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Glossary (A - D)


For more information on many of these terms see or Delaware Healthcare Association Glossary of Health Care Terms and Acronyms 

ABC Codes - Alternative Billing Codes. Used for billing alternative medical procedures. One of the ANA recognized terminologies.

AACN - American Association of Colleges of Nursing

Active Cell - the cell in a spreadsheet into which any information that is entered will be placed.

Active RFID - an RFID that is battery powered and constantly transmitting signals. Does not require scanning to be read.

Active Server Page (ASP) - an add-on for Web pages that allows for the creation of interactive pages that can show data in real time. What is an Active Server Page?

Active Window - the window on the screen on which the user is working. Other windows may be open, but not currently being worked with. A window is a file in a program such as a document in Microsoft Word.

Active Server Page - a type of Web page that is created dynamically on the fly. It pulls data from various places to create a timely page. These Web pages end in the extension .asp

Accessibility - used in connection with World Wide Web pages to denote the ability of people with disabilities to use a page. The Rehabilitation Act Amendments of 1998. Section 508 of that Act requires that when federal agencies develop or procure electronic and information technology that this technology be as accessible to Federal employees with disabilities as to those without disabilities.

Accuracy of Data - a condition that one is always working to achieve. It can be improved by methods that check the data during input such as presenting a user with a "pick list". Another method is to present the user withal screen that shows the items that will be entered into the record and asking for approval. 

Address - (on Disks) Disks are divided into tracks and sectors, each with a unique address that designates the specific track and sector of the disk where something is stored.

Address - (in RAM) A specific memory location in the computer’s RAM accessible by a unique number. Think of a computer’s memory as a group of mailboxes, each of which has a specific number or address.

ADL - Activities of Daily Living

Admission, Discharge and Transfer (ADT) - a computer system that manages data about the admission, discharge and transfer of patients within a healthcare institution.

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Advanced Search - a feature that generally provides a search with additional criteria to eliminate unwanted articles or Web pages.

Adware - software that is combined with another program and presents advertisements to the user of the program. Is sometimes distributed with free versions of downloadable software.

Agency for Health Care Policy and Research - a federal (US) department established by Congress in 1989 for the purpose of enhancing the quality, appropriateness, and effectiveness of health care services and access to care. (Page 428 has more information.)

Aggregated data - data that represents the same piece of data for many different records e.g. a list of surgeries and length of stay for all patients for the month of April. The purpose for studying data in the aggregate is to determine patterns. The data may be from any size database from just a few records to millions of records.

AHCPR - see Agency for Health Care Policy and Research

AHIMA - American Health Information Management Association

AIDSLINE - NLM online bibliographic database for comprehensive coverage of information related to AIDS.

Algorithm - a set of unambiguous steps for accomplishing a defined task. The algorithm has a definite starting and stopping point. It may contain decision points, but finite choices are given and the results of each choice clearly stated. Used when programming a computer, however, individuals use them every day, e.g. the steps one follows in starting a car.

Alliance for Nursing Informatics (ANI) - a federation of nursing informatics groups.

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Alphanumeric - a description given to any letter or number. Directions may tell you to enter any “alphanumeric” character or a combination of alphanumeric characters. This would be interpreted to mean that any letter or number will be accepted by the computer.

Alt+ - The alt key is a key on the bottom of a PC computer keyboard. When you see an instruction written Alt+D or any other key, hold down the Alt key while depressing the other key or keys.

Alternative Billing Codes - See ABC Codes

ALU - see Arithmetic Logic Unit

ALT tag - This is a code added to a graphic display that provides an alternative to the graphic. For example, a brief description of the graphic, providing a to a detailed description of the graphic.

AMIA - American Medical Information Association

ANA - American Nurses Association

Analog - A system in which the measurements are continuous. Digital systems show only given values, they skip intermediate values. An ordinary clock, which shows every conceivable time is an analog system, while a digital watch shows only definite times without any intermediate values.

Andragogy - an educational theory whose current proponent is Malcom Knowles. This theory holds that adults are need to know why they need to learn something, are capable of self-direction, bring experiences with them that can provide a resource for learning, and learn to solve problems.

ANI - Alliance for Nursing Informatics

Animation - visual representations of difficult concepts, processes, and models, often involving movement. (see page 390 or 130)

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Area Chart - similar to line charts, but the area(s) is (are) shaded. See Figure 9-11 page 156. Can be stacked as in the figure, or a simple line. Also used in pie charts.

Application program - a computer program designed for an end user such as a word processor or database. Distinguished from systems software which interacts with the computer.

App - an abbreviation for an application, or software program.

Archived - messages are archived when they are placed on a server where they can be accessed by others. This is often done with mailing group messages.

Argument - The values that a formula uses, they may be entered by the user, or be functions provided by the software. Examples may be written “= Argument + Argument” In this example for summing the user should substitute the numbers that he or she wishes to sum for the word argument.

Arithmetic Logic Unit (ALU) - the part of the CPU (central processing unit) that performs all arithmetic computations and comparisons. Essentially the brains of the computer.

Artificial intelligence - a computer application that has been designed to mimic the actions of an intelligent human in a given situation and be capable of substituting for a human. Robots are an example of artificial intelligence.

ASCII - American Standard Code for Information Interchange. A system arrived at early in the evolution of computers that provides for the identical representation of each character on the keyboard by a set decimal number. ASCII text is readable by most application programs whereas files saved by application programs are put into a proprietary format and are only readable by the program (or series such as Corel, or Smart Suite) that created them. ASCII files preserve only text, all formatting is lost. Every line of text is treated as though it were a paragraph. (See RTF). ASCII files have a file extension of “txt.” Creating a file in this format is an excellent way to transfer data from a spreadsheet or database to another application.

