New Hampshire Health Information Organization
Healthcare Provider Directory
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New Hampshire Health Information Organization
Healthcare Provider Directory
Agenda
Definition of Terms
NHHIO Architecture and HISP Services
EHR Integration Options
What is the Healthcare Provider Directory?
What is the Direct email address?
Who should be listed in the Healthcare Provider Directory?
Accessing and Sharing the Healthcare Provider Directory
Review of Required Documents
Next Steps
Questions Comments
New Hampshire Health Information Organization
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Definitions
ONC: Office of the National Coordinator - Oversees the HIE grant and certifies EHRs
DSM: Direct Secure Messaging – Encrypted exchange of information between providers and
organizations without using a centralized repository
HPD: The healthcare provider directory is a “phone book” of providers using DSM
HISP: Health Information Service Provider – Assigns Direct addresses and provides the
network for providers listed in the HPD to utilize DSM.
Direct: A national standard for interoperability using specific email type addresses, defined
message formats and transport protocols
•
XDR-SOAP (optional of ONC certification)
•
SMTP-S/MIME (required for ONC certification)
CCD: Continuity of Care Document – A medical summary of patient information
CCDA: Consolidated Clinical Document Architecture – A standard for message formats under
the Direct protocols
CEHRT: Certified Electronic Health Record Technology
New Hampshire Health Information Organization
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Agenda
Definition of Terms
NHHIO Architecture and HISP Services
EHR Integration Options
What is the Healthcare Provider Directory?
What is the Direct email address?
Who should be listed in the Healthcare Provider Directory?
Accessing and Sharing the Healthcare Provider Directory
Review of Required Documents
Next Steps
Questions Comments
New Hampshire Health Information Organization
© NHHIO. All rights reserved.
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NHHIO Mission
As healthcare organizations look to transform healthcare by providing better
healthcare, improving the health of their patients, and reducing costs, the
need to more effectively and efficiently coordinate the care of patients has
never been more important.
The electronic transmission of patient health information between health
care providers in a timely, secure, and confidential manner is an important
next step in the evolution of health care delivery in the Granite State.
New Hampshire Health Information Organization
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Health Information Service Provider (HISP)
An organization that manages security and transport for health information
exchange among health care entities or individuals using the Direct standard for
transport.
There is no specific legal designation for a HISP, nor are HISPs specifically
regulated by Meaningful Use certification rules.
Functions can be performed by existing organizations (such as EHR vendors or
HIE organizations) or by standalone organizations specializing in HISP services.
HISPs perform two key functions that support scalability of exchange using the
Direct standard.
•
Issue security certificates. HISPs establish trust networks by defining
policies for network participation and issuing security certificates tied to a
HISP anchor certificate to enforce such policies
•
Issue direct addresses. HISPs issue direct addresses tied to the HISP
anchor certificate in accordance with conventions defined by the Direct
standard
New Hampshire Health Information Organization
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NHHIO Architecture and HISP Services
CHAN
Health
Centers
Public
Health
(DHHS)
VNA /
Homecare
Inter-state / HISP
communications
ASCC
NH Statewide Network – “Backbone”
Phase I:
Node
addressing
Security
Provider
addressing
Audit
• Direct Secure Messaging
(DSM)
Relationship Listing Service (EMPI)
• Inter-state / HISP
gateway
Provider
Practices
NH
Hospital
Hospital
MD
MD
MD
MD
Behavioral
Health
Diagnostic
testing
Long-term
care
SNFs
MD
New Hampshire Health Information Organization
Phase II:
• Relationship Listing
Service (RLS) –
Electronic Master Person
Index (EMPI)
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3rd Party HISP Connections
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DSM Direct – XDR (NHHIO HISP)
Pending ONC
2014 Certification
New Hampshire Health Information Organization
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Agenda
Definition of Terms
NHHIO Architecture and HISP Services
EHR Integration Options
What is the Healthcare Provider Directory?
What is the Direct email address?
Who should be listed in the Healthcare Provider Directory?
Accessing and Sharing the Healthcare Provider Directory
Review of Required Documents
Next Steps
Questions Comments
New Hampshire Health Information Organization
© NHHIO. All rights reserved.
