Presentations on Day 1 provided an overview of the use cases, and the technical architecture and data needs and constraints of Federal Agencies. It included a summary of an extensive discussion and analysis hosted by FHA, a presentation on NPPES Modernization, and a demonstration commissioned by FHA.
Some of the most important discussion points are listed below.
- The Federal Agencies have many existing, but stove-piped, provider information databases and a great interest in coordinating provider directories across Federal Agencies. A relatively extensive summary of capabilities, preferences, and recommendations is already available based on work in 2015.
- Federal Agencies prefer a federated architectural approach in the near term to insure that individual Agency needs are met and Agency regulatory and policy constraints are addressed while minimizing the governance and operations issues that may inhibit the initial adoption.
- Migration to a hybrid approach is preferred long term to create a common approach to shared directory information and services while still allowing each Agency to manage its own unique information requirements and workflow integration.
- Most of the discussion has focused on collaboration among Federal Agencies.
Much of the discussion on Day 1 focused on NPPES and NPPES Modernization:
- NPPES was created as the authoritative database for the National Provider Identifier (NPI) for individuals and organizations.
- NPPES was not designated as a provider directory, and much of the information contained in NPPES grows stale. However, many Federal Agencies still look to NPPES for critical provider information.
- A real-time query application program interface (API) to NPPES is being rolled out in 2016 to supplement the current public access to full NPPES database downloads via a standardized flat file format. Some organizations (including Michigan) have integrated with the pilot implementation.
- Several organizations have integrated NPPES data into their own provider directories, or have also created their own APIs to NPPES data, some of them based on the FHIR API framework.
- NPPES will add data integrity checks in 2017.
- Provider updates to information stored in NPPES are not enforced. However, provider updates to PECOS information to support Medicare are now mandatory. Updates to PECOS may be used to update information in NPPES if the provider requests it.
- Several Workshop participants called for NPPES as the centralized, national provider database that should be used as the baseline for provider directories.
- It was noted, however, that NPPES does not include entries for all providers that might be required by all provider directory use cases, that the information integrity of NPPES would have to be improved, and that many organizations were represented multiple times in NPPES. If used as the baseline, NPPES would have to be supplemented with additional information (e.g., electronic service endpoints, provider organizational relationships, health plan relationships) to meet many use cases.
See Appendix F, Provider Directory Workshop Materials, for more detail on the presented material and Workshop discussions.
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