Glossary
This glossary provides definitions for terms, acronyms, and concepts used throughout the Clinware documentation.
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Healthcare Terms
Activities of Daily Living (ADL) Basic self-care tasks including bathing, dressing, eating, toileting, transferring, and continence.
Assessment Reference Date (ARD) The date used as the reference point for completing the MDS assessment, typically within 7 days of admission.
Case-Mix A method of categorizing patients based on their clinical characteristics and resource utilization patterns.
Consolidated Billing Medicare requirement that SNFs bill for most services provided to Medicare Part A residents.
Health Insurance Prospective Payment System (HIPPS) Code A five-character code used to bill Medicare for SNF services under the PPS.
Long-Term Care (LTC) Extended healthcare services for individuals with chronic illnesses or disabilities.
Minimum Data Set (MDS) Standardized assessment tool used to evaluate the functional, medical, and psychosocial status of nursing home residents.
Prospective Payment System (PPS) Medicare payment method that establishes predetermined payment rates for specific services.
Resource Utilization Group (RUG) Previous Medicare SNF payment classification system replaced by PDPM in 2019.
Skilled Nursing Facility (SNF) Healthcare facility that provides skilled nursing care and rehabilitation services.
PDPM Terms
Clinical Complexity Level of nursing care required based on medical conditions, treatments, and patient acuity.
Non-Case-Mix Component Fixed payment component that includes facility-specific factors like wage index and rural/urban status.
Non-Therapy Ancillary (NTA) PDPM component covering extensive services, high-cost drugs, and complex medical equipment.
Occupational Therapy (OT) Therapeutic services focused on helping patients perform daily activities and improve functional independence.
Patient Driven Payment Model (PDPM) Current Medicare SNF payment system implemented October 1, 2019.
Physical Therapy (PT) Therapeutic services focused on mobility, strength, and physical function restoration.
Section GG MDS section that captures functional assessment data used in PDPM calculations.
Speech-Language Pathology (SLP) Therapeutic services for communication disorders and swallowing difficulties.
Technical Terms
Application Programming Interface (API) Set of protocols and tools for building software applications and enabling system integration.
C-CDA (Consolidated Clinical Document Architecture) A standard for exchanging clinical documents between healthcare systems, defining the structure and semantics of clinical documents for interoperability.
Electronic Health Record (EHR) Digital version of a patient's medical history and health information.
Electronic Medical Record (EMR) Digital version of medical records maintained by healthcare providers, often used interchangeably with EHR.
Fast Healthcare Interoperability Resources (FHIR) Standard for exchanging healthcare information electronically.
Health Level Seven (HL7) International standards organization for healthcare data exchange.
International Classification of Diseases, 10th Revision (ICD-10) Medical coding system for diagnoses and procedures.
Representational State Transfer (REST) Architectural style for designing web services and APIs.
Interoperability & Integration Terms
360X Kno2's closed-loop referral protocol for healthcare transition of care scenarios, enabling bidirectional communication between referring facilities and accepting facilities.
Carequality A national interoperability framework that enables different health information networks to connect and exchange clinical data using standardized query-based methods.
EAF Record (External Affiliation Facility) Represents an external facility location in Epic's directory, used to route referrals and messages to external organizations.
Epic Care Everywhere Epic's health information exchange platform that enables sharing of patient data between Epic and non-Epic organizations through various interoperability standards.
Delegate In health information exchange, the technology partner authorized to initiate queries on behalf of a healthcare provider. In Clinware's case, Clinware is the Delegate acting on behalf of SNF customers.
Delegation of Authority (DoA) A legal document that establishes the authority for one entity (Delegate) to act on behalf of another entity (Principal) when accessing health information through national networks like Carequality and TEFCA.
Implementer In the Carequality framework, an organization that provides technical connectivity to the Carequality network, similar to a QHIN in TEFCA.
Object Identifier (OID) A unique identifier assigned to healthcare organizations for network identification purposes in health information exchanges.
Principal In health information exchange, the healthcare organization that has the legal right to treat patients and authorizes a Delegate to act on their behalf. In Clinware's case, the SNF customer is the Principal.
QHIN (Qualified Health Information Network) A network entity in the TEFCA framework that provides connectivity to the nationwide health information exchange, enabling interoperability between healthcare organizations.
Responder In health information exchange, the organization that holds and provides patient data in response to queries. Typically a hospital or healthcare system with an EMR.
SER Record (Servicing Provider) Represents an external provider in Epic's directory, used to route referrals and messages to specific individuals at external organizations.
TEFCA (Trusted Exchange Framework and Common Agreement) A national framework for health information exchange established by the Office of the National Coordinator for Health IT (ONC).
Attachment Metadata Additional context information associated with a document attachment in Kno2, including document type, date, privacy level, and order IDs.
Conversation Kno2 tracking object that links related messages together throughout a workflow lifecycle, enabling request-response correlation and status tracking.
Direct Protocol Standards-based secure messaging protocol for healthcare (also known as Direct Secure Messaging or Direct Trust), designed for the exchange of protected health information between healthcare providers.
DirectTrust National accreditation body for Direct Protocol participants, providing trust framework and certification for secure healthcare messaging.
E.164 International telephone numbering format standard used for fax numbers in Kno2 (e.g., +1-555-555-1234).
