National Healthcare Directory Query
1.0.0-ballot - ballot United States of America flag

National Healthcare Directory Query, published by HL7 International - Patient Administration Work Group. This is not an authorized publication; it is the continuous build for version 1.0.0-ballot). This version is based on the current content of https://github.com/HL7/fhir-directory-query/ 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.

directory-query-basic-endpoint

Capabilities for a basic Query Server for Health Services where Endpoint search capabilities are met

directory-query-basic-expanded

Capabilities for a Basic Federated Query Server for where expanded search capabilities are met

directory-query-health-or-human-services-endpoint

Capabilities for a Federated Query Server for Health or Human Services where endpoint search capabilities are met

directory-query-health-or-human-services-expanded

Capabilities for a Federated Query Server for Health or Human Services where expanded search capabilities are met

directory-query-human-services-endpoint

Capabilities for a Federated Query Server for Health Services where endpoint search capabilities are met

directory-query-human-services-expanded

Capabilities for a Federated Query Server for Health Services where expanded search capabilities are met

directory-query-provider-endpoint

Capabilities for a Federated Query Server for a Provider where endpoint search capabilities are met

directory-query-provider-expanded

Capabilities for a Federated Query Server for a Provider where minimum search capabilities are met

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.

Search by Connection Type in Endpoints

Accesses the connection type of an Endpoint

Search by Indentifer in Endpoints

Accesses the identifier of an Endpoint

Search by mime-type in Endpoints

Accesses the mime-type of an Endpoint

Search by organization in Endpoints

Accesses the organization of an Endpoint

Search by payload-type in Endpoints

Accesses the payload-type of an Endpoint

Search by status in Endpoints

Accesses the status of an Endpoint

Search by usecase-standard in Endpoints

Accesses the usecase-standard of an Endpoint

Search by usecase-type in Endpoints

Accesses the usecase-type of an Endpoint

Search by coverage-area in HealthcareService with multipleOr

This SearchParameter enables query of HealthcareService by coverage-area with mutlipleOr enabled.

Search by endpoint in HealthcareService with multipleOr

This SearchParameter enables query of HealthcareService by endpoint with mutlipleOr enabled.

Search by location in HealthcareService with multipleOr

This SearchParameter enables query of HealthcareService by location with mutlipleOr enabled.

Search by name in HealthcareService with multipleOr

This SearchParameter enables query of HealthcareService by name with mutlipleOr enabled.

Search by organization in HealthcareService with multipleOr

This SearchParameter enables query of HealthcareService by organization with mutlipleOr enabled.

Search by service-category in HealthcareService with multipleOr

This SearchParameter enables query of HealthcareService by service-category with mutlipleOr enabled.

Search by service-type in HealthcareService with multipleOr

This SearchParameter enables query of HealthcareService by service-type with mutlipleOr enabled.

Search by specialty in HealthcareService with multipleOr

This SearchParameter enables query of HealthcareService by specialty with mutlipleOr enabled.

Search by administrated-by in InsurancePlan with multipleOr

This SearchParameter enables query of InsurancePlan by administrated-by with mutlipleOr enabled.

Search by coverage-area in InsurancePlan with multipleOr

This SearchParameter enables query of InsurancePlan by coverage-area with mutlipleOr enabled.

Search by coverage-benefit-type in InsurancePlan with multipleOr

This SearchParameter enables query of InsurancePlan by coverage-benefit-type with mutlipleOr enabled.

Search by coverage-network in InsurancePlan with multipleOr

This SearchParameter enables query of InsurancePlan by coverage-network with mutlipleOr enabled.

Search by identifier in InsurancePlan with multipleOr

This SearchParameter enables query of InsurancePlan by identifier with mutlipleOr enabled.

Search by name in InsurancePlan with multipleOr

This SearchParameter enables query of InsurancePlan by specialty with mutlipleOr enabled.

Search by owned-by in InsurancePlan with multipleOr

This SearchParameter enables query of InsurancePlan by owned-by with mutlipleOr enabled.

Search by type in InsurancePlan with multipleOr

This SearchParameter enables query of InsurancePlan by type with mutlipleOr enabled.

Search by address in Location with multipleOr

This SearchParameter enables query of Location by address with mutlipleOr enabled.

Search by endpoint in Location with multipleOr

This SearchParameter enables query of Location by endpoint with mutlipleOr enabled.

Search by organization in Location with multipleOr

This SearchParameter enables query of Location by organization with mutlipleOr enabled.

Search by partOf in Location with multipleOr

This SearchParameter enables query of Location by partOf with mutlipleOr enabled.

Search by physicalType in Location with multipleOr

This SearchParameter enables query of Location by physicalType with mutlipleOr enabled.

Search by type in Location with multipleOr

This SearchParameter enables query of Location by type with mutlipleOr enabled.

Search by coverage-area in Network with multipleOr

This SearchParameter enables query of Network by coverage-area with mutlipleOr enabled.

Search by name in Network with multipleOr

This SearchParameter enables query of Network by name with mutlipleOr enabled.

Search by address in Organization with multipleOr

This SearchParameter enables query of Organization by address with mutlipleOr enabled.

Search by endpoint in Organization with multipleOr

This SearchParameter enables query of Organization by endpoint with mutlipleOr enabled.

Search by identifier in Organization with multipleOr

This SearchParameter enables query of Organization by identifier with mutlipleOr enabled.

