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Slide 1 IHE (PowerPoint)

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									             Healthcare Provider Directory
                        (HPD)
         Standards and Transaction Discussion
                                     IHE TCON -2
                                     January 19, 2010



                  Presenter: Nitin Jain (IBM/SSA)
                  SSA Representative: Shanks Kande

January 19,2010
                              SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT
      Topics
     Overview of recommended standards

     Analyze in detail the recommended standards

           ► Identify   any commonality and/or gaps between standards and HPD

     Transaction Services Metadata

     Next Steps



January 19, 2010                SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT   2
      Recommended Standards Overview
                   Standard             SDO                                Description

    ISO TC 215 : ISO/TS 21091            ISO      Directory services for health care providers, subjects of care,
    Health Informatics                            and other entities


    HL7 V3                               HL7      Covers message standards, interactions and the XML data
                                                  model for provider registry

    Lightweight Directory Access       OASIS      Defines the messaging protocol, operations and data schema
    Protocol (LDAP)                               for directory services. OASIS DSML v2 as a means to cover this
                                                  with SOAP messages

    Personnel White Pages (PWP)          IHE      The Personnel White Pages Consumer may make a wide variety
                                                  of queries and cascaded queries using LDAP. Intended for
                                                  inside of an organization;

    Universal Description Discovery    OASIS      Defines a way to publish and discover information about Web
    and Interaction                               services.




January 19, 2010                      SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT                                    3
      ISO/TS 21091 Overview
       Directory services for health care providers, subjects of care, and
        other entities
       Supports the communication through X.500 framework
       Provides common directory information model of healthcare
        professionals extending the X.500 object model
            ►      Extended Attributes (e.g. HcIdentifier, HcOrganization, HcSpecialisation)
            ►      HL7 defined attributes (e.g. HL7 Sex, HL7 County Code etc)
       Supports LDAP query and syntax for representing attributes
       Inherits security requirements for authentication and non-repudiation
        from ISO 17799 and ISO TR 13335




January 19, 2010                      SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT               4
      ISO/TS 21091: Directory Information Tree




January 19, 2010   SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT   5
      Commonality between ISO/TS 21091 and HPD
      Requirements
       Supports Transactions for
            ► Lookup  Provider (how it is extensible for other lookup attributes)
            ► Store Provider Contact Information, Credentials

       Schema for
            ► Healthcare   Organizations, different organization types
            ► Individual Professionals, Credentials

            ► Health care-specific contact information,

            ► Health care identifiers, roles (standard and local),

            ► Multiple Affiliations: Persons to Multiple Organizations affiliations

            ► Supporting Organizations (can be used for HIE/HIO information)

       Vocabulary Sets: HL7 domain, ISO 21298

January 19, 2010                SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT            6
      Gaps between ISO/TS 21091 and HPD
       Business Relationship definitions between Individual and Organization
        (how to provide a definition for a relationship entity in the X.500 object
        model)
       Electronic end point information of Provider, HIE/HIO: (could explore
        usage of UDDI standard to define a service and its end points;
        attribute to query UDDI)
       Support for SOAP/XML communication protocol?
            ►      May consider applying DSMLv2 to express LDAP requests and responses
                   in SOAP 1.1 bindings. DSMLv2 is a systematic translation of LDAP’s
                   ASN.1 grammar (defined by RFC 2251) into XML-Schema.
            ►      How easy is it to implement DSML v2?
            ►      Would it cause any unreasonable burden on the implementers and
                   adopters?

January 19, 2010                     SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT          7
      HL7 v3: Personnel Management; Provider
      Registry
       Uses Messaging protocol of HL7 v3.0
       Vocabulary Code set: Provider Role Type, HL7 Domain
        tables
       Schema
            ► Organization      (Organization), Principal Person (Individual)
            ► Licensed     Entity (Credentials), Healthcare Provider (Specialty),
                   LicensedEntity (Qualifications), AssignedEntity (Functional Role)
            ► AlsoKnownAs        (Aliases), Place (Location)
            ► OrganizationPartOf,       OrganizationContains (Organization Hierarchy)
            ► Employee,       Affiliate (Business relationships between Individual and
                   Organization)

January 19, 2010                    SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT           8
      HL7 v3: Personnel Management; Provider
      Registry




January 19, 2010   SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT   9
      Commonality between HL7 v3 and HPD
      Supports Transactions
       Add Provider
       Update Provider
       Add Provider Notification (Broadcast)
       Update Provider Notification (Broadcast)
       Query Provider Details
       Find Associated Providers Identifiers Query


      Supports SOAP/XML Communications

January 19, 2010          SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT   10
      HL 7 v3 - Gaps/Open Questions
       Electronic end point information of Provider, HIE/HIO:
        (could we support this in current schema?: use of device)
       If there is an extension needed on HL7 v3, how could IHE
        support on getting it incorporate
       What is the adoption of this standard in industry for
        directory services
       Any Interoperability issues?




