The first day of the Provider Directory Workshop concentrated on achieving a common understanding of the current state of development and implementation of provider directories. Presenters were asked to describe the characteristics, use cases, achievements, challenges, and recommendations of current provider directory initiatives and implementations. Day 1 included presentations on statewide implementations, nationwide exchange networks, health plan initiatives, Federal Agency efforts, and current technical standards, as well as two illustrative demonstrations sponsored by ONC and FHA.
The second day of the Workshop was a working session. It concentrated on an initial discussion of use cases, information needs, and stakeholder access to provider directories. It also explored further industry support and future developments in technical standards for implementing provider directories.
The following sections concentrate on reported findings in both Day 1 and Day 2 presentations and discussions.
- Lessons from Existing Implementations below lists some of the major findings reported on current implementations and planned initiatives, including those of statewide implementations, health plans and insurers, and national exchange networks.
- Federal Agency Role below lists important items from discussions of the role of Federal Agencies in provider directories, especially of the National Plan and Provider Enumeration System (NPPES) and the Provider Enrollment, Chain and Ownership System (PECOS), the registration systems for the national provider identifier (NPI) and Medicare providers, respectively.
- A discussion of past initiatives, including recommendations of the Health Information Technology Policy Committee (HITPC), Health Information Technology Standards Committee (HITSC), their task forces, and other public workgroups and meetings was presented at the Workshop. These historical materials are included in Appendix F, Workshop Materials, but not summarized in this section.
- Provider Directory Scope and Use Cases below lists important items from the discussions of scope, use cases, data attribute and feature requirements, stakeholders, and user access on the second day of the Workshop.
- Technical Standards below lists important items from presentations on technical standards for provider directories presented on Day 1, including Healthcare Provider Directory (HPD) and Fast Healthcare Interoperability Resources (FHIR), and the discussion of planned development and adoption of technical standards on Day 2.
Appendix F, Workshop Materials, and Appendix G, Workshop Demonstration, include complete materials from the Provider Directory Workshop, including presentations, recordings of most presentations and discussions, and a draft transcript of discussions for both Day 1 and Day 2.
Lessons from Existing Implementations
The presenters on Day 1 described the characteristics, use cases, achievements, challenges, and recommendations of their provider directory implementations. Some of the most important presentation points from statewide implementations, nationwide exchange networks, and health plan initiatives are listed below.
Statewide Provider Directories
Four states – Oregon, Rhode Island, California, and Michigan – presented information on the provider directory implementations or plans in their states. In all four cases, the directories were statewide implementations related to or operated by statewide health information exchange initiatives.
- 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 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.
- 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.
Health Plans
To be completed...
Nationwide Exchange Networks
To be completed...
Summary
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Federal Agency Role
To be completed...
Provider Directory Scope and Use Cases
To be completed...
Technical Standards
To be completed...