Office of the National Coordinator for Health IT Standards Interoperability Framework Electronic Service Information Discovery Data Model

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1 DATA MODEL OVERVIEW Office of the National Coordinator for Health IT The includes the following components: 1 Data Set - data elements and definitions for all data objects 2 Response Data Set - data elements for response transactions 3 Query Data Set - data elements for query transactions 4 Data model assumptions 5 Query and Response Descriptions and Examples - detailed overview of valid query and response transactions Items 1 thru 4 are worksheets embedded within this workbook. Item 5 is a separate Excel document. Three worksheets are included in this document to help clarify objects within the data model. While users of the data model are encouraged to review these supporting materials, they are not in and of themselves part of the data model. The supporting materials include: 1 ESI IntegrationProfile examples 2 ESI ContentProfile examples 3 ESI SecurityProfile examples Worksheet: Data Model Overview Version: Final 1 / 14

2 OBJECT DATA SET Name of Data Element Definition of Data Element Data type Occurrence(s) Comments/Notes The Address contains a single physical (postal) address Internationalization is currently out of scope. To be considered as necessary later. (address, telephone number, name) Address line 1 First line of an address Address line 2 Second line of an address, if needed String 0,1 City Contains a valid US city Valid US city County Contains a valid US county String 0,1 Valid list of US counties State Two digit state abbreviation Recommend vocabulary to make this an encoded value -- valid city based on USPO ZIP Code Five digit ZIP code with optional extension From list of US ZIP codes from USPO Usage Indicates the usage for this address. Valid values are: a) practice - the address at which healthcare services are provided b) mailing - the address to send general mail c) payment - the address to sent payment and billing issues d) legal - the address to which legal communication should be directed. Telephone Number Usage Telephone number in standard telephone format (aaa) nnn-nnnn Indicates the usage for this number. Valid values are: a) business b) mobile c) pager d) fax Standard telephone format (aaa) nnn-nnnn Address Telephone Number Standard Format / Vocabulary List 1 Practice location, Mailing, Payment, Legal List 2 Business, Mobile, Pager, Fax Individual First Name First Name or Given Name of the individual For names, suggest support for Soundex, partial string, and wild card Individual Middle Name Middle Name or Initial of the individual String 0,1 For names, suggest support for Soundex, partial string, and wild card Individual Last Name Last Name or Family Name of the individual For names, suggest support for Soundex, partial string, and wild card Individual Prefix Honorary title String 0,1 Honorary title, example Dr., Sister Individual Suffix Generational Identifier String 0,1 Generational identifier, example Jr., Sr., II State Issuing Two digit state abbreviation which issued the license Standard state abbreviations (e.g. CA) Issuing Authority The name of the authority issuing the license Individual Name State License Worksheet: Data Set Version: Final 2 / 14

3 License Type Describes what the individual is licensed to practice, for example: physician, nurse, dental, therapist, etc. Recommend usage from enumerated List 3 List 3 Physician, Nurse, Dental, Therapist, Pharmacist, Optician, Midwife, Medical Assistant, Allied Health, Other License Number Year Issued Status The number assigned by the Issuing Authority for this license Four digit year the Issuing Authority issued this license for this individual Status of the license: active, inactive, revoked suspended Integer 1 Valid year String 0,1 Professional Degree List 4 Active, Inactive, Revoked, Suspended Granting Institution Degree The formal name of the institution granting the professional degree Code representing the degree granted as defined in the code set List 5 MD, DO, DC, PhD, BS, BA, MPH, MS, MA, RN, LVN, LPT, OTR, AuD, OD Year Granted Four digit year degree was granted Integer 1 Valid year State Certifying Certifying Authority Certificate Type State certifying assuming it is a state based certifying authority, otherwise state is not required String 0,1 Standard state abbreviations (e.g. CA) Name of Certifying authority as it appears on the certification e.g. American Board of Internal Medicine Name of the certification as defined by the certifying authority e.g. Fellow in Endocrinology Certificate Number Certificate number assigned by the certifying authority Year Granted Four digit year certification was granted Integer 1 Policy Name Name of the Policy as defined by the community, state or federal governance, or policy authority Computable policy object Placeholder for a URL pointing to a "to be defined" Computable Policy URL 0,1 Policy Document Address Contains a URL address to where a human readable policy document can be found URL 0,1 Policy Document Electronic copy of policy in PDF format Binary 0,1 Unique ID for Electronic Service Information IntegrationProfile An identifier assigned by the provider directory whose purpose is to uniquely identify a unique ESI for an individual, organization, individual-organization relationship. A coded value which identifies the Integration Profile which describes the transport and valid contents String/Coded 1 Certification Policy Information Electronic Service Information Policy Information may contain elements related to the presence or absence of a DURSA or other policy related agreements Planning for future effort to define meta data associated with policies to automate the sharing/disclosure of data An electronic service is a new unique endpoint. A new unique electronic service should be created for each electronic address in which the data elements differ. See IntegrationProfile examples tab "Value" column for representative examples of coded elements and descriptions/constraints. Worksheet: Data Set Version: Final 3 / 14

