The Glossary of Health

Every industry has its own language that its members use to communicate clearly and efficiently. Everyone within the industry understands its unique terminology and speaks to colleagues knowing that they get it. People outside the industry, well, they’re uninitiated and don’t get the pleasure of having the inside scoop. It doesn’t matter, though; that language is just for insiders to make day-to-day operations easier, right? The rest of the world typically doesn’t need to know. And if an engineer really needs to tell a layperson about the new surgical robot he’s designing with a “non-linear probe,” he can dumb it down and tell the poor rube that the key feature is, in fact, “a curved needle.” (True story.)

Or at least that’s the way it’s supposed to work.

It doesn’t.

While industry-specific terminology —ok fine, let’s call it what it is: “jargon” — can simplify communication within relatively small groups and is generally helpful within those contexts, life in 2017 dictates that we all interact with people outside our niche way too much to be slinging jargon without a thought. Even within a niche there’s variability — one marketer’s Buyer Persona is another’s Ideal Customer Profile.

So that brings us to the world of health. The problem of language barriers in health is exacerbated by the fact that it’s not one industry but a network of interdependent yet distinct industries. You’ve got everyone from software developers to surgeons. There are also multiple political and social perspectives sprinkled into the mix.

In short it’s confusing.

Everyone knows what a hospital is, but who exactly are you talking about when you mention a “provider?”

We decided that it would be worth putting together a list of terms with definitions to help the Health:Further community at least get on the same page. So here we are, the Glossary of Health. It’s an ongoing project that will be regularly updated as we see words that should be mentioned and get feedback from our community.

Many of the terms that follow are included simply to clarify their meaning. Others, like “provider,” “healthcare” and “behavioral health” are included because they are used in different contexts by different groups. Where that happens, we will do our best to explain the different options and then provide our usage of the word. We would also ask that our contributors reference this list and use terminology based on the definitions it contains. It’s not that we expect the glossary to be the definitive source for everyone, everywhere. It’s just that our community is broad and diverse; if we are going to fulfill our mission of bringing all stakeholders together to build the future of health, we have to understand each other. This list can provide a reference point to help that happen.

Thoughts? Let us know by leaving a comment below.

Affordable: The percentage of an individual’s income spent on health services that allows them to prevent disease and/or receive care without undue financial pressure.

The Atlantic reported earlier this year that 1 in 4 American homes “is struggling to pay medical debt.” As a result, people may put off pursuing medical care until “they experience a windfall.” Studies reported by CNBC indicate that the average American shells out roughly $10,000 per year for healthcare, including insurance premiums. Slightly older studies found that insurance coverage eats up about 10% of income. However, depending on income, health status and age, that number can be in the low single digits up to well over 20%. Picking an exact percentage of income that makes care “affordable” is difficult, but less than 10% to cover insurance is a good place to start. From there, mechanisms to keep the cost of actual medical services low and payment plans to keep people from unserviceable debt and bankruptcy are necessary to.

We at Health:Further believe that everyone deserves to live a healthy life, regardless of income or socioeconomic background. We believe an affordable healthcare system is one that takes care of everyone, no matter how much or little money a patient might have. How this is accomplished is a matter of debate, and we recognize the differing and strongly held opinions. When we say “affordable,” we do not mean this as code for “universal coverage,” “single payer” or “free,” unless that is explicitly stated.

Alternative Medicine: Any medical treatment not considered mainstream or orthodox, including acupuncture, at-home care, chiropractic, energy therapies, and herbalism (Adapted from WebMD). It’s the stuff that doesn’t fall under “modern medicine” like surgical interventions, pharmaceuticals, and medical devices. Alternative medicine interventions and techniques are, as a general rule, not regulated and/or approved by the FDA. Alternative medicine advocates consider these approaches to be more natural than mainstream interventions.

Artificial Intelligence (AI): High-level computer processing that imitates analytical elements of human thinking. (Adapted from Britannica). It’s really important to distinguish between AI and machine learning. The latter is too often called the former, but is more of a mechanism to reach it. Here’s one good primer on the relationship between AI, ML and Deep Learning.

Behavioral Health: Related to but not synonymous with “mental health.” A field that looks at — and seeks to modify — human behaviors that affect well-being, particularly in the realm of mental health. Thus, it involves activities that can be altered to achieve a change in a person’s overall and/or mental health. Historically, the term was understood to include behaviors that affected any aspect of health. For example, exercise and diet in preventing diabetes and cardiac disease. That remains true; however, today that piece of the definition tends to be overshadowed by its use in the mental health arena, dealing with things like addiction.