ASCII delimited file - a type of file that is in a text format, such as Notepad creates.

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Assembly language - a second level computer programming language that enables a programmer to use words instead of numbers to tell a computer how to act.

Asynchronous learning - a form of independent learning in which learners instead of attending a class at a given time, perform their learning activities such as responding to discussions, at times that are convenient to them.

Asynchronous communication - communication in which the reply is not made immediately after the message is sent, but when the recipient is available. Email is asynchronous communication.

Atomic level data - a small piece of precise data that represents a discrete element that has not been interpreted. For example, the number 2. It can represent many different things, but alone it is atomic level data. In a blood pressure reading, there are two pieces of atomic level data, the systolic and the diastolic. Name is NOT atomic level data, it is composed of at least two pieces, first and last name and sometimes a middle name or initial.

Attribute - a characteristic that can be applied to any selected object. These include features such as bold facing text, the margins, size, and color. In designing e-Learning it denotes factors, such as color or movement, that a medium implements. In either context, the type of communications desired, and characteristics of that topic determine which attributes will best create understanding. In a database, it refers to a field.

Audit trail - a record made by a system of all the places that an individual accesses within a system. For example, if Nancy accesses the medical record of Patient Morris, there will be a record of this. Looking at the audit trail enables the system administrator to determine whether Nancy breached security with this action.

Authentication - verifying the identification of the person logging into the system using passwords, smartcards, biometrics, or a combination of these.

Avatar - a fictionalized computer representation of self used in settings such as Second Life. "Owners" of an avatar create looks and personalities for themselves in their avatar.

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AVLINE - NLM database for audiovisual programs.

Axis - in standardized classifications a concept around which a taxonomy is organized.

Backward compatibility - a program is backwardly compatible when it can use files created by an earlier version of the program, e.g. when your word processor version 12.0 will let you read and edit files created by version 9.0 of the same program. Software producers generally try to keep their products backwardly compatible, so files created with older version will not be lost when a user update. May also be called downward compatibility. See forwardly compatible.

Bandwidth - a measure of the speed at which a line (wire) transmits data. The rates depend on the type of connection such as POTS, DSL or cable.

Bar code - a method of encoding data to be machine readable. It consists of a parallel arrangement of bars (dark lines) and spaces (light elements). They represent numerical codes which conform to the Universal Product Code (UPC).

Basic - a third level programming language designed for teaching students to program a computer. Versions of it are seen in macro languages and languages used with statistical packages. Today most of the versions contain extensions, such as object-oriented features seen in Microsoft’s Visual Basic.

Bar chart - a chart that uses non-contiguous bars to display information. Best used to compare amounts. There are many different types, see Chapter 8, page 146.

Batch processing - the type of computer processing in which computer tasks are stored during working hours and then executed when the computer is idle. It is very useful for tasks that require the computer for an extended period. Once a batch job begins there is no interaction with a user. It continues until it is finished, or there is an error. Credit card companies use batch processing to process monthly bills.

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Bay - a site in a computer where disk drives (3 ½, CD-ROMS etc.) can be installed. Is not a slot.

BCC - Blind Carbon Copy. Used to send an email message that is addressed to one person to another without the original recipient knowing that another also received the message. Different than a CC.

BCS - British Computer Society

Beaming - a wireless infrared transmission between beam-enabled devices with the same operating system that is limited to 3 feet.

BDMS - Bureau of Data Management and Strategy

Benchmarking - the process of comparing cost, time, productivity, or quality of a specific process or method to another that is widely considered to be an industry standard or best practice.

Benign virus - a computer virus that is not intended to do damage to your computer, it just makes itself known when given conditions are met, such as a specified date, by displaying some sort of message, or creating a noise. They can, however, create damage.

Best of Breed - the selection of systems that "best" meet the needs of a particular service or department from different vendors. It requires building an interface at the institutional level which is difficult and rarely fully satisfactory. Trend now is to integrated systems

Big Bang Conversion - a conversion from one system to another during which the entire agency switches from one system to another at the same time.

Binary system - the system of 1's and 0's used to represent data in the computer. If you studied number systems with bases other than ten (our familiar decimal system), you would refer to the binary system as a “base two” number system and our decimal system as a base ten number system.

Binary digit - the smallest unit of information on a computer. Usually referred to as a “bit.” See bit.

BIOETHICSLINE - NLM database on health-related ethical topics, produced by the Bioethics Information Retrieval Project of the Kennedy Institute of Ethics at Georgetown University. (See

Biometric Garment - a piece of clothing that has a device embedded that is activated by receiving a signal. The signal may be activate by the wearer of the garment and may be biometric, such as voice, heart beat or pulse. Or the signal may be activated by an outside signal. In healthcare this could cause the garment wearer to transmit physiological values such as blood pressure etc.

Biometric identification - the use of physiological characteristics such as fingerprints or voice print to authenticate that a user is who she says she is. Biometrics devices are those that are capable of making an identification based on a specific human train that is unique to the individual.

BIOS - Pronounced "bye-os," it is an acronym for basic input/output system. The BIOS is built-in software generally found on the ROM chip built into the computer. It determines what a computer can do without accessing programs from a disk.

Biosurveillance - the automated monitoring of health data sources to identify trends that may indicate a disease outbreak, either natural such as with flu, or intentional from terrorism.

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Bit - This term is short for “binary digit,” which is the unit of information that a computer processes. It is represented by a one (1) if the circuit is on and a zero (0) if it is off. A single bit will have a value of either 0 or 1. To gain meaningful information, consecutive bits are combined into larger units, for example, the byte, which is composed of 8 consecutive bits will support one character. You may hear a computer classified by the number of bits it can process at one time. The greater the number of bits, the faster the machine and the larger the program that it can support.

