Outcome and Assessment Information Set. The set of data that HCFA requires HHAs to collect on their patients.


See Orange Book Code.

Off-label Use

When the US FDA approves a drug, it approves it for specific, explicit treatments. Any other use of the drug is considered off-label (i.e., unapproved). For example, a cancer drug approved for adults could help children. In that case, prescribing the drug for children would be considered off-label.
Physicians can still prescribe drugs off-label because this kind of use falls within a physician’s traditional discretion regarding the practice of medicine. Although a drug may not been approved for a specific treatment, off-label use is not likely to result in enforcement action by the FDS. However, anyone advertising or promoting the off-label use would be subject to enforcement by the FDA.
In particular, drug companies are forbidden from providing doctors and patients with verbal or written information about medical research demonstrating how a drug approved for one medical problem might help solve another. Physicians may test off-label use of a drug and even publish their findings in the medical literature, but drug companies cannot hand out reprints of such articles.
An April, 1996 article in “Ocular Surgery News” journal claims that off-label use is mostly beneficial and to support it lists the following statistics,
An American Medical Association (AMA) survey of its members revealed that an average of 40 percent of all prescriptions are used in off-label ways.
The Drug Information Division of the US Pharmacopoeia Convention (USP) found that about 20 percent of all accepted medical indications are off-label.
The article goes on to show that “specialists rely on off-label usage even more than do general practitioners.”
In specialties such as oncology (cancer treatment), more than 50 percent of the medically accepted indications are for off-label uses.
One pediatric working group estimates that up to 85 percent of all drugs used in pediatrics in the United States are off-label.
Recent estimates for dermatologists indicate about 35 percent of all medically accepted indications for drugs used in dermatology are off-label.
About 73 percent of dosing of an anti-nausea drug in children undergoing cancer treatment is off-label.
Some surveys show that 23 percent of all drug use during (mostly the third trimester) and after pregnancy is off-label.


The Office of the Inspector General of the department of Health and Human Service is responsible for investigating healthcare fraud.

Official Inventory

Inventory maintained on the general ledger (GL) as an asset to the organization. See Unofficial Inventory, also Non-Stock Item and Non-System Item.

The Object Management GroupExternal Page Policy 
(click to see policy and instructions) (OMG) is a non-profit consortium dedicated to promoting the theory and practice of object technology (OT) for the development of distributed computing systems. OMG was formed to help reduce the complexity, lower the costs, and hasten the introduction of new software applications. Its goal is to provide a common architectural framework (i.e., CORBA) for object-oriented applications based on widely available interface specifications. Its international membership currently stands at over 600 software vendors, software developers and end users.


McKessonHBOCExternal Page Policy 
(click to see policy and instructions)’s OmniLink centralized pharmacy software, offers pharmacies a way to help streamline transactions and claims processing; it is designed to increase a pharmacy’s efficiency and profitability, including daily updates on average wholesale pricing. Here’s how it works:
When a prescription is transmitted, OmniLink processes all third-party and cash transactions to make sure they meet the requirements of specific health plans. This is critical to confirm accurate reimbursements and other requirements such as generic substitution, which can save money.
Once requirements are met, the transaction is forwarded to the benefit manager or third-party claims processor for approval, after which OmniLink performs several final functions including price-checking. All of this assures that pharmacists have the most up-to-date information on-line, which results in more accurate processing of claims and enhanced patient care to customers.
Benefits of OmniLink include,
Streamlines pharmacy transactions
Increases claim accuracy, on-line in real time. Claims reconciliation are a particular feature because it can help save thousands of dollars by alerting the pharmacist to errors in the AWP. This is especially dramatic in short-pay analysis and follow-up where a pharmacist could actually lose money (e.g., a branded drug is dispensed at the generic rate).
Enables pharmacists to participate in the Patient Care Enhancing Programs. One of the big advantages of OmniLink is its ability to track product dispensing. This allows retails pharmacies to participate in highly targeted, manufacturer sponsored programs at no extra cost — and with absolute confidentiality for patients. Here is a recap,
Refill Reminder Program. This mail program alerts McKessonHBOCExternal Page Policy 
(click to see policy and instructions) to contact patients who are more than five days late on a refill. Approximately 40% of prescriptions don’t get refilled, resulting in lost revenue to the pharmacist and reduced healthcare for patients.
Patient Direct Marketing Program. Targeted mailings about new or generic drugs related to patients’ medical condition.
OTC Companion. Targeted mailings to patients about OTC products that may be beneficial “companions” to branded or generic medications they are already taking.
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. OmniLink and the CareMaxSM network help independents to compete in this managed care environment.

