HIMSS Word of The Day #549: Ancillary Care

By Eric Andrew Kristof, RN, CAHIMS | Healthcare IT Professional | HIMSS Arkansas Chapter Member

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About This Series: The HIMSS Word of The Day is a running blog series drawing from the HIMSS Dictionary of Health Information and Technology Terms, Acronyms, and Organizations, 6th Edition (2025) — the authoritative reference for healthcare IT professionals and the primary study resource for CAHIMS and CPHIMS certification. Each post paraphrases the term in plain language, grounds it in real-world healthcare IT context, and adds a bedside nursing perspective you won’t find in a textbook.

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📖 The Term: Ancillary Care

Source: HIMSS Dictionary of Health Information and Technology Terms, Acronyms, and Organizations, 6th Edition (2025)

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🔍 Plain-Language Definition

The HIMSS Dictionary uses ancillary care for the wide range of health services that surround a main medical encounter. It sorts these services into three groups. Diagnostic services cover laboratory work, radiology, genetic tests, and imaging. Therapeutic services include rehabilitation and physical and occupational therapy, along with other services the Dictionary lists, such as massage, chiropractic care, and speech therapy. Custodial services, in the Dictionary’s list, include hospice, nursing facility care, urgent care, and long-term and post-acute care (LTPAC).

That grouping is broad, and the term is not used the same way everywhere. In some sources, “ancillary services” means the diagnostic and pharmacy services a clinician orders during a visit. In others, it means support services located alongside a clinic, such as nutrition, social work, psychiatry, and physical therapy. The studies below show both uses. For that reason, the first practical step with this term is to ask what is meant and which services are included.

In health IT, ancillary care matters because most ancillary work starts with an order and ends with a result or a completed service, and several separate systems often sit in between. A clinician places an order in the electronic health record. A department system, such as a laboratory, radiology, or pharmacy system, receives it, schedules or performs the work, and sends results or status back. If the order, the patient identity, the schedule, or the result is wrong or late at any point, care is delayed. Interfaces, order sets, and shared patient identifiers connect these pieces.

Dictionary group	Examples from the Dictionary	Typical information flow
Diagnostic	Laboratory tests, radiology, genetic testing, diagnostic imaging	Order out, scheduling, result back
Therapeutic	Rehabilitation, physical and occupational therapy, speech therapy, chiropractic care, massage	Referral or order, visit notes, progress reports
Custodial	Hospice, LTPAC, urgent care, nursing facility care	Transfer summaries, care plans, status updates

⚠️ Exam Alert: Ancillary care means services that support or surround the main medical visit, grouped by the Dictionary as diagnostic, therapeutic, and custodial. Do not confuse an ancillary service (the service itself) with an ancillary system (the department software such as a laboratory or radiology information system), or with primary care, which is the main point of care. Also note that the Dictionary’s list is broader than many everyday uses of the term.

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🌐 Why It Matters: Real-World Healthcare IT Context

Research that uses the exact term “ancillary” is scattered across specialties and uses it in different ways. The sources below were chosen to show four recurring issues: whether ordered services are completed, who is at risk in ancillary units, how colocated services are used, and what it takes to bring ancillary staff into an electronic ordering system. Each was checked against its published abstract, and the type of study is noted.

Order fulfillment. Roblin and colleagues, in Medical Care (2023), used electronic health record data from three Kaiser Permanente regions to study incident neck or back pain and incident urinary tract infection visits from January 2016 through June 2021. They compared virtual visits (chats, telephone, or video) with in-person visits, and prepandemic with recovery periods, and measured how often patients fulfilled orders for five service classes for each condition. For diagnostic radiology, laboratory, and pharmacy services, fulfilled orders were generally above 70 to 80 percent. Longer distance to the clinic and higher cost-sharing from a high deductible plan did not significantly reduce fulfillment. Prior use of a mail-order pharmacy was associated with higher medication fulfillment on virtual neck and back pain visits. This is a retrospective study of one integrated system, so its results may not apply to other settings.

Risk inside ancillary units. Messer, in the Journal of Wound, Ostomy and Continence Nursing (2010), reviewed the research on pressure injury risk for patients having procedures in ancillary units such as radiology, dialysis, and cardiac and vascular laboratories. The author reports that little had been published on the topic, and that the only study found in this population reported pressure injury in 53.8 percent of patients having lengthy radiology procedures. The review identifies risk factors such as high interface pressure on support surfaces, shear from movement and positioning, advanced age, severe neurologic impairment, anesthesia and sedation, fever, sepsis, and low blood pressure. It is a single-author literature review published in 2010 that relied on limited evidence.

Colocated services. Caldwell and colleagues, in Female Pelvic Medicine and Reconstructive Surgery (2021), reviewed the records of 575 women attending an integrated practice unit for pelvic floor disorders, with nutrition, social work, psychiatry, physical therapy, and subspecialty care colocated in the clinic. Of the women, 35.14 percent attended at least one appointment with an ancillary services provider. Use did not differ between patients under a bundled payment model and those under fee-for-service (36.22 versus 33.47 percent). Social work was used more under the bundled model (15.95 versus 6.28 percent), and a diagnosis of fecal incontinence was linked to a higher chance of using any ancillary service. It is a retrospective chart review at one clinic.

