FHIR Validated Healthcare Directory

Scope

The development of a FHIR based implementation guide to enable the exchange of validated healthcare directory information between a reference source (e.g. national directory) and “local” workflow environments (e.g. local directories).

The exchange will include validation information to communicate the timing, source(s) and validation method for all of the significant elements of the healthcare directory. The implementation guide shall include constrained exchange content, conformance statements, and exchange methods. The basis of the implementation guide will be the STU3 release of the FHIR standard. The guide shall utilize existing and, where appropriate, update/define existing/new:

• Resources
• Extensions
• Profiles
• Vocabularies and Value Sets
• Operations

FHIR Infrastructure standards may be updated or expanded to support the information exchange requirements. (such as refinements to pub/sub for constraining content, and more granular provenance aspects)

Broadly, the HcDir Implementation Guide will cover, at a minimum, the following information with regard to providers, organization, aggregations and hierarchies of each entity:

• Demographics
• Credentials
• Contact Information
• Electronic End Points
• Locations
• Care Teams
• Groups
• Relationships between organizations, other organizations and locations
• Relationships between individual providers and each of the above
• Health plans, products, networks
• Proxies for individuals and groups of individuals
• Indication of incomplete records due to policy or other reasons

Suggested approach to validation of information and recommended processes (non-normative)

Exchange methods may include pull, push, publish/subscribe (may impact FHIR infrastructure standards)

Define an approach to enable the scope of information exchanged to be reduced between the validated resource and the consuming entity

Validation will include source details, status, method, dates, frequency and potentially other metadata

Recommendations for implementers re concerns with privacy and access controls may be addressed as non-normative recommendations

The project will recognize the Argonaut Provider Directory work and will utilize published artifacts where appropriate

Need

Implementers of large scale shared healthcare directories (such as country/jurisdiction scale directory services) need the ability to establish validated provider information and make it available to local workflow environments for utilization in a number of clinical and administrative Healthcare activities. Any exchange must be able to identify the validation status, process, date and source of each significant element so the downstream entity can verify that the validation process meets their local standard.

This shared directory information should be of high quality to address existing production issues causing significant inefficiencies and redundancies. Specific examples are:

• the Social Security Administration needs to identify specific providers to satisfy their claim documentation requirements
• emergency response identification of provider’s electronic endpoints.

This standard will go hand in hand with requirements that the source systems ensure the content is current, and will attest to the accuracy of the data.