On Order

The stock on order is the quantity represented by the total of all outstanding supply requisitions.


The industry’s leading commercial enterprise-wide patient scheduling system. This is a product of “the company formerly known as Atwork,” now a part of Medaphis.


The industry’s leading commercial enterprise-wide personnel scheduling system. This is a product of “the company formerly known as Atwork,” now a part of Medaphis.

Open Access

A feature of progressive insurance plans that allow its members to go directly to specialists (i.e., without having to first get a referral from a gatekeeper Physician).

Open Requisition

A supply requisition that has been printed, sent to the vendor, but not replenished completely.

Open-Ended HMO

HMOs that allow members to use out-of-network providers and still receive partial coverage.


The degree of control a corporation or individual has over the operations of a consumer health web site. A corporation or individual operates a consumer health web site if the corporation or individual is primarily responsible for the material that appears on the site, including, but not limited to, advertising, health information content, services and products.
[Source: Hi-Ethics CoalitionExternal Page Policy 
(click to see policy and instructions)]


Medicare’s Outpatient Prospective Payment System. A HCFA payment system for outpatients. This proposal has come and gone in the politics of Washington, but it is finally scheduled to be launched nationally on July 1, 2000.
For more information, check out the PPS Resource CenterExternal Page Policy 
(click to see policy and instructions). Click on “Newsletters” and then “PPS Alert.”
See APC.


An affirmative ability for a consumer to accept terms and conditions.
[Source: Hi-Ethics CoalitionExternal Page Policy 
(click to see policy and instructions)]


Operating Room. Also known as Operating Theater, outside the US.

Orange Book Code

The Orange Book Code (OBC) identifies the therapeutic equivalency ratings assigned to each approved prescription product according to the FDA’s Approved Drug Products with Therapeutic Equivalence EvaluationsExternal Page Policy 
(click to see policy and instructions) (i.e., the Orange Book). A code is assigned to all products on FDB’s NDDF regardless of whether it has been evaluated in the prescription section of the Orange Book.
The OBC is specific to a particular pharmaceutical item and the five-digit labeler code. Each drug record has only one equivalency rating. When there is more than one equivalency rating for a particular manufacturer’s product, the higher rating is assigned.
The Orange Book, although the single most complete source of equivalency information at this time, has some limitations.
The absence of a particular drug product and/or labeler from the Orange Book does not mean that the particular product is or is not equivalent. It simply means the FDA has not evaluated the safety, effectiveness and quality of that particular product. A ZB is assigned to all non-prescription pharmaceutical entities and those prescription pharmaceutical entities that are not evaluated in the Orange Book.
There are prescription products in the Orange Book that are not assigned equivalency ratings. These are single source items. Occasionally, a single source product will have an equivalency code if a company has several applications for the same drug. If a product goes from multi-source to single source, expect the equivalency rating to disappear. This could mean going from a B rating to a Z. A ZC will be assigned to those products in the Orange Book that do not have a therapeutic equivalency rating.
In general, no conclusions can be made regarding the equivalency of products with any of the Z ratings.
Other limitations include,
The FDA does not evaluate drugs that were on the market prior to 1938.
Within a given GCN, there may be both A and B ratings. This means that just because one manufacturer has an equivalent rating, not all manufacturers of the same product will have an equivalent rating.
The Orange Book has special situations which alter the meaning of some of the data. This information is provided in the front of the book. In order to use the Orange Book accurately, a knowledge of these special situations is imperative. For example, there are actually two sustained release theophylline products that are listed in the Orange Book as equivalent. Sustained release products often have bioequivalence problems. The bioavailability studies done followed administration of the particular theophylline products every 12 hours. One of these products is marketed for once daily dosing. This could be misleading unless there is an understanding that several of the equivalency evaluations depend on specific manufacturers’ labeling instructions.
Equivalent Codes
AA Product has no known bioequivalence problems in conventional dosage forms.
AB Product meets necessary bioequivalence requirements.
AN Solutions and powders for aerosolization that are marketed for use in any of several delivery systems.
AO Injectable oils with identical active ingredients, concentration and type of oil.
AP Injectable aqueous solutions including dry powders, concentrated solutions or ready-to-use solutions which are considered therapeutically equivalent if they produce the same concentration and are labeled similarly.
AT Topical products therapeutically equivalent in same dosage form.
Not Equivalent Codes
B* Products with A or B codes previously assigned; new information raised significant questions which require further FDA investigation and review to determine therapeutic equivalence.
BC Controlled-release tablets, capsules, and injectables.
BD Active ingredients and dosage forms with documented bioequivalence problems.
BE Enteric coated dosage forms.
BN Products in aerosol-nebulizer drug delivery systems that are marketed as a component of, or specifically for, a particular delivery system.
BP Active ingredients and dosage forms with potential bioequivalence problems.
BR Suppositories or enemas for systemic use.
BS Products having drug standard deficiencies.
BT Topical products with bioequivalence problems.
BX Insufficient data to determine therapeutic equivalence.
ZA Pharmaceutical entity (GCN) looked at, but particular labeler was not evaluated.
ZB Pharmaceutical entity was not evaluated.
ZC Pharmaceutical entity and labeler evaluated, but no therapeutic equivalencerating given.