BlackBerry - a line of wireless handheld devices. Introduced in 1999 it was a forerunner of today's smart phones. It allowed wierless communication in ways that were new then. During the early part of this century it became very popular with business people and because of its addictiveness,was often referred to as a CrackBerry.

Black hat hacker - an individual who uses her or her computer skills to damage computers or data. See hacker and white hat hacker

Blog - a Web site, usually on a given topic, that is (should be) continually updated. The posts are listed in reverse chronological order. Some blogs offer readers a way to comment.

Bloom's Taxonomy of Learning - a taxonomy of levels of learning developed by Benjamin Bloom in 1956. Is behavioral in orientation. (see page 394)

Bluetooth - a short-range wireless communication between devices and between the devices and the Internet whose goal is to simplify data synchronization. Prior to release a Bluetooth enabled device must pass interoperability tests by the Bluetooth Special Interest Group

Bomb - a situation in which a program hangs. Often you can close this program and reopen it and resume work. See computer crash.

Bookmark - the name some browsers (Fireworks and Netscape) give to a collection of Web addresses that the user has added to a list to make accessing it easy. Analogous to Favorites in IE.

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Boolean logic - a form of logic seen in computer applications in which all values are expressed either as true or false. Symbols used to designate this are often called boolean operators. They consist of “and,” “or,” and “not.” They may be combined with mathematical operators such as equal to (=), more than(>), less than (<).

Boot sector virus - a computer virus that affects the boot sector of a disk or diskette. Hard disks contract it when a computer is booted (started) with an infected diskette in drive A.

Boot - To start the computer. The term originated in the early days of computing when starting a computer involved manually loading every set of instructions that the computer needed. The people who had to perform these tasks likened the process to “pulling oneself up by the bootstraps,” or pulling on a strap attached to the top of boots to put on a boot. The term stuck. See warm boot and a cold boot.

Braille reader - a device that is placed near or under the keyboard. Users use their fingers to “read” the information.

Broadband - The name given to a transmission wire that can carry several channels of information at the same time. Internet connections with Cable TV and DSL are examples. Provides for a faster connection to the Internet.

Browser - Short for Web browser, this is the name given to the software that locates, downloads and displays Web pages. Two popular browsers are Microsoft Internet Explorer® and Mozilla Firefox®. Both of these are graphical browsers, which means that they can display graphics as well as text. Lynx, although not used commonly used is a text browser. It is often the browser of choice for people with severe visual disabilities.

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BSA - see Business Software Alliance.

Bug - an error or defect that causes either hardware or software to malfunction, or perform differently than what the designer or programmer had intended. Given the complexity of today’s systems and software, bugs are difficult to completely eliminate.

Bullets - in computer talk, a mark used to precede an item in a list. Application programs allow many shapes to be used as bullets. Presentation programs that create slides, call a slide in which each point is enumerated separately and preceded by a symbol a bullet slide.

Bus - conceptually, a bus is a highway that transmits data. Physically it is a set of wires that data in a computer passes through. It consists of two parts, a data bus and address bus. The address bus transfers the information to the location specified by the address bus. The size of a bus is referred to as its bandwidth and it is measured by the number of bytes that can be transmitted at the same time. The wider the bus, the faster the transmission, hence a 32 bit bus is faster than a 16 bit bus.

Business skills - information management and technology skills necessary to participate in any profession, not limited to administration, but including level in nursing.

Bus topology - a type of connection for networks in which each computer is connected to one cable called the backbone or bus.

Business Intelligence - a broad category of applications and technologies for gathering, storing, analyzing, and providing access to data to help enterprise users make better business decisions. BI applications include the activities of decision support systems, query and reporting, online analytical processing (OLAP), statistical analysis, forecasting, and data mining.

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Business Software Alliance (BSA) - an organization that works to promote the growth of the software industry. One of its primary educational aims is to prevent software piracy. BSA provides a hot line for callers who wish to report piracy. It also investigates and prosecutes cases of software piracy.

Byte - an abbreviation for “binary term,” which is a unit of storage, consisting of eight consecutive bits, that holds a single character (e.g., a letter, number, or symbol such as &). It represents 2 to the 8th power (2^8) or the number 256 which is the maximum number of characters that can be represented by a byte. Units of storage are measured using byte as the end of the word, with a term indicating thousands, millions, etc. of bytes as a prefix. For example, the prefix “kilo” indicates 1,000 and a kilobyte is roughly 1,000 bytes. Actually, because these prefixes are representative of powers of 2, the actual number of bytes in a represented by the prefix is greater than the prefix translated literally indicates. For example, a kilobyte represents 2 to the 10th power or 1,024 bytes.

C - a third level programming language, C is powerful and flexible. Because it is closer to assembly language (a second level language) programmers using it can write efficient code, however, it is more difficult to use than many other third level languages.

CC - in email, a copy of a message that is also sent to another. The original recipient knows that the other person has received it, as opposed to a BCC

C++ - a third level programming language that adds object-oriented features to the C language. It is frequently used for graphical applications.

Cable modem - a modem for use with cable TV lines. Cable modems can provide transmission speeds of up to 2 megabits per second. Its speed plus the presence of cable TV in many homes gives it appeal.

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Cache - a special form of memory that permits the CPU to access data faster. There are two types, memory cache, which is a special type of RAM where the computer stores frequently used information, and disk cache. In disk cache, a portion of RAM is set aside for data from a disk that the computer has determined the user frequently needs. L1 cache is built into the microprocessor, L2 is added on to improve performance.

CAD - Computer Aided Design

CAI - see computer-assisted instruction

CAL - Computer Aided Learning - see computer-assisted instruction

Card - a thin, rectangular plate known as a printed circuit board on which chips and other electronic components are placed. There are many different types such as a motherboard, an expansion board and a network card. See circuit board.

