Coronary Artery Bypass Graft.


A a taxi cab conveying pregnant woman, in labor, to the hospital.


Coronary Artery Disease.coronary artery bypass graft (CABG)

Call Center

A central hub for receiving calls and routing callers to the appropriate resources. In healthcare, call centers can be used to offload non-emergency callers, link consumers to educational messages, or route them to physician scheduling systems. Call center technology combined with expert systems also can help attending caregivers make triage decisions for after hours calls.


Refers to risk sharing schemes wherein a provider agrees to provide all care for each member at a flat rate (per month). The provider goes at risk for the entire expense, in effect becoming a co-insurer for its members.
Capitation can also refer to a set amount of money received or paid out. It is based on membership rather than on services delivered and is usually expressed in units per-member-per-month (see PMPM).


McKessonHBOCExternal Page Policy 
(click to see policy and instructions)’s CareMax network was designed specifically to help independent pharmacies operate more effectively in a managed care environment. McKessonHBOCExternal Page Policy 
(click to see policy and instructions) contracts with managed care organizations for the benefit of CareMax members, freeing them of the burden of having to handle lots of administrative details themselves and helping them look like a chain to managed care organizations.
A nationwide network of independent pharmacists connected by OmniLinkSM
Provides access to new managed care networks that require a single contract and single check reimbursement
Offers profitable new programs to enhance patient care
Includes all the benefits of OmniLink and Valu-RiteSM membership
Not only does this save time and improve patient care, but the CareMax network helps independent pharmacies position themselves competitively for the future.
Keeping up with competition and administrative details are daunting challenges in today’s increasingly complex managed care environment, especially for pharmacies that must meet compliance requirements and deliver quality patient care. In the past four years 12% of independent pharmacies have sold out to competitors or closed their doors. Managed care organizations are definitely driving the marketplace today and to help independent pharmacies compete McKessonHBOCExternal Page Policy 
(click to see policy and instructions) developed OmniLink and the CareMax.

Carrying Cost

Cost of carrying inventory (invested capital, handling, insurance, storage.) Usually defined as a percent of the dollar value of inventory per unit of time (usually one year). Such costs in hospitals vary from 25-35% annually (circa 1996).


Carve-in programs limit capitated rates to a subset of services. An organization may decide to be aggresive and carve-in, at a competitive rate, a subset of healthcare care services that are considered commodities in a region.


Carve-out programs exclude certain services from an organization’s capitated rate. A provider who is strong or otherwise has a lock in a specialty or a disease in a region can usually negotiate a carve out for services in that specialty (thus, preserving profitability).


See Patient Case.

Case Cart

A group of supplies used for a specific procedure. See exchange cart and PAR Area/PAR Level.

Case Management

A process established by employers and insurance companies (payors) to control (reduce) healthcare costs.
The case manager controls all healthcare matters for one a patient, including specialists, hospitalizatin, tests, etc.

Case Mix

The classification of patient population based on age, gender, and such factors as type and severity of illness and resources for treatment. Used For Diagnosis related groups DRGs, patient classification, severity of illness classification, etc.

Case Size

This field is used as a divisor. The labeler’s catalog case price is divided by the case size to calculate the trade container price.


Computed Axial Tomography. See CT.

Catalog Number

A vendor’s identification number describing an inventory item.


Complete Blood Count.


Chief Complaint. This the main reason a patient seeks medical help.


Common Category Database. Defunct product catalog and product coding scheme promulgated by HIBCC, implemented by IMS, Philadelphia, PA.


Clinical Context Object WorkgroupExternal Page Policy 
(click to see policy and instructions). At this time (ca. April 2000) this standard is Web-hostile.


Center for Disease ControlExternal Page Policy 
(click to see policy and instructions) and Prevention.


Charge Description Master. This is essentially a price list outlining the procedures performed in a hospital and the charges associated with each. Same as CRT. See also CPT


Clinical Decision Support System

Current Dental Terminology. A listing of descriptive terms and identifying codes developed by the American Dental Association (ADA) for reporting dental services and procedures to dental benefits plans.


Cost-Effectiveness Analysis.

