January 7,2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT Healthcare Provider Directory (HPD) Data Model Discussion IHE TCON January 7, 2010

January 7,2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

Healthcare Provider Directory (HPD)

Data Model DiscussionIHE TCON

January 7, 2010

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 2January 7, 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

Healthcare Provider Directory

HPD Actors and Transactions

Provider Directory Source

Provider Directory 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 Directory

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


AttributesProvider Entity HPD Provider ID – HPD Generated

Identifier

Provider Status – active/inactive in HPD

Provider Validation Flag: determines if provider information has been validated for the HPD

Provider Type – Individual or Organization

Effective Start Date - the date a record in HPD record is effective from

Effective End Date - the date a record in HPD is effective up to

Individual Provider Provider Middle Name

Provider First Name

Provider Last Name

Provider Suffix

Languages Spoken List

Provider Gender

Provider Race

Provider Birth Date

Provider Birth State Code

Provider Birth Country Code


AttributesOrganization Clinical Organization Role - role of an

organization that further classifies the clinical responsibility for the healthcare care delivered during an encounter. E.g. cardiology service, pediatric service, nursing services

Organization Description

Organization Name – name of a group or party other than an individual that render health care services

Trusted Source - Identifies if this information should be trusted or non-trusted

Provider Alias Alias Last Or Organization Name - various

names the provider is known by including maiden name or previous legal name

Alias First Name

Alias Middle Name

Alias Type Code - code identifying the type of alias name, e.g. professional name, doing business as (d/b/a) name, maiden name




AttributesAddress HPD Location ID: HPD Generated Address ID

Location Description

Location Type - type of address associated with the provider i.e. mailing, residence, remote, etc

First Line Address

Second Line Address

County

City

Country Code

Zip Code

State Code

Fax Number

Telephone Number

URL




AttributesSpecialty Specialty Type: A major grouping of

service(s) or occupation(s) of provider. E.g. Dermatology, Dental, Internal Medicine, Orthopedic etc.

Specialty Name: Provider’s specialization,, a specific medical service, a specialization in treating a specific disease. E.g. Bariatric Medicine, Geriatric Medicine, Pediatric Dermatology etc.



Credential Certification Type Name: Type of certification earned by a

provider.

Certification Type Description

Certificate Verification Date

Certification License Number

Certificate Issuing Organization

Certificate State Code

Certificate Country Code: Country where certificate is valid

Certification Award Date - date on which the certification was awarded

Certification Renewal Date

Certification Status: Active/Inactive/Pending etc.




AttributesProvider Identifier Identification Number – Unique Identifiers that may exist for a provider in a particular domain,

state or country

Identifier Type: Type of identifier such as tax identification number, state issued number, National Provider Identifier, drug identifying number, social services number, etc.

Identifier Issuing Agency: Name of the agency that issues this identifier

Identifier Issue Date: Date when this identifier is issued

Identifier Expiration Date

Identifier Status - status of the identifier: active, inactive, revoked, dropped or suspended

Identifier Description

Deactivation Reason Text

State Code: State where this identifier is valid

Country Code: Country where this identifier is valid


AttributesBusiness RelationshipThis entity establishes relationship either between Individual & Organization, Organization &

organization HPD Business Relationship ID – HPD Generated Identifier for business relationship Relationship From ID: HPD Provider Id from which business relationship originates Relationship To ID: HPD Provider Id to which business relationship is being established Relationship Type - type which describes the business relationship between an Individual or

Organization as defined in the HPD. (i.e. Individual provider "is member" of a health system) Relationship Status – active/inactive/pending Relationship Validation Flag - determines if relationship information has been validated Effective Start Date - the date a record in HPD record is effective from Effective End Date - the date a record in HPD is effective up to Relationship Number (local identifier) - unique number that an individual provider may be known

by in a particular organization or department based on this business relationship. For example, an employee ID number in a hospital


AttributesHIE/HIO HIE Name: Name of a Health Information Exchange/Network Organization.

HIE Contact Information - demographic information that allows contact with the designated individual who disseminates and receives information pertaining to an HIE/HIO (i.e. name or phone number).

HIE Identifier (OID): Unique Identifier assigned to this HIE.

HIE Certification Status: Active/Inactive/Pending status of HIE Certification by a Certifying body

HIE Certification Agency: Certification body certifying a HIE

Data Sharing Agreement Level - level of the Data Sharing Agreements for the HIE/HIO such test/production

HIE Network Info: Service end points of the HIE network.




AttributesBusiness Use Case Use Case Name – name of the the

Business Services (Use Cases) in which a HIE participates

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 - the entity (Agency, individual) who develops and owns use cases that describe business service


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 7,2010 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 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 Business relationship could exist between facility and

provider (not department).

5Education Delete

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” i.e. 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 7,2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT Healthcare Provider Directory (HPD) Data Model Discussion IHE TCON January 7, 2010