Redwood MedNet :: Glossary D

Dashboard - Management dashboards provide access to summary data on primary process details in a business. Typically a dashboard also enables drill down access to the details that are the basis for the summary view. See Business Intelligence

Data Center - A facility hosting network computer systems and other telecommunications components. Sometimes called a server farm, data centers usually include backup power systems, redundant communication circuits, environmental controls and perimeter security services. See Cloud Computing, NOC

Data Element - Formally, the smallest named unit of information in a transaction under HIPAA (45 CFR § 162.103). Generally, data elements are simple or compound. Each data element has a name, description, type, minimum, and maximum length. See Attribute, HIPAA

Data Repository - A formally structured database environment, generally with strong field level validation and terminology standards. A repository is as formal as a data warehouse, generally lacks the onboard querying capabilities of a data warehouse, and yet can be agile and adaptive when queried by distributed data sources. See Business Intelligence, CDR, Data Warehouse, Database, i2b2, Supply Chain

Data Use Agreement - A license agreement between one participant (typically a covered entity) and a second participant (who may or may not be a covered entity). The agreement governs the uses of Protected Health Information (PHI) that may be exchanged electronically between the participants using secure data network protocols. See Covered Entity, DURSA, MMPA, Participation Agreement, Protected Health Information

Data Validation - A process by which incoming data must conform to a specific standard (e.g., must be a date, or must be a number, etc.). Nonconformant data is not allowed in fields governed by strict data validation.

Data Warehouse - A purpose-built data repository, generally derived from production databases. The extra steps necessary to normalize large data sets for use as a data warehouse are intended to optimze rapid data analysis. See Business Intelligence, CDR, Data Repository, Database

Database - Stored data organized by a schema into individual fields linked together into records. See Business Intelligence, CDR, Data Repository, Data Warehouse, Schema

DBA - [1] Data Base Administrator, a functional job title in computer operations; [2] Doing Business As, (abbreviated DBA, dba, d.b.a. or d/b/a) is a legal term used in the United States and Canada, meaning that the trade name, or fictitious business name, under which the business or operation is conducted and presented to the world is not the legal name of the person or corporate entity who actually owns the business and is responsible for it. See Mendocino HRE

DBMS - Data Base Management System. See NoSQL, SQL

DDoS - Distributed Denial of Service, a DoS attack utilizing multiple sources to flood the bandwidth or resources of a targeted system. A DDoS attack requires multiple compromised systems such as a botnet. The advantage to an attacker of using a distributed attack are that multiple machines can generate more attack traffic than one machine, multiple attack machines are harder to turn off than one attack machine, and the behavior of each attack machine can be stealthier, making it harder to track and shut down. These attacker advantages cause challenges for network defenses. For example, merely purchasing more incoming bandwidth than the current volume of the attack might not help, because the attacker might be able to simply add more attack machines. See Botnet, DoS

DEA - The Drug Enforcement Administration is the division of the United States Department of Justice responsible for enforcing federal controlled substances laws and regulations. Their jurisdiction intersects with medicine in electronic prescribing services. See e-Prescribing

Decedent - A deceased individual, who still retains the right to the privacy of their protected health information (PHI) under HIPAA. Covered entities may disclose PHI to funeral directors as needed, and to coroners or medical examiners to identify a deceased person, to determine the cause of death, and to perform other functions as authorized by law. See HIPAA, PHI

Decision Support - Computer tools or applications to augment clinical decision making by providing evidence-based knowledge in the context of patient specific data. Sometimes called Decision Support System (DSS) or Clinical Decision Support (CDS). See Expert System, Guideline, Inference Engine, Protocol

Decryption - Decoding a message that has been encoded. See Encryption, PKI

DEEDS - Data Elements for Emergency Department Systems is an effort to develop uniform specifications for data entered in emergency department (ED) patient records. Current emergency care data exchange specifications, external reporting requirements and recommendations are fragmented and often spontaneously evolve in an ad-hoc fashion with multiple organizations developing incompatible data standards. The HL7 Emergency Care Work Group is currently working to move DEEDS through the balloting process. See CDC, ED, HL7

De-identified Data - Data that is intended to neither identify nor to provide a reasonable basis to re-identify the source individual. However, recent research has shown that some "de-identified" data sets can be re-identified due to the abundance of new social networking data on individuals. See Anonymize, Limited Data Set, Re-identified Data

Descendant - A concept that is located "below" another concept in a designated concept hierarchy. See Ancestor, Concept, Hierarchy, Terminology

DHCP - Decentralized Hospital Computer Program, the name adopted in 1981 at the VA for a deliberate plan and methodology established in the 1970s for the decentralized evolution and refinement of computerized clinical-application modules, and their progressive integration into a complete medical-information system for a hospital or clinic. By 1985 all VA Medical Centers were running DHCP. In 1994 DHCP was formally renamed VistA. See Hardhats, VA, VistA, VLER

DHCS - The California Department of Health Care Services is the agency that oversees Medi-Cal. The mission of DHCS is to protect and promote the health status of Californians through the financing and delivery of individual health care services. DHCS is an operating division of CHHS. See CHHS, Medi-Cal

DHHS - Department of Health and Human Services, the title of both the US federal agency and the California state agency. See CHHS, HHS

DHIMS - Defense Health Information Management System. See CHCS, DoD

DHTML - Dynamic HTML. See AJAX, HTML

Dialup - Sometimes spelled dial-up, a computer to computer connection over a legacy analog circuit which requires only modems and telephone lines. Useful in rural and frontier regions which lack broadband access to the Internet. Dialup is too slow for video, VOIP (e.g., Skype) or other modern technologies. See Analog, Broadband, POTS, VOIP

DICOM - Digital Imaging and Communications in Medicine is the international standard for medical images and related information (ISO 12052). DICOM was developed in 1993 and is maintained by the National Electrical Manufacturers Association (NEMA). DICOM defines formats for medical images that can be exchanged with the data and quality necessary for clinical use. DICOM has revolutionized the practice of radiology, allowing the replacement of X-ray film with a fully digital workflow. See ISO, NEMA

Digital - A digital signal is discrete in time and amplitude, as opposed to an analog signal, which is continuous. See Analog, DSL

Digital Certificate - A digital document issued by a certificate authority (CA) that contains the certificate holder's name, public key and expiration date. Public key encryption methods require digital certificates. See CA, Encryption, Public Key

Digital Divide - A common phrase indicating the gap between a group or community with access to digital technology (e.g., computers, video conferencing, etc.) and others with less access (or no access) to the technology.

Direct Project - The Direct Project, launched by ONC in 2010, developed specifications for a secure, scalable, standards-based way to establish universal health addressing and transport for participants (including providers, laboratories, hospitals, pharmacies and patients) to send encrypted health information directly to known, trusted recipients over the Internet. The specifications were released in 2011 under the title Applicability Statement for Secure Health Transport. See DirectTrust, ModSpec, ONC

DirectTrust - DirectTrust.org is an independent non-profit, competitively neutral trade association formed by and for the Direct community. DirectTrust.org intends to carry out its mission in a manner entirely consistent with the governance rules and regulations for the Direct Project and the NwHIN as promulgated by HHS, ONC, and the mandates of the HITECH Act. See Certificate Authority, Direct Project, HHS, HITECH, NwHIN, ONC

Disambiguate - To remove uncertainty from ambiguous data; specifically in health data to assert that two values are identical. For example, linking the health record of "Patient 1" at "Practice A" with the health record of "Patient 6" at "Practice B" because they are the same person "disambiguates" the patient identities. See Algorithm, MPI, Sensitivity, Specificity

Disclosure - The release, transfer or provision of access to protected health information (PHI). Disclosure applies to persons or organizations who receive PHI from a covered entity or from the covered entity's Business Associate (BA)s. See Business Associate, Covered Entity and PHI

Disease Management - A coordinated and proactive approach to managing care and support for patients with chronic illness (e.g., diabetes, asthma, HIV/AIDS, etc.). See CDS

Disease Registry - A purpose built clinical data repository focused on patients with chronic illness (e.g., diabetes, asthma, cancer, etc.). Modern BI tools and distributed query services now enable the creation of virtual registries by leveraging HIE services.