CEN TC 251

Comitteé Européen de NormalisationExternal Page Policy 
(click to see policy and instructions), created in 1961 to prevent technical barriers to trade. CEN accomplishes this by the dissemination of information on standardization work in Europe.
CEN TC 251 is the technical committee responsible for the organization, coordination and monitoring of the development and promulgation of standards in healthcare informatics.

Central Supply

Central Supply is the processing and distribution department for a hospital for medical and surgical supplies. They process all instruments for sterilization and equipment decontamination. In addition, they dispense supplies usually in the smallest unit of issue. The pharmacy usually handles the distribution of drugs.


Civilian Health and Medical Program, Uniformed ServiceExternal Page Policy 
(click to see policy and instructions) is a health benefits program covers medical necessities only. It provides authorized in-patient and out-patient care from civilian sources, on a cost-sharing basis. Retired military are eligible as well as dependents of active-duty, retired and deceased military.
This benefit was recently replaced by Tricare.


Civilian Health and Medical Program, Veteran AffairsExternal Page Policy 
(click to see policy and instructions) is a healthcare benefits program for
1. Dependents of veterans who have been rated by VA as having a total and permanent disability
2. Survivors of veterans who died from VA-rated service-connected conditions, or who at the time of death, were rated permanently and totally disabled from a VA-rated service-connected condition
3. Survivors of persons who died in the line of duty and not due to misconduct
Due to the similarity between CHAMPVA and TRICARE (formerly known as CHAMPUS), the two programs are easily and often mistaken for each other. However, they are separate programs and that there are distinct differences between them.


Total charge of one unit of an inventory item.

Charge Code

Also called “Charge Number” or “Charge Code Number.” A number or other identifier assigned by a hospital’s financial department to some product, service, or event for which there is some charge to the patient or their health plan.
Charge codes may refer to a unit of an NDC or to other costs (e.g., one minute of physical therapy). Only NDCs in use by a hospital will have a charge code.


Coronary Heart Disease.


Center for Healthcare Information ManagementExternal Page Policy 
(click to see policy and instructions).


College of Healthcare Information Management ExecutivesExternal Page Policy 
(click to see policy and instructions).


Community Health Information NetworkExternal Page Policy 
(click to see policy and instructions).


Cardiac Intensive Care Unit (see ICU).


Certified Information System Auditor.


Critical Incident Traning.

Class of Trade



A request (usually via a provider) to a patient’s health insurance plan for payments for healthcare services provided. See Denial of Claim.


A service that takes claims and other electronic data from providers, verifies the information and forwards the proper forms to the payors. More than a transfer station, a clearinghourse acts as a fact-checker and data format translator.


Clinical Laboratory Information Management Systems. Used for receiving clinical orders for laboratory services and for delivering the results.

Clinical Best Practices

Those clinicians and procedures that produce the highest quality of care at agreeable costs.

Clinical Data Repository

Clinical Data Repository. For example,

Clinical Decision Support

The use of information to help a clinician diagnose and treat a patient's health problem, including information about the patient and information about the kind of health problem afflicting the patient and alternative tests and treatments for it.

Clinical Information System

Hospital-based information system designed to collect and organize data related to the care given to a patient, rather than administrative data.

Clinical Integration

The degree of integration and coordination of patient care across operating units of an IHDN. Clinical integration subsumes both horizontal and vertical integration.

Clinical Outcomes

The results of a treatment plan (e.g., “the patient died”).

Clinical Pathways

A treatment plan of care (i.e., a protocol workflow) against which progress is measured. A clinical pathway shows exact timing of all key patient care activities intended to achieve expected outcomes within designated time frames. This includes documentation of problems, expected outcomes/goals, and clinical interventions/orders.
See Clinical Protocol.

Clinical Practice Guideline

An outline of broad parameters for the diagnosis, treatment, prevention, or rehabilitation of a particular health problem.

Clinical Protocol

A rigorous, detailed model of the process of care for a particular health problem. See Clinical Pathways.


The care provider staff, including pharmacists, nurses, internists, therapists, etc.

Closed Requisition

A supply requisition that has been printed, sent to the vendor and replenished completely.


Continuing Medical Education.


