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

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 2 January 5, 2010 Topics  HPD Overview  HPD Data Model Review  Next Steps

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 3 January 5, 2010 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.

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 4 January 5, 2010 Secure IT Infrastructure HIT Provider Registry HPD Actors and Transactions Provider Registry Source Provider Registry Consumer Add/Update Provider Notify of Change Subscribe Lookup Provider AuthenticationAuditing Transaction Actor

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 5 January 5, 2010 HPD Content Model  The HPD Content Model supports the query for provider based on properties, relationships, and classifications Relationships Properties Classifications Provider

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 6 January 5, 2010 Metadata based registry

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 7 January 5, 2010 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 at has business Relationship (s) Is composed of (many) Is housed in (many) Credential (s) Specialty Has Provider Has

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 8 January 5, 2010 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) Has Individual Provider (many) business relationship (s) Has Organization Department (s) Addresses (s) AliasProvider Has

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 9 January 5, 2010 Use Case View Organization HIE/HIO Use Case Owner Owns May Support Business Use Case (s) May support Belongs to Owns AliasProvider Has

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 10 January 5, 2010 Attributes Organization  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  Effective Start 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 Start Date  Effective End Date

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 11 January 5, 2010 Attributes Specialty  HPD Specialty ID  Specialty Description  Specialty Name  Effective End Date  Effective Start 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 Start 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

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 12 January 5, 2010 Attributes Business 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  Effective Start 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

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 13 January 5, 2010 Attributes Business 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  Effective Start Date

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 14 January 5, 2010 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 Backup Information

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 16 January 5, 2010 Use Case View

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 17 January 5, 2010 Feedback and considerations on data model EntityAttribute/RelationshipChangeDB Comments 1 DepartmentDelete 2 FacilityAdd a credentialing relationship with Individual Provider Add relationshipMay need a business relationship between Facility and Individual Provider 3 FacilityAdd a relationship to “Alias” 4 FacilityAdd a relationship to Business Relations Add relationshipMedVA indicated business relationship could exist between facility and provider (not department). 5 NHITPR NHIE ID DURSA LevelShould be status flag, since, for MedVa, it is only “on” or “off” 6 OrganizationAdd a relationship to Organization from Organization. Add relationshipNeeds a recursive relationship to document “an organization can be a supertype to zero, one or many subtype organizations. 7 Organization/ Individual Provider Add a privileges attributeAdd attributeA privilege distinguishes the type of “credentials” ie in good standing a individual provider has at a organization. 8 Individual /Education Add a credential attributeAdd attributeA “credentialing attribute will document educational degrees. 9 OrganizationAdd “governance”Add attributeGovernance should determine “privileges/credentialing of providers.