Healthcare Provider Directory (HPD) Standards and Transaction Discussion

1. Healthcare Provider Directory (HPD) Standards and Transaction Discussion IHE TCON -2 January 19, 2010 Presenter: Nitin Jain (IBM/SSA) SSA Representative: Shanks Kande SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

2. Topics • Overview of recommended standards • Analyze in detail the recommended standards • Identify any commonality and/or gaps between standards and HPD • Transaction Services Metadata • Next Steps SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

3. Recommended Standards Overview SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

4. ISO/TS 21091 Overview • Directory services for health care providers, subjects of care, and other entities • Supports the communication through X.500 framework • Provides common directory information model of healthcare professionals extending the X.500 object model • Extended Attributes (e.g. HcIdentifier, HcOrganization, HcSpecialisation) • HL7 defined attributes (e.g. HL7 Sex, HL7 County Code etc) • Supports LDAP query and syntax for representing attributes • Inherits security requirements for authentication and non-repudiation from ISO 17799 and ISO TR 13335 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

5. ISO/TS 21091: Directory Information Tree SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

6. Commonality between ISO/TS 21091 and HPD Requirements • Supports Transactions for • Lookup Provider (how it is extensible for other lookup attributes) • Store Provider Contact Information, Credentials • Schema for • Healthcare Organizations, different organization types • Individual Professionals, Credentials • Health care-specific contact information, • Health care identifiers, roles (standard and local), • Multiple Affiliations: Persons to Multiple Organizations affiliations • Supporting Organizations (can be used for HIE/HIO information) • Vocabulary Sets: HL7 domain, ISO 21298 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

7. Gaps between ISO/TS 21091 and HPD • Business Relationship definitions between Individual and Organization (how to provide a definition for a relationship entity in the X.500 object model) • Electronic end point information of Provider, HIE/HIO: (could explore usage of UDDI standard to define a service and its end points; attribute to query UDDI) • Support for SOAP/XML communication protocol? • May consider applying DSMLv2 to express LDAP requests and responses in SOAP 1.1 bindings. DSMLv2 is a systematic translation of LDAP’s ASN.1 grammar (defined by RFC 2251) into XML-Schema. • How easy is it to implement DSML v2? • Would it cause any unreasonable burden on the implementers and adopters? SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

8. HL7 v3: Personnel Management; Provider Registry • Uses Messaging protocol of HL7 v3.0 • Vocabulary Code set: Provider Role Type, HL7 Domain tables • Schema • Organization (Organization), Principal Person (Individual) • Licensed Entity (Credentials), Healthcare Provider (Specialty), LicensedEntity (Qualifications), AssignedEntity (Functional Role) • AlsoKnownAs (Aliases), Place (Location) • OrganizationPartOf, OrganizationContains (Organization Hierarchy) • Employee, Affiliate (Business relationships between Individual and Organization) SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

9. HL7 v3: Personnel Management; Provider Registry SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

10. Commonality between HL7 v3 and HPD Supports Transactions • Add Provider • Update Provider • Add Provider Notification (Broadcast) • Update Provider Notification (Broadcast) • Query Provider Details • Find Associated Providers Identifiers Query Supports SOAP/XML Communications SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

11. HL 7 v3 - Gaps/Open Questions • Electronic end point information of Provider, HIE/HIO: (could we support this in current schema?: use of device) • If there is an extension needed on HL7 v3, how could IHE support on getting it incorporate • What is the adoption of this standard in industry for directory services • Any Interoperability issues? SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

12. LDAP V3 • Basis for ISO/TC 21091 • Lightweight exchange protocol of X.500 schema • Exchange protocol TCP/IP with LDAP specific syntax • Operations: StartTLS, Bind, Search, Compare, Update, Abandon, Unbind SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

13. LDAP v3 - Advantages • LDAP a very commonly implemented protocol, many implementations including opensource • LDAP well understood and adopted across many industries • LDAP schema supports most requirements of HPD and can be extended • ISO and IHE have already adapted generic LDAP to the healthcare provider space – providing a platform for our work SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

14. LDAP v3 - Disadvantages • No support for SOAP/XML communication protocol in native LDAP communication protocol. • May consider applying DSMLv2 to express LDAP requests and responses in SOAP bindings. DSMLv2 is a systematic translation of LDAP’s ASN.1 grammar (defined by RFC 2251) into XML-Schema. • How easy is it to implement? • Would it cause any unreasonable burden on the implementers and adopters? • No automatic support for Notification SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

15. PWP – Personnel White Pages SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

16. PWP – Query Personnel White Pages Transaction • Standard: Lightweight Directory Access Protocol (v3) • Commonly used schema found in X.500 Schema for LDAP and inetOrgPerson • Schema includes required elements for: • Names • phone #s • Email • Organization • Address • Language • Title • Optional elements: • Alias • Vehicle license • Department • employee # • employee type • home address/phone • Photo • Locality • URI • Manager • preferred delivery method • registered address • Secretary • Uid • User S/MIME Certificate • X.500 ID SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

17. PWP – Disadvantages • Intended for inside of an organization. Not Designed for Broader scale to allow cross-enterprise queries. • Need to accommodate Health care specifics attributes SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

18. HPD Actors and Transactions Provider Directory Source Add/Update Provider Secure IT Infrastructure Notify of Change Healthcare Provider Directory Provider Directory Consumer Lookup Provider Subscribe Authentication Auditing Transaction Actor SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

19. Transaction Metadata Add/Update Provider Request • Organization/Individual Provider Name, Demographics, Aliases • Individual Provider Identifiers • Individual Provider Specialty • Individual provider association to the provider organization • Organization structure including Facilities • Organization/Individual Provider Association to HIE/HIO • Provider Status Add/Update Provider Response • HPD Provider ID • Acknowledgement SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

20. Transaction Metadata Lookup Provider Request • Provider Name, Alias • Provider Address • Provider global and directory Identifier (NPI, HPD Provider Id) • Provider other traits such as DOB, Gender • Provider Specialty • Zip code (geographic searches) Lookup Provider Response • Provider Name, • Demographics • Provider Identifiers • Provider Specialty • Individual provider association to the provider organization • Provider Association to HIE • Associated HIE URLs • Provider and relationship Status • Exact Match Indicator • Ambiguous Match indicator • Provider Type (Department, organization, Individual) SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

21. Transaction Metadata Subscribe Request • Event definition code • Provider Identifier such as HPD ID • Provider Name • Subscriber Name • Subscriber Identifier Subscribe Response • Subscription Id • Confirmation message SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

22. Transaction Metadata Notification Request • N/A Notification Response (Same as Lookup Provider Response) • Provider Name, • Demographics • Provider Identifiers • Provider Specialty • Individual provider association to the provider organization • Provider Association to HIE • Associated HIE service endpoints (URLs) • Provider and relationship Status • Provider Type (organization, Individual) SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

23. Next Steps (to be completed by Face to Face) • Decide on Content Model Standards • Decide on Communication standards • Confirm metadata for the Transactions • Confirm Data modeling tool SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

24. Backup Slides SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT

25. HL7 v3: Personnel Management; Provider Registry SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT