1. © 2016 California Association of Health Information Exchanges Licensed under a Creative Commons Attribution Share-Alike 3.0 LicenseCreative Commons Attribution Share-Alike 3.0 License Provider Information as a Component of Trust: California’s Directory Services Robert M. Cothren, PhD Executive Director California Association of Health Information Exchanges

2. What are we doing? Establishing a trusted network for inter-organizational exchange through voluntary self-governance of statewide HIE 5 April 2016ONC/FHA Provider Directory Workshop2

3. Before we get started… Yes, this is yet another presentation on using HPD 5 April 2016ONC/FHA Provider Directory Workshop3

4. How do I establish trust? 1.Know your conversation is not overheard 2.Know the information can be trusted 3.Know who you are talking about 4.Know who you are talking to 5.Know how the information will be used 6.Know you have permission for the conversation 45 April 2016ONC/FHA Provider Directory Workshop

5. A component of trust… 1.Know your conversation is not overheard 2.Know the information can be trusted 3.Know who you are talking about 4.Know who you are talking to 5.Know how the information will be used 6.Know you have permission for the conversation 55 April 2016ONC/FHA Provider Directory Workshop

6. What are we trying to achieve? No longer reasonable to know everything about your trading partners –Purpose of Directory Services: Discover individuals, organizations, and the means by which to exchange information with them NOT provider directories and NOT Direct addresses 65 April 2016ONC/FHA Provider Directory Workshop

7. What are we trying to achieve? From the Interoperability Roadmap… N.Reliable resource location: The ability to rapidly locate resources, including providers, individuals, APIs, networks, etc. by their current or historical names and descriptions will be necessary for a learning health system to operate efficiently. Seehttp://www.healthit.gov/sites/default/files/nationwide- interoperability-roadmap-draft-version-1.0.pdfhttp://www.healthit.gov/sites/default/files/nationwide- interoperability-roadmap-draft-version-1.0.pdf 75 April 2016ONC/FHA Provider Directory Workshop

8. What are we trying to achieve? Discover individuals, organizations, and the means by which to exchange information with them –Must be more than a directory of Direct addresses –Direct is an important (near-term) use case –Must contain all means to exchange: Direct addresses, Exchange endpoints, FHIR resources –Must link methods to individuals and organizations 85 April 2016ONC/FHA Provider Directory Workshop

9. What are we trying to achieve? Discover individuals, organizations, and the means by which to exchange information with them –Must be more than a directory of Direct addresses –Must include context –Providers practice at more than one location, in more than one context, each of which may have different means of exchange 95 April 2016ONC/FHA Provider Directory Workshop

10. What are we trying to achieve? Discover individuals, organizations, and the means by which to exchange information with them –Must be more than a directory of Direct addresses –Must include context –Information must be up-to-date –Information changes –We are exchanging PHI based on this information 105 April 2016ONC/FHA Provider Directory Workshop

11. What are we trying to achieve? Discover individuals, organizations, and the means by which to exchange information with them –Must be more than a directory of Direct addresses –Must include context –Information must be up-to-date –Must prepare for more than just providers –Focus today is to individual providers and provider organizations, but the list of stakeholders is larger 115 April 2016ONC/FHA Provider Directory Workshop

12. How are we doing it? –Management is distributed –The best way to keep the data accurate is to manage it at the authoritative organization –Architecture is federated –One means to achieve distributed management –Distributes the workload –Use is governed by policy –Need to establish how everyone behaves 125 April 2016ONC/FHA Provider Directory Workshop

13. How are we doing it? IHE’s Healthcare Provider Directory (HPD) Profile National, open standard that supports: –Individuals and organizations –Relationships among individuals and organizations –Electronic services (beyond Direct, including FHIR) –Context for electronic services (for an individual, an organization, or a relationship) –Federation Seehttp://www.ihe.net/uploadedFiles/Documents/ITI/ IHE_ITI_Suppl_HPD.pdfhttp://www.ihe.net/uploadedFiles/Documents/ITI/ IHE_ITI_Suppl_HPD.pdf 135 April 2016ONC/FHA Provider Directory Workshop

14. What can it do? Complex relationships 145 April 2016ONC/FHA Provider Directory Workshop

15. What can it do? Complex relationships 155 April 2016ONC/FHA Provider Directory Workshop

16. How are we doing it? Participation in CTEN Directory Services is governed by policy –For both information directories or query clients –Establishing behaviors for data integrity, access, security, etc. –Supporting local autonomy Seehttp://www.ca-hie.org/site-content/2014/10/CTEN-Policy- EPP-6-for-Federated-Provider-Directory-Services-v1.0.pdfhttp://www.ca-hie.org/site-content/2014/10/CTEN-Policy- EPP-6-for-Federated-Provider-Directory-Services-v1.0.pdf 165 April 2016ONC/FHA Provider Directory Workshop

17. How are we doing it? Policies establish a minimum dataset –Required data for each individual or organization –Limited to what is really required –Not all HPD requirements are “required” –Every individual must have an organization –Every service must have a context Seehttp://www.ca-hie.org/site-content/2015/09/CTEN-Policy- EPP-6.1-Minimum-Data-Set-for-Directory-Services-v1.0.pdfhttp://www.ca-hie.org/site-content/2015/09/CTEN-Policy- EPP-6.1-Minimum-Data-Set-for-Directory-Services-v1.0.pdf Seehttp://www.ca-hie.org/site-content/2015/08/CTEN- Minimum-Data-Set-for-Directory-Services-v1.0.xlsxhttp://www.ca-hie.org/site-content/2015/08/CTEN- Minimum-Data-Set-for-Directory-Services-v1.0.xlsx 175 April 2016ONC/FHA Provider Directory Workshop

18. ??? 185 April 2016ONC/FHA Provider Directory Workshop

19. So maybe not HPD after all… Any standard will work as long as –It is open –It is adopted by industry –It supports individuals and organizations –It supports context and complex relationships –It supports “all” stakeholders –It supports discovery of “all” types of electronic exchange 5 April 2016ONC/FHA Provider Directory Workshop19

20. What more can I tell you? 205 April 2016ONC/FHA Provider Directory Workshop

21. Contact Information Robert M. Cothren, PhD Executive Director California Association of Health Information Exchanges p925-934-2280 erobert.cothren@ca-hie.orgrobert.cothren@ca-hie.org whttp://www.ca-hie.orghttp://www.ca-hie.org 215 April 2016ONC/FHA Provider Directory Workshop