extranet can be viewed as an extension of a company’s intranet that is extended to users outside the company, usually partners, vendors, and suppliers. It has also been described as a “state of mind” in which the Internet is perceived as a way to do business with a selected set of other companies (business-to-business, B2B), in isolation from all other Internet users. In contrast, business-to-consumer (B2C) models involve known servers of one or more companies, communicating with previously unknown consumer users. An extranet is like a DMZ in that it provides access to needed services for channel partners, without granting access to an organization’s entire network.
Fat Client
(also called heavy, rich, or thick client) is a computer (client) in client–server architecture or networks that typically provides rich functionality independent of the central server. Originally known as just a ‘client’ or ‘thick client’, the name is contrasted to thin client, which describes a computer heavily dependent on a server’s applications.
A fat client still requires at least periodic connection to a network or central server, but is often characterised by the ability to perform many functions without that connection. In contrast, a thin client generally does as little processing as possible and relies on accessing the server each time input data needs to be processed or validated.
Firewall
firewall is a device or set of devices designed to permit or deny network transmissions based upon a set of rules and is frequently used to protect networks from unauthorized access while permitting legitimate communications to pass.
Many personal computer operating systems include software-based firewalls to protect against threats from the public Internet. Many routers that pass data between networks contain firewall components and, conversely, many firewalls can perform basic routing functions. [1]
GUI
In computing, a graphical user interface (GUI, sometimes pronounced gooey[1]) is a type of user interface that allows users to interact with electronic devices with images rather than text commands. GUIs can be used in computers, hand-held devices such as MP3 players, portable media players or gaming devices, household appliances and office equipment . A GUI represents the information and actions available to a user through graphical icons and visual indicators such as secondary notation, as opposed to text-based interfaces, typed command labels or text navigation. The actions are usually performed through direct manipulation of the graphical elements.[2]
Host
A network host is a computer connected to a computer network. A network host may offer information resources, services, and applications to users or other nodes on the network. A network host is a network node that is assigned a network layer host address.
Computers participating in networks that use the Internet Protocol Suite may also be called IP hosts. Specifically, computers participating in the Internet are called Internet hosts, sometimes Internet nodes. Internet hosts and other IP hosts have one or more IP addresses assigned to their network interfaces. The addresses are configured either manually by an administrator, automatically at start-up by means of the Dynamic Host Configuration Protocol (DHCP), or by stateless address autoconfiguration methods.
Interface Engine
Integration of health applications requires information created and updated in one heath application to be seamlessly available in other applications. For example information created in a patient administration system to be available in the clinical information system as well as other departmental systems such as pathology, radiology and pharmacy. A common approach is to interface information from one application to many other systems using HL7.
Intranet
is a computer network that uses Internet Protocol technology to securely share any part of an organization’s information or network operating system within that organization. The term is used in contrast to internet, a network between organizations, and instead refers to a network within an organization. Sometimes the term refers only to the organization’s internal website, but may be a more extensive part of the organization’s information technology infrastructure. It may host multiple private websites and constitute an important component and focal point of internal communication and collaboration. Any of the well known Internet protocols may be found in an intranet, such as HTTP (web services), SMTP (e-mail), and FTP (file transfer protocol). Internet technologies are often deployed to provide modern interfaces to legacy information systems hosting corporate data.
