Glossary of Terms

A1c: Shorthand for glycated hemoglobin. A1c is a blood test to measure the amount of sugar in the bloodstream over a 3-month period. Glycated hemoglobin is produced when excess glucose attaches itself to red blood cells. A high percentage of glycated hemoglobin indicates potential problems with blood sugar control.

Acute Myocardial Infarction (AMI): An AMI or heart attack, occurs when the arteries leading to the heart become blocked and the blood supply is slowed or stopped. When the heart muscle can't get the oxygen and nutrients it needs, the part of the heart tissue that is affected may die.

Algorithm: A detailed sequence of actions to solve a problem or accomplish a task.

Audit or Data Collection Audit: A systematic inspection of data collection processes and/or medical records to verify the integrity of data reported in the Performance & Progress Report.

Beta Blockers: Medicine used to lower blood pressure, treat chest pain and heart failure, and to help prevent a heart attack. Beta blockers relieve the stress on the heart by slowing the heart rate and reducing the force with which the heart muscles contract to pump blood.

Blood Culture: A blood test to detect bacteria in the blood.

Centers for Medicare and Medicaid (CMS): The federal agency that runs the Medicare program for the elderly aged and disabled. In addition, CMS works with the states to run the Medicaid program for low-income individuals.

Congestive Heart Failure (CHF): Congestive heart failure, or heart failure, is a condition in which the heart can't pump enough blood to the body's other organs. The "failing" heart keeps working but not as efficiently as it should.

Consumer Assessment of Health Plans (CAHPS): CAHPS surveys probe those aspects of care for which consumers and patients are the best and/or only source of information, as well as those that consumers and patients have identified as being important.

Criteria: Attributes or rules that serve as the basis for evaluation, definition or classification of something; evaluation standards.

Denominator: The number below the line in a fraction. Denotes how many parts make up the whole.

Diabetes: Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is required to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.

Economic Efficiency: The direct and indirect costs of high quality healthcare.

Effectiveness: Institute of Medicine category that calls for providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit.

Health Employer Data Information Set (HEDIS): HEDIS is a tool created by the National Committee for Quality Assurance (NCQA) to collect data about the quality of care and services provided by the health plans. HEDIS consists of a set of performance measures that compare how well health plans perform in key areas: quality of care, access to care and member satisfaction with the health plan and doctors. NCQA requires health plans to collect this information in the same manner so that results can be fairly compared to one another.

Health Plan: An organization that offers reimbursement for its members' health care services. It can be a health maintenance organization (HMO), a preferred provider organization (PPO), a commercial insurance carrier or a company that self-insures.

Institute of Medicine (IOM): An organization within the National Academy of Sciences that acts as an advisor in health and medicine and conducts policy studies relevant to health issues. The IOM was chartered in 1970 by National Academy of Science to enlist distinguished members of appropriate professions in the examination of policy matters pertaining to the health of the public. The IOM is an advisor to federal government on issues of medical care, research and education.

Joint Commission on Accreditation Of Healthcare Organizations (JCAHO): An organization that evaluates and accredits health care organizations and programs in the United States. JCAHO is an independent, not-for-profit organization. A hospital is accredited by JCAHO if it meets certain quality standards. These checks are done at least every 3 years. Most hospitals take part in these accreditations.

Leapfrog Group: More than 160 organizations that buy health care who are working to initiate breakthrough improvements in the safety, quality and affordability of healthcare for Americans.

Left Ventricular Function Assessment (LVF): A test to check how well the heart is pumping.

LDL Cholesterol: Low-density lipoprotein cholesterol, or LDL cholesterol (sometimes called bad cholesterol), is a lipid that narrows or blocks your blood vessels. Blocked vessels can lead to a heart attack or a stroke. Reaching your LDL cholesterol target, usually below 130, is the most effective way to protect your heart and blood vessels.

Measurement: The process of collecting data to assess performance conducted at a single point in time or repeated over time.

n: The number of patients included in the sample size population; where possible and appropriate, the sample size is statistically significant.

N: The total patient population for an Organization; not a statistical sample.

Numerator: The number above the line in a fraction. Denotes the number of parts out of the whole that are being counted.

Outcome Measure: A measure that indicates the result of a process.

Oxygenation Assessment: Test that measures the amount of oxygen in your blood.

Patient-Centeredness: Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring the patient's values guide all clinical decisions.

Percent: A percent is a ratio of a number to 100 expressed using the percent symbol %.

Percentile: A percentile rank is the percentage of scores that fall below a given score. For example, a raw score of 75 on a test might be transformed into a percentile rank of 98 and interpreted as "You did better than 98% of the students who took this test."

Percutaneous Coronary Intervention (PCI): A procedure, such as angioplasty, that opens a blocked blood vessel.

Performance Measure: Provides and indication (e.g., rate, ratio, index, percentage) t of an organization's/or provider's ability to provide care most likely to ensure a good patient outcome.

Pneumonia: An inflammation of the lungs caused by a viral, bacterial, or fungal infection, which lowers the oxygen level in the blood.

Pneumonia (pneumococcal) Vaccination: Vaccine given to prevent pneumonia.

Process Measure: A series of actions, functions or changes, which lead to a certain anticipated outcome. A scientific basis exists for believing that the process, when executed well, will increase the probability of achieving a desired outcome.

Quality: Quality health care is how well a doctor, hospital, health plan, or other provider of health care, keeps its members healthy or treats them when they are sick. Good quality health care means doing the right thing at the right time, in the right way, for the right person and getting the best possible results.

Risk-adjustment: A tool to account for patient-related variation (age, sex, additional diseases) when comparing different populations of patients (example, physician group A and physician group B.

Safety: The avoidance of injuries to patients from the care that is intended to help them.

Specifications: A definition of the data elements, data sources, timing and frequency of data collection and reporting for the WCHQ Performance and Progress Report.

Target Population: The numerator (cases) and denominator (population sample meeting specified criteria) of the measure.

Timeliness: The ability to provide the appropriate care when it is needed.