January 19, 2010         SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT   11
      LDAP V3
        Basis for ISO/TC 21091
        Lightweight exchange protocol of X.500 schema
        Exchange protocol TCP/IP with LDAP specific syntax
        Operations: StartTLS, Bind, Search, Compare, Update,
         Abandon, Unbind




January 19, 2010        SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT   12
      LDAP v3 - Advantages
      LDAP a very commonly implemented protocol, many
       implementations including opensource
      LDAP well understood and adopted across many industries
      LDAP schema supports most requirements of HPD and can be
       extended
      ISO and IHE have already adapted generic LDAP to the healthcare
       provider space – providing a platform for our work




January 19, 2010         SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT      13
      LDAP v3 - Disadvantages
        No support for SOAP/XML communication protocol in
         native LDAP communication protocol.
             ► May      consider applying DSMLv2 to express LDAP requests and
                   responses in SOAP bindings. DSMLv2 is a systematic translation
                   of LDAP’s ASN.1 grammar (defined by RFC 2251) into XML-
                   Schema.
             ► How     easy is it to implement?
             ► Would     it cause any unreasonable burden on the implementers and
                   adopters?
        No automatic support for Notification



January 19, 2010                   SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT       14
      PWP – Personnel White Pages

                                                         hite
                                              Personnel W Pages
                                                    Consum er


                                   hite
                   Find Personnel W Pages [ITI-23]                              hite
                                                               Query Personnel W Pages [ITI-24]




                                 DNS Server                             hite
                                                             Personnel W Pages Directory




January 19, 2010                    SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT                    15
      PWP – Query Personnel White Pages
      Transaction Directory Access Protocol
      Standard: Lightweight                                     Optional elements:
       (v3)
                                                                     ►Alias

                                                                     ►Vehicle    license
       Commonly used schema found in X.500 Schema                   ►Department
       for LDAP and inetOrgPerson
                                                                     ►employee      #
                                                                     ►employee      type
       Schema includes required elements for:                       ►home    address/phone
             ►Names
                                                                     ►Photo
             ►phone   #s                                             ►Locality
             ►Email
                                                                     ►URI
             ►Organization
                                                                     ►Manager
             ►Address
                                                                     ►preferred     delivery method
             ►Language
                                                                     ►registered    address
             ►Title
                                                                     ►Secretary

                                                                     ►Uid

                                                                     ►User    S/MIME Certificate
                                                                     ►X.500    ID

January 19, 2010               SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT                             16
      PWP – Disadvantages
        Intended for inside of an organization. Not Designed for Broader scale to allow
       cross-enterprise queries.
       Need to accommodate Health care specifics attributes




January 19, 2010                SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT                 17
       HPD Actors and Transactions

    Provider Directory Source           Add/Update Provider




                      Notify of Change                         Secure IT Infrastructure



       Provider Directory        Lookup
           Consumer              Provider
                                                                     Healthcare
                                                                  Provider Directory
                     Subscribe
                                                          Authentication      Auditing
      Transaction
      Actor

January 19, 2010            SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT                    18
      Transaction Metadata
       Add/Update Provider Request                                      Add/Update Provider
        Organization/Individual Provider Name,                          Response
         Demographics, Aliases
                                                                         HPD Provider ID
        Individual Provider Identifiers
                                                                         Acknowledgement
        Individual Provider Specialty
        Individual provider association to the provider
         organization
        Organization structure including Facilities
        Organization/Individual Provider Association to
         HIE/HIO

        Provider Status




January 19, 2010                      SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT              19
      Transaction Metadata
       Lookup Provider Request                                         Lookup Provider
        Provider Name, Alias                                           Response
        Provider Address                                               Provider Name,
        Provider global and directory Identifier (NPI, HPD             Demographics
         Provider Id)
                                                                        Provider Identifiers
        Provider other traits such as DOB, Gender
                                                                        Provider Specialty
        Provider Specialty
                                                                        Individual provider association to the
        Zip code (geographic searches)                                  provider organization
                                                                        Provider Association to HIE
                                                                        Associated HIE URLs
                                                                        Provider and relationship Status
                                                                        Exact Match Indicator
                                                                        Ambiguous Match indicator
                                                                        Provider Type (Department,
                                                                          organization, Individual)
January 19, 2010                     SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT                                   20
      Transaction Metadata
       Subscribe Request                                              Subscribe Response
        Event definition code                                         Subscription Id
        Provider Identifier such as HPD ID                            Confirmation message
        Provider Name
        Subscriber Name

        Subscriber Identifier




January 19, 2010                    SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT                 21
      Transaction Metadata
       Notification Request                 Notification Response
        N/A                                (Same as Lookup Provider
                                              Response)
                                             Provider Name,
                                             Demographics
                                             Provider Identifiers
                                             Provider Specialty
                                             Individual provider association to the provider
                                              organization
                                             Provider Association to HIE
                                             Associated HIE service endpoints (URLs)
                                             Provider and relationship Status

                                             Provider Type (organization, Individual)



January 19, 2010        SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT                              22
      Next Steps (to be completed by Face to Face)

     Decide on Content Model Standards

     Decide on Communication standards

     Confirm metadata for the Transactions

     Confirm Data modeling tool




January 19, 2010      SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT   23
      Backup Slides




January 19, 2010      SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT   24
      HL7 v3: Personnel Management; Provider
      Registry




January 19, 2010   SOCIAL SECURITY ADMINISTRATION-HIT SUPPORT   25

								
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