National Directory of Healthcare Providers & Services (NDH) Implementation Guide
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National Directory of Healthcare Providers & Services (NDH) Implementation Guide, published by HL7 International / Patient Administration. This guide is not an authorized publication; it is the continuous build for version 1.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-us-ndh/ and changes regularly. See the Directory of published versions

Artifacts Summary

This page provides a list of the FHIR artifacts defined as part of this implementation guide.

Behavior: Capability Statements

The following artifacts define the specific capabilities that different types of systems are expected to have in order to comply with this implementation guide. Systems conforming to this implementation guide are expected to declare conformance to one or more of the following capability statements.

NDH Attestation Server Capability Statement

This Section describes the expected capabilities of the NDH Attestation Server which is responsible for receiving information from attestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by NDH Attestation Servers are defined.

NDH Verification Server Capability Statement

This Section describes the expected capabilities of the NDH Verification Server which is responsible for receiving information from primary source. The complete list of FHIR profiles, RESTful operations, and search parameters supported by NDH Verification Servers are defined.

National Directory API Base Expanded Server Capability Statement

This Section describes the expected capabilities of the NDH Server actor which is responsible for providing responses to the queries submitted by the NDH Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by NDH Servers are defined. NDH Clients have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.

National Directory API Base Server Capability Statement

This Section describes the expected capabilities of the NDH Server actor which is responsible for providing responses to the queries submitted by the NDH Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by NDH Servers are defined. NDH Clients have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.

National Directory API Capability Statement

This Section describes the expected capabilities of the NDH Server actor which is responsible for providing responses to the queries submitted by the NDH Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by NDH Servers are defined. NDH Clients have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.

Workflow Directory Server Endpoint Basic Query Capability Statement

This Section describes the expected capabilities of the Distributed Workflow Directory Server which is responsible for providing responses to the queries submitted by the Distributed Workflow Directory Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by Distributed Workflow Directory Servers are defined. Distributed Workflow Directory Clients have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.

Workflow Directory Server Endpoint Expanded Query Capability Statement

This Section describes the expected capabilities of the Distributed Workflow Directory Server which is responsible for providing responses to the queries submitted by the Distributed Workflow Directory Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by Distributed Workflow Directory Servers are defined. Distributed Workflow Directory Clients have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.

Workflow Directory Server Health And Human Service Basic Query Capability Statement

This Section describes the expected capabilities of the Distributed Workflow Directory Server which is responsible for providing responses to the queries submitted by the Distributed Workflow Directory Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by Distributed Workflow Directory Servers are defined. Distributed Workflow Directory Clients have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.

Workflow Directory Server Health And Human Service Expanded Query Capability Statement

This Section describes the expected capabilities of the Distributed Workflow Directory Server which is responsible for providing responses to the queries submitted by the Distributed Workflow Directory Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by Distributed Workflow Directory Servers are defined. Distributed Workflow Directory Clients have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.

Workflow Directory Server Human Service Basic Query Capability Statement

This Section describes the expected capabilities of the Distributed Workflow Directory Server which is responsible for providing responses to the queries submitted by the Distributed Workflow Directory Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by Distributed Workflow Directory Servers are defined. Distributed Workflow Directory Clients have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.

Workflow Directory Server Human Service Expanded Query Capability Statement

This Section describes the expected capabilities of the Distributed Workflow Directory Server which is responsible for providing responses to the queries submitted by the Distributed Workflow Directory Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by Distributed Workflow Directory Servers are defined. Distributed Workflow Directory Clients have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.

Workflow Directory Server Payer Provider Network Query Capability Statement

This Section describes the expected capabilities of the Distributed Workflow Directory Server which is responsible for providing responses to the queries submitted by the Distributed Workflow Directory Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by Distributed Workflow Directory Servers are defined. Distributed Workflow Directory Clients have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.

Workflow Directory Server Provider Basic Query Capability Statement

This Section describes the expected capabilities of the Distributed Workflow Directory Server which is responsible for providing responses to the queries submitted by the Distributed Workflow Directory Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by Distributed Workflow Directory Servers are defined. Distributed Workflow Directory Clients have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.

Workflow Directory Server Provider Expanded Query Capability Statement

This Section describes the expected capabilities of the Distributed Workflow Directory Server which is responsible for providing responses to the queries submitted by the Distributed Workflow Directory Requestors. The complete list of FHIR profiles, RESTful operations, and search parameters supported by Distributed Workflow Directory Servers are defined. Distributed Workflow Directory Clients have the option of choosing from this list to access necessary data based on their local use cases and other contextual requirements.

Behavior: Operation Definitions

These are custom operations that can be supported by and/or invoked by systems conforming to this implementation guide.

Scheduled NDH Export Operation

Scheduled NDH Export Operation

Behavior: Search Parameters

These define the properties by which a RESTful server can be searched. They can also be used for sorting and including related resources.