4 IntegrationProfileVersion The version(s) of the Integration Profile supported String See IntegrationProfile examples tab for representative examples of coded versions for each Integration Profile and descriptions/constraints. IntegrationProfileOptions Options defined for the specific Integration Profile String/Coded Defined by the specific implementation guide ContentProfile An object that identifies, if appropriate, the Content See ContentProfile examples tab for representative examples Profile supported by the service. of coded elements and descriptions. SecurityProfile An object that identifies, if appropriate, the Security See SecurityProfile examples tab for representative examples Profile supported by the service. of coded elements and descriptions Address The address of the Electronic Service The Integration Profile identified will define the format of this value Preferred Method ContentProfile Integer between 0 and 99 indicating the preferred order of the service, where 0 is the most preferred service and 99 is the least preferred A coded value that identifies, if appropriate, the Content Profile supported by the service. Numeric, 2 digit String/Coded 1 ContentProfileVersion The version(s) of the Content Profile supported String ContentProfileConstraints SecurityProfile A coded value that identifies, if appropriate, additional constraints on this Content Profile An coded value that identifies, if appropriate, the Security Profile supported by the service. String/Coded String/Coded 1 SecurityProfileVersion Version(s) of the Security Profile supported String SecurityProfileConstraints A coded value that identifies, if appropriate, constraints supported by this SecurityProfile String/Coded 0,1 ContentProfile SecurityProfile See the ContentProfile examples tab for representative examples of coded elements and descriptions. See the ContentProfile examples tab for representative examples of coded versions for each ContentProfile and descriptions/options. See the ContentProfile examples tab for representative examples of coded elements and descriptions. See the SecurityProfiile examples tab for representative examples of coded elements and descriptions See the SecurityProfile examples tab for representative examples of coded versions for each SecurityProfile and descriptions/constraints See the SecurityProfile examples tab for representative examples of coded elements and descriptions Worksheet: Data Set Version: Final 4 / 14

5 RESPONSE DATA SET Name of Data Element Definition of Data Element Data type Occurrence(s) Comments/Notes While not required, it is highly recommended that all individuals/organizations have a valid ESI. Individual While most individual data elements are not required, it is recommended that individuals have sufficient data elements defined to aid in disambiguation. Individual ID An identifier assigned by the provider directory whose purpose is to uniquely identify an individual record within this provider directory. Return of this information assumes that the query included information from the Individual Section or a unique reference for the individual Alternate Individual Identifier An identifier, usually unique, associated with this Individual ID String May be any alternative identifier, including an OID. Individual Record Status Status of the Individual Valid values are "active" or "inactive" "retired" and "deceased" Legal Individual Name Legal name of the individual - see Individual Name (for individuals, this is the name on the birth certificate or 1 naturalization forms or as legally changed) Alternate/Other Known Individual Alternative or other names used by the individual - see Names Individual Name Individual Provider Type Code to define type of provider based on standard code set Code ISO Individual Specialty Specialty of Individual Code ISO or provider taxonomy code sets Individual Gender Gender of Individual String 0,1 Set of "M", "F", no entry or null would be used for unknown or indeterminate Date of Birth Birthdate of individual Date 0,1 Individual Address Physical Addresses for the individual - see Address Individual Telephone Telephone numbers for the Individual - See Telephone Number Individual NPI NPI assigned by NPPES NPI Registry Integer 0,1 Single NPI for a person - Single Type 1 NPI Individual Certification List of certifications held by the individual - see Certification Individual State License List of state licenses held by the individual - see State License Individual Professional Degree List of professional degrees held by the individual - see Professional Degree Individual addresses used by the individual (other than for Direct) String Standard Format / Vocabulary Individual Electronic Service Information Description of electronic services provided by the individual - see Electronic Service Information Individual Public Digital Certificate A base 64 encoded representation of the public digital certificate String This is a list of organization public digital certificates Individual Digital Certificate ID Serial number from the public digital certificate String Individual Digital Certificate Distinguished Name Distinguished Name field from digital certificate String Organization This is a list of digital certificate Serial Numbers for all individual public digital certificates This is a list of digital certificate Distinguished Names for all Individual Public Digital Certificates Organization ID An identifier assigned by the provider directory whose purpose is to uniquely identify an organization record within this provider directory. Alternate Organizational Identifier An identifier, usually unique, associated with this Organization ID String May be any alternative identifier, including an OID. Organizational Record Status Status of the Organization Valid values are "active" or "inactive" Worksheet: Response Data Set Version: Final 5 / 14

