Understanding WHO is doing the work/bot the provider but

indiv. health systems.

NPI- validate it first.

No wrong door approach or are we being prescriptive?

• 1/2 room says can't be prescriptive

Standards- data claims need to be standard regardless of

door

• Standards process and content leverage work already done

Provider Burden- what is required of the provider?

Not clear who is responsible for updating info (provider/org)

Independent of authoritative source, its ok if auth. source

for electronic endpoints- needs to be defined.

Many data come from auth. source.

Different data has different auth. source- needs to be handled 

via governance

Trust on certain elements by specific data

Group effort to attest

Providers need to own specific data

NPESS authoritative for specific content (must account for in Cascade)

• Nat. Practitioner Data Bank
• Fed of state Med Boards
• NATE
• DirectTrust

Data Practitioner

Huge amount of rules!

Has to be grounded in regulations

JCAHO credentialing

Data vs. information- how are we sending it?

Creating a solution-source not revising directory structure.

Information is also for the patient. This can change

by the hour.

Med advantage- ex. helps provider attest.

Think of "web of data"- tells where to go to get additional data. 

Diff. verification based on data.

If data is already validated, do not need to repeat

• validation/ data tracking/mgmt component.

TAXID number as well as EIDN? (Virtual attendee added)

Validation tasks for now includes cleaning up data.

Variable data that is time sensitive, providers often do not know

the answers. Need confirmation within practice.

Look at:

• List of Excluded Individuals/Entities (LEIE)
• System for Award Management (Sam.gov)

Data accuracy needs to be lightweight and quick

Tree structure- collected from auth source/distribution

 of data may be different

No single way to connect, should be one door for each

type of data

Avoid technical governance?

Where I got it and how it was validated.

Reach agreement about what is "durable": what if it changes?

Need provider expectations on time needed to verify.

Need structure at a data level.

"Durable"- not a lot of this that "cannot" change.

System of record: need master data mgmt.- there is

high probability of producing bad data.

Decide who gets to adjudicate "speciality"

or different data.

Attestation vs. data use need standards

Need to address multiple different master data sources.

Consider different ideals for doing ahead of time

vs. on the spot. "emergency management".

Not just talking about stds for validating but a std that

everyone follows (NPI Chain)

Do we want to say this should be done one time and 

one time only (validation)

Certification Authorities

Fed entity- where PD are RHIO

Trust of authority is at the local level (diff levels to

choose from)

Identify activities that drive human level of

verification before they happen.

• Which elements need validation prior to sharing?

Multiple "sources of truth"- How do we break down

use case silos? We keep limiting access

• Should not restrict sources of truth to only certain groups

Clinical side- "data provenance" who did data come from,

who is the source?

• what happens when data needs to be corrected
  • some one else owns it- needs to be corrected from the source?

Credentialing assertion cannot be "free" text

Verify economically

Who pays now?

Who wants to pay?

Who should pay?

Diff states have diff. requirements for validated data

Health Plan

Sites will vary by site/location, this information

has to be done by provider type and at a cadence

that satisfies that site.

• where do we draw lines for frequency of updates?
• mechanics- try to get as many data pts as possible

There will be things ppl have to get to source of truth

• credentialing vs. provider directory world

Multi-source verification- what is correct in a mess of data?

Difficult when there is no single source for data;

reality is that we won't have it.

Receiver may need to choose level of verification

due to their use case.

• different needs and approaches

Need to build "feedback loop" to report bad data.

Need to verify provider auth. prior to delving into

public health

70 different groups- if many doing do not have std method to correct data.

Safe harbor structure- provider is on

the hook-  will get involved. "users on hook by

regulations will not be penalized for errors".

• If entity is sued, how does liability fall out?