CareTeam Name

Select CareTeams with the specified name or alias

CareTeam endpoint

Select CareTeams with the specified endpoint

CareTeam location

Select CareTeams operating at the specified location

CareTeam organization

Select CareTeams managed by the specified organization

CareTeam service

Select CareTeams providing the specified service

CareTeam verification-status

Select CareTeams with the specified verification-status

Endpoint access-control-mechanism

Select Endpoints that support the type of services indicated by a specific access-control-mechanism

Endpoint connection-type-version

Select Endpoints that support the type of services indicated by a specific connection-type-version

Endpoint dynamic-registration-trust-profile

Select Endpoints that support the type of services indicated by a specific dynamic-registration-trust-profile

Endpoint ihe-connection-type

Select Endpoints that support the type of services indicated by a specific ihe-connection-type

Endpoint nonfhir-usecase-type

Select Endpoints that support the type of services indicated by a specific nonfhir-usecase-type

Endpoint trust-framework-type

Select Endpoints that support the type of services indicated by a specific trust-framework-type

Endpoint usecase-type

Select Endpoints that support the type of services indicated by a specific usecase-type

Endpoint verification-status

Select Endpoints that support the type of services indicated by a specific verification-status

HealthcareService eligibility

Select HealthcareService with the specified eligibility

HealthcareService location

Select HealthcareService with the specified location

HealthcareService network

Select HealthcareService with the specified network

HealthcareService new patient

Select HealthcareService with the specified new patient

HealthcareService new patient from network

Select HealthcareService with the specified new patient from network

HealthcareService organization

Select HealthcareService with the specified organization

HealthcareService program requirement age group

Select HealthcareService with the specified program requirement age group

HealthcareService program requirement birthsex

Select HealthcareService with the specified program requirement birthsex

HealthcareService program requirement employment status

Select HealthcareService with the specified program requirement employment status

HealthcareService program requirement gender identity

Select HealthcareService with the specified program requirement gender identity

HealthcareService program requirement insurance status

Select HealthcareService with the specificed program requirement insurance status

HealthcareService program requirement preferred language

Select HealthcareService with the specified program requirement preferred language

HealthcareService program requirement va status

Select HealthcareService with the specified program requirement va status

HealthcareService social service requirement age group

Select HealthcareService with the specified social service requirement age group

HealthcareService social service requirement birthsex

Select HealthcareService with the specified social service requirement birthsex

HealthcareService social service requirement employment status

Select HealthcareService with the specified social service requirement employment status

HealthcareService social service requirement gender identity

Select HealthcareService with the specified social service requirement gender identity

HealthcareService social service requirement insurance status

Select HealthcareService with the specified social service requirement insurance status

HealthcareService social service requirement preferred language

Select HealthcareService with the specified social service requirement preferred language

HealthcareService social service requirement va status

Select HealthcareService with the specified social service requirement va status

HealthcareService verification status

Select HealthcareService with the specified verification status

Healthcareservice new-patient-and-from-network

Select Healthcareservice of the specified new-patient and from-network

InsurancePlan coverage-area

Select products that are offered in the specified location

InsurancePlan coverage-benefit-type

Select products that are offered in the specified coverage-benefit-type

InsurancePlan coverage-network

Select products offering covered benefits through the specified coverage network

InsurancePlan coverage-type

Select products that are offered in the specified coverage-type

InsurancePlan network

Select products that are offered in the specified network

InsurancePlan plan-network

Select products that are offered in the specified plan-network

InsurancePlan plan-type

Select products that are offered in the specified plan-type

InsurancePlan verification-status

Select InsurancePlan by verification status

Location accessibility

Select Locations of the specified accessibility

Location contains

Select Locations of the specified contains (co-ordinates)

Location new-patient

Select Locations of the specified new-patient

Location new-patient-and-from-network

Select Locations of the specified new-patient and from-network

Location new-patient-from-network

Select Locations of the specified new-patient-from-network

Location verification-status

Select Locations of the specified verification-status

Network coverage-area

Select health insurance provider networks available in a region described by the specified location. This search parameter is for the NDH Network Profile Resource only.

Organization or Network verification-status

Select Organization or Network with the specified verification status

OrganizationAffiliation location

Select OrganizationAffiliation with the specified location

OrganizationAffiliation participating organization

Select OrganizationAffiliation with the specified participating organization

OrganizationAffiliation primary organization

Select OrganizationAffiliation with the specified primary organization

OrganizationAffiliation verification-status

Select OrganizationAffiliation with the specified verification-status

OrganizationAffiliation via-intermediary

Select OrganizationAffiliation of the specified via-intermediary

Practitioner endpoint

Select Practitioner with the specified endpoint

Practitioner qualification-code

Select Practitioner with a type of qualification matching the specific code

Practitioner qualification-issuer

Select Practitioners with a qualification issued by the specified organization

Practitioner verification-status

Select Practitioner with the specified verification-status

PractitionerRole location

Select roles where the practitioner location

PractitionerRole network

Select roles where the practitioner is a member of the specified health insurance provider network