Distribute - The Distributed Surveillance Taskforce for Real-time Influenza Burden Tracking and Evaluation (Distribute) was a community-based public health information system and network of users organized and supported by the International Society for Disease Surveillance (ISDS) to conduct electronic population-level emergency department (ED) syndromic surveillance for influenza-like illness (ILI). See Biosurveillance, ISDS, ILI, Syndrome

DMH - The California Department of Mental Health is entrusted with leadership of the California mental health system. DMH is an operating division of CHHS. See CHHS

DMHC - The California Department of Managed Health Care is the California agency that oversees health care for the 20 million people who belong to managed health care plans. DMHC is an operating division of the Business, Transportation and Housing Agency.

DMZ - In computer security the "demilitarized zone" or DMZ is a physical or logical subnetwork that contains and exposes an organization's external services to a larger untrusted network, usually the Internet. Typically managed by a "firewall" the purpose of a DMZ is to add an additional layer of security to an organization's perimeter so that an external attacker only has access to facilities or content in the DMZ, rather than to internal network services. See Firewall, Router

DNS - The Domain Name System, defined in RFC 1034, is a hierarchical naming service that translates Internet domain names (host names that are meaningful to humans) into binary address strings associated with specific network address locations. See Internet, RFC

DNT - Do Not Track is [1] a request header field employed as an HTTP mechanism for expressing user preference regarding tracking, [2] an HTML DOM property to make that expression readable by scripts, and [3] an API that allows scripts to register site-specific exceptions granted by the user. See API, DOM, HTML, HTTP

DOB - Date of Birth. See PHI

DoD - The United States Department of Defense is the Cabinet level agency, headquartered at the Pentagon in Virginia, that commands the U.S. Army, Navy, Air Force and Marine Corps. See CHCS, DHIMS, TATRC, USAF

DOM - The Document Object Model is a platform and language neutral interface that allows programs and scripts to dynamically access and update the content, structure and style of documents. The W3C DOM Working Group was closed in 2004 after completion of the DOM Level 3 Recommendations. The WebApps Working Group is the successor activity at W3C. See DNT, HTML, W3C, WebApps

DOQ-IT - The Doctors Office Quality Information Technology program was operated by CMS. DOQ-IT ended in April 2009. See CMS

DoS - Denial of Service (DoS), in computing, is an attack that seeks to make a machine or a network resource unavailable to its intended users. There are many ways to launch and sustain a DoS attack. As a term, a DoS attack is sent by one system or person, while a Distributed Denial of Service (DDoS) attack is sent by two or more systems (typically bots) or persons. See Bot, DDoS

DPEI - Division of Preparedness and Emerging Infections at the CDC. See Biosurveillance, CDC

DQ - Document Query is part of the IHE query-exchange profile. See CONNECT, DR, IHE, NwHIN, PDQ

DR - Document Retrieve. See DQ, IHE

DRM - Digital Rights Management, a generic term for access control technologies employed by copyright holders to limit the use of digital content. Some DRM technologies are controversial and have led to sprawling legal and court battles over alleged anti-competitive practices by copyright holders. See cc, Copyright, EFF, Free Software, Intellectual Property

DSL - Digital telephony technology initially developed as "Digital Subscriber Loop" and later marketed to consumers as "Digital Subscriber Line." By segregating digital signals into separate bands on a single circuit, DSL can provide both voice and data services on the same copper wire. See Broadband, Dialup, POTS, WiMAX

DSMO - Designated Standards Maintenance Organizations are named by HHS to maintain code sets and transaction standards. See HL7, NCPDP

DSS - See Decision Support

DSTU - Draft Standard for Trial Use, an early milestone in the development of a technology standard. See ISO, SDO, Standard

DURSA - The Data Use and Reciprocal Support Agreement is a production document for the NwHIN. The DURSA was developed by ONC. See NwHIN, NwHIN Exchange