6 Organization Legal Name Legal name of the organization String 0,1 Legal name of organization if this Organization ID has a legal name Organization Alias Alternate names for the organization String Includes DBA's and non-legal names such as departments or roles Organization Address Physical addresses of the Organization - see Address 1..n For name and address, suggest support for partial string (check with use case) Organization Type Type of the organization..n For Organization type from ISO Organization Telephone Telephone numbers for the organization - see Telephone Number 1..n Organization NPI National provider identifier issued to the organization String Issued by NPPES Organization Certification Certifications held by the organization - see Certification Organization Specialty Specialty of the Organization String Organization Policy Information Policies supported by the Organization - see Policy Information Organization s for the organization (other than Direct) String Organization Electronic Service Information Organization Public Digital Certificate Description of electronic services provided by the Organization - see Electronic Service Information Standard Code Sets for Specialty (example: Healthcare Provider Taxonomy Code Set) -- note added to agree with query (ISO 21298) A base 64 encoded representation of the public digital certificate String This is a list of organization public digital certificates Organization Digital Certificate ID Serial number from the public digital certificate String Organization Digital Certificate Distinguished Name Distinguished Name field from digital certificate String Individual ID Individual ID (see Individual) Organization ID Organization ID (see Organization) Telephone Telephone numbers used by the individual referenced by Individual ID when associated with the organization referenced by Organization ID - see Telephone Number Individual Organization Relationship This is a list of digital certificate serial numbers for all organization public digital certificates This is a list of digital certificate Distinguished Names for all organization Public Digital Certificates Individual-Organization addresses (other than Direct) used by the individual referenced by Individual ID when associated with the organization referenced by Organization ID String Electronic Service Information Organization Public Digital Certificate Describes electronic services supported by the individual when associated with the organization - see Electronic Service Information A base 64 encoded representation of the public digital certificate String This is a list of organization public digital certificates Organization Digital Certificate ID Serial number from the public digital certificate String This is a list of digital certificate serial numbers for all organization public digital certificates Organization Digital Certificate Distinguished Name Distinguished Name field from digital certificate String Organization Organization Relationship Parent Organization ID Organization ID (see Organization) of the parent Child Organization ID Organization ID (see Organization) of the child This is a list of digital certificate Distinguished Names for all Organization Public Digital Certificates Worksheet: Response Data Set Version: Final 6 / 14

7 Provider Directory ID An identifier assigned to the provider directory whose purpose is to uniquely identify the provider directory from which a set of data is retuned. Provider Directory These data elements must provide a means for a query response to indicate the provider directory that is the source of the response. Provider Directory Name The name associated with the Provider Directory Worksheet: Response Data Set Version: Final 7 / 14