PractitionerRole new-patient

Select roles where the practitioner new-patient

PractitionerRole new-patient-from-network

Select roles where the practitioner new-patient-from-network

PractitionerRole organization

Select roles where the practitioner organization

PractitionerRole verification-status

Select roles where the practitioner verification-status

Practitionerrole new-patient-and-from-network

Select roles where the practitioner with the specified new-patient and from-network

VerificationResult attestation-communication-method

Select validation information for data that was attested to by communication-method

VerificationResult attestation-onbehalfof

Select validation information for data that was attested to by onbehalfof

VerificationResult attestation-who

Select validation information for data that was attested to by the specified individual or organization

VerificationResult primarysource-type

Select verification information for data that was verified against the specified primary source type

VerificationResult primarysource-validation-date

Select verification information for data that was verified against the specified primary source validationDate

VerificationResult primarysource-validation-status

Select verification information for data that was verified against the specified primary source validationStatus

VerificationResult primarysource-who

Select verification information for data that was verified against the specified primary source who

VerificationResult status

Select verification information for data that was verified against the specified status

VerificationResult status-date

Select verification information for data that was verified against the specified statusDate

VerificationResult target

Select verification information for data that was verified against the specified target

VerificationResult validator-organization

Select verification information for data that was verified against the specified validator-organization

Structures: Resource Profiles

These define constraints on FHIR resources for systems conforming to this implementation guide.

NDH Base CareTeam Profile

Defines the basic constraints and extensions on the CareTeam resource for use in a National Directory of Healthcare Providers & Service (NDH)

NDH Base Endpoint Profile

The technical details of an endpoint that can be used for electronic services, such as a portal or FHIR REST services, messaging or operations, or DIRECT messaging.

NDH Base HealthcareService Profile

The HealthCareService resource typically describes services offered by an organization/practitioner at a location. The resource may be used to encompass a variety of services covering the entire healthcare spectrum, including promotion, prevention, diagnostics, pharmacy, hospital and ambulatory care, home care, long-term care, and other health-related and community services.

NDH Base InsurancePlan Profile

An InsurancePlan is a discrete package of health insurance coverage benefits that are offered under a particular network type. A given payer’s products typically differ by network type and/or covered benefits. A plan pairs a product’s covered benefits with the particular cost sharing structure offered to a consumer. A given product may comprise multiple plans (i.e. each plan offers different cost sharing requirements for the same set of covered benefits). InsurancePlan describes a health insurance offering comprised of a list of covered benefits (i.e. the product), costs associated with those benefits (i.e. the plan), and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc.

NDH Base Location Profile

A Location is the physical place where healthcare services are provided, practitioners are employed, organizations are based, etc. Locations can range in scope from a room in a building to a geographic region/area.

NDH Base Network Profile

A Network refers to a healthcare provider insurance network. A healthcare provider insurance network is an aggregation of organizations and individuals that deliver a set of services across a geography through health insurance products/plans. In the NDH IG, individuals and organizations are represented as participants in a National Directory Exchange Network through the practitionerRole and National Directory Exchange-organizationAffiliation resources, respectively.

NDH Base Organization Profile

An organization is a formal or informal grouping of people or organizations with a common purpose, such as a company, institution, corporation, community group, or healthcare practice. Guidance: When the contact is a department name, rather than a human (e.g., patient help line), include a blank family and given name, and provide the department name in contact.name.text

NDH Base OrganizationAffiliation Profile

The OrganizationAffiliation resource describes relationships between two or more organizations, including the services one organization provides another, the location(s) where they provide services, the availability of those services, electronic endpoints, and other relevant information.

NDH Base Practitioner Profile

Practitioner is a person who is directly or indirectly involved in the provisioning of healthcare.

NDH Base PractitionerRole

PractitionerRole typically describes details about a provider. When the provider is a practitioner, there may be a relationship to an organization. A provider renders services at a location. Practitioner participation in healthcare provider insurance networks may be direct or through their role at an organization. PractitionerRole involves either the actual or potential (hence the optionality on Practitioner) of an individual to play this role on behalf of or under the auspices of an organization. The absence of a Practitioner resource does not imply that the Organization itself is playing the role of a Practitioner, instead it implies that role has been established by the Organization and MAY apply that to a specific Practitioner.

NDH Base Restriction

his profile sets minimum expectations for searching for and fetching information associated with a restriction. It identifies which elements, extensions, vocabularies and value sets SHALL be restricted in the Consent resource when using this profile.

NDH Base Verification

Describes Verification requirements, source(s), status and dates for one or more elements

National Directory API CareTeam Profile

Defines the basic constraints and extensions on the CareTeam resource for use in a National Directory of Healthcare Providers & Service (NDH)

National Directory API Endpoint Profile

The technical details of an endpoint that can be used for electronic services, such as a portal or FHIR REST services, messaging or operations, or DIRECT messaging.

National Directory API HealthcareService Profile

The HealthCareService resource typically describes services offered by an organization/practitioner at a location. The resource may be used to encompass a variety of services covering the entire healthcare spectrum, including promotion, prevention, diagnostics, pharmacy, hospital and ambulatory care, home care, long-term care, and other health-related and community services.

