PA Interdependent Registries

Introduction

The primary implementer of the HL7 V3 role-based registries appears to be Canada. Canada has production implementations of Client (AKA Patient) and Provider registries. At the May 2010 Working Group Meeting Ron Parker of Canada Infoway gave a presentation to the Patient Administration work group addressing lessons learned and future architectural plans for Canada. See Ron's presentation in the 20100517_PA_WMG_Attachements.zip file.

The most significant finding is that real world applications require that different types of registries work together. The challenge for Patient Administration is to define interactions that span a number of topics:

• Person topic (DSTU in Patient Administration domain)
• Patient topic (DSTU in Patient Administration domain)
• Service Delivery Location (DSTU in Patient Administration domain)
• Provider topic (Normative R1 in Personnel Management domain)
• Organization topic (Normative R1 in Personnel Management domain)

Also, the Canadian Notional Architecture includes two additional registries for which a standard has not been defined. It seems possible that these additional registries would fall under the scope of a work group other than Patient Administration. Defining interactions that would also include these registries could present a technical challenge.

• Health Service
• Health Program

Business Cases

1. HITSP/IS03 Consumer Empowerment and Access to Clinical Information via Networks identified three standards gaps:
   • IER 73 – Request/receive provider information
   • IER 74 – Access/select provider information
   • DR 73 – Provider identification (consumer oriented terminology for provider type role)
2. HITSP/CAP121 Communicate Referral Request Capability identified a gap:
   • Currently no standard available for a provider registry from which to select a provider based on patient preferences or on Health Plan Eligibility. Candidate standards in HL7 and ASC X12 are awaiting harmonization.
3. The Health Information Technology Policy Committee's Information Exchange Workgoup has identified Provider Directories as a key enabler for nationwide health information exchange.
4. HL7 EHR System Functional Model see IN.3 Registry and Directory Services

Use Cases

1. Consumer Empowerment: Consumer Access to Clinical Information ONC Use Case
2. Consultations and Transfers of Care ONC Use Case
3. Scheduling ONC Use Case

Existing Standards

1. ASC X12 274 Health Care Provider Directory
2. ANSI/HL7 V3 Personnel Management, Provider topic - message specification
3. CMS National Provider Identifier
4. HITSP/C83 CDA Content Modules Component – HL7 V3 CDA Healthcare Provider module
5. HL7 Healthcare, Community Services and Provider Directory - service functional model
6. HL7 V3 Patient Administration, SDLOC DSTU
7. IHE Healthcare Provider Directory (based on LDAP and ISO 21091) - draft
8. ISO/DIS 21091 Health Informatics – Directory services for security, communications and identification of professionals and patients
9. Medbiquitous Healthcare Professional Profile Schema

Analysis Documents

1. HITSP Information Interchange Subcommittee Interface to Provider Directory/Registry Harmonization Project
2. Healthcare, Community Services and Provider Director Service Functional Profile, Release 1 mapped to HL7 Personnel Management