Provider Directories Meeting

Presented By Alan Viars and Richard Gilbert

June 19, 2014

NPPES Modernization ProjectNPPES Modernization Project

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.

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What is NPPES?What is NPPES?

• NPPES Provides Individuals and Healthcare Organization a unique identifier for healthcare transactions - an NPI

• NPI records are based on self reported (unverified), information.

• Nearly all payers require providers and suppliers to have an NPI.

• NPPES manages over 4 Million NPIs, and tens of thousands of updates per month.

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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.

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HHS Entrepreneurs

HHS Entrepreneurs

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Program Goal: Attract entrepreneurial talent to work with HHS staff on high-risk, high-reward projects for 13 months

To Date: 9 Projects (from 2 cohorts), 6 Operating and Staff Divisions (ASPA, ASPR, ONC, ACF, CMS, HRSA), 12 External Entrepreneurs , and 29 Internal Entrepreneurs

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.

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NPPES Modernization - GoalNPPES Modernization - Goal

• The goal for NPPES Modernization Project is to improve provider data quality, consistency, and usability for CMS, HHS, and the public.

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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.

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ProblemProblem

• Primary information in NPPES, such as provider’s practice addresses and telephone numbers are out of date.

• Providers have little to no incentive to update his or her record. The result is “staleness” of the data.

• Data accessibility and consistency issues exist amongst CMS systems.

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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.

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Project ObjectivesProject Objectives

• Collect input and feedback from internal stakeholders, providers, data consumers.

• Improve data quality in existing system• Develop a web service for internal and

external users.• Develop a new fully-functional system of

NPPES that makes providers want to keep their data current.

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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.

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High -Level ArchitectureHigh -Level Architecture

• Web Site – The new prototype system based on modern web stack using a 3-tier architecture where database access, control logic, and display logic are separated.

• Develop a framework for managing all provider-like enumerations (NPI, HPID, OEID, etc.).

• Create a series of “micro-services” that can be used for reporting and as well as data feeds for other applications. (e.g. a way for PECOS to fetch addresses, taxonomies, identifiers, and other information from NPESS).

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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.

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Existing System SnapshotExisting System Snapshot

• A circa 2000 technology stack– No major technology refresh or user interface

overhaul since inception.– Tied to outdated web technology.– Complicated, expensive, and difficult to change.– No simple method for system to system

connectivity.

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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.

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New Website and Data Service Snapshot

New Website and Data Service Snapshot

• A contemporary open source technology stack– Mobile ready – Uses a responsive design to adapt

to smartphone, tablet, or desktop computers.– Designed on technology used to run some of the

webs largest sites.– A RESTFul API– Streamlined interface functionality to maintain

large numbers of provider records.

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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.

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Challenges and ObstaclesChallenges and Obstacles

• Access to server space for development, testing, and production within CMS.

• Interfacing with existing systems (e.g. I&A, PECOS).

• Network and system constraints slowing and complicating the development process.

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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.

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RESTFul APIRESTFul API

• Using a GeoJSON-like approach• Based around a JSON document that contains

all necessary provider info.• Can be expanded and contain extra

information as needed.

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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.

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Pseudo JSON ExamplePseudo JSON Example

{    number: 123456789,    type:  "NPI-1",          basic: {            first_name: "Ada",             last_name:"Lovelace",            ...            },     addresses:[...],     taxonomies[...],     licenses:[...],     identifiers:[...],     direct_addresses:[...]}     

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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.

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Launch Plan

Transition Plan

Prototype Updates

TimelineTimeline

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Community / Stakeholder Feedback

PrototypeConcept

January2014

April2014

July2014

October2014

December2014

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.

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Prototype ScreenshotsPrototype Screenshots

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(Draft Images / Work In Progress)

INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.

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More InformationMore Information

• Check out http://npi.io• We are conducting stakeholder interviews by

phone to collect requirements.• The project is open source. We will accept

pull requests.

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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.

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QuestionsQuestions

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