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Electronic Health Record (EHR) Integration
DSM
NHHIO Trust
Network
Basic Direct Secure Messaging
• Web-based access
• Email client access
Web
Managed Direct Secure Messaging
• Client-deployed hardware device
(LAND Appliance)
• Monitored by OH Managed
Services
HPD
DSM
Connect
Direct Secure Messaging with
EHR System integration
• Encrypted S/MIME access
• HISP-HISP Capability
• Encrypted XDR access
CERT
MSG
DSM
Direct
New Hampshire Health Information Organization
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Agenda
Definition of Terms
NHHIO Architecture and HISP Services
EHR Integration Options
What is the Healthcare Provider Directory?
What is the Direct email address?
Who should be listed in the Healthcare Provider Directory?
Accessing and Sharing the Healthcare Provider Directory
Review of Required Documents
Next Steps
Questions Comments
New Hampshire Health Information Organization
© NHHIO. All rights reserved.
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What is the Healthcare Provider Directory?
The Healthcare Provider Directory (HPD) is a searchable directory of individual
and organizational healthcare providers
• Individual Provider – A person who provides healthcare services, such
as a physician, nurse practitioner, physician assistant or nurse
• Organizational Provider – An organization that provides or supports
healthcare services such as hospitals, health centers, or practices
It allows discovery of a provider's electronic messaging details, in particular, the
Direct email address
It stores demographics, contact information, specialties, organizational
relationships, and other information for delivery of messages
New Hampshire Health Information Organization
© NHHIO. All rights reserved.
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Agenda
Definition of Terms
NHHIO Architecture and HISP Services
EHR Integration Options
What is the Healthcare Provider Directory?
What is the Direct email address?
Who should be listed in the Healthcare Provider Directory?
Accessing and Sharing the Healthcare Provider Directory
Review of Required Documents
Next Steps
Questions Comments
New Hampshire Health Information Organization
© NHHIO. All rights reserved.
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What is the Direct email address?
The Direct email address allows for:
• Discovery of the provider or organization for electronic delivery
• Provides their location on the HISP network
• Provides security certificate information
NHHIO example:
Organization Direct Address: exeter@direct.exeterhospital.nhhio.com
Provider Direct Address: John.smith@direct.exeterhospital.nhhio.com
New Hampshire Health Information Organization
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Direct email address components
Domain
Endpoint
John.smith@direct.exeterhospital.nhhio.com
Direct Address
Domain: The domain of the address is used for location of delivery, and
transport method of delivery if any conversion is required.(XDR-SMTP)
•
•
•
•
DSM Connect (LAND Appliance)
DSM Direct
DSM Web (email product)
HISP-HISP (ie. Surescripts, eClinicalworks)
Endpoint: The final destination for delivery within the EHR application or other
DSM product
New Hampshire Health Information Organization
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Direct email address examples
Organization Name
Access Sports Medicine
Androscoggin Valley Hospital
Carroll County VNA
Catholic Medical Center
Central New Hampshire VNA
Cheshire Medical Center
Cheshire Medical Center -Test
Community Health Access Network
Concord Hospital
Coos County Family Health Services
Cornerstone VNA
Cottage Hospital
Dartmouth Hitchcock Medical Center
Dept. of Public Health - Test
Dept. of Public Health - Prod
Developmental Services of Stafford County
Elliot Hospital
Exeter Hospital
Domain
direct.accessports.nhhio.com
direct.avh.nhhio.com
direct.vnsncc.nhhio.com
direct.cmc-nh.nhhio.com
direct.centralvna.nhhio.com
direct.cheshire-med.nhhio.com
direct.cheshire-med-test.nhhio.com
direct.chan-nh.nhhio.com
direct.crhc.nhhio.com
direct.ccfhs.nhhio.com
direct.cornerstonevna.nhhio.com
direct.cottagehospital.nhhio.com
direct.dartmouthhitchcock.nhhio.com
direct.dhhs-test.nhhio.com
direct.dhhs.nhhio.com
direct.communitypartnersnh.nhhio.com__
direct.elliothospital.nhhio.com
direct.exeterhospital.nhhio.com
Direct Address
accesssports@direct.accesssports.nhhio.com
avh@direct.avh.nhhio.com
vnsncc@direct.vnsncc.nhhio.com
cmc-nh@direct.cmc-nh.nhhio.com
centralvna@direct.centralvna.nhhio.com
cheshire-med@direct.cheshire-med.nhhio.com
cheshire-med@direct.cheshire-med-test.nhhio.com
chan-nh@direct.chan-nh.nhhio.com
concordhospital@direct.crhc.nhhio.com
ccfhs@direct.ccfhs.nhhio.com
cornerstonevna@direct.cornerstonevna.nhhio.com
cottagehospital@direct.cottagehospital.nhhio.com
dartmouthhitchcock@direct.dartmouthhitchcock.nhhio.com
dhhs@direct.dhhs-test.nhhio.com
dhhs@direct.dhhs.nhhio.com
communitypartnersnh@direct.communitypartnersnh.nhhi
elliot@direct.elliothospital.nhhio.com
exeter@direct.exeterhospital.nhhio.com
New Hampshire Health Information Organization
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Why use Direct email address?
