Glossary of terms used by Care Connect

Glossary of common terms and abbreviations used though-out the Care Connect documentation site.

HL7 Admit/Discharge & Transfer messages carry patient demographic information for HL7 communications but also provide important information about trigger events (such as patient admit, discharge, transfer, registration, etc.). Some of the most important segments in the ADT message are the PID segment, the PV1 (Patient Visit). ADT messages are extremely common in HL7 processing and are among the most widely used of all message types.
The term Application Programming Interface is quite a confused term in the context of FHIR. Strictly speaking, an API is a set or services offered by a programming library that can be made use of by another application. Historically these would have been made available from a single machine although now they are available across networks.

In the service/message/document categorisation, an API is a service interface although many don’t consider it so. As technology became increasingly capable of supporting distributed operations, the differences between SOA (Service Oriented Architecture) and API became blurred. In the context of FHIR we define APIs as REST based interfaces.
An initiative launched by HL7 to accelerate the development and adoption of FHIR. Supported by 11 organizations, including EHR vendors Epic and Cerner and health systems Mayo Clinic and Intermountain Healthcare.
The Common Assurance Process is an NHS process that needs to be followed to gain accreditation allowing for connection directly to the Spine and PDS.
Consolidated CDA is an XML based implementation guide that specifies encoding, structure and semantics for a document that summarises a single patient’s clinical information.
The Clinical Commissioning Group is an NHS organisation made up of GP practices looking to understand the health needs of local people and use funds given by NHS England to buy services which meet those needs. Key challenges for our organisation are: tackling health inequalities and unwanted variations in quality of care, a growing elderly population with more long term conditions and a health and social care system in which any funding growth will be limited.
The Clinical Document Architecture provides an exchange model for clinical documents (such as discharge summaries and progress notes). By leveraging the use of XML, the HL7 V3 Reference Information Model (RIM) and coded vocabularies, CDA makes documents both machine-readable and human-readable.
The Code 4 Health, Community Interoperability Board was established early in 2016. This network of networks has taken on a leadership role across the service to coordinate and deliver working interoperability standards.
Clinical Information Modeling Initiative An international collaboration dedicated to providing a common format for detailed specifications for the representation of health information content. In this way semantically interoperable information may be created and shared in health records, messages, and documents.
The NHS Dictionary of Medicines and Devices is a dictionary of descriptions and codes which represent medicines and devices in use across the NHS. It is delivered through a partnership between NHS Digital and the NHS Business Services Authority and provides the recognised NHS Standard for uniquely identifying medicines and medical devices used in patient care.
Domain Message Specification Description of messages definitions and interactions relating to a specific business area (such as Ambulance, Child Health or Discharge etc.)
Department of Health
The Directory of Services searches for available service to match patient needs. It can also be manually searched via a desktop of mobile device. The content services profiled on the DoS is owned and managed locally.
Draft Standard for Trial Use
Electronic Prescription Service (Prescribe & Dispense implemented in HL7v3/ebXML),(Prescription search Implemented with HL3 v3 RESTful) There is an inflight proprietary Restful API
The NHS e-Referral Service combines electronic booking with a choice of place, date and time for first hospital or clinic appointments. Patients can choose their initial hospital or clinic appointment, book it in the GP surgery at the point of referral, or later at home on the phone or online
The FHIR Management Group provides day-to-day oversight of FHIR-related work group activities including performing quality analysis, monitoring scope and consistency with FHIR principles and aiding in the resolution of FHIR-related intra and inter-work group issues.
The FHIR Maturity Model provides a sense of how mature a resource is based on the level and types of review it has been subject to.
System transferring full GP records between GP systems when patients register with a new GP. (Implemented using HL7 v3)
Although initially used as an adjunct to support effective training, the Intelligent Data Toolkit has been enhanced to support content changes in the clinical system and to enable cost effective commissioning in localities.
The Interoperability Toolkit, in the context of the NHS this is a set of common specifications, frameworks and implementation guides to support interoperability within local organisations and across local health and social care communities.
Javascript Object Notation is a lightweight data-interchange format. It is easy for humans to read and write and easy for machines to parse and generate. It is based on a subset of the JavaScript Programming Language.
Legitimate Relationship Service
Meaningful Use
Messaging Exchange for Social Care is the main asynchronous messaging service used across health and social care. It works on the Spine infrastructure. It’s used to transfer electronic messages directly from one application to another, so different organisations can communicate securely. As an example, pathology labs use MESH to communicate test results to GP practices. MESH replaced the Data Transfer Service (DTS).
The Medical Interoperability Gateway is a supplier lead interoperability solution provided by EMIS + Vision which allows third parties access to GP data data.
The Message Implementation Manual describes the HL7 messages used for communications across the NPfIT programme.
- Not all messages are HL7v3
- Not all messages are in the MIM
N3 is a Wide Area IP Network (WAN), connecting many different sites across the NHS within England & Scotland. It also connects to other networks via Gateways, notably to the Internet via the Internet Gateway.
.NET is both a business strategy from Microsoft and its collection of programming support for Web services. Microsoft’s goal is to provide individual and business users with a seamlessly interoperable and Web-enabled interface for applications and computing devices and to make computing activities increasingly Web browser-oriented. The .NET platform includes servers; building-block services, such as Web-based data storage; and device software. It also includes Passport, Microsoft’s fill-in-the-form-only-once identity verification service.
NHS Digital
The National Record Location Service The National Record Locator Service is technical proof of concept acting as a national index to identify available records for patients and locate them across local and national care record solutions (such as SCR).
The Organisational Data Service is responsible for publishing organisation and practitioner codes, along with related national policies and standards. They’re also responsible for the ongoing maintenance of the organisation and person nodes of the Spine Directory Service, the central data repository used within various NHS systems and services.
The Patient Administration System records the patient’s demographics (e.g. name, home address, date of birth) and details all patient contact with the hospital, both outpatient and inpatient.