ISP
An Internet service provider (ISP) is a company that provides access to the Internet. Access ISPs directly connect customers to the Internet using copper wires, wireless or fiber-optic connections.[1] Hosting ISPs lease server space for smaller businesses and host other people servers (colocation). Transit ISPs provide large tubes for connecting hosting ISPs to access ISPs.[2]
Java
Java is a programming language originally developed by James Gosling at Sun Microsystems (which is now a subsidiary of Oracle Corporation) and released in 1995 as a core component of Sun Microsystems’ Java platform. The language derives much of its syntax from C and C++ but has a simpler object model and fewer low-level facilities. Java applications are typically compiled to bytecode (class file) that can run on any Java Virtual Machine (JVM) regardless of computer architecture. Java is a general-purpose, concurrent, class-based, object-oriented language that is specifically designed to have as few implementation dependencies as possible. It is intended to let application developers “write once, run anywhere.” Java is currently one of the most popular programming languages in use, particularly for client-server web applications.[9][10]
LAN (Local Area Network)
– connects network devices over a relatively short distance
OSI (Open System Interconnection)
The Open Systems Interconnection Reference
Model (OSI Model or OSI Reference
Model for short) is a layered abstract
description for communications and computer
network protocol design, developed as part of
the Open Systems Interconnection initiative. It
is also called the OSI seven layer model
Reference Model
in systems, enterprise, and software engineering is a model of something that embodies the basic goal or idea of something and can then be looked at as a reference for various purposes.
Portal
refers to a Web site or service that offers a broad array of resources and services, such as e-mail, forums, search engines, and online shopping malls. The first Web portals were online services, such as AOL, that provided access to the Web, but by now most of the traditional search engines have transformed themselves into Web portals to attract and keep a larger audience.

(2) An enterprise portal is a Web-based interface for users of enterprise applications. Enterprise portals also provide access to enterprise information such as corporate databases, applications (including Web applications)

Relationship Database
matches data by using common characteristics found within the data set. The resulting groups of data are organized and are much easier for many people to understand.
For example, a data set containing all the real-estate transactions in a town can be grouped by the year each transaction occurred, the sale price, a buyer’s last name and so on. Such a grouping uses the relational model (a technical term for this is schema). Hence, such a database is called a “relational database.”
Sniffer
Packet analyzer (aka network analyzer, protocol analyzer or sniffer), computer software or hardware that can intercept and log traffic passing over a digital network
SOAP (Simple Object Access Protocol)
“Request and receive messages”
• Web service equivalent of an order
• A Remote Procedure Call (RPC)
that consists of XML
sent over HTTP
– Other transport protocols can be used
• Similar in structure to a letter:
– A message is written in XML
– The message is wrapped in an
XML envelope
SQL
developed in the 1970s and adopted as a
standard relational language in 1986
SQL (officially /??s kju? ??l/, often /?si?kw?l/;[3] often referred to as Structured Query Language) is a programming language designed for managing data in relational database management systems (RDBMS
Server
a computer that is dedicated to
providing information in response to external requests
T1,T2,T3
he Triple class is an extension of std::pair. Triple is a heterogeneous triple: it holds one object of type T1, one of type T2, and one of type T3. A Triple is much like a container, in that it “owns” its elements. It is not actually a model of container, though, because it does not support the standard methods (such as iterators) for accessing the elements of a container.
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Tablet Computer
, or simply tablet, is a complete mobile computer, larger than a mobile phone or personal digital assistant, integrated into a flat touch screen and primarily operated by touching the screen. It often uses an onscreen virtual keyboard, a passive stylus pen, or a digital pen[citation needed], rather than a physical keyboard.[1][2]
Thin Client
A thin client (sometimes also called a lean or slim client) is a computer or a computer program which depends heavily on some other computer (its server) to fulfill its traditional computational roles. This stands in contrast to the traditional fat client, a computer designed to take on these roles by itself. The exact roles assumed by the server may vary, from providing data persistence (for example, for diskless nodes) to actual information processing on the client’s behalf.
UI
The user interface, in the industrial design field of human–machine interaction, is the space where interaction between humans and machines occurs. The goal of interaction between a human and a machine at the user interface is effective operation and control of the machine, and feedback from the machine which aids the operator in making operational decisions. Examples of this broad concept of user interfaces include the interactive aspects of computer operating systems, hand tools, heavy machinery operator controls, and process controls. The design considerations applicable when creating user interfaces are related to or involve such disciplines as ergonomics and psychology.