Case sensitive - a condition in which the computer evaluates not only the characters entered, but also whether a letter is upper or lower case. Passwords are usually case sensitive, as can be the addresses of Web sites after the first single forward slash (\).

Catalog - as formerly used by the ICNP, and now known as a subset, a group of terms created from a standardized terminology by pre-cordinating the terms from an axis in the terminology.

CBI - computer-based instruction - see computer-assisted instruction

cc - carbon copy. A method of sending an email message to more than one person.

CCC - See Clinical Care Classification

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CCHIT - Certification Commission for Healthcare Information Technology

CDA - see Clinical Document Architectures

CCDS - see Clinical Decision Support System

Cell - a rectangle in a spreadsheet, named by a letter and a number.

Cell Address - the location of a cell or rectangle in a spread sheet, it is expressed by using the letter at the top of the column and the number of the row in which it is located, e.g. C4 would mean the cell under the C that is also in fourth row.

Cell Range - a group of contiguous cells between one address such as A1 to C10. Can be named and treated as a whole.

Cell Phone - a wireless telephone.

Center for Nursing Advocacy - a private agency that disseminated information about media portrayals of nursing. Unfortunately, it was disbanded in December 2008.

Centers for Medicare and Medicaid Services (CMS) - a U.S. federal agency which administers Medicare, Medicaid, and the Children's Health Insurance Program.

Central Processing Unit (CPU) - sometimes referred to as the “brains” of the computer, the CPU is the most important element of a computer system. The CPU contains the ALU and the control unit. They are named by the manufacturer an are one of the determining factors in how a computer behaves in terms of speed, and compatibility.

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Certification Commission for Healthcare Information Technology - a voluntary private-sector organization that is charged with developing and evaluate health information technology products. Products they have vetted and approved then carry their seal of approval. Unfortunately, these products are not necessarily HL7 compatible.

Chart - the term used by computer programs for a graph. The term graphic is used for images, generally pictures, but it can refer to any object that can be treated as a whole.

Chat - a term used for synchronous, or real-time communication via text on a computer. After initiating the chat, either user types messages which appear on the other users monitor. Often more than two people are involved in a chat. This mode of communication is sometimes used in Web-based learning. It can be confusing because as a user is replying to one message, another may appear.

Child table - a detail table in a relational database. The child table has a field that is identical to one in the master table so that data from other fields in the child can be integrated with data from fields in the master table.

Chip - a semi-conducting square often less than ¼ square inches that can contain millions of electronic circuits. The CPU is one of many types of chips that are used in a computer.

Chunking - an educational theory that holds that information in short term memory is limited to seven items, plus or minus two.

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CINAHL - A bibliographic database for nursing, allied health, alternative therapies, and patient/consumer health that includes more nursing periodicals than any other database. It also indexes knowledge-based information resources in many formats. CINAHL is produced by CINAHL Information Systems in Glendale, CA.

Circuit board - a thin, rectangular plate, often called a card, on which chips and other electronic components are placed. There are many different types such as a motherboard, an expansion board and a network card.

Classification - a method of grouping like items so that they can be referred to in a more abstract manner. May use a taxonomy.

Classless Inter-Domain Routing (CIDR) - see IP address.

Client - a networked computer, such as a PC that relies on a server for some operations. These functions include sending and receiving email, storing files for use throughout the network, and in some cases processing data. The client may be a video-text terminal, or a powerful computer capable of doing its own processing.

Client-server architecture - a type of network connection in which PCs or workstations called clients have software that allows them to communicate with another computer, known as the server, which can process and respond to the requests from the clients. Servers can process information, and store files used by all, including application programs. The WWW is an example of client server architecture as are many healthcare information systems.

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Clinical Care Classification (CCC) - Clinical Care Classification (formerly the HHCC). One of the ANA Recognized Standard Terminologies. Developed by Saba to predict resource use in home care for Medicare and Medicaid patients. Now used in all clinical areas. Is in the public domain. See chapter 16 for more information.

Clinical Data Repository - ".. a real-time database that consolidates data from a variety of clinical sources to present a unified view of a single patient. It is optimized to allow clinicians to retrieve data for a single patient rather than to identify a population of patients with common characteristics or to facilitate the management of a specific clinical department." From (No longer available at this URL)

Clinical Decision Support System - a "system that links health observations with health knowledge to influence health choices by clinicians for improved health care." see Decision Support

Clinical Document Architecture (CDA) - a document markup standard (specifying tags that denote give characteristics) that specifies the structure and semantics of a clinical document (such as a discharge summary or progress note) for the purpose of data exchange

Clinical Documentation - a documentation system that is used in the clinical area that is is part of the clinical workflow and provides communication of real-time information.

Clinical Information System - information technology that is applied at the point of clinical care. It includes electronic medical records, clinical data repositories, decision support programs (such as clinical guidelines and drug interaction checking), handheld devices for collecting data and viewing reference material, imaging modalities and communication tools such as electronic messaging systems.

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Clinical Pathway - a program that provides timing and sequence of key interventions necessary for the desired patient outcome.

Clip art - a form of electronic artwork that can be inserted into a computer document. Most word processors and presentation programs come with clip-art, or clip-art for the program can be bought separately. Clip-art can also be found on the web. When using clip-art check the copyrights to be certain the use is legal.

Clipboard - a place in the computer’s memory (RAM) on which objects that are being cut or copied are kept. Once on the clipboard, an object remains there until replaced by another object, or deleted from the clipboard by the user. Some modern software, such as Microsoft Office products allow you to have more than one item on the clipboard.