As of July, 2001, incoming agency Secretary Tommy Thompson changed the name of the Health Care Financing Administration, to “Centers for Medicare and Medicaid Services.” So HCFA is now CMMS (from an acronym to an abbreviation).
In any case, this still is the Federal agency that manages Medicare, Medicaid and Child Health.


Certificate of Medical Necessity.


Competitive Medical Plans.


Certified Nurse Midwife. See also other Nursing Titles.


Clinical Observation Access Service. The CORBAmed standard interface to integrate clinical information in a distributed enterprise.


Coordination of Benefits. When a patient carries more than one type of health insurance, insurers and health plans use this verification system to figure which part of the claim should go to which payor and to make sure the same claim is not paid twice..


The Consolidated Omnibus Budget Reconciliation Act of 1985. It requires group insurance plans of more than 20 employees to continue to offer health insurance for you and your family for 18 months after you leave your job. If you opt for this coverage, you pay the premium. See also EMTALA.


Refers to the joint branding of a web page or section of a consumer health web site between two or more corporate entities or individuals. Co-branding may involve the joint operation of services, health information content or products that appear on a consumer health web site
[Source: Hi-Ethics CoalitionExternal Page Policy 
(click to see policy and instructions)].


See Complexity of Illness.


Computer Output to Laser Disk.

Columbia Bay Area Healthcare

Formerly known as Good Samaritan Health System, it is made up of,
four hospitals
San José Medical Center
Good Samaritan Hospital
Mission Oaks Hospital, in San José
South Valley Hospital, in Gilroy
two surgery centers
one home healthcare center
a partridge in a pear tree
They provide care for about 60,000 lives in the South Bay. Thomas May, formerly of UniHealth, is its CEO (ca. April 2000).

Complexity of Illness

Complexity of Illness (COI) is a numerical assessment of complexity assigned to a case after discharge. It is usually measured on a 1-to-4 scale, with 1 being the least complex,
Code Description
1 Minor
2 Moderate
3 Major
4 Extreme
The state of California mandates the use of APR-DRG and the 1-to-4 COI measure; hospitals in other states, however, may use other COI ranges.


Refers to the following of rules governing the dispensing and purchasing of pharmaceuticals within a provider network. For dispensing (prescriptions), this is compliance to a formulary. For purchasing, this is compliance to a contract established with either a GPO or a pharmaceutical manufacturer.

Computer-based Patient Record

The Computer-based Patient Record (CPR) is a compilation of non-redundant, longitudinal health data about a person across a lifetime, including facts, observations, interpretations, plans, actions, and outcomes.
Health data includes information on,
history of illness and injury,
functional status,
diagnostic studies,
consultation reports,
treatment records
It also includes wellness data such as
immunization history,
behavioral data,
environmental information,
health insurance,
administrative data for care delivery processes,
legal data such as consents.
The who, what, when, and where of data capture are also identified.
In addition to physical health information, these records may also include infomation about,
family relationships,
sexual behavior,
substance abuse,
private thoughts and feelings collected during psychotheraphy.
The Institute of MedicineExternal Page Policy 
(click to see policy and instructions) of the National Academy of SciencesExternal Page Policy 
(click to see policy and instructions) has developed a very specific definition of a Computer-based Patient RecordExternal Page Policy 
(click to see policy and instructions). Accordingly, the system must meet the following requirements,
Must be longitudinal; it must be linked with other clinical records, and must follow a patient from cradle to grave
Must assist in the process of clinical problem-solving and provide convenient access to authorized users at all times
Must enable providers to evaluate and manage the quality and costs of care
Must support a massive, flexible database in a complex hospital environment and adequately address the problems of direct data entry by healthcare providers
Must provide clinicians with an accessible, intelligible assembly of clinical data that characterizes the condition, prior management and current treatment plan of a patient
Must provide a clearly defined and well-organized database to permit epidemiological assessment of patient outcomes and patterns of practice, revealing merits of management strategies in specific clinical contexts
Must provide interactive decision support tools based on information derived from critically analyzed population data
Must decrease administrative record keeping and form submission responsibilities that burden healthcare providers
According to one source, the complete health record, includes the following,
Insurance Policies
Birth Data
Growth and Development
Medical History
Surgical History
Obstetrical History
Dental History
Screening Tests
Family Genetics
UnHealthy Habits
Travel History
Enviromental Risks
Review of Systems
Eye Information
Devices and Prosthesis
Vital Signs
Physical Exam
Health Maintenance
Laboratory Studies
Imaging Studies
Healthcare Documents
The table below gives an excellent comparison of terms that are thrown around loosely in healthcare. It appeared in the article “Defining the CPR,” by Richard S Dick, PhD, and William F Andrew, PE in the April 1999 issue of ADVANCE for Health Information ExecutivesExternal Page Policy 
(click to see policy and instructions).
Comparison of Criteria