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	Health Informatics Glossary A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Dashboard - Management dashboards provide access to summary data on primary process details in a business. Typically a dashboard also enables drill down access to the details that are the basis for the summary view. See Business Intelligence Data Center - A facility hosting network computer systems and other telecommunications components. Sometimes called a server farm, data centers usually include backup power systems, redundant communication circuits, environmental controls and perimeter security services. See Cloud Computing, NOC Data Element - Formally, the smallest named unit of information in a transaction under HIPAA (45 CFR § 162.103). Generally, data elements are simple or compound. Each data element has a name, description, type, minimum, and maximum length. See Attribute, HIPAA Data Repository - A formally structured database environment, generally with strong field level validation and terminology standards. A repository is as formal as a data warehouse, generally lacks the onboard querying capabilities of a data warehouse, and yet can be agile and adaptive when queried by distributed data sources. See Business Intelligence, CDR, Data Warehouse, Database, i2b2, Supply Chain Top of Page Data Use Agreement - A license agreement between one participant (typically a covered entity) and a second participant (who may or may not be a covered entity). The agreement governs the uses of Protected Health Information (PHI) that may be exchanged electronically between the participants using secure data network protocols. See Covered Entity, DURSA, MMPA, Participation Agreement, Protected Health Information Data Validation - A process by which incoming data must conform to a specific standard (e.g., must be a date, or must be a number, etc.). Nonconformant data is not allowed in fields governed by strict data validation. Data Warehouse - A purpose-built data repository, generally derived from production databases. The extra steps necessary to normalize large data sets for use as a data warehouse are intended to optimze rapid data analysis. See Business Intelligence, CDR, Data Repository, Database Database - Stored data organized by a schema into individual fields linked together into records. See Business Intelligence, CDR, Data Repository, Data Warehouse, Schema DBA - [1] Data Base Administrator, a functional job title in computer operations; [2] Doing Business As, (abbreviated DBA, dba, d.b.a. or d/b/a) is a legal term used in the United States and Canada, meaning that the trade name, or fictitious business name, under which the business or operation is conducted and presented to the world is not the legal name of the person or corporate entity who actually owns the business and is responsible for it. See Mendocino HRE DBMS - Data Base Management System. See NoSQL, SQL DDoS - Distributed Denial of Service, a DoS attack utilizing multiple sources to flood the bandwidth or resources of a targeted system. A DDoS attack requires multiple compromised systems such as a botnet. The advantage to an attacker of using a distributed attack are that multiple machines can generate more attack traffic than one machine, multiple attack machines are harder to turn off than one attack machine, and the behavior of each attack machine can be stealthier, making it harder to track and shut down. These attacker advantages cause challenges for network defenses. For example, merely purchasing more incoming bandwidth than the current volume of the attack might not help, because the attacker might be able to simply add more attack machines. See Botnet, DoS DEA - The Drug Enforcement Administration is the division of the United States Department of Justice responsible for enforcing federal controlled substances laws and regulations. Their jurisdiction intersects with medicine in electronic prescribing services. See e-Prescribing Top of Page Decedent - A deceased individual, who still retains the right to the privacy of their protected health information (PHI) under HIPAA. Covered entities may disclose PHI to funeral directors as needed, and to coroners or medical examiners to identify a deceased person, to determine the cause of death, and to perform other functions as authorized by law. See HIPAA, PHI Decision Support - Computer tools or applications to augment clinical decision making by providing evidence-based knowledge in the context of patient specific data. Sometimes called Decision Support System (DSS) or Clinical Decision Support (CDS). See Expert System, Guideline, Inference Engine, Protocol Decryption - Decoding a message that has been encoded. See Encryption, PKI DEEDS - Data Elements for Emergency Department Systems is an effort to develop uniform specifications for data entered in emergency department (ED) patient