New Hampshire Health Information Organization
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Agenda
Definition of Terms
NHHIO Architecture and HISP Services
EHR Integration Options
What is the Healthcare Provider Directory?
What is the Direct email address?
Who should be listed in the Healthcare Provider Directory?
Accessing and Sharing the Healthcare Provider Directory
Review of Required Documents
Next Steps
Questions Comments
New Hampshire Health Information Organization
© NHHIO. All rights reserved.
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Who should be listed in the Healthcare Provider Directory?
Direct Secure Messaging (DSM) is the encrypted exchange of information
between providers and is generalized as the replacement for current faxing and
paper based transmission of information
The Healthcare Provider Directory (HPD) is the “phonebook” that would
replace the contact fax numbers or mailing address of your individual and
organizational providers
The HPD is the “phonebook” presented to the NHHIO community for referral
provider information – How do you want to be seen in the directory? All
providers? All departments? A consolidated view?
New Hampshire Health Information Organization
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Can a provider have multiple Direct addresses?
Yes: Although the endpoint (provider) may be the same, the provider may
work in multiple domains (organizations).
Domain: The domain for the endpoint (provider) could exist in multiple
organizations and may be using multiple methods of connectivity based on
local EHR capabilities.
•
•
•
•
DSM Connect (LAND Appliance)
DSM Direct (connect through EHR)
DSM Web (email product)
HISP-HISP (ie. Surescripts, eClinicalworks, Greenway)
Example:
John.smith@direct.exeterhospital.nhhio.com
John.smith@direct.surescripts.com
New Hampshire Health Information Organization
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Can a provider have multiple Direct addresses?
HPD
Dr. Smith
DSM Connect
Dr.Smith
#1
Dr. Smith
DSM Web
Dr. Smith
#3
Dr.Smith
#2
Dr. Smith
DSM Direct
Dr. Smith works in 3 facilities in the State. He connects through his EHR
at site #1 (XDR) and site #2 (S/MIME) but uses Webmail at site 3.
New Hampshire Health Information Organization
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Can an organization have multiple domains?
Yes: Based on the integration methods of the EHR systems, an organization
may have an inpatient and outpatient domain, or may be using the domain
provided by another HISP:
Example:
Inpatient system is connected by DSM Connect (LAND Appliance) and NHHIO
provides HISP services: snhmc@direct.snhmc.nhhio.com
Outpatient system (GE) is connected to Surescripts HISP:
John.smith@direct.surescripts.com
New Hampshire Health Information Organization
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Can an organization have multiple domains?
Parent Organization
HPD
MR
LAND Appliance
Specialist
Specialist
PCP
PCP
MR
Provider Practices
EHR Vendor HISP
New Hampshire Health Information Organization
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Can multiple providers use a single Direct address?
Yes: The endpoint of the address is used by the local EHR to determine the
final delivery location of the information. Based upon the functionality of your
EHR vendor, or based upon your current staff resources and workflows,
multiple providers can use the same Direct address to centralize delivery of
information
Example:
System is connected by DSM Connect (LAND Appliance) and NHHIO provides
HISP services:
Dr. John Smith: orthopedics@direct.dartmouthhitchcock.nhhio.com
Dr. Sue Jones: orthopedics@direct.dartmouthhitchcock.nhhio.com
New Hampshire Health Information Organization
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Can multiple providers use a single Direct address?
