Recognizing that terminology in the health care sector (private and public) varies from organization to organization, the Foundation identified words in our vernacular that might be confusing. We hope these definitions will provide clarity for our grantees and constituents as we work together to make Colorado the healthiest state in the nation.
adequate amounts of fruits and vegetables: This standard varies according to weight, age and gender, but for an average 2,000-calorie diet, people need 2.5 cups of vegetables and 2 cups of fruits per day. (USDA)
adequate health coverage: Having insurance that meets the needs of the patient; having insurance and reporting no problems because of cost. (Centers for Disease Control and Prevention)
built environment: Defined broadly to include land-use patterns, the transportation system and design features that together provide opportunities for travel and physical activity. "Land-use patterns" refer to the spatial distribution of human activities. The "transportation system" refers to the physical infrastructure and services that provide the spatial links or connectivity among activities. "Design" refers to the aesthetic, physical and functional qualities of the built environment, such as the design of buildings and streetscapes, and relates to both land use patterns and the transportation system. (Transportation Research Board)
chronic disease: Illnesses that are prolonged, do not resolve spontaneously and are rarely cured completely. (CDC)
chronic disease self-management: The systematic provision of education and supportive interventions by health care and other staff to increase patients' skills and confidence in managing their health problems, including regular assessment of progress and problems, goal setting and problem-solving support. (Institute of Medicine)
convenient access: Proximity of locations where residents can obtain affordable fruits, vegetables, whole grains, low-fat milk and other foods that make up the full range of a healthy diet. Defined as within one mile in urban areas and within 10 miles for rural areas. (USDA)
coordinated care: The provision of a combination of health services and information that meets a patient's needs; coordination of care is a component of integrated care.
electronic health record (EHR): A computerized record that contains patient information such as medical history, allergies, immunizations, medications, diagnoses and test results. An EHR contains most of the same information found in a paper medical record and is highly secured to protect the privacy of patients and their information. These records provide more accurate and complete information and help providers give the best possible care. Electronic health records are a type of health information technology and the basis for health information exchange. (Office of the National Coordinator for Health Information Technology)
evidence-based care: The integration of best research evidence with clinical expertise and patient values. (Institute of Medicine)
- best research evidence: Clinically relevant research, primarily from patient-centered clinical research on the accuracy of diagnostic tests; the power of prognostic markers; and the efficacy and safety of therapeutic, rehabilitative and preventive regimens. (Institute of Medicine)
- clinical expertise: the ability to use clinical skills and past experience to rapidly identify a patient's unique health state and diagnosis, individual risks and benefits of potential interventions, and personal values and expectations. (Institute of Medicine)
- patient values: Preferences, concerns and expectations of each patient, which must be integrated into clinical decisions if they are to serve the patient. (Institute of Medicine)
food deserts: Areas that lack access to affordable fruits, vegetables, whole grains, low-fat milk and other foods that make up the full range of a healthy diet. (CDC)
Funding Strategies: Specific tactics to help the Foundation achieve its community outcomes in Healthy Living, Health Coverage and Health Care. View the Foundation's seven Funding Strategies.
health information exchange (HIE): A network which allows health care information to be shared between health care providers within a community or larger region. HIE lets clinical information move electronically between the different health care information systems that may be used by a patient's different providers (e.g., specialists, labs) while maintaining the privacy, security and accuracy of the information being exchanged. (Colorado Regional Health Information Organization)
health information technology (HIT): Generally considered to be the use of computer hardware and software to store, protect, retrieve and transfer clinical, administrative and financial information electronically within health care settings.
health insurance exchange: State-based marketplaces that offer small businesses and individuals a choice of affordable health plans that meet new essential benefit standards. (The Commonwealth Fund)
health professional: A licensed professional who delivers appropriate health care in a systematic way to individuals in need of health care services. Health professionals include physicians, dentists, dental hygienists, physicians' assistants, behavioral health specialists, nurses and a wide variety of other individuals regulated and/or licensed to provide some type of physical, mental or oral health care.
health professional shortage area (HPSA): Urban or rural areas, population groups, or medical or other public facilities with shortages of primary medical care, dental or mental health providers. (Department of Health and Human Services)
healthy meals at school: Students need healthy food in order to meet their potential to learn and thrive. The USDA School Meals Initiative sets minimum nutrition standards that comply with the Dietary Guidelines for Americans. Other national entities, like the Alliance for a Healthier Generation, have established school meal guidelines that encourage more fresh fruits and vegetables; whole grains; food low in fat, sodium and sugar; and fewer processed and/or fried foods. (Alliance for a Healthier Generation)
healthy vending choices: Students need healthy food in order to meet their potential to learn and thrive. Vending machines in schools should offer beverage options including water without added sugar or artificial sweetener, 100 percent real fruit juice and fat-free or low-fat milk. Food options must be low in fat, sodium and sugar. These recommendations are aligned with specific guidelines developed for healthy vending by the Alliance for Healthier Generation and the Institute of Medicine.
integrated care: The provision of comprehensive, coordinated and continuous services that provide a seamless process of care. (Institute of Medicine)
- comprehensive care addresses any health problem at any given stage of a patient's life cycle. (IOM)
- coordinated care is the provision of a combination of health services and information that meets a patient's needs. (IOM)
- continuous care is delivered over time by a single individual or a health care team and includes the effective and timely communication of health information. (IOM)
interdisciplinary: Members from different professions and occupations (e.g., primary care physician, psychologist, nurse practitioner) closely working together and communicating frequently to optimize care for the patient. (IOM)
long-term services and supports: A broad range of supportive services needed by people who have limitations in their ability to perform daily activities because of a physical, cognitive, or mental disability or condition. (National Health Policy Forum)
meaningful use: Simply put, "meaningful use" means providers need to show they're using certified EHR technology in ways that can be measured significantly in quality and in quantity. (Centers for Medicare & Medicaid Services)
Measurable Results: Numeric milestones used to gauge progress toward the Foundation's goals. View the Foundation's 12 Measurable Results.
medical home: A health care setting that provides patients with timely, well-organized care and enhanced access to providers. (The Commonwealth Fund)
medically underserved area: A county or group of contiguous counties, a group of county or civil divisions, or a group of urban census tracts in which residents have a shortage of personal health services. (Department of Health and Human Services)
mission-driven investments: Financial investments made with the intention of furthering the Foundation's mission through positive impact on its Measurable Results and recovering the principal invested and earning a financial return.
necessary care: The care which, in the opinion of the treating physician, is reasonably needed to prevent the onset or worsening of an illness, condition, or disability; to establish a diagnosis; to provide palliative, curative, or restorative treatment for physical and/or mental health conditions; and help the individual achieve or maintain maximum functional capacity in performing daily activities. (U.S. Department of Health and Human Services)
overweight/obesity: In those aged 6 to 19 years, overweight or obesity is defined as at or above the sex- and age-specific 95th percentile of body mass index (BMI) based on "CDC Growth Charts: United States." In adults, obesity is defined as a BMI of 30 kg/m2 or more, and overweight is a BMI of 25 kg/m2 or more. (CDC)
personal health record: Like an electronic health record, a personal health record, or PHR includes information such as allergies, immunization dates, family medical history, and contact information for family members and health care providers. Information in an EHR is typically entered and accessed by a health care provider. A PHR is designed to be set up and accessed by those receiving health services. While some people keep this information in a folder or file cabinet at home, having it in electronic form means it can be safely stored and shared easily with others who need it.
physical activity: In an educational environment, activity that can be integrated in educational curriculum, recess, intramurals and PE classes. (North Carolina Department of Public Instruction)
Recommendations for adults:
- Cardio or aerobic activities: at least 30 minutes of moderate-intensity physical activity daily on most days of the week or at least 20 minutes of vigorous-intensity physical activity three days a week. (CDC)
- moderate-intensity aerobic activities: produce a noticeable increase in heart rate, while still being able to talk comfortably. Examples include dancing, riding a stationary bike, mowing the lawn, walking at a brisk pace.
- vigorous-intensity aerobic activities: produce a substantial increase in heart rate, while breathing hard and fast. Examples include jogging, swimming laps, playing tennis (singles) and moving or pushing furniture. (CDC)
- When limited by abilities or conditions, older adults should focus on exercises that maintain or improve their balance and level of fitness. (CDC)
Recommendations for children and adolescents: at least 60 minutes of moderate-intensity physical activity (such as brisk walking, playing tag, jumping rope or swimming) on most days of the week, preferably daily.
physical education: A curriculum in which students are taught skills, knowledge and concepts that enhance a physically active lifestyle. In other words, physical education teaches us how to be physically active. (North Carolina Department of Public Instruction)
pre-existing condition: A limitation or exclusion of benefits relating to a condition based on the fact that the condition was present before the date of enrollment for such coverage, whether or not any medical advice, diagnosis, care, or treatment was recommended or received before such date. (Affordable Care Act)
primary care: The provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients and practicing in the context of family and community. (IOM) The Foundation's definition of primary care includes primary physical, oral and behavioral health care needs.
public health: The practice of preventing disease and promoting good health within groups of people, from small communities to entire countries. Public health professionals rely on policy and research strategies to understand issues such as infant mortality and chronic disease in particular populations. Rather than being a single discipline, public health includes professionals from many fields with the common purpose of protecting the health of the population. (American Public Health Association)
quality health care: The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. To achieve quality health care, the system must focus on six specific aims for improvement, built around the core need for health care to be safe, effective, patient-centered, timely, efficient and equitable. (Institute of Medicine)
recreational exercise: Leisure-time physical activity, such as sports or hobbies, that are not associated with activities part of regular job duties, household chores or transportation. (CDC)
safety net: Health care providers that deliver a significant level of health care and other related services regardless of a patient's ability to pay. Safety net providers serve individuals who are primarily uninsured, publicly insured or who are otherwise vulnerable. Vulnerable individuals include those with chronic diseases, the elderly and those living in rural or low-income urban areas. (IOM)
underinsurance: in general, people are considered underinsured if they cannot afford recommended care despite having insurance. The Commonwealth Fund defines an underinsured person as someone who has insurance all year but who has inadequate financial protection indicated by any one of the following:
- Annual out-of-pocket medical expenses total 10 percent or more of income
- For low-income adults (making less than 200 percent of the federal poverty level), out-of-pocket medical expenses total 5 percent or more of income
- Health plan deductibles are 5 percent or more of income
underserved: Insufficient health resources (manpower and/or facilities) to meet the medical needs of the individual.