Clock speed - The measurement of how often a pulse of electricity “cycles” or circulates through the circuits of a chip which determines how fast information is processed. The more cycles per given time period, the greater the processing speed. Clock speed that use to be measured in megahertzes (MHz) on newer computers is measured in gigahertzes (GHz).

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Clone - a product that functions exactly like the more well-known product. A PC that was an IBM clone would perform exactly like the IBM.

Closed-Loop Safe Medication Administration - the right patient receives the right medication. An essential component of patient safety improvement used with bar-coded or RFID tagged bracelets is used with the eMar.

CMI - see computer managed instruction

CMS - see Centers for Medicare and Medicaid Services

CNPII - see Committee for Nursing Practice Information Infrastructure.

Cobol - a third level programming language designed for business applications.

Code - statements written in a programming language which are the computer is capable of executing to perform a function. Can also be the "tags" in html.

Code of Ethics - a set of guidelines which are designed to set out acceptable behaviors for members of a particular group, association, or profession. Many organizations govern themselves with a code of ethics, especially when they handle sensitive issues like health care. In addition to setting a professional standard, a code of ethics can also increase confidence in an organization by showing outsiders that members of the organization are committed to following basic ethical guidelines in the course of doing their work. From

Codebook - a "book" (often a table in spreadsheet) that records what numbers in a statistical program.

Cold boot - Turning on a computer (Booting) and having it run through all the start up procedures needed before it can be used. As opposed to a warm boot in which case the computer is restarted without turning it off.

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Collective Intelligence - knowledge and understanding that emerges from large groups of people.

Column - a vertical line. In a spreadsheet they are designated by a letter. In a database, they are fields.

Combo Box - an object that can be placed on a spreadsheet or database that when clicked shows a drop down box.

Committee for Nursing Practice Information Infrastructure (CNPII) - The ANA committee that reviews terminologies for recognition. NIDSEC evaluates their use by vendors.

Community Health Information Network (CHIN) - a network of integrated health records of selected data for a community. When a CHIN is functional, the information would be available to healthcare providers such as hospitals, clinics, nursing homes and other health interested organizations such as public health, social services, employers and educational institutions.

Compatibility - the ability of parts of a computer to work together. It may refer to the ability of an operating system to work with user created files or the ability of an application program to work with files created with a later version of the same program. For example, files created on a Macintosh computer and saved in their native format are not compatible with any applications on a PC. See backward compatibility.

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Combinational terminology - one that consists of terms in various axis that are combined to make a useful term. See pre-cordinated term and post-coordinated term

Combinatorial - see combinational terminology.

Compile - part of the process of converting a program not written in the lowest level language (machine language) to machine language so it can be run by the computer. Programming languages are referred to as source code, while the final product is machine language. For programs in all languages except Java this is done before the program is distributed. With Java the computer compiles the program as it is run meaning that it will work with any operating system.

Composite key - a key for a database that is composed of two or more fields. A key field is a field on which a database will always be indexed (sorted). The data it contains must be unique for that table, that is, no other record in the database will have the same entry in the key field. In a composite key, there may be instances where one of the entries in a key field will be identical with those in other records, but the combination of entries in the fields will be the only instance of that combination in the database.

Computer-Assisted Instruction (CAI) - instruction delivered by computer. Can vary from a simple computer program to one involving multimedia.

Computer crash - a situation in which the computer stops working or a program unexpectedly gives you an error message and quits work, taking all the unsaved data with it. A crash is NOT the operators fault. They are often caused by “memory fights,” that is two programs demanding the same slot in memory with the one that was there first refusing to relinquish it. They may also be caused by too little RAM. If a computer is crashing repeatedly there may be a hardware or software bug, or the computer may need more RAM.

Computer fluency - The skills, knowledge, and desire necessary to not only use the computer in a current setting, but to acquire new skills as the environment demands.

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Computer generated information systems - computer applications that assist individuals in creating information and knowledge. There are many types: decision support tools, expert systems, and artificial intelligence.

Computer languages - a way of communicating with a computer. There are several levels of languages, lowest, machine language; second level, assembly; third level, high-level languages such as Basic or C; and fourth level languages such as standard query language. The higher the level of language, the closer it comes to natural language, the lower the language the closer it is to machine language.

Computer Managed Instruction (CMI) - a system that performs some of the administrative tasks that are a part of computer-based-instruction. May also deliver the instruction.

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Computer freeze - a situation in which the computer decides to ignore any input from a user. This is usually related to one program and may be remedied by tapping and holding down in order the following keys: Ctrl, Alt, and Delete. Then selecting end this program from the screen that appears. (If using VISTA, select "Open task Manager, then select the program.) Another term for this occurrence is “hang,” as in “My word processor hung.”

Computer-managed-learning (CML) - See computer-managed-instruction.

Computer malware - software that does malicious things. Includes viruses, worms, Trojan Horses, spyware, and some adware.

Computer networking - the connection of two or more computers so that they can share files and/or data.

Computerized Provider Order Entry (CPOE). Although the term says physician, it includes nurse practitioners with prescriptive authority. It describes the use of the computer to enter prescriptions. These systems should be able to catch not only errors in prescribing, but also problems with drug interactions or allergies that could present a problem. In short, a well designed CPOE should be a decision support system for clinicians who prescribe medications. It will not make decisions for the clinician, but present difficulties, if any, that it sees with a given order.

Computer Virus - See virus.

Computer-based Patient Record Institute (CPRI) - a non-profit organization composed of members of groups such as nursing, medical records, dentistry, patients, and third party payers whose goal is the development of the computerized patient record. In 2002 they combined with HIMSS.

