Healthcare Provider Directory (HPD) Data Schema Discussion ONC S&I Framework Nitin Jain (IBM) Karen Witting (IBM)

HPD Schema The HPD supports the Individual and Entity level providers and relationship between and among them. Individual Relationships Organization

Attributes - Summary Organizational Individual Type of organization Status (Active/Inactive) Names (Legal and other) Contacts Electronic Service URI Medical records delivery email Addresses (Billing, Mailing, etc) Languages Specialties Credentials Identifiers (NPI, Tax #, etc) Public keys/certificates Business phone & FAX Relationships Addresses (Billing, Mailing, etc.) Languages Specialties Credentials Identifiers (NPI, Tax #, etc) Certificates Business phone, pager & FAX Facility name Relationships

Organization Attributes Description Type The type of organization represented. Some values are: Hospitals HIEs IDNs Associations Labs Clinics, Departments Pharmacies Practice Components: Type Code, Type Description Status The status of this organization. Active – This organization is currently in existence. Inactive – This organization is no longer in existence Name This attribute contains multiple names for an organization. Type of Names: Legal Name, Other Known names Contact Multiple individuals who can be contacted in reference to this organization, including a phone number and e-mail address. An individual role can be included in the name, instead of an individual. Electronic Service URI Reference to an entry in a systems directory or to a services definition page where this organization has its electronic access points defined. Medical Records Delivery Email Address Electronic mailing address of an organization where medical or administrative records can be sent

Organization Attributes – contd. Description Address Physical address information for an organization. Each type of address can be primary or secondary. Addresses that are no longer valid are marked as Inactive. Billing Address • One primary address-the preferred billing address for the organization • Multiple secondary billing addresses • Multiple inactive addresses which were once used as billing addresses but are no longer valid. Mailing Address • One primary address-the preferred mailing address for the organization • Multiple secondary mailing addresses • Multiple inactive addresses which were once used as mailing addresses but are no longer valid. Practice Address • Multiple primary addresses-All locations where healthcare services are provided • There are no secondary practice addresses • Multiple inactive addresses which were once used as practice addresses but are no longer valid. Components: streetNumber, streetName, city, state, postalCode, country or a full address string

Organization Attributes – contd. Description Language Language(s) that an Organization support Specialty Organization’s specialization, a specific medical service, a specialization in treating a specific disease. Some specialties are: Psychiatry Radiology Endocrinology Components: Issuing Authority, Code System, Code: CodeDisplayName Credential This includes certifications or licenses earned by an organization. Components: credentialType, credentialName, credentialNumber, credentialDescription, credentialIssueDate, credentialRenewalDate, credentialStatus Identifier National, Regional or local identifier that uniquely identify an organization that is may be publicly shared. Some examples are: National Provider Identifier #, Tax ID # Components: Assigning Authority OID, Identifier Type, ID, Status Signing Certificate Public key and certificate for the user’s non-repudiation signing certificate used for health transactions

Organization Attributes Description Organization Certificate Used for storing health care organization certificates; Certificate purpose constraint can be found by looking inside the certificates. Business Phone Business Telephone number Fax Facsimile Telephone number Relationship (memberOf) Determine which organizations this organization provider is a member of

Individual Provider Attributes Description Type Type of individual provider. E.g. Physician, Pharmacist, Nurse, Nurse Practitioner, Physical Therapist Components: Type Code, Type Description Status The status of this individual. Active – currently practicing Inactive – currently not practicing Retired Deceased Name This attribute contains multiple names for an individual. Components: Primary Name, Title, First, Middle, Last, Other Known names Gender HL7 Gender types Electronic Service URI Reference to an entry in a systems directory or to a services definition page where this individual has its electronic access points defined. Email-address Intended for general purpose email communication Medical Records Delivery Email Address Electronic mailing address of an individual where medical or administrative records can be sent