Some PAS systems do support additional clinical behaviours.
The HL7 Patient Identification segment is found in every type of ADT message (i.e. ADT-A01, ADT-A08, etc.) and contains 30 different fields with values ranging from patient ID number, to patient sex, to address, to marital status, to citizenship. The PID segment provides important identification information about the patient and, in fact, is used as the primary means of communicating the identifying and demographic information about a patient between systems.
The Patient Demographic Service is a national electronic database of NHS patients containing details such as name, address, date of birth and NHS Number (known as demographic information). (Implemented with HL7 v3)
Role Based Access Control defines roles and allowed business activities associated with a user (via their smartcard). (Implemented using SAML)
Representational State Transfer is a protocol based upon a network of Web resources (a virtual state-machine) where the user progresses through the application by selecting links, such as /user/tom, and operations such as GET or DELETE (state transitions), resulting in the next resource (representing the next state of the application) being transferred to the user for their use. Typically preferred due to it being “stateless” so no information about the client session needs to be maintained on the server.
Interfaces are often referred to as being “RESTful” when they follow principles of “REST” to avoid debate about whether they conform to “REST”.
The Reference Information Model is the cornerstone of the HL7 Version 3 development process. An object model created as part of the Version 3 methodology, the RIM is a large, pictorial representation of the HL7 clinical data (domains) and identifies the life cycle that a message or groups of related messages will carry. It is a shared model between all domains and, as such, is the model from which all domains create their messages.
Resource-oriented architecture is a style of software architecture and programming paradigm for designing and developing software in the form of resources with “RESTful” interfaces.
The NHS Spine Directory Service is a component of the NHS Spine service comprising of the Spine User Directory and Spine Accredited Systems and Services. The SDS ensures that transactions/messages are only processed from authorised users and systems. (Implemented with LDAP)
The most comprehensive and precise clinical health terminology product in the world, owned and distributed by SNOMED International.
Method for systems integration and development that allows different applications to exchange data in a loosely coupled way.
A protocol specification for exchanging structured information in the implementation of web services. SOAP allows processes running on disparate operating systems (such as Windows and Linux) to communicate using Extensible Markup Language (XML). Since Web protocols like HTTP are installed and running on all operating systems, SOAP allows clients to invoke web services and receive responses independent of language and platforms.
A collection of national applications, services and directories which support the health and social care sector in the exchange of information in national and local IT systems
Standard for Trial Use The original DSTU2 FHIR standard has been superseded by the new standard STU3. To reflect that important parts of the spec are well past the draft stage
eXtensible Markup Language is a protocol designed to store and transport data. XML was designed to be both human and machine readable.
XPath is a major element in the XSLT standard. XPath can be used to navigate through elements and attributes in an XML document. XPath is a syntax for defining parts of an XML document. XPath uses path expressions to navigate in XML documents. XPath contains a library of standard functions.
The Unified Modelling Language is a family of graphical notations baked by a single meta-model, that help in designing and describing software systems. Especially useful when working with OOP paradigms..
Use Case
A list of actions or event steps, typically defining the interactions between a role (known in the Unified Modeling Language as an actor) and a system, to achieve a goal. The actor can be a human or other external system.
Use Case Diagram
A visual presentation of a Use Case, standardised within UML.
A Vendor Neutral Archive is medical imaging technology in which images and documents (and potentially any file of clinical relevance) are stored (archived) in a standard format with a standard interface, such that they can be accessed in a vendor-neutral manner by other systems.
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