Standardized Terminology and Language in Informatics

Standardized Terminology and Language in Informatics

Standardized terminology and language in informatics play a crucial role as it ensures a standard language of communication among professionals and their users. According to Hebda, Hunter, and Czar (2019), standardized terminologies are defined as “certain languages created according to guidelines and approved by an authoritative body; they are used to ensure accurate data collection.” Medicare is one of the largest federal health programs in the United States that is involved in the payment of medical expenses for the population, especially those aged 65 years and above. On the other hand, Medicaid is a state and federal program focused on assisting in footing costs for people with low incomes or poor communities (Burd et al., 2016).

The Centers for Medicare and Medicaid Services (CMS) is the main agency that oversees programs such as Medicaid, Medicare, and the Children’s Health Insurance Program (CHIP) (Centers for Medicare and Medicaid Services, 2019). The CMS also regulates and oversees the federal and state health insurance marketplaces. Through the collection and analysis of data, the CMS produces quality reports that help eliminate fraud and abuse instances within the healthcare system. The CMS reimburses healthcare facilities through the inpatient or outpatient prospective payment systems (IPSS/OPSS). According to this system of payment, hospitals and reimbursement-eligible facilities are paid fixed and predetermined amounts by the CMS based on the condition of the patients and the treatment provided (Centers for Medicare and Medicaid Services, 2019).

Nursing practice is concerned with the provision of a high standard of care. One of the surest ways to rate the standards of care is through the Hospital Consumer Assessment of Healthcare Providers (HCAHPS). Institutions tend to adhere to the highest levels of practice, leading to patient satisfaction and improvement of patient outcomes. According to the CMS (2017), HCAHPS scores are linked with improved accountability and enhanced quality and safety of care. Care provided and patient satisfaction is used by the CMS when calculating the reimbursements. Therefore, reimbursements can lead to the provision of the highest quality of care consistent with evidence-based care practices.

References

Burd, C., Brown, N. C., Puri, P., & Sanghavi, D. (2016). A Centers for Medicare & Medicaid services lens toward value-based preventive care and population health. Public Health Reports, 132(1), 6-10. https://doi.org/10.1177/0033354916681508

Centers for Medicare and Medicaid Services. (2017). CMS covers 100 million people. https://www.cms.gov/

Centers for Medicare and Medicaid Services. (2019, November 29). Prospective payment systems – General information | CMS. CMS. Retrieved May 16, 2021, from https://www.cms.gov/Medicare/Medicare-Fee-for-Service- Payment/ProspMedicareFeeSvcPmtGen

Hebda, T., Hunter, K., & Czar, P. (2019). Handbook of informatics for nurses & healthcare professionals (6th ed.). Pearson.

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Standardized Terminology and Language in Informatics is an important part of healthcare. Nurses and healthcare workers need to understand and be able to communicate clearly.

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