HPD
Specialist
Specialist
PCP
PCP
MR
MR
*message details in clinical
documentation will
determine final destination*
New Hampshire Health Information Organization
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Agenda
Definition of Terms
NHHIO Architecture and HISP Services
EHR Integration Options
What is the Healthcare Provider Directory?
What is the Direct email address?
Who should be listed in the Healthcare Provider Directory?
Accessing and Sharing the Healthcare Provider Directory
Review of Required Documents
Next Steps
Questions Comments
New Hampshire Health Information Organization
© NHHIO. All rights reserved.
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How do I access the HPD?
The HPD will reside at the NHHIO central site and can be accessed in several
ways:
• Organizations using DSM Web will have the HPD automatically
incorporated and will work just like a MS Outlook directory
• Organizations using an EHR application:
 Receive a .CSV file periodically to update their internal directory or
manually enter updated information
 View full HPD through NHHIO portal (to be implemented)
 Receive or query against an HPD+ formatted file that can be
presented within the EHR application
New Hampshire Health Information Organization
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Will other HISP HPDs be available to NHHIO?
Yes: Organizations who have enrolled as NHHO participants, but are also
connecting to another HISP, will provide NHHIO with the same HPD
information as all participants
 Direct address field information will be populated with previously assigned
addresses (can export HPD from current vendor)
 Organizations who join a vendor HISP, but do not participate with NHHIO
will not be able to access NHHIO HPD through the portal
 Only vendor HISP address information for participating providers and
organizations will be viewable or available in the NHHIO HPD
New Hampshire Health Information Organization
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How do I update the HPD?
Currently, NHHIO is working with Orion Health to determine the most effective
and efficient method for updating:
 The NHHIO web-portal and access administrator documentation is designed
to allow participants to manually update the HPD as needed
 To start, participants will send additional .CSV files with new providers, or
email notification of terminated providers
 Updated HPD information will be distributed to participants (access
administrators) based on volume and timing of changes
New Hampshire Health Information Organization
© NHHIO. All rights reserved.
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Agenda
Definition of Terms
NHHIO Architecture and HISP Services
EHR Integration Options
What is the Healthcare Provider Directory?
What is the Direct email address?
Who should be listed in the Healthcare Provider Directory?
Accessing and Sharing the Healthcare Provider Directory
Review of Required Documents
Next Steps
Questions Comments
New Hampshire Health Information Organization
© NHHIO. All rights reserved.
- 32 -
How do I submit the HPD?
Field Section
System ID
Field Name
Field Requirement when using group
Code Table
Sample Organization
Sample Individual
Required for Individual and Organization
SYS_A
SYS_A
ProviderId
The code for the facility or system associated with the Local ID
The identification code for the record used by the local system or
facility
Required for Individual and Organization
AGEN
5824
ProviderTypeCode
Identifies if Provider is an Individual or an organization (facility).
Required for Individual and Organization
TYPE_CODE
ORG
IND
Issuing Authority
Type
ID
Status
Type
Required for Individual and Organization
Required for Individual and Organization
Required for Individual and Organization
Required for Individual and Organization
Required for Individual and Organization
ID_ISSUING_AUTHORITY
ID_TYPE
2.16.840.1.113883.4.6
NPI
104
Hospital
2.16.840.1.113883.4.6
NPI
666789-800
Active
Ambulatory
Name
Issuing authority of ID OID (OID for a Registered Namespace)
Type of ID e.g. NPI
Identifier value
Status of ID
Type of provider
The individual provider’s first name or the provider organization
name.
A General Hospital
JULIA
LastName
The individual provider’s last name
NAME_PREFIX
The individual’s title or prefix
NAME_SUFFIX
Name ending used to distinguish persons with the same name
NAME_HONOR
An academic or professional suffix for the individual
Status Type Code
Name
The status for the record e.g. Active, Inactive
The individual provider’s alternate first name or the provider's
alternate organization name.