National Directory API InsurancePlan Profile

An InsurancePlan is a discrete package of health insurance coverage benefits that are offered under a particular network type. A given payer’s products typically differ by network type and/or covered benefits. A plan pairs a product’s covered benefits with the particular cost sharing structure offered to a consumer. A given product may comprise multiple plans (i.e. each plan offers different cost sharing requirements for the same set of covered benefits). InsurancePlan describes a health insurance offering comprised of a list of covered benefits (i.e. the product), costs associated with those benefits (i.e. the plan), and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc.

National Directory API Location Profile

A Location is the physical place where healthcare services are provided, practitioners are employed, organizations are based, etc. Locations can range in scope from a room in a building to a geographic region/area.

National Directory API Network Profile

A Network refers to a healthcare provider insurance network. A healthcare provider insurance network is an aggregation of organizations and individuals that deliver a set of services across a geography through health insurance products/plans. In the NDH IG, individuals and organizations are represented as participants in a National Directory Exchange Network through the practitionerRole and National Directory Exchange-organizationAffiliation resources, respectively.

National Directory API Organization Profile

An organization is a formal or informal grouping of people or organizations with a common purpose, such as a company, institution, corporation, community group, or healthcare practice. Guidance: When the contact is a department name, rather than a human (e.g., patient help line), include a blank family and given name, and provide the department name in contact.name.text

National Directory API OrganizationAffiliation Profile

The OrganizationAffiliation resource describes relationships between two or more organizations, including the services one organization provides another, the location(s) where they provide services, the availability of those services, electronic endpoints, and other relevant information.

National Directory API Practitioner Profile

Practitioner is a person who is directly or indirectly involved in the provisioning of healthcare.

National Directory API PractitionerRole

PractionerRole describes details about a provider, which can be a practitioner or an organization. When the provider is a practitioner, there may be a relationship to an organization. A provider renders services to patients at a location. Practitioner participation in healthcare provider insurance networks may be direct or through their role at an organization.

Payer Provider Network Local Directory API Endpoint Profile

The technical details of an endpoint that can be used for electronic services, such as a portal or FHIR REST services, messaging or operations, or DIRECT messaging.

Payer Provider Network Query HealthcareService Profile

The HealthCareService resource typically describes services offered by an organization/practitioner at a location. The resource may be used to encompass a variety of services covering the entire healthcare spectrum, including promotion, prevention, diagnostics, pharmacy, hospital and ambulatory care, home care, long-term care, and other health-related and community services.

Payer Provider Network Query InsurancePlan Profile

An InsurancePlan is a discrete package of health insurance coverage benefits that are offered under a particular network type. A given payer’s products typically differ by network type and/or covered benefits. A plan pairs a product’s covered benefits with the particular cost sharing structure offered to a consumer. A given product may comprise multiple plans (i.e. each plan offers different cost sharing requirements for the same set of covered benefits). InsurancePlan describes a health insurance offering comprised of a list of covered benefits (i.e. the product), costs associated with those benefits (i.e. the plan), and additional information about the offering, such as who it is owned and administered by, a coverage area, contact information, etc.

Payer Provider Network Query Location Profile

A Location is the physical place where healthcare services are provided, practitioners are employed, organizations are based, etc. Locations can range in scope from a room in a building to a geographic region/area.

Payer Provider Network Query Network Profile

A Network refers to a healthcare provider insurance network. A healthcare provider insurance network is an aggregation of organizations and individuals that deliver a set of services across a geography through health insurance products/plans. In the NDH IG, individuals and organizations are represented as participants in a National Directory Query Network through the practitionerRole and National Directory Query-organizationAffiliation resources, respectively.

Payer Provider Network Query Organization Profile

An organization is a formal or informal grouping of people or organizations with a common purpose, such as a company, institution, corporation, community group, or healthcare practice. Guidance: When the contact is a department name, rather than a human (e.g., patient help line), include a blank family and given name, and provide the department name in contact.name.text

Payer Provider Network Query OrganizationAffiliation Profile

The OrganizationAffiliation resource describes relationships between two or more organizations, including the services one organization provides another, the location(s) where they provide services, the availability of those services, electronic endpoints, and other relevant information.

Payer Provider Network Query Practitioner Profile

Practitioner is a person who is directly or indirectly involved in the provisioning of healthcare.

Payer Provider Network Query PractitionerRole

PractionerRole describes details about a provider, which can be a practitioner or an organization. When the provider is a practitioner, there may be a relationship to an organization. A provider renders services to patients at a location. Practitioner participation in healthcare provider insurance networks may be direct or through their role at an organization.

Structures: Extension Definitions

These define constraints on FHIR data types for systems conforming to this implementation guide.

NDH Accessibility

An extension to describe accessibility options offered by a practitioner or at a location.