8 QUERY DATA SET Name of Data Element Definition of Data Element Data type Occurrence(s) Comments/Notes Standard Format / Vocabulary Note: See Query and Response Examples for response requirements based on various combination of query elements Note: If query includes an object (e.g. address object) it must include one or more of the data elements defined in that data object Individual Individual ID As defined in the Response Data Set String 0,1 Allows query for specific Individual data set and/or limits Organization data set retrieval to those with a relationship with the selected Individual ID Alternate Individual Identifier As defined in the Response Data Set String Allows query by alternate, usually unique, identifiers such as OIDs Legal Individual Name As defined in the Response Data Set 0,1 Query may include any of the individual name object data set For names, suggest support for Soundex, partial string, and wild card. Alternate/Other Known Individual Query may include any of the Individual Name data set As defined in the Response Data Set 0,1 Names Individual Provider Type As defined in the Response Data Set String By selected item in code set ISO21298 Individual Gender Gender of Individual String 0,1 Set of "M", "F", no entry or null would be used for unknown or indeterminate Individual Specialty Specialty of Individual String ISO or provider taxonomy code sets Individual Address See the Address Query may include any of the Address data Individual Telephone Number As defined in Telephone Number Query may include any of the Telephone Number data set Individual NPI NPI assigned by NPPES NPI Registry Integer 0,1 Issued by NPPES Individual Individual String Query may include any of the data set Individual Electronic Service Query may include any of the Individual Electronic Address See Electronic Service Information Information Individual Digital Certificate ID As defined in the Response Data Set String This is a query field for a unique Digital Certificate serial number. Individual Digital Certificate distinguished name As defined in the Response Data Set String This is a query field for a unique Digital Certificate distinguished name. Individual Professional Degree See Professional Degree Query may include any of the Professional Degree data Individual State License See State License Query may include any of the State License data Individual Certification See Certification Query may include any of the Certification data Organization Organization ID As defined in the Response Data Set String 0,1 Allows query for specific Organization data object and/or limits Individual data set retrieval to those with a relationship with the selected Organization ID Alternate Organization Identifier As defined in the Response Data Set String Allows query by alternate, usually unique, identifiers such as OIDs Organization legal name Legal organization name String 0,1 Organization Alias Alternate names for the organization String 0,1 Includes DBA's Organization Address See Address Query may include any of the Address data For name and address, suggest support for partial string Organization Type As defined in the Response Data Set String By selected item in code set Telephone As defined in the Telephone Number String Query may include any of the Telephone Number data Organization NPI National provider identifier issued to the organization String Issued by NPPES Organization Specialty Specialty of Organization String By selected item in code set Organization s for the organization (other than Direct) String Query may include any of the data Organization Electronic Service Query may include any of the Electronic Service Information See Electronic Service Information Information Organizational Digital Certificate ID As defined in the Response Data Set String This is a query field for a unique Digital Certificate serial number Organizational Digital Certificate distinguished name As defined in the Response Data Set String This is a query field for a unique Digital Certificate distinguished name Worksheet: Query Data Set Version: Final 8 / 14

9 Provider Directory ID As defined in the Response Data Set String 0,1 If present, it is the unique ID assigned to a specific Provider Directory that is the target of the query Provider Directory Name As defined in the Response Data Set String 0,1 Name of Provider Directory to query Telephone As defined in the Telephone Number String Individual-Organization Organization Electronic Service Information addresses (other than Direct) used by the individual referenced by Individual ID when associated with the organization referenced by Organization ID Provider Directory Individual Organization Relationship See Electronic Service Information Query may include any of the Telephone Number data String Query may include any of the data Query may include any of the Electronic Service Information Worksheet: Query Data Set Version: Final 9 / 14

10 Item 1 Assumption ASSUMPTIONS The transport protocol for Query for Electronic Service Information will provide appropriate identification of the querying individual/organization. All Worksheet: Assumptions Version: Final 10 / 14