Big Data: The large volume of information about individuals and groups that is created by constantly accumulating digital interactions and records.

Blockchain: A time-stamped, open-source digital registry that securely records and shares different types of data across a network. Want to know more? Turns out our friends at Hashed Health just published a list of key terms in blockchain. Give it a read!

Clinician: Any individual medical professional who delivers care to patients. Can include MD, DO, NP, CRNA, PA, RN, CNA, LPN, among others. Often referred to as providers, we use the term “clinician” to distinguish between hospitals and facilities that provide medical care (see “Provider”). The three main types of clinicians are primary caregivers, specialty caregivers, and nurses. (Adapted from MedlinePlus Medical Encyclopedia, which uses the term “provider.”)

Community Hospital: A general term for smaller, non-federal hospitals. Often refers to rural hospitals. (Adapted from athenahealth)

Demographics: The number and characteristics (such as age, race, income) of people who live in a particular area or form a particular group (Adapted from the Cambridge Dictionary)

Disruptive: This is subjective and tough to define, we’re working on it…

Diversity: Diversity includes gender, ethnic background, socioeconomic status, educational status and background, age, and profession. At Health:Further, diversity means the welcoming of all ideas, provided they are optimistic, respectful and evidence-based. We seek to represent and elevate a variety of backgrounds and opinions.

Electronic Health Record (EHR): “A digital version of a patient’s paper chart,” which enables a higher level of liquidity for patient data (healthIT.gov). Includes much or all of a patient’s health history, doctors notes, test results, etc. Also called an Electronic Medical Record (EMR).

Health Insurance Is a type of insurance coverage that covers the cost of an insured individual’s medical and surgical expenses. Depending on the type of health insurance coverage, either the insured pays costs out-of-pocket and is then reimbursed, or the insurer makes payments directly to the provider. (Adapted from Medical News Today).

The concept of health insurance is often termed “healthcare” when discussing policy. For example, many advocates for “universal healthcare” mean that they wish to see everyone covered by some form of health insurance policy so that necessary healthcare services can be paid for. While this is a common and understandable use of the term, we prefer to separate the terms “health insurance” and “healthcare.” We use the former to describe a mechanism for hedging against medical expenses and paying for them when they occur. We define the latter below.

Health: “A state of complete physical, mental and social well-being and not merely the absence of disease” (The World Health Organization). It includes environmental, lifestyle, medical, genetic and mental factors, therefore being a broader idea than “healthcare.”

To repeat, “health” is distinct from “healthcare.” The Health:Further ideals state that “health is a human right.” This means that every individual should have the opportunity to live a healthy life, while recognizing that there are numerous opinions about the best regulatory and economic policies to achieve that aim. Thus, it is a broader statement than “healthcare is a human right,” which tends to suggest that a particular economic policy (generally involving specific mechanisms of providing health insurance) is an innate right. Yeah, it’s a touchy subject.

Healthcare: “The organized provision of medical care to individuals or a community” (Oxford Dictionary). At Health:Further, we view healthcare as falling under the umbrella of “health” rather than a synonym for it. The healthcare industry provides medical services and the mechanisms to pay for it, but does not encompass everything that contributes to health. Indeed, only a small percentage (10–20% by some estimates) of “health” is defined by what we would consider “healthcare” — i.e., medical services designed to prevent and treat disease.

Innovation: The process of designing or creating a new idea, product, or method. Innovation can be broken down into different levels, but it’s important to note that the term can be used to describe anything new, even if a simple creative application of an existing idea or product. Therefore, innovation can be anything on the continuum from incremental to revolutionary, with the majority falling closer to the incremental. People describing their products as “innovative,” can run the risk of overstating the significance of their product’s effect on a particular area of health(care). i.e., conflating “innovative” with “revolutionary” or “disruptive.”

Insurance Premiums: The amount of money an insured patient must pay out of pocket for medical procedures.

Investor: A person who gives money to a business with the hope or expectation of eventually earning profit as the business’s revenue grows. (Adapted from Investopedia)

Machine Learning: An application of artificial intelligence (AI) that refers to the ability for a computer or other machine to continually improve its own processing powers based on inputs over time (Adapted from expertsystem.com). Machine learning is a mechanism by which artificial intelligence can be achieved. See these pieces from Nvidia and Intel. If you’re looking for a deeper dive into machine learning, check out this series on Medium.

Marketer: An organization or individual who works to bring their product to their target audience, a process that includes market research and advertising. Healthcare marketing is becoming more and more salient as the healthcare industry becomes more patient-focused and the individual patient gains more buying power.