Medical Records Delivery Email Address
LastName
Address Line 1
Address Line 2
City
State
Postal Code
Country
Address Line 1
Address Line 2
City
State
Postal Code
Country
Address Line 1
Address Line 2
City
State
Postal Code
Country
Direct Address
The individual provider’s alternate last name
The concatenated first line of the location address
The concatenated second line of the location address
The location city
The location state
The location postal code
The location country
The concatenated first line of the location address
The concatenated second line of the location address
The location city
The location state
The location postal code
The location country
The concatenated first line of the location address
The concatenated second line of the location address
The location city
The location state
The location postal code
The location country
Direct address for organization and individual
Business Phone
Phone Number
Primary business phone number for provider/organization
Provider ID
Provider External ID
Provider Type
Provider Name
SystemID
Field Description
Required for Individual and Organization
Required for individual
Not Used for Organization
Optional for Individual
Not used for Organization
Optional for Individual
Not used for Organization
Optional for Individual
Not used for Organization
Status
Alternate Name
Provider Mailing Address
Provider Billing Address
Provider Practice Address
Membership
Related Organization Id The organization ID of which the individual is a member
The system ID of the organization of which the individual is a
Related SystemId
member
ID_STATUS
PROVIDER_TYPE
Required for Individual and Organization
Required for organization
Optional for Individual
Required for individual
Not Used for Organization
Required for Individual and Organization
Optional for Individual and Organization
Optional for Individual and Organization
Optional for Individual and Organization
Optional for Individual and Organization
Optional for Individual and Organization
Required for Individual and Organization
Optional for Individual and Organization
Optional for Individual and Organization
Optional for Individual and Organization
Optional for Individual and Organization
Optional for Individual and Organization
Required for Individual and Organization
Optional for Individual and Organization
Optional for Individual and Organization
Optional for Individual and Organization
Optional for Individual and Organization
Optional for Individual and Organization
Required for Individual and Organization
RODRIGUEZ
DR
MD
PROVIDER_STATUS for provider
ORG_STATUS for orgs
Active
My General Hospital
Active
Juila
Jones
15 Spencer St
Suite 4
Connellsville
Connellsville
PA
PA
154252405
154252405
US
US
10 Broadway
15 Spencer St
Suite 4
Connellsville
Connellsville
PA
PA
154252405
154252405
US
US
10 Broadway
15 Spencer St
Suite 4
Connellsville
Connellsville
PA
PA
154252405
154252405
US
US
info@ageneralhospital.org jrod@ageneralhospital.org
10 Broadway
STATE/PROVINCE
STATE/PROVINCE
STATE/PROVINCE
Required for Individual and Organization
Required for individual
Not Used for Organization
Required for individual
Not Used for Organization
New Hampshire Health Information Organization
5551235417
5555512345
104
SYS_A
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Required Documents
 Appendix C – Provider Directory Upload File Format
New Hampshire Health Information Organization
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Agenda
Definition of Terms
NHHIO Architecture and HISP Services
EHR Integration Options
What is the Healthcare Provider Directory?
What is the Direct email address?
Who should be listed in the Healthcare Provider Directory?
Accessing and Sharing the Healthcare Provider Directory
Review of Required Documents
Next Steps
Questions Comments
New Hampshire Health Information Organization
© NHHIO. All rights reserved.
- 35 -
Next Steps
 Complete and return Appendix C – Provider Directory Upload File Format
 Complete Declaration of Identify Form (Contact NHHIO for form)
 Exploration of EHR functionality
New Hampshire Health Information Organization
© NHHIO. All rights reserved.
- 36 -
Agenda
Definition of Terms
NHHIO Architecture and HISP Services
EHR Integration Options
What is the Healthcare Provider Directory?
What is the Direct email address?
Who should be listed in the Healthcare Provider Directory?
Accessing and Sharing the Healthcare Provider Directory
Review of Required Documents
Next Steps
Questions Comments
New Hampshire Health Information Organization
© NHHIO. All rights reserved.
- 37 -
NHHIO Resources
www.nhhio.org
Project Contact Information
125 Airport Road, Concord, New Hampshire, 03301
Office. (603) 219-0184
Fax. (603) 218-6126
www.NHHIO.org
Jeff Loughlin
Executive Director
c: (508) 326-3944
o: (781) 434-7751
jloughlin@maehc.org
Jackie Baldaro
Project Manager
c: (339) 223-0888
o: (781) 434-7553
jbaldaro@maehc.org
New Hampshire Health Information Organization
© NHHIO. All rights reserved.
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