DATA DICTIONARY
DESCRIPTIVE LIST OF THE NAME, DEFINITION AND ATTRIBUTES OF DATA ELEMENTS TO BE COLLECTED IN AND IS OR DATABASE WHOSE PURPOSE ITS TO STANDARDIZE DEFINITIONS AND ENSURE CONSISTENT USE
IS
INFORMATION SYSTEM
IS AN AUTOMATED SYSTEM THAT USES COMPUTER HARDWARE AND SOFTWARE TO RECORD, MANIPULATE, STORE, RECOVER AND DISSEMINATE DATA.
SYSTEM THAT RECEIVES AND PROCESSES INPUT AND PROVIDES OUTPUT
PRIMARY DATA SOURCES
COME DIRECTLY FROM THE ORIGINAL SOURCE. THE HIGHEST QUALITY OF DATA WILL ALWAYS COME FORM THE PRIMARY SOURCE WHICH IS THE ORIGINAL SOURCE
I.E. PATIENT, HEALTHRECORD
COLLECTION
THE PROCESS BY WHICH DATA ELEMENTS ARE ACCUMULATED OR GATHERED.
DATA ACCESSIBILITY
DATA ACCURACY
DATA ITEMS ARE EASILY OBTAINABLE BY AUTHORIZED USERS.
HEALTH RECORD MUST BE ACCURATE AND COMPLETE. FREE OF IDENTIFIABLE ERRORS
HEALTH INFORMATICS
IS A SCIENTIFIC DISCIPLINE THAT IS CONCERNED WITHT HE COGNITIVE, INFORMATION PROCESSING AND COMMUNICATION TASKS OF HEALTHCARE PRACTICE, EDUCATION, AND RESEARCH, INCLUDING THE INFORMATION SCIENCE AND TECHNOLOGY TO SUPPORT THESE TASKS.
IMPACT OF TECHNOLOGY ON PATIENT CARE
1. ACTUAL CARE PROVIDED TO THE PATIENT
2. PATIENT ENGAGEMENT IN HEALTHCARE
3. CREATION OF EVIDENCE BASED MEDICINE
CREATION OF PRACTICE GUIDELINES
PATIENT SAFETY
SECONDARY DATA SOURCE
ARE DERIVED FROM THE PRIMARY SOURCES SUCH AS THE HEALTH RECORD. SECONDARY SOURCES INCLUDE:
INDICES REGISTRIES, AND OTHER DATA BASES
USED TO CONDUCT RESEARCH, ADDRESS POPULATION HEALTH ISSUES & ADMINISTRATIVE PURPOSES - MONITOR FOR POSSIBLE FRAUD
WAREHOUSING
PROCESS AND SYTEMS USED TO ARCHIVE DATA OE INVOLVES THE METHODS USED OT STORE THE DATA.
COMPREHENSIVINESS
CONSISTANCY
MEANS THAT THE HEALTH RECORD MUST BE COMPLETE, ALL REQUIRED DATA ARE INCLUDED.
ENSURES THAT LIKE DATA ARE THE SAME ON EACH DOCUMENT OR COMPUTER SCREEN. ENTERED ONCE IN THE SYSTEM AND SHOWS UP ON DIFFERENT SCREENS
DATA ANALYTICS
IS THE SCIENCE OF EXAMINING RAW DATA WITH THE PURPOSE OF DRAWING CONCLUSIONS ABOUT INFORMATION. THIS INFO CAN THEN BE USED TO MAKE BUSINESS DECISIONS CONCERNING WHICH SERVICES TO PROVIDE AND HOW TO IMPROVE PATIENT CARE
IMPACT OF TECHNOLOGY ON PATIENT SAFETY
USE OF BARCODES TO VERIFY PATIENT IDENTIFICATION FOR MEDICATION ADMINISTRATION
CHECKING MEDICATIONS ORDERED AGAINST ALLERGIES AND OTHER MEDICATION ADMINISTRATION
IMPROVED DATA QUALITY THROUGH EDITS AND STANDARDIZATION
CLINICAL PROVICER ORDER ENTRY
DATA CAPTURE
IS THE PROCESS OF RECORDING HEALTHCARE RELATED DATA IN A HEALTH RECORD SYSTEM OR CLINICAL DATABASE.
