January 5, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT Healthcare Provider Directory (HPD) Data Model Discussion IHE Tcon January 5, 2010

January 5, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

Healthcare Provider Directory (HPD)

Data Model DiscussionIHE Tcon

January 5, 2010

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 2January 5, 2010

Topics

HPD Overview

HPD Data Model Review

Next Steps


HPD Overview This proposal recommends development of a unified approach

for electronic lookup query where, upon initiated with a unique identifier or key demographic elements, an authorized user may obtain content of a unique provider entry with high reliability.

Beyond the query lookup functionality, there is a minimum set of transactions required to create and maintain the directory service, first of which is the ability to make additions and updates to provider entries.

The scope of this proposal focuses initially on the minimum “foundational” set required for defining a provider directory, resulting in a usable work product as well as recommendations for future phase expansions.


Secure IT Infrastructure

HIT Provider Registry

HPD Actors and Transactions

Provider Registry Source

Provider Registry Consumer

Add/Update Provider

Notify of Change

Subscribe

LookupProvider

Authentication AuditingTransaction

Actor


HPD Content Model The HPD Content Model supports the query for provider

based on properties, relationships, and classifications

Relationships

Properties

Classifications

Provider


Metadata based registry

Provider HITPR Metadata

Properties- Identifiers- Name, Alias- Location- Electronic end URLs- Specialty- Certificates- Status- User- defined

Relationships- Provider Credentials- Provider Affiliations- Geographic- Status - user-defined

Classifications- Provider Type- Location Type- Credential Type

Organization- Hospital- Lab- Practice- Radiology- Business Entity- Etc

Individual- Physician - Nurse- Lab Technician- Pharmacist- Physical Therapist - Etc


Individual Provider View

Individual Provider

Alias

Organization (s)

Education (s)

Department (s)

Facility (s)

Addresses (s)

has business Relationship (s)

Is housed in (many)

Is composed of (many)

Is located atIs located athas business Relationship (s)

Is composed of (many)Is housed in (many)

Credential (s)

Specialty

HasHas

Has

Has

Provider Has


Organization View

Organization

Specialty (s)

Department (s)

Facility (s)

Addresses (s)

Is housed in (many)

Is composed of (many)

Which are located at

Which are at(Many) Business Relationship (s)

Is Composed of (many)Is housed in (many)

Credential (s)

HasHas

Individual Provider

(many) business relationship (s)

Has

Organization

Department (s)

Addresses (s)

AliasProvider Has


Use Case View

Organization

HIE/HIO

Use Case Owner

OwnsMay Support

BusinessUse Case (s)

May support

Belongs to

Belongs to

Owns

AliasProvider Has


AttributesOrganization HPD Organization ID

ClinicalOrganizationRole

Organization Description

Organization Name

Effective End Date

Effective Start Date

Trusted Source

EIN

Provider Entity HPD Provider ID

Provider Status

Provider Tax ID

Provider Type

Provider Enumeration Date

Provider DEA

Provider CLIA ID

Provider Medicare ID (Legacy List)

Provider UPIN (Legacy List)

Provider NPI List

Provider Validation Flag

Effective End Date


Individual Provider HPD Individual Provider ID

Provider Middle Name

Provider First Name

Provider Last Name

Provider Suffix

Languages Spoken List

Provider Gender

Provider Race

Provider Validation Flag

Provider Birth Date

Provider Birth State Code

Provider Birth Country Code

Social Security Number

Provider Alias Alias Last Or Organization Name

Alias First Name

Alias Middle Name

Alias Type Code


Effective End Date


AttributesSpecialty HPD Specialty ID

Specialty Description

Specialty Name

Effective End Date


Credential Certification Type Name

Certification Type Description

State Code

CERT Verify Date

Certification License Number

CERT ORG ID

Certification Date

Credential Date

Renewal Date


Effective End Date

Education ED Activity Title ID

ED Award Date

ED Course Date

ED Creation Date

ED Degree Description

ED Degree Type ID

ED Degree Level

ED Hours

ED Provider ID

ED End Date

ED Method

ED ORG ID

ED Renewal Date

ED Training Type

ED Start Date

ED Verify Date


AttributesBusiness Relationship HPD Business Relationship ID HPD Individual Provider ID HPD Department ID HPD Organization ID Relationship Type Relationship Status Trust Indicator Effective End Date Effective Start Date Relationship Number (Local Identifer)

Address HPD Location ID

Location Description

City

Zip Code

Location Type

First Line Address

Second Line Address

Fax Number

Telephone Number

Country Code

URL

Effective End Date


State Code

Additional Identifier Provider Addition Identifier

Identifier Type

Identifier Issue Date

Identifier Expiration Date

Identifier Status

Identifier Notes

Identifier Verification Date

Deactivation Reason Code

State Code


AttributesBusiness Use Case Use Case Name Use Case Service Description Use Case Service Status Effective End Date Effective Start Date

Use Case Owner Use Case Owner Address

Use Case Owner Phone Number

Use Case Owner Contact Name

Use Case Owner Name

HIE/HIO HIE Name

HIE Contact Information

HIE Identifier (OID)

HIE Partnership Status

HIE Certification Status

DURSA Level

HIE Network Info

Effective End Date



Next Steps

Decide on a Data Modeling tool

► Current use: IBM Rational Software Architect and Computer Associates ERWIN

► Propose Open source data modeling tool

Standards (TCON – January 19, 2010)

January 5, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

Backup Information


Use Case View


Feedback and considerations on data model

Entity Attribute/Relationship Change DB Comments

1 Department Delete

2Facility Add a credentialing relationship

with Individual ProviderAdd relationship May need a business relationship between Facility and

Individual Provider

3 Facility Add a relationship to “Alias”

4Facility Add a relationship to Business

RelationsAdd relationship MedVA indicated business relationship could exist

between facility and provider (not department).

5NHITPR NHIE ID

DURSA Level Should be status flag, since, for MedVa, it is only “on” or “off”

6Organization Add a relationship to Organization

from Organization.Add relationship Needs a recursive relationship to document “an

organization can be a supertype to zero, one or many subtype organizations.

7Organization/ Individual Provider

Add a privileges attribute Add attribute A privilege distinguishes the type of “credentials” ie in good standing a individual provider has at a organization.

8Individual /Education

Add a credential attribute Add attribute A “credentialing attribute will document educational degrees.

9Organization Add “governance” Add attribute Governance should determine

“privileges/credentialing of providers.

Documents

January 5, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT Healthcare Provider Directory (HPD) Data Model Discussion IHE Tcon January 5, 2010