URL
In computing, a Uniform Resource Locator or Universal Resource Locator (URL) is a character string that specifies where a known resource is available on the Internet and the mechanism for retrieving it.
VPN
A virtual private network (VPN) is a network that uses primarily public telecommunication infrastructure, such as the Internet, to provide remote offices or traveling users access to a central organizational network.
VPNs typically require remote users of the network to be authenticated, and often secure data with encryption technologies to prevent disclosure of private information to unauthorized parties.
VPNs may serve any network functionality that is found on any network, such as sharing of data and access to network resources, printers, databases, websites, etc. A VPN user typically experiences the central network in a manner that is identical to being connected directly to the central network. VPN technology via the public Internet has replaced the need to requisition and maintain expensive dedicated leased-line telecommunication circuits once typical in wide-area network installations.
WAN
is a geographically dispersed
telecommunications network
Web Server
Software components that can be published,
located, and run over the Internet using
Extensible Markup Language (XML)
Wi-Fi
is a mechanism for wirelessly connecting electronic devices. A device enabled with Wi-Fi, such as a personal computer, video game console, smartphone, or digital audio player, can connect to the Internet via a wireless network access point. An access point (or hotspot) has a range of about 20 meters (65 ft) indoors and a greater range outdoors. Multiple overlapping access points can cover large areas
Architecture
determines how
applications integrate and relate to each other
There are two primary types of architectures
– Peer-to-peer (P2P) network
– Client/server network
CDSS
• Medical information processing systems that are
designed to aid clinicians in making complex and/or
less-than-complex clinical-based decisions
• Use CDSS to query general and specific questions
about the conditions of their patients, infer and/or
forecast resulting outcomes, & arrive at the computed alternatives and/or choice outcomes for the decision makers
CPOE
• An automated order entry system that
captures a physician’s instructions
regarding the care of their patients
• Often implemented as a component
of the EHR
• must be able to communicate orders
to other connected systems within the
EHR
• Can have additional uses, including
providing necessary information,
when combined with other workflow
tools
Detailing
DSS
is a computer-based information system that supports business or organizational decision-making activities. DSSs serve the management, operations, and planning levels of an organization and help to make decisions, which may be rapidly changing and not easily specified in advance.
EHR
– records that span
organizations
EMR
– contains information from a single organization
•The health information of an individual patient that exists as
part of a complete history
– Designed to provide clinicians with a comprehensive
picture of the patient’s health status at any time
• Replaced older terms
– Computerized Patient Records (CPR)
– Electronic Medical Records (EMR)
• Capture, using all available patient-provider encounters, both
the historic and current records of a patient’s health information
EMPI (Enterprise Master Patient Index)
a
relational database containing IDs of all
patients seen anywhere in the system
ePrescribing/eRx
• Ability to create a prescription electronically
• Ability to receive automated decision support during script creation
– Medication lists and information
– Eligibility determination
– Formulary coverage from insurer including co-pay information
– Prior authorization
– clinical decision support including Drug interactions, drugallergy, etc.
• Ability to send script electronically to pharmacy using standard
transmission messaging (NCPDP SCRIPT, ASC12)
HIE
is defined as the mobilization of healthcare information electronically across organizations within a region, community or hospital system.
HIE provides the capability to electronically move clinical information among disparate health care information systems while maintaining the meaning of the information being exchanged. The goal of HIE is to facilitate access to and retrieval of clinical data to provide safer, more timely, efficient, effective, equitable, patient-centered care. HIE is also useful to Public Health authorities to assist in analyses of the health of the population.
LIS (Laboratory Information System
Contains all lab tests ordered and their results
and stored as coded results (LOINC etc.) in many systems
MPI
database program that
collects a patient’s various
hospital identification
numbers, e.g. from the blood
lab, radiology department,
and admissions, and keeps
them under a single,
enterprise-wide identification
number.