NDH Age Group

Age Group

NDH Age Range

Age Range

NDH Associated Servers

This extension is designed to store information about servers that may be associated with the current endpoint. It defines a set of servers that could be linked to this endpoint. If a server is associated, the server’s type and URL will be included. For example, if your system features two types of endpoints: a standard endpoint and a proxy endpoint associated with the server. For example, the proxy endpoint can be configured to interface with AEGIS software, allowing the software to record transactions and ensure compliance with pertinent standards or regulations. Implementing such a configuration in a production environment would offer the flexibility to switch between standard and proxy modes (associated server) as necessary. Consequently, it is essential to have both standard and proxy endpoints readily available for seamless transitions as required.

NDH Combined Payload And MimeType

Combined Payload And MimeType

NDH Communication Proficiency

An extension to express a practitioner’s spoken proficiency with the language indicated in practitioner.communication.

NDH Contactpoint Availabletime

An extension representing the days and times a contact point is available

NDH Delivery Method

An extension describing the service delivery method. If service delivery is virtual, one or more delivery modalities should be specified.

NDH Digitalcertificate

A digital certificate, used to identify a user or group of users, or for encrypted communications

NDH Dynamic Registration

Dynamic registration within a trust framework refers to a process where clients can register with a server or service provider dynamically and securely at runtime, rather than being pre-registered manually. This approach is often used in environments where scalability, flexibility, and security are crucial. Currently, dynamic registration is used in SMART and UDAP.

NDH Endpoint Access Control Mechanism

Endpoint access control mechanisms protect and manage access to healthcare endpoints, ensuring secure data exchange between systems. They standardize methods to secure endpoints, ensuring interoperability and security.
In certain use cases requiring system scalability and flexibility, different profiles may be utilized based on the chosen access control mechanism. For example, the Unified Data Access Profile (UDAP) uses JWT access tokens.

NDH Endpoint Connection Type Version

An extension for endpoint connection type version

NDH Endpoint EnvironmentType

Endpoint Environment Type

NDH Endpoint IHE Specific Connection Type

Endpoint IHE Specific Connection Type

NDH Endpoint Non FHIR Usecase

NonEndpointUseCase is an enumeration of the specific use cases (service descriptions) supported by the endpoint

NDH Endpoint Rank

Order established by a Role, Organization… for Endpoints capable of transferring the same content

NDH Endpoint Reference

The technical details of an endpoint that can be used for electronic services

NDH Endpoint Testing Certification

An extension for endpoint testing certification

NDH Endpoint Usecase

EndpointUseCase is an enumeration of the specific use cases (service descriptions) supported by the endpoint

NDH FHIR IG

FHIR IG

NDH Funding Source

The sources of funding for a service or organization

NDH HealthcareService or Program Requirement

Service or Program requirement indicates whether the program is available to anyone, or only to those meeting certain criteria.

NDH Healthcareservice Reference

Reference to healthcareservice resource

NDH Identifier Status

Describes the status of an identifier

NDH InsurancePlan Reference

Reference to insuranceplan resource

NDH Language Speak

Language Speak

NDH Location Reference

A reference to a Location resource (NDH-Location) defining the coverage area of a health insurance provider network

NDH Logo

Logo

NDH Network Reference

A reference to the healthcare provider insurance networks (NdhNetwork) the practitioner participates in through their role

NDH New Patients

New Patients indicates whether new patients are being accepted in general, or from a specific network.
This extension is included in the PractitionerRole, HealthcareService, and Location profiles.
This provides needed flexibility for specifying whether a provider accepts new patients by location and network.

NDH New Patients Characteristics

Characteristics of accepted patients

NDH Org Description

An extension to provide a human-readable description of an organization

NDH Organization Alias Period

The period of time the organization alias was actively used

NDH Organization Alias Type

Type of organization alias (legal alternative, historical)

NDH Payment Accepted

Methods of payment that can be used for a healthcare service

NDH Practitioner Qualification

An extension to add status and whereValid elements to a practitioner’s qualifications.

NDH Qualification

An extension to add qualifications for an organization (e.g. accreditation) or practitionerRole (e.g. registered to prescribe controlled substances).

NDH Rating

Rating

NDH Rating Details

Rating Details

NDH Required Document

Documents that are required in order to access or use services (eg. Gov’t issued ID, passport)

NDH Secure Exchange Artifacts

This extension is designed to store information about the type of public certificate, the public certificate itself, and the expiration date of the certificate. Public certificates, issued by Certificate Authorities, are intended for sharing and inspection by others as part of the trust and verification process in digital communications. Each certificate includes an expiration date, which is a crucial piece of information easily accessible to anyone examining the certificate. The expiration date plays a significant role in validating the certificate’s current validity and in maintaining security within digital communications. This extension should be used when the standard for exchange requires the discovery of the public key.

NDH Supported IG

Supported IG

NDH Supported IG Actor

Supported IG Actor

NDH Trust Framework

A trust framework typically requires the use of signed artifacts and public certificates to ensure security, integrity, and trust in digital communications and transactions. For trust frameworks that use private PKI there is no need to use this extension unless the goals is to provide access to endpoints via the endpoint reference on any of the relevant resources (e.g., careteam, healthcareService).