ANALYSIS
THE PROCESS OF TRANSLATING DATA INTO MEANINGFUL INFORMATION OR CONVERTING DATA INTO INFORMATION.
DATA CURRENCY
DATA DEFINITION
ENSURES THAT DATA ARE UP TO DATE. A DATA VALUE IS UP TO DATE IF IS CURRENT FOR A SPECIFIC POINT IN TIME, AND IT IS OUTDATED IF IT WAS CURRENT AT A PRECEDING TIME BUT INCORRECT AT A LATER TIME.
IS THE SPECIFIC MEANING OF A HEALTHCARE RELATED DATA ELEMENT.
DATA MINING
IS THE PROCESS OF EXTRACTING AND ANALYZING LARGE VOLUMES OF DATA FROM A DATA BASE FOR THE PURPOSE OF IDENTIFYING HIDDEN AND SOMETIMES SUBTLE RELATIONSHIPS OR PATTERNS AND USING THOSE RELATIONSHIPS TO PREDICT BEHAVIORS.
IMPACT OF TECHNOLOGY ON THE HIM PROFESSION
HIM CAN PERFORM MANY TASKS BECAUSE OF THE EHR:
ASSINING DIAGNOSIS & CPT CODES
MANAGING REGISTRIES
TRANSCRIBING DOCUMENTS
ANALYIZING THE HEALTH RECORD
DOCUMENTATION OF ROI
CAC
DATA INTEGRITY
IS THE EXTENT TO WHICH HEALTHCARE DATA ARE COMPLETE, ACCURATE, CONSISTENT AND TIMELY.
DATA INTEGRITY IS ABOUT THE DATA ITSELF.
APPLICATION
THE PURPOSE FOR THE DATA COLLECTION OR THE REASON FOR COLLECTING THE DATA
DATA GRANULARITY
DATA PRECISION
THE LEVEL OF DETAIL AT WHICH THE ATTRIBUTES AND VALUES OF HEALTHCARE DATA ARE DEFINED.
ENSURES THAT THERE IS JUSTIFICATION FOR THE NEED TO COLLECT THE DATA, SUCH AS FOR PATIENT CARE, DATA ANALYSIS, BILLING AND OTHER OPERATIONAL TASKS.
DASH BOARDS
ARE REPORTS OF PROCESS MEASURES TO HELP LEADERS FOLLOW PROGRESS TO ASSIST WITH STRATEGIC PLANNING. THE DASH BOARD PROVIDES THE STATUS ON KEY MEASURES. THE DASH BOARD WOULD ALLOW THE USER TO MONITOR THESE KEY MEASURES CLOSELY.
HEI
HEALTH INFORMATION EXCHANGE IS THE EXCHANGE OF HEALTH INFO ELECTRONICALLY BETWEEN PROVIDERS AND OTHERS WITH THE SAME LEVEL OF INTEROPERABILITY. ALLOWS ACCESS TO PATIENT INFO EVEN IF THE PREVIOUS HEALTH RECORDS ARE LOCATED WITH HEALTHCARE PROVIDERS WITH OTHER FACILITIES WHETHER LOCAL OR IN OTHER STATES
DATA QUALITY
IS THE RELIABILITY AND EFFECTIVENESS OF DATA FOR ITS INTENDED USES IN OPERATIONS, DECISION MAKING AND PLANNING. QUALITY FOCUSES ON USING THE DATA.
CHARACTERISTICS OF DATA QUALITY
ACCURACY
COMPREHENSIVENESS
CURRENCY
GRANULAIRTY
RELEVANCY
ACCESSIBLITY
CONSITENCY
DEFINITION
PRECISION
TIMELINESS
DATA RELEVANCY
DATA TIMELINESS
IS THE EXTENT TO WHICH HEALTHCARE RELATED DATA ARE USED FOR THE PURPOSE FOR WHICH THEY WERE COLLECT. ONLY DATA THAT ARE NEEDED OR EXPECTED TO BE NEEDED IN THE FURTURE ARE COLLECTED.
DATA SHOULC BE RECORDED IN AN APPROPRIATE PERIOD OF TIME AFTER THE EVENT OR SHOULD BE AVAILABLE TO THE USER WHEN NEEDED.