Skip to main content

Provider Directory Strategies

The Office of the National Coordinator asked me to present the Massachusetts Provider Directory approach to the Provider Directory Community of Practice (CoP) on March 21.

Here's the powerpoint that I'll present tomorrow.

It highlights the decisions we had to make (Entity v. Individual, Central v. Federated, web API verses LDAP, etc)

Issue: Should we include organizations, individuals or both in the provider directory?
Answer: The directory should have a schema that enables lookup of entities (e.g., Organizations, Departments, State Agencies, Payer Organizations, Patient Health Record services) AND an individual's affiliation with an entity trusted by the HIE.  You can lookup John Halamka to discover that I'm affiliated with BIDMC, then lookup BIDMC to determine how to exchange data with my organization.

Issue: Should the Provider Directory be centralized or federated?
Answer:  The Provider Directory should be centralized at the State level, given lack of proven scalable approaches to federated provider directories standards and architecture.  However, Public Key Infrastructure can be federated based on the Direct DNS specification for certificate exchange.

Issue: How should we expose Provider Directory services to the Internet?
Answer: A SOAP-based web services API will support query/response, add/change,  and delete operations over the Internet.  An LDAP approach will support directory access for applications behind the MassHealth firewall.

Issue: How should we populate the provider directory?
Answer:  Commercial databases often lack timely updates.   In Massachusetts, we have several existing data sources to leverage including those used by payers for quality reporting, those used by provider organizations, and those used by the regional extension center.

Issue: How will we integrate this service into EHRs?
Answer: We will work with EHR vendors via a centralized program management office to procure software components that integrate provider directory and HIE transport services into the workflow of the EHR itself.  We will not force clinicians with certified EHRs to use a disconnected portal outside of their the EHR.

I look forward to speaking with the Provider Directory Community of Practice (CoP) to hear about approaches in other states and share lessons learned.

Comments

Post a Comment

Popular posts from this blog

clip on magnetic sunglasses visit here

Save with prescription glasses and sunglasses. Prescription eyeglasses with magnetic clip on sunglasses. A wide selection of colors and styles for every budget! -GlassesPoint. Prescription eyeglasses with magnetic clip on sunglasses. A wide selection of colors and styles for every budget! Free magnetic clip on with every pair of glasses.  The operator should contact lens Plano glasses a few days of Sun and Rx on the other person. Many people choose single vision lenses, designed for a specific use, such as prescription sunglasses. Clip-ons magnetic magnetic clip ons often come with their prescription glasses frames. Prescription glasses Goggles4u dollars from 29.99 with free shipping. Takumi neodium magnet glass features recipes that are light, strong and in. The combination of some normal prescription glasses and a pair of polarized glasses that glare-resistant to outdoor activities. clip on magnetic sunglasses visit here
Post a Comment
Read more

The Tragedy of Underfunded Mental Health Care

Today’s Managing Health Care Costs Indicator is   19,900 The NY Times  on Friday had a deeply disturbing article on a murder that stunned the mental health community here in Massachusetts.    A long-term schizophrenic man, off his medicine and spiraling into incoherence, killed a young female counselor who was the sole worker at a group home in a Boston suburb.   His mother, who works at a Boston teaching hospital, was frantic with worry as her adult son, who had been arrested for assault multiple times, was becoming more psychotic.    It was hard for her to get anyone’s attention. The counselor was the first in her family to get a college degree, and had just decided to go to nursing school.    Now she’s dead – and her family had trouble scraping together the resources for a burial.   The schizophrenic will be imprisoned for the rest of his life – which ironically could be the best chance for him to get appropriate medical care. Both...
Post a Comment
Read more

How a Well-Intended FDA Policy on Colchicine is Harming Patients

The road to hell is paved with good intentions. The FDA has reaffirmed the truth of this aphorism with its policy about Colchicine. Here's the story: I recently spoke with a friend who has a family member suffering from Familial Mediterranean Fever (FMF), an auto-inflammatory disorder, most commonly seen in eastern Mediterranean populations. The condition is characterized by recurrent painful inflammation of the abdomen, chest and joints, accompanied by fever. FMF is associated with mutation of a gene on chromosome 16 involved with regulating Pyrin, a protein that is part of the inflammatory response. There is no specific test for the disease. Diagnosis is made on the basis of symptoms, family history, and ruling out other conditions. Since the 1960s, Colchicine, a plant extract first used for treatment of gout two thousand years ago, has been used for treating FMF. As an ancient treatment widely used prior to formation of the FDA, Colchicine did not require FDA approval as a new ...
Post a Comment
Read more