Healthcare Provider Directory HPD Standards and Transaction Discussion

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

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 January 19, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 2

Recommended Standards Overview Standard SDO Description ISO TC 215 : ISO/TS 21091 Health Informatics ISO Directory services for health care providers, subjects of care, and other entities HL 7 V 3 HL 7 Covers message standards, interactions and the XML data model for provider registry Lightweight Directory Access Protocol (LDAP) OASIS Defines the messaging protocol, operations and data schema for directory services. OASIS DSML v 2 as a means to cover this with SOAP messages Personnel White Pages (PWP) IHE The Personnel White Pages Consumer may make a wide variety of queries and cascaded queries using LDAP. Intended for inside of an organization; Universal Description Discovery and Interaction January 19, 2010 OASIS Defines a way to publish and discover information about Web services. SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 3

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. Hc. Identifier, Hc. Organization, Hc. Specialisation) ► HL 7 defined attributes (e. g. HL 7 Sex, HL 7 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 January 19, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 4

ISO/TS 21091: Directory Information Tree January 19, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 5

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: HL 7 domain, ISO 21298 January 19, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 6

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 DSMLv 2 to express LDAP requests and responses in SOAP 1. 1 bindings. DSMLv 2 is a systematic translation of LDAP’s ASN. 1 grammar (defined by RFC 2251) into XML-Schema. ► How easy is it to implement DSML v 2? ► Would it cause any unreasonable burden on the implementers and adopters? January 19, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 7

HL 7 v 3: Personnel Management; Provider Registry § Uses Messaging protocol of HL 7 v 3. 0 § Vocabulary Code set: Provider Role Type, HL 7 Domain tables § Schema ► Organization (Organization), Principal Person (Individual) ► Licensed Entity (Credentials), Healthcare Provider (Specialty), Licensed. Entity (Qualifications), Assigned. Entity (Functional Role) ► Also. Known. As (Aliases), Place (Location) ► Organization. Part. Of, Organization. Contains (Organization Hierarchy) ► Employee, Affiliate (Business relationships between Individual and Organization) January 19, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 8

HL 7 v 3: Personnel Management; Provider Registry January 19, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 9

Commonality between HL 7 v 3 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 January 19, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 10

HL 7 v 3 - 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 HL 7 v 3, how could IHE support on getting it incorporate § What is the adoption of this standard in industry for directory services § Any Interoperability issues? January 19, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 11

LDAP V 3 § Basis for ISO/TC 21091 § Lightweight exchange protocol of X. 500 schema § Exchange protocol TCP/IP with LDAP specific syntax § Operations: Start. TLS, Bind, Search, Compare, Update, Abandon, Unbind January 19, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 12

LDAP v 3 - 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 January 19, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 13

LDAP v 3 - Disadvantages § No support for SOAP/XML communication protocol in native LDAP communication protocol. ► May consider applying DSMLv 2 to express LDAP requests and responses in SOAP bindings. DSMLv 2 is a systematic translation of LDAP’s ASN. 1 grammar (defined by RFC 2251) into XMLSchema. ► How easy is it to implement? ► Would it cause any unreasonable burden on the implementers and adopters? § No automatic support for Notification January 19, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 14

PWP – Personnel White Pages January 19, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 15

PWP – Query Personnel White Pages Transaction Directory Access Protocol §Standard: Lightweight §Optional elements: (v 3) ►Alias §Commonly used schema found in X. 500 Schema for LDAP and inet. Org. Person §Schema includes required elements for: ►Names ►phone #s ►Email ►Organization ►Address ►Language ►Title ►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 January 19, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT ID 16

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 January 19, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 17

HPD Actors and Transactions Provider Directory Source Add/Update Provider Notify of Change Provider Directory Consumer Lookup Provider Secure IT Infrastructure Healthcare Provider Directory Subscribe Transaction Actor January 19, 2010 Authentication SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT Auditing 18

Transaction Metadata Add/Update Provider Request § Organization/Individual Provider Name, Demographics, Aliases § Individual Provider Identifiers § Individual Provider Specialty Add/Update Provider Response § HPD Provider ID § Acknowledgement § Individual provider association to the provider organization § Organization structure including Facilities § Organization/Individual Provider Association to HIE/HIO § Provider Status January 19, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 19

Transaction Metadata Lookup Provider Request § Provider Name, Alias Lookup Provider Response § Provider Address § Provider Name, § Provider global and directory Identifier (NPI, HPD Provider Id) § Demographics § Provider other traits such as DOB, Gender § Provider Specialty § Zip code (geographic searches) § 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) January 19, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 20

Transaction Metadata Subscribe Request Subscribe Response § Event definition code § Subscription Id § Provider Identifier such as HPD ID § Confirmation message § Provider Name § Subscriber Identifier January 19, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 21

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) January 19, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 22

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 January 19, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 23

Backup Slides January 19, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 24

HL 7 v 3: Personnel Management; Provider Registry January 19, 2010 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 25