October 7, 2009 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

Health IT Provider RegistryIHE Proposal Overview

Proposed Editor: Shanks Kande, Marty Prahl (US Social Security Administration)

October 7, 2009

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 2October 7, 2009

Health IT Provider Registry (HITPR) Profile Proposal

► The Problem domain

► Use Cases - Strategic Drivers

► HITPR – Context Architecture

► Proposed Standards & Systems

► Discussion Items

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 3October 7, 2009

The Problem domain Provider Identification Inefficiency:

► No standardized processes for electronically searching, using typical provider attributes, and with assurance, identifying the provider, location (physical, electronic end points), credentials and method for communication.

► Multiple disparate provider information sources, each one holding a key piece of provider information

Dissemination of Provider Credentials: ► Allow multiple trusted sources to publish provider credentials that

can be distributed and accessible to consumers in real-time.► Provide tools for validation of provider credentials ► Eliminate duplication of provider records across disparate data

sources

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 4October 7, 2009

Health IT Provider Registry (HITPR) definition We envision HITPR as a unified directory of providers

containing identifiers, demographic credentials, locations (physical, electronic) and relationship data

“Provider” is scoped for medical information entities such as physicians, medical laboratories, hospitals, dentists, pharmacists, nurses, diagnostic imaging professionals etc.

HITPR provides directory services to systems over a network or an information exchange using standards based messages

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 5October 7, 2009

Use Cases: Strategic Drivers for health IT “meaningful use”

Use Case Use of HITPR Stakeholders

Social Security Administration Disability Determination

Identify claimant’s providers by demographics & affiliations

Locate providers’ electronic end points in the network to support directed electronic requests

Claimants, Providers, SSA, Health Information Exchanges, Social Services programs

Emergency Response Contact providers and identify “Medical Reservists”

Verify provider credentials

Citizens, Providers, Public health Officials, State & Local Epidemiologists, Response Workers

Consumer Access to Provider List Select provider of care list from registry to grant or deny access permissions

Alerts on provider demographic updates

Consumers, Families, PHR vendors, providers

E-Prescription Prescriber credentials (DEA) validation

Identify & communicate with prescribers on drug recall

Providers, Patients, Pharmaceuticals, Drug Safety Officials

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 6October 7, 2009

Trusted SourcePublic

Trusted SourcesCommercial

Federated Data Sourcing

HITPR

SecureStandards-

based

SecureStandards-

based

Physicians

EMRProviderInformation

Lookup

Hospitals

HITPR supports standards based query and publishing of data

Federal & State Agencies& Health Institutes

SSA, CDC, CMS, VHADoD, etc.

Consumers

Publish ProviderInformation

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 7October 7, 2009

Proposed Standards & Systems HL7 v3 which covers message standards, interactions and the XML data

model for provider registry. Lightweight Directory Access Protocol (LDAP) – defines the messaging

protocol, operations and data schema for directory services. UDDI standard- OASIS approved standard that specifies protocols for

creating a registry for Web services, methods for controlling access to the registry, and a mechanism for distributing or delegating records to other registries. Current NHIN registry specification uses UDDI standard.

ANSI ASC X12 –standard transaction set for interoperable EDI with registry. Standard mechanism for registry replication between Master and slave

nodes. Meta Data based Registry supporting standards for:

► Multiple Provider Identifiers and Demographic traits► Maintaining history of data (only deactivating record– no deleting of the data)► Relationships among entities (provider-organization, organization-facility,

organization-Information Exchange)

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 8October 7, 2009

Discussion Items Immediate need of HITPR within US NHIN to facilitate

nationwide directory services in support of “meaningful use”

The Provider Registry service is also desired in other countries: Canada, Australia, Germany

We propose the technical profile to be scoped for:► Defining Registry data model: Provider demographics, identifiers,

locations, electronic service end points, business relationships, service dates, preferences, and status etc.

► Defining message Interface (Publishing, Querying, Validating)► Synchronizing data with trusted sources► Replication techniques & Cross Community Access