Bringing ancillary staff into ordering. Cooley and colleagues, in the American Journal of Health-System Pharmacy (2012), reviewed lessons from pharmacy-led teams implementing computerized prescriber order entry at four academic medical centers. They identify factors they consider essential, including involvement of all ancillary personnel in planning, development, implementation, and refinement; equipment with a high level of interoperability with existing systems and automated dispensing machines; order sets and decision support tailored to clinical workflows; and adequate resources for training and support. This is an experience-based review from four institutions, not a controlled study.

A narrative view from pediatrics. Alsabri and colleagues, in Indian Pediatrics (2020), described ancillary services in US pediatric departments as helping reduce stress, improve patient satisfaction, and conserve staff time, and they expect these services to gain recognition as free-standing children’s hospitals emerge. The abstract is a narrative view without reported data, so its claims are best read as the authors’ perspective.

Taken together, the sources show that ancillary care is mostly about handoffs: from order to completed service, from clinic to specialty unit, and from planning to training. They also show that the term covers very different services.

Common ancillary care problems:

• Using “ancillary” without saying which services are meant
• Orders that are placed but never completed, scheduled, or resulted
• Department systems that do not share patient identity, orders, or results cleanly with the EHR
• Ancillary staff left out of system planning and training
• Patients at risk during long procedures in imaging or procedure units
• Referrals and transfers without the information the next service needs

What supports reliable ancillary care:

• Clear order-to-result workflows with named owners for each step
• Interfaces and patient identifiers that connect department systems to the EHR
• Ancillary staff on design, testing, and training teams
• Order sets and decision support matched to how departments actually work
• Risk checks and positioning protocols for patients in procedure units
• Tracking of order completion, not just order entry

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🏥 The Nurse’s Perspective: Clinical, Bedside, & Workflow

Nurses send patients to ancillary services all day, and they receive the results that come back.

At the Bedside

Nurses prepare patients for imaging, laboratory draws, dialysis, and therapy, then watch for changes afterward. The pressure injury review is a reminder that time on a procedure table or in a lab carries its own risks, so hand-offs between the unit and the procedure area include skin and positioning information as well as the order.

In Clinical Workflow

Nurse informaticists often work with department leaders on how orders are routed, how transport and scheduling are tracked, and how results reach the right nurse. They look for steps where an order exists but no one is sure whether the service happened. The order fulfillment study is a prompt for this: counting orders placed does not count services completed.

In EHR Implementation (Go-Live Perspective)

During an Epic Go-Live, analysts at the elbow hear about orders that did not reach a department, results that did not post, and schedules that did not match. They trace each issue through the order, the interface, and the department’s own system. The CPOE experience at four academic centers suggests why early involvement of ancillary staff pays off: they know where the order will go and what the department needs to act on it.

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🎓 CAHIMS / CPHIMS & HIMSS Perspective

CAHIMS Exam Domain Mapping

Ancillary care connects orders, departments, and information flow:

CAHIMS Domain	How Ancillary Care Appears
Healthcare & Technology Environments	The range of care settings and support services around a visit
Clinical Informatics	Orders, results, referrals, and clinical workflows with department staff
Healthcare Information & Systems Management	Department systems, interfaces, patient identity, and order tracking
Management & Leadership	Stakeholder involvement, training, and workflow ownership across departments

Key Terms to Know Alongside Ancillary Care

• Ancillary System — department software, such as for the laboratory, radiology, or pharmacy
• Order Entry — electronic placement of orders by clinicians
• Interface — connection that lets two systems exchange data
• Diagnostic Services — tests and imaging used to identify conditions
• Long-Term and Post-Acute Care (LTPAC) — care settings such as skilled nursing facilities after a hospital stay
• Care Coordination — deliberate organization of activities among those involved in a patient’s care

HIMSS Organizational Position

HIMSS offers education and research on health information and technology topics through its Resource Center. Members can find related information on the HIMSS Resource Center page.

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🔗 Explore Further: External References

1. Roblin et al. (2023), Medical care — Did Access to Ambulatory Care Moderate the Associations Between Visit Mode and Ancillary Services Utilization Across the COVID-19 Pandemic Period? https://pubmed.ncbi.nlm.nih.gov/36893417/
2. Messer (2010), Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society — Pressure ulcer risk in ancillary services patients https://pubmed.ncbi.nlm.nih.gov/20228656/
3. Caldwell et al. (2021), Female pelvic medicine & reconstructive surgery — The Use of Ancillary Services Under a Bundled Care Versus a Fee-For-Service Payment Model https://pubmed.ncbi.nlm.nih.gov/34261108/
4. Cooley et al. (2012), American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists — Implementation of computerized prescriber order entry in four academic medical centers https://pubmed.ncbi.nlm.nih.gov/23230041/
5. Alsabri et al. (2020), Indian pediatrics — Ancillary Services in Pediatric Departments of USA https://pubmed.ncbi.nlm.nih.gov/33231173/
6. HIMSS — Resource Center https://www.himss.org/resource-center

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Term source: HIMSS Dictionary of Health Information and Technology Terms, Acronyms, and Organizations, 6th Edition (2025). All definitions in this series are paraphrased for editorial purposes. Readers are encouraged to consult the primary source for exact language.

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Eric Andrew Kristof, RN, CAHIMS is a Healthcare IT professional and HIMSS Arkansas Chapter member based in Hot Springs Village, AR, with hands-on Epic Go-Live experience and a diverse healthcare and IT background. He writes at kristof.org at the intersection of clinical care and healthcare technology.