Order Count

The quantity represented by the total of all outstanding supply requisitions.

Order Quantity

The amount of a particular item that is ordered from a vendor each time the available stock (on hand plus on order) falls below the reorder point. Also called lot size.

Ordering Cost

The costs for placing orders, expediting, inspection, and changing or setting up facilities to produce in-house.


The industry’s leading commercial OR scheduling system. This is a product of “the company formerly known as Atwork,” now a part of Medaphis.


Operation Restore Trust. In 1993 the Clinton Administration launched a campaign designed to reduce fraud, abuse and waste within the Medicare and Medicaid programs. DHHS initiated Operation Restore Trust in May 1995.
ORT effectively coordinated the efforts of HCFA, HHS Inspector General, and the HHS Administration on Aging to investigate healthcare fraud.


Over the counter.


The results of specific treatment plans. Possible outcomes may be,
cure of a disease
elimination or reduction of a patient’s symptomatology
arresting or slowing of a disease process
preventing a disease or symptomatology.
Outcomes analysis allows for continuous improvement of prescribed treatment or treatments for a particular medical condition.

Out of Plan

Providers who are not contracted with a managed care network. HMOs will not reimburse visits to an out of plan provider, but PPOs do.
See also out of network.

Out of Network

Same as out of plan.


A patient registered for outpatient treatment (e.g., emergency care, outpatient surgery, outpatient clinic). The patient receives healthcare services treatment without an overnight stay in a hospital or inpatient facility. With the advent of managed care in the US, many risk carriers (e.g., insurance companies, large employers) limit the type and number of tests and procedures (including surgery) that are covered only if they are performed on an outpatient basis.
See also ambulatory.

Outpatient Process

Description of outpatient process,
1 Patient is registered for outpatient services.
2 The patient receives various treatments and procedures. The corresponding treatment CPT codes are recorded.
3 Appropriate drugs are ordered by the physician. These drugs are issued by the pharmacy.
4 Pharmacy charges are entered into the financial system; case data is entered into the the clinical systems.


Other Weird Arrangements. In the book The New Rules of Healthcare Marketing: 23 strategies for success,” the author, Arthur C Sturm, Jr. says,
“Hospitals, physician practices, and other entities are teaming up to work with a daunting alphabet soup of arrangements, from IDNs to GPWWs to OWAs.”


Office of Workers’ Compensation Programs. Among other things, they administer the FECA.