NDH Usage Restriction

The FHIR specification contains a security meta tag which can be used to inform systems of the sensitivity of resources, as well as by access control mechanisms to ensure content isn’t exposed that shouldn’t be. This mechanism only goes to the resource level, this reference to a usage-restriction (consent) extends this further into the resource, and can be applied to any element, and may apply to all properties beneath the element (e.g. If applied to an identifier on a practitioner, then all the properties of the identifier should not be exposed unless it is understood) This will be expected to be used as a modifier extension.

NDH Verification Status

Indicates a resource instance verification status

NDH Via Intermediary

A reference to an alternative point of contact (NdhPractitionerRole, NdhOrganization, NdhOrganizationAffiliation, or NdhLocation) for this organization

NDH usage restriction fhir path

NDH usage restriction to resource element level

Terminology: Value Sets

These define sets of codes used by systems conforming to this implementation guide.

Accepting Patients Codes Value Set

Codes to identify if the practice is accepting new patients

Accessibility Value Set

Codes for documenting general categories of accommodations available

Age Range Value Set

Codes for documenting age range

Associated Servers Type Value Set

Associated Servers Type

Consent Policy Rules Value Set

Code for Consent Policy Rules

Delivery Methods Value Set

Codes for documenting delivery methods

Digital Certificate Use Value Set

Codes for the Digital Certificate Use

Employment Status Value Set

Codes for documenting employment status

Endpoint Access Control Mechanism Value Set

Codes for documenting access control mechanism

Endpoint Connection Types Value Set

Endpoint Connection Types

Endpoint FHIR Mimetype Value Set

Endpoint FHIR mimetype

Endpoint HIE Specific Connection Types Value Set

Endpoint HIE Specific Connection Types

Endpoint Payload Type Value Set

Endpoint Payload Types are constrained to NA (Not Applicable) as part of this IG

Endpoint Testing Method Value Set

Codes for documenting testing method

Endpoint common mimetype Value Set

Endpoint common mimetype

Healthcare Service Category Value Set

Broad categories of healthcare services being performed or delivered.

Healthcare Service Eligibility Code Value Set

Codes for Healthcare Service Eligibility Code

HealthcareService Type Value Set

HealthCareService type Value Set

IG Actor Value Set

Codes to identify IG Actor

Identifier Status Value Set

Codes for Identifier Status

Individual Specialties, Degrees, Licenses, and Certificates Value Set

Individual Specialties, Degrees, Licenses, and Certificates

Individual and Group Specialties

Individual and Group Specialties from National Uniform Claim Committee (NUCC) Health Care Provider Taxonomy code set.

Insurance Plan Type Value Set

Categories of cost-sharing used by plans

Insurance Product Type Value Set

A distinct package of health insurance coverage benefits that are offered using a particular product network type

Insurance Status Value Set

Codes for documenting insurance status

Language Proficiency Value Set

Codes for documenting spoken language proficiency based on the Interagency Language Roundtable scale of abilities to communicate in a language

NDH Benefit Type Value Set

Codes for NDH Insurance Benefit Type.

NDH Care Team Category Value Set

Codes for NDH Care Team Category

NDH Consent Category Value Set

Code for NDH Consent Category Value Set

NDH Consent Scope Value Set

Code for NDH Consent Scope Value Set

NDH Direct Trust Endpoint Usecase Value Set

Codes for documenting business use case by a general grouping by business area.

NDH Direct Trust Payload Type Value Set

Payload types for NDH Direct Trust

NDH Endpoint Environment Value Set

Codes for NDH Endpoint Environment

NDH FHIR Endpoint Usecase Value Set

Codes for documenting business use case by a general grouping by business area.

NDH Insurance Coverage Type Value Set

Codes for NDH Insurance Coverage Type.

NDH Verification Process Value Set

Codes for documenting verification process

NDH Verification Status Value Set

Codes for verification status

Network Type Value Set

Single value describing networks.

Non-Individual Specialties

Non-Individual Specialties from National Uniform Claim Committee (NUCC) Health Care Provider Taxonomy code set.

Organization Alias Type Value Sete

Categories of an organization’s Alias based on criteria in provider directories.

Organization Type Value Set

Categories of organizations based on criteria in provider directories.

OrganizationAffiliation Roles

Value Set for Organization Affiliation Roles

PractitionerRole Code Value Set

Codes for the capabilities that an individual, group, or organization is acknowledged to have in a payer network, including general codes from the HL7 PractitionerRole Code System

Qualification Status Value Set

The state indicating if a qualification is currently valid.

Secure Exchange Artifacts Value Set

Secure Exchange Artifacts

Specialties Value Set

Specialties value set based on National Uniform Claim Committee (NUCC) Health Care Provider Taxonomy code set

Specialties, Degrees, Licenses, and Certificates Value Set

Specialties and Degree License and Certificates

Trust Framework Type Value Set

Trust Framework Type

Trust Profile Value Set

Codes for documenting trust profile

Virtual Modalities Value Set

Codes for virtual service delivery modalities

Terminology: Code Systems

These define new code systems used by systems conforming to this implementation guide.