records. Current emergency care data exchange specifications, external reporting requirements and recommendations are fragmented and often spontaneously evolve in an ad-hoc fashion with multiple organizations developing incompatible data standards. The HL7 Emergency Care Work Group is currently working to move DEEDS through the balloting process. See CDC, ED, HL7 De-identified Data - Data that is intended to neither identify nor to provide a reasonable basis to re-identify the source individual. However, recent research has shown that some "de-identified" data sets can be re-identified due to the abundance of new social networking data on individuals. See Anonymize, Limited Data Set, Re-identified Data Top of Page Descendant - A concept that is located "below" another concept in a designated concept hierarchy. See Ancestor, Concept, Hierarchy, Terminology DHCP - Decentralized Hospital Computer Program, the name adopted in 1981 at the VA for a deliberate plan and methodology established in the 1970s for the decentralized evolution and refinement of computerized clinical-application modules, and their progressive integration into a complete medical-information system for a hospital or clinic. By 1985 all VA Medical Centers were running DHCP. In 1994 DHCP was formally renamed VistA. See Hardhats, VA, VistA, VLER DHCS - The California Department of Health Care Services is the agency that oversees Medi-Cal. The mission of DHCS is to protect and promote the health status of Californians through the financing and delivery of individual health care services. DHCS is an operating division of CHHS. See CHHS, Medi-Cal DHHS - Department of Health and Human Services, the title of both the US federal agency and the California state agency. See CHHS, HHS DHIMS - Defense Health Information Management System. See CHCS, DoD DHTML - Dynamic HTML. See AJAX, HTML Dialup - Sometimes spelled dial-up, a computer to computer connection over a legacy analog circuit which requires only modems and telephone lines. Useful in rural and frontier regions which lack broadband access to the Internet. Dialup is too slow for video, VOIP (e.g., Skype) or other modern technologies. See Analog, Broadband, POTS, VOIP DICOM - Digital Imaging and Communications in Medicine is the international standard for medical images and related information (ISO 12052). DICOM was developed in 1993 and is maintained by the National Electrical Manufacturers Association (NEMA). DICOM defines formats for medical images that can be exchanged with the data and quality necessary for clinical use. DICOM has revolutionized the practice of radiology, allowing the replacement of X-ray film with a fully digital workflow. See ISO, NEMA Digital - A digital signal is discrete in time and amplitude, as opposed to an analog signal, which is continuous. See Analog, DSL Top of Page Digital Certificate - A digital document issued by a certificate authority (CA) that contains the certificate holder's name, public key and expiration date. Public key encryption methods require digital certificates. See CA, Encryption, Public Key Digital Divide - A common phrase indicating the gap between a group or community with access to digital technology (e.g., computers, video conferencing, etc.) and others with less access (or no access) to the technology. Direct Project - The Direct Project, launched by ONC in 2010, developed specifications for a secure, scalable, standards-based way to establish universal health addressing and transport for participants (including providers, laboratories, hospitals, pharmacies and patients) to send encrypted health information directly to known, trusted recipients over the Internet. The specifications were released in 2011 under the title Applicability Statement for Secure Health Transport. See DirectTrust, ModSpec, ONC DirectTrust - DirectTrust.org is an independent non-profit, competitively neutral trade association formed by and for the Direct community. DirectTrust.org intends to carry out its mission in a manner entirely consistent with the governance rules and regulations for the Direct Project and the NwHIN as promulgated by HHS, ONC, and the mandates of the HITECH Act. See Certificate Authority, Direct Project, HHS, HITECH, NwHIN, ONC Top of Page Disambiguate - To remove uncertainty from ambiguous data; specifically in health data to assert that two values are identical. For example, linking the health record of "Patient 1" at "Practice A" with the health record of "Patient 6" at "Practice B" because they are the same person "disambiguates" the patient identities. See Algorithm, MPI, Sensitivity, Specificity Disclosure - The release, transfer or provision of access to protected health information (PHI). Disclosure applies to persons or organizations who receive PHI from a covered entity or from the covered entity's Business Associate (BA)s. See Business Associate, Covered Entity and PHI