Healthcare Business Scopes available for separate import

Last updated: Jun 21, 2024

The Knowledge Accelerator for Healthcare has the following Business Scopes available for separate download and import.

Data Privacy
Clinical Order – Imaging
Health Plan Product – Features and Benefits
Patient Administration – ADT
Patient Practitioner
Personal Health Record - Continuity Of Care
Submitted Healthcare Claim

Each Business Scope consists of:

A set of business terms with:
- Concept terms that describe the main concepts for each business scope
- Property terms that describe the attributes or characteristics of the Concept terms
- Relationship terms that describe how one concept is connected to another Concept
An associated set of secondary subcategories that classify these terms
A set of Reference Data sets and their values
Sample policies and governance rules in the area of data privacy

Data Privacy

A business scope that groups terms for data privacy that includes a taxonomy of terms addressing the personal information of individuals and mappings of core business terms to the GDPR and CCPA regulations.

The data privacy scope is comprised of two subcategories:

Personal Data

A set of business terms with classifications to guide the identification of Personal Information (PI) and Sensitive Personal Information (SPI). This set of terms is not intended to be a definitive standard for data privacy and protection requirements, as the classifications of PI and SPI may vary in different legal jurisdictions. The scope is designed to be a template to accelerate governance of data privacy information. The main concepts covered in this business scope include:

Personal Data Concepts
Basic Personal Information Address Person Contact Person Criminal & Offense Activity Criminal Justice History Substance Abuse History Education & Skills Academic History Professional Certification Finance Bank Account Claim Employment Event	Health & Biometric Care Plan Clinical Finding Diagnosis Disease Risk Management DNA Sample Family History Gene Identification Mental Health History Patient Allergy Patient Immunization History Patient Medical History Online Activities Social Media Persona Social Media Post Opinion Survey Response Personal Communication Agreement Communication Consent Survey Response Personal Human Resources Absence Employment Event HR Performance Review Immigration Job Assignment Person Employment History Personal Location Address Geographic Area Tracking Tag Identifier	Schedules Personnel Schedule Telephony & Video Communication

Personal Data Concepts

Basic Personal Information
- Address
- Person Contact
- Person

Criminal & Offense Activity
- Criminal Justice History
- Substance Abuse History
Education & Skills
- Academic History
- Professional Certification
Finance
- Bank Account
- Claim
- Employment Event

Health & Biometric
- Care Plan
- Clinical Finding
- Diagnosis
- Disease Risk Management
- DNA Sample
- Family History
- Gene Identification
- Mental Health History
- Patient Allergy
- Patient Immunization History
- Patient Medical History

Online Activities
- Social Media Persona
- Social Media Post
Opinion
- Survey Response
Personal Communication
- Agreement
- Communication
- Consent
- Survey Response
Personal Human Resources
- Absence
- Employment Event
- HR Performance Review
- Immigration
- Job Assignment
- Person Employment History
Personal Location
- Address
- Geographic Area
- Tracking Tag Identifier

Schedules
- Personnel Schedule

Telephony & Video
- Communication

Regulatory Alignment

The Knowledge Accelerator for Healthcare contains key terms from two leading data privacy regulations, the General Data Protection Regulation (GDPR) and the California Consumer Privacy Act (CCPA). These regulatory terms are related to the business terms within the Business Core Vocabulary, which helps data users identify enterprise information that is relevant to these regulations.

Clinical Order – Imaging

A Business Scope that groups terms that are related to the placing of a clinical order by a healthcare practitioner for a diagnostic image or set of images for a patient and the clinical findings that result from this order. The main concepts covered in this business scope include:

Clinical Order – Imaging Concepts
Body Site Clinical Finding Diagnosis Document	Imaging Order Imaging Instance Imaging Procedure Item Imaging Result Imaging Series Imaging Study	Order Patient Practitioner Procedure Specimen

Health Plan Product – Features and Benefits

A Business Scope that groups terms that are related to the components of a health plan product and its features and benefits as well as the certification of that product in given locations by a regulatory authority. The main concepts covered in this business scope include:

Health Plan Product – Features and Benefits Concepts
Brand Consumer Health Plan Product Coverage Agreement Coverage Eligibility Geographic Area Healthcare Insurer	Health Plan Product Health Plan Benefit Health Plan Feature Health Plan Product Certification Health Plan Product Specification	Health Plan Group Organization Regulatory Authority

Patient Administration – ADT

A Business Scope that groups terms that are related to the management of an in-patient scenario where a patient is admitted to a hospital setting for care and subsequently discharged or transferred. The main concepts covered in this business scope include:

Patient Administration – ADT Concepts
Address Email Address Phone Admission Discharge	Encounter Healthcare Event Patient Patient Administration Event	Person Point Of Care Location Practitioner Transfer

Patient Practitioner

A Business Scope that groups terms that are related to information required to fully describe a patient as a person, a healthcare practitioner and the relationships between patients and practitioners. The main concepts covered in this business scope include:

Patient Practitioner Concepts
Address Email Address Phone Degree Household Party Specialty Patient Patient Annotation	Person Person Country Citizenship Person Employment History Person Ethnicity Person Identification Person language Person Race Person Tribal Citizenship Military Service History	Practitioner Practitioner Credential Practitioner Language

Personal Health Record - Continuity Of Care

A Business Scope that groups terms that are related to an individual’s medical history that would be recorded in various care settings or when enrolling in a health plan and might be exchanged between authorized providers and payers. The main concepts covered in this business scope include:

Personal Health Record - Continuity Of Care Concepts
Address Email Address Phone Patient Person	Personal Health Observation Criminal Justice History Family History Functional Status Medical Equipment Mental Health History OBGYN History Patient Health Management History Patient Immunization History Patient Medical History Patient Medication History Social History Socioeconomic History Substance Abuse History Vital Sign	Encounter Plan Member

Submitted Healthcare Claim

A Business Scope that groups terms that are related to a claim as it would be submitted by a healthcare provider or received by a payer organization. The main concepts covered in this business scope include:

Submitted Healthcare Claim Concepts
Claim Claim Amounts Claim Attachment Claim Code Claim Diagnosis Codes Claim Note Claim Occurrence Codes Claim Procedure Codes Claim Reference Claim Value Code	Claim Line Claim Line Amounts Claim Line Attachment Claim Line Code Claim Line Diagnosis Codes Claim Line Note Claim Line Occurrence Codes Claim Line Payment information Claim Line Quantities Claim Line Reference Codes Dental Claim Line Tooth Information Medical Claim Line Pharmacy Claim Line Item	Healthcare Insurer Patient Plan Member Practitioner Provider Supplied Demographic Information