Mental Health: Encompases our emotional, psychological, and social well-being. It affects how we think, feel, and act. It also helps determine how we handle stress, relate to others, and make choices. (Adapted from MentalHealth.gov)

Network Effect: “A phenomenon whereby a good or service becomes more valuable when more people use it. The internet is a good example. Initially, there were few users of the internet, and it was of relatively little value to anyone outside of the military and a few research scientists. As more users gained access to the internet, however, there were more and more websites to visit and more people to communicate with. The internet became extremely valuable to its users.” (From Investopedia).

Obamacare / ACA : The Patient Protection and Affordable Care Act is a reformative federal healthcare policy signed into law by President Barack Obama in 2010. The primary goals of the law are to prevent anyone from being excluded from obtaining and retaining insurance coverage, and to incentivize/require everyone to have insurance. The law, designed to roll out over the course of 10 years, was ultimately meant to reduce overall healthcare spending in the US. (Adapted from the New England Journal of Medicine)

Optimism: “Hopefulness and confidence about the future or the success of something” (Oxford Dictionary). We believe innovation requires optimism. Our healthcare system is dysfunctional, and the future of health can seem bleak — but instead of falling into negativity, we seek out and amplify ideas and solutions that are creating and will create the future we hope for.

Payor (or Payer): The entity that foots the bill for a medical service, often a health insurance company, but could include an employer authorized to self-insure its employees healthcare costs and/or a government/government entity that pays for healthcare services (Adapted from Oregon Legal Glossary). At Health:Further, we use the term “Payer” to describe insurance companies unless otherwise noted.

Precision Medicine: According to the National Institutes of Health (NIH), precision medicine is “an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person … This approach will allow doctors and researchers to predict more accurately which treatment and prevention strategies for a particular disease will work in which groups of people. It is in contrast to a ‘one-size-fits-all’ approach, in which disease treatment and prevention strategies are developed for the average person, with less consideration for the differences between individuals.”

Provider: As noted under “Clinician,” this term can refer to doctors and nurses, and sometimes pharmacists. However, it can also refer to hospitals and health systems, which are the large-scale providers of medical care. This is how we use the term at Health:Further.

Respect: “Due regard for the feelings, wishes, or rights of others” (Oxford Dictionary). We’re informal, but still considerate. We challenge the status quo, but without being obnoxious. We think it’s ok to be irreverent, as long as we’re not throwing unnecessary shade. We criticize ideas, not people — and we think all criticism should be constructive.

Self-Care: Actions deliberately taken to maintain or improve one’s personal health, especially mental/emotional and physical health. Common methods of self-care include prioritizing sufficient sleep, moderate amounts of daily exercise, a nutritious diet, meditation and other relaxation exercises, and nourishing a strong social circle (Adapted from PsychCentral). “Self-Care” ties in closely with the traditional definition of “Behavioral Health.”

Startup: An amorphous term describing a young company at an early stage of development. It is more proper to think about companies in terms of their financial standing rather than age, but startups tend to be five years old or younger. The four rough phases of a company’s life are Startup, Growth-Stage, Established, and then Exited.

Stem Cell Therapy: A new form of medical treatment using very young embryonic cells that have not yet differentiated into a specific bodily function. Stem cell therapy has been used to treat leukemia, heart disease, diabetes, macular degeneration, and multiple sclerosis. (Adapted from NIH.gov)

Sustainable: Executed in such a way that a method or process conserves or regenerates resources rather than depleting them.

Telehealth: Any remotely administered medical care, whether through a phone call, video call, or other digital medium.

Universal Coverage: Literally, a state where all members of a society have some form of health insurance. The popular understanding of this term, and the definition that we use at Health:Further, puts the emphasis on government subsidizing of health insurance. “Universal Coverage” is often used as a synonym for “socialized medicine” or “single-payer” in which the government takes on significant or even full responsibility for providing coverage.

Urban Design: The intentional planning of a city’s built environment to maximize the pleasure and utility of residents’ and visitors’ experiences in the city, economic profit and growth, and environmental sustainability. (Adapted from urbandesign.org)

User Experience (UX): How a consumer interacts with a product — especially relating to the ease and comfort with which they can use it, and how they perceive its value. (Adapted from Smashing Magazine)

User Interface (UI): The actual interaction between user and computer. User interface greatly affects user experience, and creating a good user experience will inform the design of the user interface. For example, if a company has a website that requires people to create an account, but has a poorly designed website on which it is difficult to register for that account, the bad website and registration forms (the UI) create a poor UX.