Vital Signs

A brute force attack tries every possible value for a password until it finds the right one. This post explains the HIMSS Dictionary definition and why length, rate limiting, and multifactor authentication matter, then reviews six sources: NIST SP 800-63B-4 digital identity guidelines, the HIPAA person or entity authentication standard, a log study of more than one million brute force attacks on five servers, a simulation of an IoMT key scheme, a clinician cyber hygiene review, and a smartcard with fingerprint two-factor system for hospitals.

Data archiving is the practice of moving data that is no longer in active use to separate storage for long-term retention, while keeping it indexed and searchable. This post explains the HIMSS Dictionary definition and how archiving differs from backup, then reviews six sources: a policy paper on preserving clinical records, the Manchester migration from about 1,000 legacy systems, a cost-benefit analysis of vendor neutral archives, a cloud PACS archive holding more than 450 TB, a pathology archive study, and the HIPAA documentation retention rule.

A virtual community is a group of people who share interests, ideas, and feelings and connect through the Internet and collaborative networks. This post explains the HIMSS Dictionary definition, then reviews five sources: best-practice guidelines for online aphasia support groups, a survey of members of the global AI Nurses Network, a comparison of 2,761 Facebook comments in COPD groups with ChatGPT answers, the co-production of an online peer support platform for people with long-term conditions, and a survey of peer-supported people with epilepsy and multiple sclerosis.

A transaction standard specifies the format of the messages that a system sends or receives, not how information is stored inside the system. This post explains the HIMSS Dictionary definition and the HIPAA regulatory definitions of standard transaction, format, data content, and operating rules, then reviews five sources: the HHS interim final rule on operating rules, an overview of HIPAA administrative simplification, a synthetic X12 837 claims generator for education, a national survey of 1,147 providers on electronic prior authorization, and an evaluation of the Fast Prior Authorization Technology Highway.

Open source is software whose source code is available to users, who can read and modify it. This post explains the HIMSS Dictionary definition and the Open Source Initiative’s ten criteria, then reviews five sources: a survey of 257 health facilities using electronic medical records in Rwanda, a mixed-methods study of OpenMRS and a commercial EHR in Philippine primary care, an integration of the Orthanc imaging server with OpenMRS, and a framework for transitioning a national EMR in Mozambique from an OpenMRS-based system.

Natural language is the everyday speech and writing people use, set against formal computer languages. This post explains the HIMSS Dictionary definition and how it differs from natural language processing, then reviews five sources: an AI chatbot that answered 1,000 natural-language questions about ophthalmic records with 96 percent accuracy, a natural-language query platform for 1.2 million ECG records, multilingual documentation workflows in a Swiss hospital, a voice-guided colonoscopy documentation pilot, and a study of documented interpreter use among emergency department patients with limited English proficiency.

The ISO/IEEE 11073 standards are a family of health informatics and medical device communication standards that provide real-time plug-and-play interoperability and help exchange vital signs and device data acquired at the point of care. This post explains the HIMSS Dictionary definition, then reviews five sources: a standards-based e-health solution implemented in 26 environments in Spain, an extension of the personal health device standards to a treadmill, a Bluetooth implementation for pulse oximeter and ECG devices, a test of 5G and Wi-Fi 6 for cable-free surgical navigation, and a time-sensitive networking approach to bounded latency in operating room networks.

Data cleaning, also called data cleansing or data scrubbing, is the process of fixing or deleting data that are wrong, partial, badly formatted, or repeated, and of making sure the data in a storage resource are accurate. This post explains the HIMSS Dictionary definition, then reviews five sources: a study of duplicate patient records among 3,018,413 patients, a case study of merging two hospitals’ patient indexes, a pedigree deduplication method that automated 99.95 percent of processing, a correction for an inflated NHS adult population denominator, and a cleaning and imputation pipeline for postoperative ICU blood pressure data.

Business e-mail compromise, or BEC, is a sophisticated scam that targets businesses working with foreign suppliers or businesses that regularly make wire transfer payments. This post explains the HIMSS Dictionary definition, then reviews five sources: the FBI Internet Crime Complaint Center’s 2024 annual report, a multicenter study of simulated phishing at six US health care institutions, an evaluation of mandatory phishing training for high-risk employees, a randomized experiment with a real phishing simulation at a Norwegian hospital, and a review of cybersecurity do’s and don’ts in health care.

An access control list, or ACL, is a list of permissions attached to an object that specifies who or what may access it and which operations they may perform. This post explains the HIMSS Dictionary definition, then reviews six sources: NIST’s guide to attribute-based access control, the HIPAA Security Rule’s access control standard, a systematic review of role-based access control in health information systems, a patient-centric consent extension of role-based access, a hospital model that cut the number of roles by 68 percent, and an adaptive access governance model aimed at insider breaches.