Disease Management - A coordinated and proactive approach to managing care and support for patients with chronic illness (e.g., diabetes, asthma, HIV/AIDS, etc.). See CDS Disease Registry - A purpose built clinical data repository focused on patients with chronic illness (e.g., diabetes, asthma, cancer, etc.). Modern BI tools and distributed query services now enable the creation of virtual registries by leveraging HIE services. Distribute - The Distributed Surveillance Taskforce for Real-time Influenza Burden Tracking and Evaluation (Distribute) was a community-based public health information system and network of users organized and supported by the International Society for Disease Surveillance (ISDS) to conduct electronic population-level emergency department (ED) syndromic surveillance for influenza-like illness (ILI). See Biosurveillance, ISDS, ILI, Syndrome Top of Page DMH - The California Department of Mental Health is entrusted with leadership of the California mental health system. DMH is an operating division of CHHS. See CHHS DMHC - The California Department of Managed Health Care is the California agency that oversees health care for the 20 million people who belong to managed health care plans. DMHC is an operating division of the Business, Transportation and Housing Agency. DMZ - In computer security the "demilitarized zone" or DMZ is a physical or logical subnetwork that contains and exposes an organization's external services to a larger untrusted network, usually the Internet. Typically managed by a "firewall" the purpose of a DMZ is to add an additional layer of security to an organization's perimeter so that an external attacker only has access to facilities or content in the DMZ, rather than to internal network services. See Firewall, Router DNS - The Domain Name System, defined in RFC 1034, is a hierarchical naming service that translates Internet domain names (host names that are meaningful to humans) into binary address strings associated with specific network address locations. See Internet, RFC DNT - Do Not Track is [1] a request header field employed as an HTTP mechanism for expressing user preference regarding tracking, [2] an HTML DOM property to make that expression readable by scripts, and [3] an API that allows scripts to register site-specific exceptions granted by the user. See API, DOM, HTML, HTTP DOB - Date of Birth. See PHI DoD - The United States Department of Defense is the Cabinet level agency, headquartered at the Pentagon in Virginia, that commands the U.S. Army, Navy, Air Force and Marine Corps. See CHCS, DHIMS, TATRC, USAF DOM - The Document Object Model is a platform and language neutral interface that allows programs and scripts to dynamically access and update the content, structure and style of documents. The W3C DOM Working Group was closed in 2004 after completion of the DOM Level 3 Recommendations. The WebApps Working Group is the successor activity at W3C. See DNT, HTML, W3C, WebApps DOQ-IT - The Doctors Office Quality Information Technology program was operated by CMS. DOQ-IT ended in April 2009. See CMS Top of Page DoS - Denial of Service (DoS), in computing, is an attack that seeks to make a machine or a network resource unavailable to its intended users. There are many ways to launch and sustain a DoS attack. As a term, a DoS attack is sent by one system or person, while a Distributed Denial of Service (DDoS) attack is sent by two or more systems (typically bots) or persons. See Bot, DDoS DPEI - Division of Preparedness and Emerging Infections at the CDC. See Biosurveillance, CDC DQ - Document Query is part of the IHE query-exchange profile. See CONNECT, DR, IHE, NwHIN, PDQ DR - Document Retrieve. See DQ, IHE DRM - Digital Rights Management, a generic term for access control technologies employed by copyright holders to limit the use of digital content. Some DRM technologies are controversial and have led to sprawling legal and court battles over alleged anti-competitive practices by copyright holders. See cc, Copyright, EFF, Free Software, Intellectual Property DSL - Digital telephony technology initially developed as "Digital Subscriber Loop" and later marketed to consumers as "Digital Subscriber Line." By segregating digital signals into separate bands on a single circuit, DSL can provide both voice and data services on the same copper wire. See Broadband, Dialup, POTS, WiMAX DSMO - Designated Standards Maintenance Organizations are named by HHS to maintain code sets and transaction standards. See HL7, NCPDP DSS - See Decision Support DSTU - Draft Standard for Trial Use, an early milestone in the development of a technology standard. See ISO, SDO, Standard DURSA - The Data Use and Reciprocal Support Agreement is a production document for the NwHIN. The DURSA was developed by ONC. See NwHIN, NwHIN Exchange

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Health Informatics Glossary