Computerized Decision Support System - see Clinical Decision Support System

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Computerized Patient Record (CPR) - a lifelong record of healthcare for an individual. The system in which it resides will provide clinicians ready access to knowledge from many sources that is related to any aspect of the patient’s and perform predetermined analyses to find conditions that need attention, and provide access to information resources such as articles in periodicals. Current terminology is Electronic Health Record

Confidentiality - the protection of information about individuals from unauthorized use.

Consumer Assessment of Health Providers & Systems - "...a public-private initiative to develop standardized surveys of patients' experiences with ambulatory and facility-level care." From

Consumer Informatics - an applied science using concepts from communication, education, behavioral science and social networking {Houston, 2001 #1370}. It is designed to provide healthcare information to consumer/patients, allow consumers to make informed decisions, promote healthy behaviors, and promote information exchange and social support. (Houston, T. K. and H. E. Ehrenberger (2001). "The potential of consumer health informatics." Seminars in Oncology Nursing 17(1): 41-47.) It often refers to consumer use of electronic communications such as email and the Web in their healthcare. Its aim is to improve health outcomes through consumer participation in their healthcare.

Context-sensitive help - help that when requested, matches the general feature that you are using. For example, if you entering vital signs into a hospital information system, when you tapped F1 to request help, help for accomplishing that task would automatically be accessed.

Contingency Plan- Sometimes referred to as "Plan B." It is a detailed plan that addresses steps to take in the event of the occurrence of significant implementation problems.

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Control unit - an element in the CPU that obtains program instructions and either carries them out itself or directs them to the ALU to be accomplished.

Coordinated Licensure Information System - a cooperative effort by the National Council of State Boards to create a coordinated data base of all licensed registered nurses and licensed practical/vocational nurses that includes information on the licensure and disciplinary history of each nurse contributed by member states. Its purpose is to assist in the coordination of nurse licensure and enforcement efforts.

Core Measures - a set of care processes developed by The Joint Commission to measure performance.

Cost Benefit - a value of the cost of the item versus its return in benefits. Sometimes referred to as Return on Investment (ROI)

Cookie - a WWW phenomenon in which a visited site sends a piece of data to the users computer and reads it the next time the user visits the site. The information is stored in an ASCII text file called the cookie file. Cookies enable the visited site to better serve the visitor. They do NOT read any information from a user’s hard drive except what is in the cookie file. See

CPR - acronym for computerized patient record. (See computerized patient record.)

CPT - American Medical Association’s Common Procedural Terminology.

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CPU - see Central Processing Unit

Cracker - an individual who illegally breaks into computer systems with the intent of doing damage. This term has faded in use and been replaced by the term hacker. A better term for these individuals is “black hat hacker.”

Crash - see computer crash, or computer freeze

Crop - To cut part of an image out of a picture. When cropping is done in a presentation program, the original image is preserved, just parts of it are invisible. In graphical programs, it is possible to cut out the portion of an image that one wants and delete the rest.

Ctrl+ - The ctrl (control) key is a key on the bottom of a PC computer keyboard. When you see an instruction written Ctrl+D, hold down the Ctrl key while depressing the other key or keys.

Cumulative stress disorder (CSD)- An inflammation or damage to tendons that occurs when repeated stress is placed on the tendons, muscles, or nerves. Sometimes referred to as a repetitive strain injury (RSI) or a cumulative trauma disorder.

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Cumulative chart - a chart that instead of showing a base number, accumulates the date. For example, if you wish to show births, instead of showing the number of births per month, for each month you would add the prior numbers so that January would show only January, while February would show January and February, and June would show all January, February, March, April, May and June etc.

Cursor - the original term designating the screen location where whatever the user entered would appear. Today referred to as the “insertion point.”

Cyberchondria - term used to designate those who use the Web for health information. The term is a combination of the terms cyber and hypochondria to coin a word that tends to appear pejorative, or implying that a person is obsessive, but Harris International views it as a healthy habit. See

Dashboard - a user interface that, somewhat resembling an automobile's dashboard, organizes and presents information in a way that is easy to read. May be interactive. Can provide business intelligence and management reports.

Data - a discrete piece of objective “information.” Theoretically it is the plural of datum, but in common usage data is used to designate both singular and plural forms of the word. Data can have many different nuances. In a database it is a piece of information about something, e.g. the pulse of a client. It can be used to refer to any information that we input into a computer in any format such as a word processing document, a spreadsheet or slides that we have created with a presentation program. It is one of the major concepts in nursing informatics theory of data>information>knowledge>wisdom.

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Data bank - a collection of data in data base format about a given subject. A data bank of client information would contain specified data about many patients probably from different sources, a data bank of movies would contain information about many movies.

Database - A collection of data structured so that desired information can be quickly found. Can exist in a paper format, e.g. a phone book, but is more efficient when in an electronic format. With a phone book in electronic format you could easily find to whom a number or a given address belonged, or reorder the records by phone numbers. A typical database is structured with fields and records that are organized into tables (files).

Database management system (DBMS) - a system that manages a collection of files, often in a table format that enable users to store, modify, and extract information. A hospital information system and a computerized library system are examples.

Database model - The structure on which a database is constructed. Two early models were the hierarchal and network. A current model is relational.

Data dump - Erasing files from a disk in a way that makes it impossible for recovery programs to read any data. May also be called disk wiping.

DataFerrett - a browser designed by the Federal Government that must be downloaded and installed to a local computer. Once installed, users can access public microdata from a variety of Federal Agencies. (see page 426)

Data mining - an analytical, automated process that uses computer “intelligence” to discover hidden relationships in large databases that are too complex to be found using conventional statistical techniques. Requires, however, someone familiar with the data. Is not done blindly. For more information see Two Crows Corporation. (1999). Introduction to data mining and knowledge discovery from

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Data Flow Diagram (DFD) - a visualization of how data flows through an information system. There will be symbols that indicate where the data is collected, where it flows after being collected, where it is stored, how it is processed, and its eventual destination. Like maps, they can be very detailed as with a part of a system, for an entire hospital information system, or even a regional or national information system.