Unit testing is the practice of checking each of an application’s smallest testable pieces, called units, by itself to confirm it works. Tests are often automated, though manual testing is possible. This post explains the HIMSS Dictionary definition, then reviews five sources: FDA guidance on software validation, the HL7 FHIR testing framework, a test-driven development project that reached 78 percent code coverage with 875 custom tests, an automated testing framework for biomedical pipelines, and a proposal for clinical testing harnesses for agentic AI.

A smartphone is a mobile telephone that also contains a computer, which lets it browse the web and run apps. This post explains the HIMSS Dictionary definition, then reviews five sources and NIST guidance: a comparison of nursing students’ smartphone use across five years, a study of 61,057 secure messages between interns and nurses, a survey of emergency department consultations by instant messaging, a study of smartphone distraction among 319 surgical nurses, and patients’ attitudes toward a secure photography app.

A real-time location system, or RTLS, provides actionable information about the location, status, and movement of equipment and people, and the HIMSS Dictionary compares it to an indoor GPS for hospitals. This post explains the HIMSS Dictionary definition, then reviews six sources: a qualitative study of RTLS in 23 U.S. hospitals, crash cart tracking across 349 carts in 8 hospitals, tracking of mobile X-ray machines, use of RTLS to monitor mobilization after abdominal surgery, a falls study using mobile workstation coverage, and an emergency department study of how staff spend their time.

Kerberos is a ticket-based protocol that lets trusted computers verify each other’s service requests over a network, like the Internet, that cannot be trusted. This post explains the HIMSS Dictionary definition, then reviews five sources: the Kerberos Version 5 specification in RFC 4120, a radiology single sign-on integration using a directory service, an XML security scheme that pairs Kerberos authentication with authorization, a ticket-based security scheme for multicenter research data, and a smartcard-based single sign-on design for telemedicine.

A flow sheet is a tabular summary of information arranged to display the values of variables as they change over time. In the EHR it is the main place where nurses chart vital signs, assessments, intake and output, and other repeated measures. This post explains the HIMSS Dictionary definition, then reviews six sources: nurse interviews on flowsheet documentation burden, a workflow redesign that cut reassessment steps by 88 to 97 percent, a pipeline that aligned flowsheets across two sites, a test of generative AI on flowsheet data, a breastfeeding data preparation study of 33,285 dyads, and a randomized crossover trial of a spatial alternative to the linear flowsheet.

An expert system is an artificial intelligence-based system that converts the knowledge of an expert in a specific subject into software code, usually built from a knowledge base, an inference engine, and a user interface. This post explains the HIMSS Dictionary definition, then reviews six sources: a hybrid rule-based and language model decision support system tested in two German nursing homes, the development of a knowledge base with 138 care problems for older adult care, an inspectable rule-based tool for diabetic menu planning, the evolution of the Arden Syntax standard, a historical review of knowledge-based expert systems in health informatics, and a retrieval-augmented architecture for post-surgical monitoring.

A cyberattack is an attack carried out through cyberspace that targets an organization’s use of computing to disrupt, disable, destroy, or maliciously control its environment, damage the integrity of its data, or steal controlled information. This post explains the HIMSS Dictionary definition, then reviews five sources: a cohort study of cardiac arrests at hospitals next to a ransomware-infected organization, an analysis of the 2017 WannaCry attack on the NHS, a description of a hospital shutdown and recovery, an economic case study of attacks on Portuguese public hospitals, and a systematic review of patient harms during hospital cyberattacks.

An Ambulatory Diagnostic Group, or ADG, is a method of categorizing outpatient episodes, and the HIMSS Dictionary points readers to the related ACG and APG systems. This post explains the HIMSS Dictionary definition, then reviews six sources: two Ontario cohort studies of ADGs predicting one-year mortality, a diabetes cohort in Zaragoza, an Italian regional cost study, a Norwegian validation of ACG risk scores, and a study of prescription fill rates added to ACG-based models.

The Value Modifier was a Medicare adjustment, applied on a per-claim basis to payments under the Physician Fee Schedule and set at the Taxpayer Identification Number level, that rewarded quality performance and lower costs. This post explains the HIMSS Dictionary definition, then reviews five sources: the 2015 law that ended the separate modifier and carried its measures into MIPS, a study of length of stay risk adjustment, a cross-specialty analysis of 558,296 clinicians in the 2018 MIPS, a study of how practice characteristics related to 2019 MIPS scores, and a framework for an emergency medicine MIPS Value Pathway.

A Trojan horse is a computer program that appears to have a useful function but also has a hidden and potentially malicious function that evades security mechanisms, sometimes by exploiting the legitimate authorizations of the user who runs it. This post explains the HIMSS Dictionary definition, then reviews five sources: NIST’s guide to malware incident prevention and handling, a large analysis of mobile health apps on Google Play, a review of ransomware in hospitals and trauma centers, a review of linear accelerator cybersecurity, and a scoping review of machine learning for health care cybersecurity.