PACS
A picture archiving and communication system (PACS) is a medical imaging technology which provides economical storage of, and convenient access to, images from multiple modalities (source machine types).[1] Electronic images and reports are transmitted digitally via PACS; this eliminates the need to manually file, retrieve, or transport film jackets. The universal format for PACS image storage and transfer is DICOM (Digital Imaging and Communications in Medicine). Non-image data, such as scanned documents, may be incorporated using consumer industry standard formats like PDF (Portable Document Format), once encapsulated in DICOM. A PACS consists of four major components: The imaging modalities such as X-ray computed tomography (CT) and magnetic resonance imaging (MRI), a secured network for the transmission of patient information, workstations for interpreting and reviewing images, and archives for the storage and retrieval of images and reports. Combined with available and emerging web technology, PACS has the ability to deliver timely and efficient access to images, interpretations, and related data. PACS breaks down the physical and time barriers associated with traditional film-based image retrieval, distribution, and display.
PHR
• A personal health record is much more than
records, PHR is a broad term of art for:
“an Internet-based set of tools that allows
people to access and coordinate their lifelong
health information and make appropriate parts
of it available to those who need it.” –Markle Foundation
Physician Portal
is the single access point for PatientKeeper applications, uniting information from across the healthcare community. With the PatientKeeper Portal, physicians no longer need to learn and navigate multiple hospital systems.
By delivering information from hospital systems, practice EMRs, and reference labs, the PatientKeeper Physician Portal is a key component to HIE initiatives. And the foundation for a community-wide electronic health record.
Practice Management System (PMR/PMS)
is a category of software that deals with the day-to-day operations of a medical practice. Such software frequently allows users to capture patient demographics, schedule appointments, maintain lists of insurance payers, perform billing tasks, and generate reports.
Supply Chain Management
Understanding how to manage the information flow
throughout a supply chain (SC) so that the total SC
effectiveness is maximized
CCHIT
The Certification Commission for Health Information Technology (CCHIT) is an independent, 501(c)3 nonprofit organization with the public mission of accelerating the adoption of robust, interoperable health information technology. The Commission has been certifying electronic health record technology since 2006 and is approved by the Office of the National Coordinator for Health Information Technology (ONC) of the U.S. Department of Health and Human Services (HHS) as an Authorized Testing and Certification Body (ONC-ATCB). The CCHIT Certified program is an independently developed certification that includes a rigorous inspection of an EHR’s integrated functionality, interoperability and security using criteria developed by CCHIT’s broadly representative, expert work groups. These products may also be certified in the ONC-ATCB certification program.
DICOM
– Another messaging standard
– Standard of choice for transmitting diagnostic
images
– Closely supported by all of the imaging vendors
and is working with the HL7 group
HL7
a set of standards
designed to develop a cost-effective approach
to system connectivity
HTTP
is used to transmit web
pages over the Internet.
interoperability
the capability of two or more
computer systems to share data and resources,
even though they are made by different
manufacturers
SDO
Service Data Objects is a technology that allows heterogeneous data to be accessed in a uniform way. The SDO specification was originally developed in 2004 as a joint collaboration between BEA and IBM and approved by the Java Community Process. Version 2.0 of the specification was introduced in November 2005 as key part of the Service Component Architecture.
S&I Framework
The Standards and Interoperability (S&I) Framework is a set of integrated functions, processes, and tools being guided by the healthcare and technology industry to achieve harmonized interoperability for healthcare information exchange.

The Standards and Interoperability (S&I) Framework is an investment by the country in a set of harmonized interoperability specifications to support national health outcomes and healthcare priorities, including Meaningful Use, the Nationwide Health Information Network, and the ongoing mission to create better care, better population health and cost reduction through delivery improvements.

Scalability
In electronics (including hardware, communication and software) scalability is the ability of a system, network, or process, to handle growing amounts of work in a graceful manner or its ability to be enlarged to accommodate that growth.[1] For example, it can refer to the capability of a system to increase total throughput under an increased load when resources (typically hardware) are added. An analogous meaning is implied when the word is used in a commercial context, where scalability of a company implies that the underlying business model offers the potential for economic growth within the company.