This comparison of criteria among the PPR, EMR/EPR and CPR is intended to help define various terms used interchangeably in the health care information management marketplace. The basis for comparison is the IOM's 1991 study report (revised 1997) on the CPR.

Note that the ERM/EPR is recognized as a transitional technology facilitating the evolution of a robust CPR — the ultimate vision of the IOM. The EMR/EPR will remain, in an ever-increasing capacity, a supplemental component technology of the CPR designed to provide historical support for the CPR.
Clinical data dictionary No No Yes
Standardized vocabulary No No/Partial Yes
Technology standard No No/Partial Yes
Nosology and coding structure No No/Partial Yes
Standard codes No No/Partial Yes
Messaging standard No Yes Yes
Structured data No No Yes
Unstructured data Yes YEs Supported
Machine readable No Yes Yes
Clinical documentation Manual Paritla/Computer Online
Clinical decision support No No Yes
Management analysis No Rare Yes
Access to remote databases No No Yes
Feedback support No Rare Yes
Document imaging - scanned No Yes Supported
Document imaging - imported No Yes Supported
Document imaging - COLD No Yes Supported
Diagnostic imaging No Supported via communication Supported
Full motion video (video conferencing, ultrasound, etc.) No Supported Supported
Dictation Transcription Partial/Scanned Supported
Voice files No Supported Supported
Audio files No Supported Supported
Signal tracings No Supported Supported
Secured access Limited Yes Yes
Customized views Limited Yes Yes
Meets all current and anticipated legal and administrative standards for medical records Yes Yes Not currently
Legal patient record Yes Yes, state-by-state Future
Note: This list is not all-inclusive. You may find additional applicable criteria. Please direct your comments to William F. Andrew, PE, at 941.299.4767.


The amount that you pay, as a portion of your bill, in a fee for service or PPO insurance plan. This amount is usually expressed as a percentage of the total — if the insurance company pays 80% of the claim, you pay 20% of co-insurance. This can be paid out-of-pocket or with another insurance policy (hence the name).
This method of splitting the bill does not come into effect until you have paid your full deductible.


The amount paid by patients every time they use medical services or get prescription drugs.
Co-insurance -- The amount you are required to pay, as a portion of your bill, in a fee for service or PPO medical plan. This amount is usually expressed as a percentage of the total -- if the insurance company pays 80 percent of the claim, you pay 20 percent. This method of splitting the bill does not come into effect until you have paid your full deductible.


Chronic Obstructive Pulmonary Disease. According to the Virtual HospitalExternal Page Policy 
(click to see policy and instructions),
Chronic obstructive lung disease is a disorder characterized by abnormal tests of expiratory flow that do not normalize with treatment and do not change markedly over time. Within this definition, the two major categories of disease are:
Emphysema Acondition of the lung characterized by an abnormal permanent enlargement of the air spaces distal to the terminal bronchioles, accompanied by the destruction of their walls, but without obvious fibrosis
Chronic Bronchitis Chronic or recurrent excess mucus production (for most days during at least three months during two consecutive years). Airways obstruction is implied in the definition


The Common Object Request Broker Architecture. See OMG and CORBAmed


CORBAmedExternal Page Policy 
(click to see policy and instructions) is the OMG’s Healthcare Domain Task Force. Its main goal is to adopt vendor-neutral common interfaces that:
Improve the quality of care and reduce costs by using CORBA technologies for interoperability throughout the global Healthcare community
Use the OMB technology adoption process to standardize interfaces for healthcare objects
Incorporate input from other healthcare standards organizations and consortia.
CORBAmed uses existing healthcare content standards such as HL7, UMLS, and CEN TC 251, and its design is based on ISO standard traslations for common middleware technologies including DCOM, Java, CORBA, and XML. CORBAmed 1.0 (ca. Nov 1999) includes PIDS, TQS, COAS, and RAD.


