Page History

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• All four states emphasized the need for governance for their statewide directory initiatives.
• All four states emphasized the directory’s support of health information exchange, but some states – perhaps most notably Michigan – built and continue to build upon that single use case to increase value.

• All four states emphasized data quality, but had different approaches to addressing the requirement, from scrubbing the data through centralized processes, to depending upon the quality processes of data contributors, sometimes supported or enforced by policy.

• Participants in Oregon’s Oregon’s current provider directory export provider information in standardized comma-separated value (CSV) flat file format which is scrubbed, consolidated, and exchanged with other participants.

  • Oregon describes the method as an inelegant solution necessary until such time as there exists a widely-adopted standard for interoperable provider directories.

  • Oregon is in the process of developing a statewide directory to replace its current process. The purpose of the new directory will expand upon supporting transitions of care via Direct messaging to also create a directory that will address potential health plan penalties for inaccurate data. However, there remain questions concerning a technical standard, fee structure, and project scope.

  • The initiative is supported in part by recent legislation creating a Common Credentialing Program and allowing for fees associated with creating and maintain the provider directory.

• The goal of a new Rhode Island directory is to provide patients, doctors, hospitals, health plans, and the State with timely and accurate information about the location and affiliations of providers, whether to select a local doctor, make a referral to a provider in the patient’s health plan, to send health information to support transitions of care, to attribute patients to doctors in a health network, or to understand the availability of doctors across the state.

  • Rhode Island plans to manage the provider directory much like its health information exchange, collecting and aggregating data across organizational boundaries to create a single, authoritative source of truth as a longitudinal record of provider information. Rhode Island will identify and acquire data feeds for the provider directory, create and maintain consistent reference data and master data definitions, analyze data for quality and reconcile issues, and publish relevant data to appropriate users.

• California created and operates a federated provider directory. It stores no data at the state level, but produces a logical statewide directory by consolidating information from other data sources in real time in response to a request. The primary use case is to support electronic exchange of health information for transitions of care.
  
  • California describes the provider directory as a component of the trust framework for statewide health information exchange. It has published a set of policies for the use of provider directory information and contribution of information to the federated structure, as well as a minimum data set for directory contributors based on the HPD data model.

  • Use of California’s provider directory is decreasing as a result of dwindling vendor support for HPD; the directory had six participants in 2015 but has only two today. It anticipates a transition to a new interoperability standard as soon as 2016, but to maintain the federated structure.

  • See the section on Technical Standards for more on California’s experience with HPD.

• Michigan has created a centralized provider directory with distributed management based on the Salesforce platform.

  • Michigan emphasizes support of valuable use cases as the core to achieving sustainability and high data quality. It has interfaced to NPPES through the pilot for NPPES Modernization, supports the HPD data model, has deployed an extension to the FHIR framework for RESTful APIs, and has incorporated support for provider-patient associations, care teams, and alerts.

  • See the section on Technical Standards for more on Michigan’s support for multiple provider directory standard APIs.

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