Health Information Service Provider (HISP) Organization that provides Direct Protocol messaging services, similar to an email provider but specifically for healthcare communications.
Kno2 Healthcare interoperability platform that enables secure exchange of clinical information between healthcare organizations using various protocols including 360X, Direct Protocol, and tracked fax.
Message Disposition Notification (MDN) Read receipt functionality in Direct Protocol messaging to confirm message receipt and processing.
Order ID Unique identifier linking a Kno2 message or fax to a specific clinical order or care plan, enabling automatic document association and filing.
OSU (Unsolicited Observation Results) HL7 message type used in 360X protocol for sending status updates and clinical information.
S/MIME Secure/Multipurpose Internet Mail Extensions. Encryption standard used in Direct Protocol for securing email messages with digital certificates.
Tracking Code Unique code embedded in tracked fax documents that enables automatic correlation of response faxes with original requests.
Transition of Care Process of moving a patient from one care setting to another (e.g., hospital to skilled nursing facility), involving transfer of clinical information and care responsibilities.
Trust Anchor Root certificate authority in the Direct Protocol trust framework, used to validate the authenticity of other certificates.
Trust Bundle Collection of trusted certificates in the Direct Protocol framework, used to validate sender identity and establish trust relationships.
X.509 Digital certificate standard used in Direct Protocol and other secure communications for authentication and encryption.
Security & Authentication Terms
mTLS (Mutual Transport Layer Security) Bidirectional certificate-based authentication where both client and server verify each other's identity using digital certificates.
Service Account Non-human account used for application-to-application authentication and authorization, typically used by services and automated processes.
System Acronyms
CMS Centers for Medicare & Medicaid Services
EPIC Electronic health record system and company
HIPAA Health Insurance Portability and Accountability Act
IT Information Technology
JSON JavaScript Object Notation (data format)
MAC Medicare Administrative Contractor
MDS Minimum Data Set
NPI National Provider Identifier
OIG Office of Inspector General
PCC Point Click Care
PDPM Patient Driven Payment Model
PPS Prospective Payment System
RAI Resident Assessment Instrument
RUG-IV Resource Utilization Group Version IV
SNF Skilled Nursing Facility
SQL Structured Query Language
UAT User Acceptance Testing
UI/UX User Interface / User Experience
Clinical Acronyms
ADL Activities of Daily Living
ARD Assessment Reference Date
BMI Body Mass Index
CHF Congestive Heart Failure
COPD Chronic Obstructive Pulmonary Disease
CVA Cerebrovascular Accident (Stroke)
DVT Deep Vein Thrombosis
GERD Gastroesophageal Reflux Disease
HIPPS Health Insurance Prospective Payment System
HTN Hypertension
LOS Length of Stay
MI Myocardial Infarction
OT Occupational Therapy
PT Physical Therapy
SLP Speech-Language Pathology
TBI Traumatic Brain Injury
UTI Urinary Tract Infection
Business Terms
Admission Process of accepting a patient into the SNF for care.
Care Plan Comprehensive plan outlining patient's care goals and interventions.
Census Number of patients currently residing in the facility.
Discharge Process of releasing a patient from the SNF.
Length of Stay (LOS) Duration of a patient's stay in the facility.
Occupancy Rate Percentage of available beds that are occupied.
Payer Mix Distribution of payment sources (Medicare, Medicaid, Private Pay, etc.).
Quality Measures Standardized metrics used to assess healthcare quality and outcomes.
Referral Request for patient admission from a hospital or other healthcare provider.
Reimbursement Payment received for healthcare services provided.
Regulatory Terms
Balanced Budget Act of 1997 Federal legislation that established the SNF PPS.
Code of Federal Regulations (CFR) Rules and regulations published by federal agencies.
Compliance Adherence to laws, regulations, and standards.
Federal Register Official journal of the federal government for proposed and final rules.
Medicaid State and federal program providing healthcare coverage for low-income individuals.
Medicare Part A Hospital insurance coverage including SNF services.
Medicare Part B Medical insurance coverage for outpatient services.
Quality Assurance Systematic approach to ensuring healthcare quality and safety.
Survey Regulatory inspection of healthcare facilities for compliance.
Data Management Terms
Backup Copy of data stored for recovery purposes.
Cache Temporary data storage for improved performance.
Database Organized collection of structured data.
Encryption Process of encoding data to prevent unauthorized access.
Integration Connection and communication between different systems.
Migration Process of moving data from one system to another.
Redundancy Duplication of data or systems for reliability.
Replication Process of maintaining identical copies of data across multiple systems.
Scalability Ability of a system to handle increased workload.
Version Control Management of changes to documents or code over time.
Quality & Performance Terms
Audit Trail Record of system activities and data changes.
Benchmark Standard or reference point for measuring performance.
Dashboard Visual display of key performance indicators and metrics.
Key Performance Indicator (KPI) Measurable value that demonstrates system or business effectiveness.
Monitoring Continuous observation of system performance and health.
Optimization Process of improving system efficiency and performance.
Service Level Agreement (SLA) Contract defining expected service performance levels.
Throughput Amount of data or transactions processed in a given time period.
Uptime Amount of time a system is operational and available.
Workflow Sequence of activities or processes to complete a task.
For additional definitions or clarifications, please refer to the official CMS documentation or contact the development team.