Total cost of one unit of an inventory item.

Cost-Effectiveness Analysis

A structured, comparative evaluation of two or more healthcare interventions.

Cost Shifting

Refers to the shifting of cost from public patients (e.g., Medicare, Medicaid) to private ones. This happens as a side effect of HCFA mandating lower length of stay (LOS) at healthcare institutions and of paying a percentage of charges rendered. These institutions in return raised their per-procedure and supply charges across the board, impacting private patients in addition to the (targeted) public patients.


Class of Trade (COT) refers to a designation given to a healthcare provider facility as eligibility for a pricing plan. There are five classes of trade,
1. Government
2. Not for Profit (NFP)
3. Alternate Care Site (e.g., Outpatient clinics, DINB, Hospice services)
4. Extended Care
5. Acute Care
6. (Full) Retail
The cost of pharmaceuticals and medical & surgical supplies increases as you move from class one to class five. See Class of Trade.


Continuous Process Improvement.


1. Computer-based Patient Record.
2. “Cardio-Pulmonary Resuscitation” (better known as “Mouth-to-Mouth Resuscitation”).


Carte du Professionnel de Santé. An identification card for French healthcare providers; now a smart card.


Current Procedure Terms. A systematic listing and coding of healthcare procedures and services performed by clinicians. (The American Medical Association’s) CPT-4 refers to procedures delivered by physicians; (the American Dental AssociationExternal Page Policy 
(click to see policy and instructions) CPT-2 codes) CPT-2 refers to procedures delivered by dentists.
RRAs code CPTs from the patient’s chart. This code is then used as input to the calculation of DRGs or some other patient classification scheme (e.g., APR-DRG). In order to completely describe an event, one or more diagnosis codes (e.g., ICD-9s) must be assigned to it as well.
See also CDM, and CRT.


Continuous Quality Improvement. A process of quality assurance and ongoing improvement. This is a big requirement for JCAHO certification. Payors, too, are very interested in this dimension of care.


The process of verifying the credentials of all clinicians allowed to practice at a provider institution (e.g., physicians, nurses). The process involves checking references, as well as verification and storage of key physical documents (e.g., priviliges, DEA and state licenses, certificates, diplomas). It gives the hiring institution information and feedback on healthcare professionals at the time of new staff applications and reappointments.

Critical Incident Syndrome

Bouts of depression, self-blame and other symptoms that an EMT and other health providers may go through after a traumatic or gruesome episode.
What Caroline (the star EMT in FOX’ Bay Watch) went through after a guy drowned.


Clinical Research Organization.


Charge Revenue Table. Same as CDM.


Canadian Society for Pharmaceutical ScienceExternal Page Policy 
(click to see policy and instructions), also known as Société Canadienne des Sciences Pharmaceutiques.


Civil Service Retirement System.


Computer Tomography. See CAT.


From cyan (blue). As in “she is becoming cyanotic.”

Cycle Counting

Inventory records must be highly accurate (more than 98-99%). Two methods of auditing inventory records are,
Periodic Physical Counting
Cycle Counting
Cycle Counting is a continuous physical counting of inventory so that all items are counted at a specified frequency. Inventory records can be periodically reconciled with actual data. A cycle is the time required to count all items in inventory at least once.
For example, a medical center has 6400 items in stock, as per the table below. The materials management department is open 250 days per year and wishes to count class A items five times per year (e.g., high turnover, high cost items), class B items two times (e.g., high cost items) and class C items once (e.g., low cost items). A daily cycle count of 36 items would cover all 6,400 items in stock at least once a year.
per Year
A 5 8
B 2 8
C 1 20
TOTAL 6,400   36 9,000

Cycle Stock

One of the two main components of any item inventory, the cycle stock is the most active part; it is the part that depletes gradually and is replenished cyclically when orders are received.

The other part is safety stock, a cushion of protection against uncertainty in the demand or in the replenishment lead time.