OASIS |
|
Outcome and Assessment Information Set. The set of data that HCFA
requires HHAs to collect on their patients. |
OBC |
|
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 physicians 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. |
|
OIG |
|
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. |
OMG |
|
The Object
Management Group
(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. |
OmniLinkSM |
|
McKessonHBOC s
OmniLink centralized pharmacy software, offers pharmacies a way
to help streamline transactions and claims processing; it is designed
to increase a pharmacys efficiency and profitability, including
daily updates on average
wholesale pricing. Heres 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 McKessonHBOC
to contact patients who are more than five days late on
a refill. Approximately 40% of prescriptions dont
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 todays 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. |
One-CallTM |
|
The industrys leading commercial enterprise-wide patient scheduling
system. This is a product of the company formerly known as Atwork,
now a part of Medaphis. |
One-StaffTM |
|
The industrys 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. |
Operate |
|
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 Coalition ] |
OPPS |
|
Medicares 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 Center .
Click on Newsletters and then PPS Alert.
See
APC. |
Opt-In |
|
An affirmative ability for a consumer to accept terms and conditions.
[Source:
Hi-Ethics Coalition ] |
OR |
|
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 FDAs
Approved
Drug Products with Therapeutic Equivalence Evaluations
(i.e., the Orange Book). A code is assigned to all products on
FDBs 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 manufacturers 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. |
ORSOSTM |
|
The industrys leading commercial OR scheduling
system. This is a product of the company formerly known as Atwork,
now a part of Medaphis. |
ORT |
|
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. |
OTC
| |
Over the counter. |
Outcomes
| |
The results of specific treatment plans. Possible outcomes may be,
|
cure of a disease |
|
elimination or reduction of a patients
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. |
Outpatient
| |
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. |
|
OWA
| |
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.
|
OWCP
| |
Office of Workers Compensation Programs. Among other things, they
administer the FECA. |
|
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