Accepting Patients Codes Code System

Codes to identify if the practice is accepting new patients

Accessibility Code System

General categories of accommodations available.

Age Range Code System

This code system includes codes for indicating the age range of a person.

Credential Status Code System

This code system contains codes for indicating the status of a credential, such as an identifier or qualification.

Delivery Methods Code System

Categories of healthcare service delivery methods.

Digitalcertificate Use Code System

This code System includes the choice of use digital certification

Endpoint Access Control Mechanism Code System

Endpoint Access Control Mechanism

Endpoint Connection Types (additional) Code System

Extension codes for http://terminology.hl7.org/CodeSystem/endpoint-connection-type

Endpoint Testing Method Code System

Endpoint Testing Method

Healthcare Service Category Code System

Broad categories of healthcare services being performed or delivered

IG Actor Code System

IG Actor

Insurance Plan Type Code System

Categories of cost-sharing used by plans

Insurance Product Type Code System

A distinct package of health insurance coverage benefits that are offered using a particular product network type.

Insurance Status Code System

This code system includes codes for indicating the status of a person’s insurance coverage.

Language Proficiency Code System

Codes for documenting spoken language proficiency based on the Interagency Language Roundtable scale of abilities to communicate in a language.

NDH Associated Servers Type Code System

NDH Associated Servers Type

NDH ConsentScopeCodes Code System

This code system includes the Consent scope codes for National Healthcare Directory

NDH Direct Trust Endpoint Usecase Code System

NDH Direct Trust Endpoint Usecase

NDH Direct Trust Payload Type Code System

NDH Direct Trust Payload Type

NDH Endpoint Environment Code System

NDH Endpoint Environment

NDH FHIR Endpoint Use Case Code System

NDH FHIR Endpoint Use Case

NDH Organization Affiliation Role for HIE

Codes For Organization Affiliation Role for HIE

NDH Payer Characteristics Code System

NDH Payer Characteristics

NDH Resource Instance Verification Status Code System

NDH Resource Instance Verification Status

NDH Secure Exchange Artifacts Code System

NDH Secure Exchange Artifacts

NDH Verification Process Code System

NDH Verification Process

National Healthcare Directory Consent Category Code System

This code system includes Directory Consent Category codes.

National Healthcare Directory ConsentPolicyRules Code System

This code system includes Policy Rule codes.

Organization Affiliation Role

Codes For Organization Affiliation Role

Organization Alias Type Code System

The state indicating if an Organization has an alias.

Organization Type Code System

Categories of organizations based on criteria in provider directories.

Practitioner Role Codes Code System

A capability that an individual, group, or organization is acknowledged to have in a payer network.

Qualification Status Code System

The state indicating if a qualification is currently valid.

Trust FrameworkType Code System

Trust Framework Type

Trust Profile Code System

Trust Profile

Virtual Modalities Code System

Categories of virtual service delivery modalities.

Example: Example Instances

These are example instances that show what data produced and consumed by systems conforming with this implementation guide might look like.

Acme

Payer Organization

AcmeOfCTPortalEndpoint

Endpoint for Acme of CT Portal

AcmeQHPBronze

Acme of CT QHP Bronze Plan

AcmeQHPBronze3

Acme of CT QHP Bronze Plan 2

AcmeQHPGold

Acme of CT QHP Gold Plan

AcmeofCTPremNet

Acme of CT Premium Premium Network

AcmeofCTStdNet

Acme of CT Standard Network

AcmeofCTStdNet2

Acme of CT Standard Network 2

Backport Subscription for Practitioner Qualification Change

Topic-based ‘Practitioner Qualification Change’ subscription.

BigBox

Organization that Manages 2 of PharmChain’s pharmacies

BlueCrossBlueShield-CT

Blue Cross Blue Shield of Connecticut

BlueCrossBlueShield-CT-ORG

Organization Manage Blue Cross Blue Shield of Connecticut PPO Network

BlueCrossBlueShield-CT-PPO

Blue Cross Blue Shield of Connecticut PPO Network

BurrClinic

Burr Clinic provides service to Hartford Hospital

BurrClinicAffil

Burr Clinic’s affiliation with Acme of CT Provider Network and Hartford General Hospital

BurrClinicAffil2

Burr Clinic’s affiliation with Acme of CT Provider Network and Hartford General Hospital

BurrClinicServices

Burr Clinic Services

BurrClinicServices2

Burr Clinic Services 2

CareTeam1

Burr Clinic’s Care Team

CareTeam2

Burr Clinic’s Care Team

CoordinationOfCareEndpoint

Endpoint for Coordination of Care

DirectTrustEndpointAdtNotifications

Endpoint for DirectTrust

DirectTrustEndpointReferrals

Endpoint for DirectTrust

Example-license

Example license

GaryGroup

Solo Practitioner Gary Group

HamiltonClinic

Hamilton Clinic (a Division of Hartford Hospital)

