October 7, 2009 SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT Health IT Provider Registry IHE Proposal Overview Proposed Editor: Shanks Kande, Marty Prahl (US Social Security Administration) October 7, 2009

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 2 October 7, 2009 Health IT Provider Registry (HITPR) Profile Proposal ► The Problem domain ► Use Cases - Strategic Drivers ► HITPR – Context Architecture ► Proposed Standards & Systems ► Discussion Items

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 3 October 7, 2009 The Problem domain  Provider Identification Inefficiency: ► No standardized processes for electronically searching, using typical provider attributes, and with assurance, identifying the provider, location (physical, electronic end points), credentials and method for communication. ► Multiple disparate provider information sources, each one holding a key piece of provider information  Dissemination of Provider Credentials: ► Allow multiple trusted sources to publish provider credentials that can be distributed and accessible to consumers in real-time. ► Provide tools for validation of provider credentials ► Eliminate duplication of provider records across disparate data sources

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 4 October 7, 2009 Health IT Provider Registry (HITPR) definition  We envision HITPR as a unified directory of providers containing identifiers, demographic credentials, locations (physical, electronic) and relationship data  “Provider” is scoped for medical information entities such as physicians, medical laboratories, hospitals, dentists, pharmacists, nurses, diagnostic imaging professionals etc.  HITPR provides directory services to systems over a network or an information exchange using standards based messages

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 5 October 7, 2009 Use Cases: Strategic Drivers for health IT “meaningful use” Use CaseUse of HITPR Stakeholders Social Security Administration Disability Determination  Identify claimant’s providers by demographics & affiliations  Locate providers’ electronic end points in the network to support directed electronic requests Claimants, Providers, SSA, Health Information Exchanges, Social Services programs Emergency Response  Contact providers and identify “Medical Reservists”  Verify provider credentials Citizens, Providers, Public health Officials, State & Local Epidemiologists, Response Workers Consumer Access to Provider List  Select provider of care list from registry to grant or deny access permissions  Alerts on provider demographic updates Consumers, Families, PHR vendors, providers E-Prescription  Prescriber credentials (DEA) validation  Identify & communicate with prescribers on drug recall Providers, Patients, Pharmaceuticals, Drug Safety Officials

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 6 October 7, 2009 Trusted Source Public Trusted Sources Commercial Federated Data Sourcing HITPR Secure Standards- based Secure Standards- based Physicians EMR Provider Information Lookup Hospitals HITPR supports standards based query and publishing of data Federal & State Agencies & Health Institutes SSA, CDC, CMS, VHA DoD, etc. Consumers Publish Provider Information

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 7 October 7, 2009 Proposed Standards & Systems  HL7 v3 which covers message standards, interactions and the XML data model for provider registry.  Lightweight Directory Access Protocol (LDAP) – defines the messaging protocol, operations and data schema for directory services.  UDDI standard- OASIS approved standard that specifies protocols for creating a registry for Web services, methods for controlling access to the registry, and a mechanism for distributing or delegating records to other registries. Current NHIN registry specification uses UDDI standard.  ANSI ASC X12 –standard transaction set for interoperable EDI with registry.  Standard mechanism for registry replication between Master and slave nodes.  Meta Data based Registry supporting standards for: ► Multiple Provider Identifiers and Demographic traits ► Maintaining history of data (only deactivating record– no deleting of the data) ► Relationships among entities (provider-organization, organization-facility, organization-Information Exchange)

SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT 8 October 7, 2009 Discussion Items  Immediate need of HITPR within US NHIN to facilitate nationwide directory services in support of “meaningful use”  The Provider Registry service is also desired in other countries: Canada, Australia, Germany  We propose the technical profile to be scoped for: ► Defining Registry data model: Provider demographics, identifiers, locations, electronic service end points, business relationships, service dates, preferences, and status etc. ► Defining message Interface (Publishing, Querying, Validating) ► Synchronizing data with trusted sources ► Replication techniques & Cross Community Access