Individual Provider Attributes – contd. Description Address Physical address information. Each type of address can be primary or secondary. Addresses that are no longer valid are marked as Inactive. Billing Address • One primary address-the preferred billing address • Multiple secondary billing addresses • Multiple inactive addresses which were once used as billing addresses but are no longer valid. Mailing Address • One primary address-the preferred mailing address • Multiple secondary mailing addresses • Multiple inactive addresses which were once used as mailing addresses but are no longer valid. Practice Address • Multiple primary addresses-All locations where healthcare services are provided • There are no secondary practice addresses • Multiple inactive addresses which were once used as practice addresses but are no longer valid. Components: streetNumber, streetName, city, state, postalCode, country or a full address string

Individual Provider Attributes – contd. Description Language Language(s) that the provider is fluent in Specialty Individual’s specialization, a specific medical service, a specialization in treating a specific disease. Some specialties are: Psychiatry, Radiology, Endocrinology etc. Components: Issuing Authority, Code System, Code: CodeDisplayName Credential This includes certifications or licenses earned by an individual. E.g. Preventive Cardiology, Diabetes Counselling, PharmD, MD Components: credentialType, credentialName, credentialNumber, credentialDescription, credentialIssueDate, credentialRenewalDate, credentialStatus Identifier National, Regional or local identifier that uniquely identify an individual that is may be publicly shared. Some examples are: National Provider Identifier #, Tax ID #, Hospital Issued ID Components: Assigning Authority OID, Identifier Type, ID, Status Signing Certificate Public key and certificate for the user’s non-repudiation signing certificate used for health transactions

Individual Provider Attributes Description User Certificate X.509 user certificate for general purpose use; purpose constraint can be found by looking inside the certificates S-Mime Certificate PKCS#7 SignedData used to support S/MIME; typically used for encrypting mime messages over an email. Other purpose constraint can be found by looking inside the certificates. Provider Business Phone Business Telephone number Provider Mobile Phone Business Mobile Provider Pager Pager # Fax Facsimile Telephone number Facility name Facility name that a postal service uses to identify a provider’s facility. Relationship (memberOf) Determine which organizations this individual provider is a member of

Relationship Attributes Description Group Name Name of the relationship group. Group Owner Directory Identifier of an organization that owns the relationship group Member Identifier of individual or organization that is a member of this group

Individual Provider View Name Organizational Provider Identifier Addresses is a member of (0..N) is located at (0..N) Credential Specialty has (0..N) Relationship Group owns (0..N) has (1..N) - The chart depicts the data model as it pertains to Individual Providers defined by the Provider Information Directory. The cardinality 0..N implies an attribute is optional but could have many values. 1..N implies that an attribute is required and could have many values. Individual Provider has information related to Address, Name, Identifier, Credential and Specialty as described in the chart before. The relationship between individual and an organizational provider is modeled using the concept of group. As shown in the chart, an organizational provider can own one or multiple groups. Each group could have several individual members.

Organization View Name Organizational Relationship Group Provider Specialty Sub-Organizations e.g. Facilities Addresses is composed of (0..N) Credential Is located at (0..N) Identifier Owns (0..N) Relationship Group is a member of (0..N) Name Individual Provider has (0..N) has (1..N) is a member of (1..N) The chart depicts the data model pertaining to an Organizational Provider as defined by the Provider Information Directory. The cardinality 0..N implies an attribute is optional but could have many values. 1..N implies that an attribute is required and could have many values. - An Organizational Provider has attributes to capture information related to Address, Name, Identifier, Credential and Specialty that are previously described to you. An Organizational Provider may be composed of multiple Organizational Providers such as facilities (or any business structure for an organization). These are depicted as sub-Organizational Providers. The relationship between organizations is maintained through the concept of Relationship groups. An Organizational provider can own one or many Relationship groups. A Relationship group could have one or more members of both provider types: organizational and individual. Sub-organizations such as facilities are associated with their parent organization through Relationship group.