Cloud Computing (laas,Paas,Saas)
g is Internet-based computing, whereby
shared resources, software and information are
provided to computers and other devices on-demand,
like the electricity grid.
Infrastructure as a
Service(IaaS)
• Computing hardware,
physical plant, networking,
storage, VM
• eg. Amazon S3 & EC2
Platform as a
Service(PaaS)
• All resources needed to build
and deploy applications
• eg. Jboss App. Server
Software/Application
as a Service(SaaS)
• Entire application is
available on the web
• eg. Google Apps
Meaningful Use
The first steps in achieving meaningful use are to have a certified electronic health record (EHR) and to be able to demonstrate that it is being used to meet the requirements. Stage 1 contains 25 objectives/measures for Eligible Providers (EPs) and 24 objectives/measures for eligible hospitals. The objectives/measures have been divided into a core set and menu set. EPs and eligible hospitals must meet all objectives/measures in the core set (15 for EPs and 14 for eligible hospitals). EPs must meet 5 of the 10 menu-set items during Stage 1.[6
SLA (Service Level Agreement)
A service-level agreement is a part of a service contract where the level of service is formally defined. In practice, the term SLA is sometimes used to refer to the contracted delivery time (of the service) or performance. As an example, internet service providers will commonly include service level agreements within the terms of their contracts with customers to define the level(s) of service being sold in plain language terms. In this case the SLA will typically have a technical definition in terms of mean time between failures (MTBF), mean time to repair or mean time to recovery (MTTR); various data rates; throughput; jitter; or similar measurable details.
HITECH Healthcare
Hi-Tech Healthcare, Inc. provides a wide range of home medical supplies and equipment, such as: oxygen equipment, ventilators, sleep therapy and hospital beds to help improve the quality of life for patients at home and long-term care environments. Our trained and caring specialists talk to both the patient and the caregiver to evaluate the home environment and provide the appropriate equipment as directed by the doctor’s treatment plan. Our highly trained staff sets up safe and easy to use equipment for our patients.
Technology for Economic and Clincal Health Act
The Health Information Technology for Economic and Clinical Health Act (HITECH Act or “The Act”) is part of the American Recovery and Reinvestment Act of 2009 (ARRA). ARRA contains incentives related to health care information technology in general (e.g. creation of a national health care infrastructure) and contains specific incentives designed to accelerate the adoption of electronic health record (EHR) systems among providers.

Because this legislation anticipates a massive expansion in the exchange of electronic protected health information (ePHI), the HITECH Act also widens the scope of privacy and security protections available under HIPAA; it increases the potential legal liability for non-compliance; and it provides for more enforcement.

ONC
is the principal Federal entity
charged with coordination of nationwide
efforts to implement and use the most
advanced health information technology
and the electronic exchange of health
information.
Legacy System
A legacy system is an old method, technology, computer system, or application program that continues to be used, typically because it still functions for the users’ needs, even though newer technology or more efficient methods of performing a task are now available. A legacy system may include procedures or terminology which are no longer relevant in the current context, and may hinder or confuse understanding of the methods or technologies used.
RHIO (A Regional Health Information Organization)
A Regional Health Information Organization (RHIO) is a multistakeholder organization expected to be responsible for motivating and causing integration and information exchange among stakeholders that region’s revamped healthcare system. Generally these stakeholders are developing a RHIO to affect the safety, quality, and efficiency of healthcare as well as access to healthcare through the efficient application of health information technology. Regions in the US continue to use various definitions of “multistakeholder organizations.” For instance, in Wichita, Kansas the Clinics Patient Index is a software architecture as well as support environment that facilitates integration among outpatient clinics and hospital emergency departments. In Maryland, Virginia and eslewhere, RHIOs are forming with multiple hospitals, while still others might include medical societies, payers and major employers.

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