11 This worksheet contains representative examples of IntegrationProfiles and is not part of the data model, except as a reference. Value Version Form of the Address String Content specification Further refining comments Location of specification Options Option specification DirectProjectSMTP address any ability+statement+for+secure+h ealth+transport URLof CAQH CORE Connectivity https + SOAP 1.2 and https V2.2.0 WSDL(caqh.org/SOAP/WSDL/CORERu any Rule MIME Multipart.php le2.2.0.wsdl MLLP HL7 V2.5 V2.5 IP address & port Lab Result - ELINCS, S&ILRIORURO1,... CIRImmunizationHL V3.0 URL of WSDL not allowed XDR:DocumentRecipient:Pro vide&register XDS:DocumentRegistry:Prov ide&register XDS:DocumentRegistry:Regi strystoredquery XDS:DocumentRegistry:Retr ievedocset PDQ:DemographicSupplier: PatientDemographicQuery PIX:PatientIdentitySource:Pa tientidentifyfeed URL of WSDL any FT URL of WSDL any FT URL of WSDL not allowed FT URL of WSDL not allowed FT IP address & port not allowed FT IP address & port not allowed FT PIX:Manager:Query IP address & port not allowed FT PDQV3:DemographicSupplie r:patientdemographicquery PIXV3:PatientIdentifySource: PatientIdentifyFeed URL of WSDL not allowed FT URL of WSDL not allowed FT PIXV3:Manager:Query URL of WSDL not allowed FT XDM:PortableMediaImporter: SMTP XCA:RespondingGateway:Cr ossgatewayquery XCA:RespondingGateway:Cr ossgatewayretrieve INTEGRATION PROFILE EXAMPLES address any FT URL of WSDL not allowed FT URL of WSDL not allowed FT CIR HL7 Web Service Integration Guide for Immunization Transactions using HL7 version nloads/pdf/cir/cir-hl7.web-serviceintegration-guide.pdf mework/index.cfm#it : Vol. 2b Section 3.41 mework/index.cfm#it : Vol. 2b Section 3.41 mework/index.cfm#it : Vol. 2a Section 3.18 mework/index.cfm#it : Vol. 2b Section 3.43 mework/index.cfm#it : Vol. 2a Section 3.21 mework/index.cfm#it : Vol. 2a Section 3.8 mework/index.cfm#it : Vol. 2a Section 3.9 Pediatric mework/index.cfm#it : Vol. 2b Demographic Section 3.37 mework/index.cfm#it : Vol. 2b Continuation Section 3.44 Pediatric mework/index.cfm#it : Vol. 2b Demographic Section 3.45 mework/index.cfm#it : Vol. 2b Continuation Section 3.32 mework/index.cfm#it : Vol. 2b Section 3.38 mework/index.cfm#it : Vol. 2b Section 3.39 Worksheet: IntegrationProfile Examples Version: Final 11 / 14

12 XCPD:RespondingGateway: PatientDiscovery HPD:ProviderInformationDir ectory:providerinformationq uery URL of WSDL not allowed TI URL of WSDL not allowed TI mework/index.cfm#it : XCPD Supplement mework/index.cfm#it : HPD Supplement Worksheet: IntegrationProfile Examples Version: Final 12 / 14

13 This worksheet contains representative examples of ContentProfiles and is not part of the data model, except as a reference. Value Version Content Type Content Form Content Standard Location of specification Constraint Option Specification Lab Result - ELINCS V1.2 Ambulatory Lab Result Structured ELINCS HL7-R1 S&ILRIORURO1 V1.0 Lab Result - S&I LRI IG Structured S&I LRI HL7 ORU^R01 _SIF_LABRESULTS_R1_N1_2011SEP.pdf HITSP C32 V2.5 Care Summary Structured HITSP C32 PrefixAlpha=4&PrefixNumeric=32 EHIWG CCD V1.0 Care Summary Structured EHR-HIE Interoperability Workgroup CCD tbd PDF Any content Structured or Unstructured umber=38920 DICOM V3.5 Image Report Structured DICOM PS 3.12 medical.nema.org X12N 270/271 ' Eligibility Request and Health Care Eligibility Benefit X279, Structured Response Inquiry and Response X279A1 CAQH CORE Phase I Operating Rules CAQH CORE Phase II Operating Rules V1.1.0 V2.x.x Eligibility Request and Response Eligibility Request and Response & Claim Status Structured Structured CONTENT PROFILE EXAMPLES CAQH CORE Phase I Operating Rules for X12N X279, X279A1 Eligibility CAQH CORE Phase II Operating Rules for X12N X212 Claim Status, X279, X279A1 Eligibility GU NG RU RN ISO OIDs Non Global Identifiers Placer / Filler Order Number Universal Service Identifier Worksheet: ContentProfile Examples Version: Final 13 / 14

14 Standards and Interoperability Framework This worksheet contains representative examples of SecurityProfiles and is not part of the data model, except as a reference. Value Version Specification Location of specification Constraints Option specification SAML 2.0 Security Markup Langugage Basic Basic Attribute Profile X.500/LDAP X.500/LDAP Attribute Profile Trust:<name> This defines one of several possible X.509 certificate trust anchors, a set of possible trust anchors is below at row 15 NwHIN 3.0 The NwHIN authorization framework t/gateway/ptargs_0_12811_ _0_0_18/NHIN_AuthorizationFra meworkproductionspecification_v3. 0.pdf S/MIME 3.1 Secure/Multipurpose Internet Exentsions WS-Security 1.1 UserName Token SECURITY PROFILE EXAMPLES Trust:<name> Examples of Trust:<name> Trust: Federal Bridge Trust: Safe Biopharma This defines one of several possible X.509 certificate trust anchors, a set of possible trust anchors is below at row 15 Worksheet: SecurityProfile Examples Version: Final 14 / 14