Glossary

The importance criterion assesses the extent to which the specific measure focus is evidence-based and important to making significant gains in health care quality (e.g., safety, timeliness, effectiveness, efficiency, equity, patient-centeredness) and improving health outcomes for a specific high-impact aspect of health care where there is variation in or overall poor performance. 

Industry standard modeling techniques use a standard visual approach to facilitate communication related to business models and software design. For example, Unified Modeling Language (UML) uses integrated diagrams to specify and document the structure and dynamic behavior of information system and software artifacts.

Inferno is a rich and rigorous testing suite for Health Level Seven International® Fast Healthcare Interoperability Resources® (FHIR®) to help measure developers implement the FHIR standard consistently. Two options are available for measure developers wanting to use Inferno. The Inferno Program Edition is used to help test requirements of the Standardized Application Programming Interface for Patient and Population Services criterion § 170.315(g)(10) in the 2015 Edition Cures Update. The Inferno Community Edition contains a community-curated set of tests and tools for select FHIR Implementation Guides.

Informatics activities include tasks related to knowledge engineering and technical development of clinical practice guidelines artifacts (L2 to L4)(See Levels of knowledge representation for CPG). These may include, but not limited to developing use case diagrams, flow diagrams, and decision trees; identifying relevant data elements, Fast Healthcare Interoperability Resources® profiles, terminologies, value sets, libraries, rules, and logic representations; writing software code (e.g., for clinical decision support); and developing comprehensive test cases and testing resources.

With an integrated process, steps related to guideline development, informatics activities, implementation, evaluation, and communications are conducted in parallel, insofar as possible, rather than in sequence.

An intensional value set is a list of codes based on a logical statement that often has an algorithmic basis for selection of concepts.

An interested party is an individual, group, or organization affected by the outcome of a project and, thus, has an interest in the project's success.

An intermediate outcome measure is a measure assessing the change produced by a health care intervention leading to a long-term outcome.

An inverse measure is a measure in which a lower performance rate is better. Therefore, a zero performance rate for these measures is a good score. For example, the National Healthcare Safety Network calculates most healthcare-associated infections (HAIs) as a standardized infection ratio (SIR). The SIR compares the actual number of HAIs (the numerator) with the predicted number based on the baseline U.S. experience (e.g., standard population), adjusting for several risk factors found to be most associated with differences in infection rates. The goal is to have the numerator equal to or very close to zero, thereby having an SIR equal to or very close to zero.

The Interoperability Standards Advisory (ISA) process represents the model by which the Office of the National Coordinator for Health Information Technology (ONC) coordinates interoperability standards and implementation specifications for industry use to fulfill specific clinical health information technology interoperability needs. ONC updates the ISA throughout the year to include improvements based on recommendations received from public comments and subject matter experts. These updates are published in an annual Reference Edition. To learn more about the ISA, please visit https://www.healthit.gov/isa/about-isa.