Data security - the protection of data such that it is retrievable 10, 25 or 50 years after it is entered into a computer. This involves all procedures that protect data from loss or corruption such as computer crashes and natural and man-made disasters, as well as ensuring compatibility between the method of storage and current retrieval modes.

Data warehouse - A data warehouse is a collection of diverse data from sources that one would not think of relating that is specifically structured for query and analysis. Developing a data warehouse involves processes that extract the data, then clean and date it. Large healthcare databases would produce volumes of information if put into a warehouse and subjected to data mining.

Debug - finding and correcting "bugs" or imperfections. Usually refers to a system. The hardest bug to fix is one that is intermittent, or that is difficult to recreate.

Decision models - a simplified representation of a situation that can be used for making decisions. A map is a model used to make decisions about the best route from point A to point B.

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Decision-support systems - part of an information system that correlates information from many different sources including specific patient data and the literature to provide suggestions to the clinician. It may be a spreadsheets on which a user creates a model to use and specially designed decision tools that assist the user to structure the problem and make a decision based on a weighted analysis of the analysis. See Clinical Decision Support System.

Decrypt - the process of translating a coded, or encrypted, message into a readable format.

Deep linking - a hyperlink on a Web page that links to a page other than the sites’ home page. In most Web sites a home page is the top page in the hierarchy of pages. Home pages are often the information just beyond the two forward slashes of an URL to the next forward slash. Any characters beyond that link to other pages on the site are called deep links.

Default - the setting, value or procedure that a program or device will automatically assume unless specifically given other instructions. Margin settings in a word processor and width of columns in a spreadsheet are but one of many instances. There is a default, but the settings can be changed either in a single case, or the new setting can often be made the default.

Default drive - the disk drive that the computer will save files to or read files from unless given other instructions.

Defrag - a system utility program that defrags a disk. When a computer stores files on disks if a file is too large to be stored in one sector (physical section of a disk that can be located with an address), parts of the file are stored in other sectors. These sectors are not always contiguous, creating more wear on the drive as well as taking more time for the drive to find the complete file. When a disk is defragged, the sectors for all files are moved to contiguous locations.

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De-identify (data) the process of removing any information from aggregated data that could be used to identify the person about whom the data was created. Such data is said to be De-identified data. See unidentifiable data

Denial of service attack - An condition in which an attacker prevents legitimate users from accessing information or services such as email or a company’s Web site. The most common type occurs when an attacker floods a network with information, often with spam. In a distributed denial-of-service attack, an attacker takes advantage of security vulnerabilities on other computers and programs them to send huge amounts of data to a Web site often causing the Web site to crash, but always making it inaccessible to use by legitimate users. To protect your computer from being part of this scheme, install and maintain both firewall and anti-virus software.

Department of Health and Human Services, sometimes just referred to as HHS (Health and Human Services)

Descriptive Data Analysis - A summary of the raw data in a research project that includes sample size, maximum and minimum values, averages and measures of variation of the data about the average such as standard deviation. Descriptive statistics describe the basic features of the data in a study. With simple graphics analysis, they form the basis of virtually every quantitative analysis of data. This is often a first step, prior to more complex inferential analysis.

Desktop - the screen that contains program icons that appears after the computer is turned on. Clicking any of the icons will open the program to which that icon belongs. Users can also save folders or files to the desktop of easy access.

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Desk top publishing - the use of the personal computer, specialized programs, and a high quality printer to produce written material that resembles material that is professionally printed.

Desktop computer - a personal computer that consists of a monitor, keyboard and CPU unit. The CPU unit can be a “desktop,” (one that has its largest surface parallel to a horizontal surface) or a “tower” (a unit whose largest surface is vertical to the ground and is meant to stand upright).

Detail table - a table in a relational database that has a field that is identical to one in the master table. This enables data from other fields in the detail table to be integrated with data from other fields in both tables to create a form or a report. Sometimes called a child table.

Dialog Box - a box that pops up when you request a feature that requires more than a simple selection in a program. You enter the information needed and the feature performs according to the information you provided.

DHHS - see Department of Health and Human Services

Digest - an option for mailing lists in which all the messages for one day are sent as one message.

Digital - - A system that is based on discontinuous, discrete, data instead of a continuous, or analog data. A digital watch shows only given times, sometimes to the second, often to the minute. An ordinary clock, on the other hand is an analog device. In a regular clock the hands move continuously around the face depicting every conceivable time.

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Dial-up connection - a method of connecting to the Internet in which the user “dials” a number to establish the connection. This is the slowest form of Internet connection and is still prevalent in many rural areas. In metropolitan areas is being supplanted by broadband connections

Digital camera - a camera that records images on a disk rather than on file. So named because the images are digits, rather than true images. These images can be downloaded to a computer and manipulated with a graphics program. The quality of the output is limited by the memory in the camera, the resolution of the digitizing mechanism and by the resolution of the output device which could be a computer monitor or a printer.

Digital subscriber line - see DSL

Disk drive - a device that reads or retrieves data from and writes (saves) data to a disk. There are different types of disk drives, e.g. a hard disk drives which read and write data to a computer’s internal hard disk, floppy drives that read and write to a diskette, and optical disk drives which read and may right to optical disks such as CD-ROMS.

Diskette - any removable disk that can read or write data to a disk with the exception of a CD-ROM or DVD. The original diskettes were physically floppy. The term “floppy disk” is now sometimes used for the more firm storage diskettes (3.5in) that are in use today.

