tag:blogger.com,1999:blog-4384692836709903146.post7383712505955713538..comments2024-03-27T09:55:23.143-07:00Comments on Dispatch from the Digital Health Frontier: Provider DirectoriesJohn Halamkahttp://www.blogger.com/profile/04550236129132159307noreply@blogger.comBlogger7125tag:blogger.com,1999:blog-4384692836709903146.post-61873160800160845552010-11-14T10:33:01.266-08:002010-11-14T10:33:01.266-08:00The international healthcare community has been ad...The international healthcare community has been addressing the need for provider directories/registries for a decade or more, as is apparent in the Canada Health Infoway blueprint. Provinces have executed their "blueprint compliant" strategy in several different fashions, realizing that knowing who providers are and where they practice, as well as understanding the relationships between patients (clients) and providers is important to appropriate information exchange. EHR procurements in countries like Singapore include provider registries/directories as core functionality. And, some countries are executing new procurements as their legacy provider registry of 10+ years no longer meets the market demands. Lots to explore and consider as the US develops policies and standards.Lorraine Fernandesnoreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-22070342993828924992010-11-12T12:06:19.015-08:002010-11-12T12:06:19.015-08:00Thank you for a very informative and thorough disc...Thank you for a very informative and thorough discussion of a complicated subject. From our perspective at CAQH, I would like to reiterate our belief that ultimately the industry will need to address both the provider group (entity) AND the individual provider data transmission needs you raise if we are going to develop a nationally workable, efficient, and cost-effective set of mechanisms that facilitate highly targetable healthcare information exchange.<br /><br />CAQH is fully committed to the current objectives of the Provider Director Task Force regarding entity directories, and looks forward to the upcoming discussions and recommendations for individual level directories.Sorin Davisnoreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-70698258707512397592010-11-11T17:28:57.229-08:002010-11-11T17:28:57.229-08:00Great summary, John. It is important to remembe...Great summary, John. It is important to remember that the HIT Policy Committee focuses on the EHR. As a result, it is natural that the Information Exchange Workgroup focus on organizational directories to facilitate communications between EHR systems. A national directory of EHR systems will be a major forward step toward improved interoperability.<br /><br />As you said, it is far easier to create an organizational directory than a directory of healthcare individuals.IAMPLEhttps://www.blogger.com/profile/16163482916073783954noreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-63153381899843602272010-11-10T09:04:45.264-08:002010-11-10T09:04:45.264-08:00The HIT Policy workgroups as done an excellent job...The HIT Policy workgroups as done an excellent job of bringing the right parties to the table to set common requirements and priorities across a diverse list of stakeholders. <br /><br />I agree that the focus on organizations within provider directories is a good place to start, but individual providers need to be in a provider directory as well for fine grained routing of patient information but also to eventually serve as a basis for physician quality reporting and accountable care (see http://masteringdatamanagement.com/index.php/2010/08/20/webinar-recap-the-value-of-a-provider-registry-in-a-real-hie/). One potential challenge to this is that many IDNs do not have organizational, department or floor (aka - non-person) information stored in any systems today in a method that is easily shareable with a provider dictionary. That said, they do have individual provider practice and privilege information within credentialing and other systems used to for clinical purposes. <br /><br />One way to adddess this is to provide a way to take location information from these individual provider records, and create a singular organizational entity to represent that location with a relationship between the individual and the organization. Another way may be to enable the grouping of multiple providers through data relationships to establish a "group of providers" that constitute an "organization" without requiring an actual organizational entity to exist.<br /><br />I look forward to the final recommendations made by the HIT team as we work on how to get health systems with varying levels of data availability to accomplish their implementations using the published recommendations. I believe there are many ways to accomplish this and value to supporting an organizational directory but the full value will be achieved when individual providers and eventually relationships with patients to support virtual care teams (see http://www.initiate.com/resources/Documents/Initiate-Provider-Management-Solution-Brief.pdf) to drive intelligent communication of patient data while accommodating unique delivery preference across practices - both paper based and electronic.Deanna Nolehttp://masteringdatamanagement.com/index.php/author/dnole/noreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-47737202227709635082010-11-09T07:28:00.285-08:002010-11-09T07:28:00.285-08:00I hope the Provider Dictionary Task Force is not r...I hope the Provider Dictionary Task Force is not re-inventing the wheel, especially when well-proven baseline directory standards exist with healthcare-specific extensions.<br /><br />I'm sure you are aware of "HITSP T64 Identify Communication Recipients Transaction." Among its referenced standards is<br />"ISO/TS 21091:2005<br />Health informatics -- Directory services for security, communications and identification of professionals and patients." <b>That's where to start.</b> <br /><br />The ISO standard defines minimal specifications for directory services for health care using the X.500 framework. This Technical Specification provides the common directory information and services needed to support the secure exchange of health care information over public networks.<br /><br />ISO/TS 21091:2005 addresses the health directory from a community perspective in anticipation of supporting inter-enterprise, inter-jurisdiction and international health care communications.<br /><br />ISO/TS 21091:2005 also supports directory services aiming to support identification of health professionals and organizations and the patients/consumers. The latter services include aspects sometimes referred to as master patient indices.<br /><br />The health care directory will only support standard LDAP Client searches. However, a client using the LDAP protocol internally can be eaily built to allow other mechanisms, such as a RESTful query.Glen F. Marshallhttp://www.grok-a-lot.comnoreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-58943148254303043162010-11-09T06:59:14.432-08:002010-11-09T06:59:14.432-08:00Great description of a complex issue John. The In...Great description of a complex issue John. The Information Exchange WG will present recommendations on entity-level directories later this month ("yellow pages" for those old enough to know what that means). In December, we'll turn to individual-level directories mapped to entity-level (sort of "white pages" crossed with "yellow pages"). Hopefully that will help tip the balance toward convergence and away from chaos!Written by Micky Tripathihttps://www.blogger.com/profile/05509578835081383261noreply@blogger.comtag:blogger.com,1999:blog-4384692836709903146.post-88299449643027626542010-11-09T06:31:58.547-08:002010-11-09T06:31:58.547-08:00This is a complex problem indeed. However, it sou...This is a complex problem indeed. However, it sounds like everyone is still thinking in terms of different medical records belonging to different organizations and physicians. This problem would be a lot simpler if the whole thing was centered around the patient.Petehttp://otoole.wordpress.comnoreply@blogger.com