HansSolo

Solo Practitioner Hans Solo

HansSoloClinic

Location of Hans Solo’s clinic

HansSoloDirectTrustEndpointReferrals

Hans Solo Endpoint for DirectTrust

HansSoloPatientAccessEndpoint

Hans Solo Endpoint for Patient Access

HansSoloRole

Solo practitioner practice in his own clinic

HansSoloRole2

Solo practitioner has privileges at a hospital

HansSoloService

Hans Solo Services

HartfordOrthopedicServices

Hartford Orthopedic Services

HartfordOrthopedics

Hartford Orthopedic Services is a group providing Orthopods for Acme of CT at Hartford General Hospital

HealthcareService-Social-Hope-CBO

HOPE INC Healthcare Service

HealthcareService-Social-Towson-Food

Towson Healthcare Service

HealthcareServiceHomelessAssistance

Healthcare Service for Homeless Assistance

HealthcareServiceWomenShelter

Women’s shelter healthcare service

HealthcareServiceWomenShelterAll

Women’s shelter healthcare service

HospLoc1

Location1 of Hartford Hospital

HospLoc2

Location2 of Hartford Hospital

HospLoc3

Location2 of Hartford Hospital

Hospital

Hartford General Hospital

Hospital2

Hartford General Hospital

IheEndpoint

Endpoint for IHE

JoeSmith

Practitioner Dr Joe Smith

JoeSmithHospitalRole

Dr Smith Internal Medicine at Hartford General Hospital

JoeSmithRole2

Dr Smith Internal Medicine at Burr Clinic

JoeSmithRole3

Dr Smith Internal Medicine at Burr Clinic

Location-Social-Hope-CBO

HOPE FOOD DISPENSARY

Location-Social-Towson-Food

Towson Food INC

LocationGen1

NdhNdApiLocation LocationGen1

LocationGen2

NdhNdApiLocation LocationGen2

LocationWelcomeHome

Location for Welcome Home

LocationWomenShelter

Women’s shelter Location

LocationWomenShelterAll

Women’s shelter Location

MedicareAdvantage

Medicare Advantage Plan

MedicareAdvantageHMO

Medicare Advantage HMO

MilitaryHealthcareOrganization

Military Healthcare Organization

Network1

Network1

Network2

Network2

NetworkGen1

NdhNdApiNetwork NetworkGen1

NetworkGen2

NdhNdApiNetwork NetworkGen2

OrgHousingAssistanceHubManagement

Organization that manages the Housing Assistance Hub

OrgManageNetwork

Organization Manage Payer Network

OrgOneNetwork1Affiliation

Organization Affiliation for OrgOne in Network1

OrgOneNetwork2Affiliation

Organization Affiliation for OrgOne in Network2

OrgOneWithNetwork1AndNetwork2

Organization participating in Network1 and Network2

Organization-Social-Hope-CBO

A food dispensary entity

Organization-Social-Towson-Food

A food dispensary entity

OrganizationGen1

NdhNdApiOrganization OrganizationGen1

OrganizationGen2

NdhNdApiOrganization OrganizationGen2

OrganizationWelcomeHome

Organization for Welcome Home (Homeless Assistance)

Parameters - US SNOMED

Parameters - US SNOMED

PatientConsent

Patient that gives consent

PharmChain

Organization that Provides Pharmacy Services

PharmChainAffil1

Organization Affiliation for PharmChain (Retail)

PharmChainRetailService

Pharmacy Service provided by PharmChain

PharmLoc1

Location of Pharmacy1 in PharmChain’s network

PharmLoc2

Location of Pharmacy2 in PharmChain’s network

PharmLoc3

Location of Pharmacy3 in PharmChain’s network

PharmLoc4

Location of Pharmacy4 in PharmChain’s network

PractitionerOneNetwork1Role

PractitionerOne Network 2023 PractitionerRole

PractitionerOneNetwork2Role

PractitionerOne Network 2024 PractitionerRole

PractitionerOneWithNetwork1AndNetwork2

Practitioner1 with Network1 and Network2

PractitionerRestrict

Do not disclose Practitioner home address

PractitionerTwoNetwork1LeftAfterSixMonthRole

PractitionerTwo Network 2023 First Six Months PractitionerRole

PractitionerTwoWithNetwork1LeftAfterSixMonths

Practitioner2 with Network 2023 for first six months

SocialServiceHousingNetwork

Hub for Social Service Housing

StateOfCTLocation

State of CT Area

StateOfIllinoisLicBoard

State of Illinois Licensing Board

Verify-Hospital

Verify Hartford General Hospital

Verify-Hospital-2

Verify Hartford General Hospital

Verify-JoeSmith

Verify Practitioner Joe Smith

Verify-JoeSmith-2

Verify Practitioner Joe Smith

Verify-JoeSmithHospitalRole

Verify Joe Smith’s role at Hartford General Hospital

diamond-mtls-endpoint2

This is a test endpoint for the MTLS example

diamondonyxhealth2

This is a test organization for the MTLS example

location-bundle

All location resources