Disk Operating System - see operating system

Directory - the original name for file folder on a PC. Still used on larger computers and the Web. See folder.

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Disk drive - a machine that reads and writes data onto a disk. It rotates the disk very fast and has one or more “heads’ that read and write data. It is accessed via a slot that matches the type of the disk, generally on the front of the computer. Disk drives can be either housed within the computer (internal) or housed in a separate box that connects to the computer (external).

Disk wiping- Erasing files from a disk in a way that makes it impossible for recovery programs to read any data. May also be called data dumping.

Distance Learning - learning in which the learners are physically separate from the teacher. Modes of learning include correspondence, video, CAI, and the Internet. See synchronous and asynchronous learning.

Distributed Learning - education that is not face to face and which uses some form of technology.

DNS - This acronym has three meanings, judge which is meant by the context. Domain Name System, Domain Name Server, or Domain Name Service.

Docking Station - a device that is designed to be attached to a portable computer. They allow laptop user to connect with the amenities of a desktop computer such as a regular size monitor, full-size keyboard, and regular mouse. May be called a port replicator or computer extender.

Document - in this book, any item created by a user in an application program. See file.

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Domain - a part of the hierarchical naming systems for the Internet. Top Level Domains can provide clues as to the type of organization sponsoring that Internet site and the country where this server resides. The letters in the top level domain will be found after the last period, in the first segment of the computer name following the “http://”. E.g. in the URL, the letters “com” represent the top domain.

Domain Name System (DNS) - a system under which each computer on the Internet has a registered number and a name. The alphabetic names are generally used when sending messages or requesting a WWW file because they are easier to remember. The DNS translates these alphabetic names into the numbers that match the character name. These are Internet Protocol (IP) addresses. For example, the domain name might translate to If one DNS server doesn't know how to translate a particular domain name, it asks another one, and so on, until the correct IP address is returned.

Download - moving computer data from one computer to another. This term usually refers to moving data from a server to a smaller computer. See upload.

Downstream - the term used to refer to data that is sent from a server to a client. Often used to refer to information that is sent from the Internet to a user. See upstream.

DOS - the acronym for the original PC disk operating system developed by Microsoft®. Although it can refer to any operating system, DOS is usually used to denote the operating system for early PCS, which has been replaced by Windows.

Dot - the way that a period in an URL or email address is spoken. For example the email address would be spoken aloud as “Florence dot Nightingale at StThomas dot org.”

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Dot pitch - this term refers to how much vertical distance there is between each pixel. The smaller the dot pitch, the sharper the image. If, however, the distance is too small the screen brightness and contrast will be lessened. On color monitors the range is from 0.22 mm to 0.42 mm. The 0.22 mm dot pitch gives a better picture than the 0.42mm.

Drill and Practice - a method of imparting facts that involves repeated exposure to the information followed by questions. Useful at the lowest level of learning in Bloom's Taxonomy.

Drop down box - a list of choices that appears when a given feature is selected, such as a menu option.

DRAM - dynamic RAM. It is the type of RAM found in most micro-computers. See SRAM and RAM.

Driving force - behaviors, beliefs, organizational culture that exist in an organization or individual that can be a positive force towards change, or a force that helps to maintain equilibrium.

Download - transmit information from a larger computer to a smaller one. This process is often associated with copying files from an Internet server to a PC, but it can also refer to copying information from a PC to a PDA type computer. See upload.

Downward compatibility - see backwardly compatible.

Digital subscriber line (DSL). A telephone line that uses sophisticated schemes to pack data so that it can be sent in digital format over existing phone lines in a way that it shares the same line with regular voice. Usability is limited by the distance a user is from the telephone switching station.

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DRGs - diagnosis related group. They are a classification of a hospital stay in terms of what was wrong with, and what was done for a patient.

Drop-down menu - a menu that appears or “drops down” when an item is clicked. Items that will present another menu when clicked are indicated by an ellipsis (...) or an arrow. Generally an arrow means another menu will appear and an ellipsis designates that a pop up dialog box will appear.

Driver - this is a program that controls the interface between a peripheral device such as a printer, or scanner and the computer. When a peripheral, such as a printer, is added to a system, the appropriate driver must also be installed to allow the device to work. This is why many peripherals come with diskettes. One of the hazards of buying generic equipment that does not come with a diskette, is that the driver for the device may not be easily available.

DSL - acronym for digital subscriber line. DSL technologies use sophisticated schemes to pack data onto existing telephone lines. Sometimes referred to as “last-mile” technologies because they are used for connection from the telephone switching station to a home or office. DSL requires that the client computer be less than 20,000 feet (as this is written - this may increase) from the telephone switching station. DSL sends information in an area of a telephone wire unused by normal voice communications, hence can operate simultaneously with voice connections. It requires a special DSL modem. There are different types of DSL, most connections today in the U.S. are ADSL (Asymmetric Digital Subscriber Lines), while in Europe they are more often SDLS (symmetric digital subscriber line). Speeds vary depending on the type of DSL and the distance from the central station.

Dvorak keyboard - a keyboard designed so that the middle row of keys includes the most common letters. In addition, common letter combinations are positioned in such a way that they can be typed quickly. Should common sense prevail (not likely) it would replace the QWERTY Keyboard. From Webopedia - "It has been estimated that in an average eight-hour day, a typist's hands travel 16 miles on a Qwerty keyboard, but only 1 mile on a Dvorak keyboard."

Dynamic IP address - and IP address that changes each time a user is on the Internet. Those who use POTS connections always have dynamic IP addresses. Cable and DSL line users often can choose between a dynamic or static IP address. See static IP address. Having a dynamic IP address makes it more difficult for intruders to invade a computer.

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Created December 18, 2011

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