Search by name in Organization with multipleOr

This SearchParameter enables query of Organization by name with mutlipleOr enabled.

Search by partOf in Organization with multipleOr

This SearchParameter enables query of Organization by partOf with mutlipleOr enabled.

Search by type in Organization with multipleOr

This SearchParameter enables query of Organization by type with mutlipleOr enabled.

Search by endpoint in OrganizationAffiliation with multipleOr

This SearchParameter enables query of Organization by endpoint with mutlipleOr enabled.

Search by location in OrganizationAffiliation with multipleOr

This SearchParameter enables query of Organization by location with mutlipleOr enabled.

Search by network in OrganizationAffiliation with multipleOr

This SearchParameter enables query of Organization by network with mutlipleOr enabled.

Search by participating-organization in OrganizationAffiliation with multipleOr

This SearchParameter enables query of Organization by participating-organization with mutlipleOr enabled.

Search by primary-organization in OrganizationAffiliation with multipleOr

This SearchParameter enables query of Organization by primary-organization with mutlipleOr enabled.

Search by role in OrganizationAffiliation with multipleOr

This SearchParameter enables query of Organization by role with mutlipleOr enabled.

Search by service in OrganizationAffiliation with multipleOr

This SearchParameter enables query of Organization by service with mutlipleOr enabled.

Search by specialty in OrganizationAffiliation with multipleOr

This SearchParameter enables query of Organization by specialty with mutlipleOr enabled.

Search by attestation-who in VerificationResult with multipleOr

This SearchParameter enables query of VerificationResult by attestation-who with mutlipleOr enabled.

Search by primarysource-who in VerificationResult with multipleOr

This SearchParameter enables query of VerificationResult by primarysource-who with mutlipleOr enabled.

Search by target in InsurancePlan with multipleOr

This SearchParameter enables query of VerificationResult by target with mutlipleOr enabled.

Search by category in CareTeam with multipleOr

This SearchParameter enables query of Careteams by category with mutlipleOr enabled.

Search by endpoint in CareTeam with multipleOr

This SearchParameter enables query of Careteams by endpoint with mutlipleOr enabled.

Search by location in CareTeam with multipleOr

This SearchParameter enables query of Careteams by location with mutlipleOr enabled.

Search by name in CareTeam with multipleOr

This SearchParameter enables query of Careteams by name with mutlipleOr enabled.

Search by organization in CareTeam with multipleOr

This SearchParameter enables query of Careteams by organization with mutlipleOr enabled.

Search by service in CareTeam with multipleOr

This SearchParameter enables query of Careteams by service with mutlipleOr enabled.

Search by family name in practitioner with multipleOr

This SearchParameter enables query of practitioner by family with mutlipleOr enabled.

Search by given name in practitioner with multipleOr

This SearchParameter enables query of practitioner by given with mutlipleOr enabled.

Search by identifier in practitioner with multipleOr

This SearchParameter enables query of practitioner by identifier with mutlipleOr enabled.

Search by identifier-assigner in practitioner with multipleOr

This SearchParameter enables query of practitioner by identifier-assigner with mutlipleOr enabled.

Search by name in practitioner with multipleOr

This SearchParameter enables query of practitioner by name with mutlipleOr enabled.

Search by qualification-code in practitioner with multipleOr

This SearchParameter enables query of practitioner by qualification-code with mutlipleOr enabled.

Search by qualification-issuer in practitioner with multipleOr

This SearchParameter enables query of practitioner by qualification-issuer with mutlipleOr enabled.

Search by endpoint in practitionerRole with multipleOr

This SearchParameter enables query of practitionerRole by endpoint with mutlipleOr enabled.

Search by location in practitionerRole with multipleOr

This SearchParameter enables query of practitionerRole by location with mutlipleOr enabled.

Search by network in practitionerRole with multipleOr

This SearchParameter enables query of practitionerRole by network with mutlipleOr enabled.

Search by organization in practitionerRole with multipleOr

This SearchParameter enables query of practitionerRole by organization with mutlipleOr enabled.

Search by practitioner in practitionerRole with multipleOr

This SearchParameter enables query of practitionerRole by practitioner with mutlipleOr enabled.

Search by role in practitionerRole with multipleOr

This SearchParameter enables query of practitionerRole by role with mutlipleOr enabled.

Search by service in practitionerRole with multipleOr

This SearchParameter enables query of practitionerRole by service with mutlipleOr enabled.

Search by specialty in practitionerRole with multipleOr

This SearchParameter enables query of practitionerRole by specialty with mutlipleOr enabled.

Structures: Resource Profiles

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

National Directory Endpoint Qry Care Team

Defines the basic constraints and extensions on the CareTeam resource for use in a Validated Healthcare Directory

National Directory Endpoint Qry Exchange Endpoint

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 Endpoint Qry Exchange HealthcareService

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 Endpoint Qry Exchange InsurancePlan

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 Endpoint Qry Exchange Location

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 Endpoint Qry Exchange Network

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. A network is typically owned by a payer.

In the NatlDir 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 Endpoint Qry Exchange Organization

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 Endpoint Qry Exchange OrganizationAffiliation

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 Endpoint Qry Exchange Practitioner

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

National Directory Endpoint Qry Exchange 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. When the provider is a practitioner, there may also be a relationship to an organization. Practitioner participation in healthcare provider insurance networks may be direct or through their role at an organization.

National Directory Endpoint Qry Exchange Verification

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

National Directory Endpoint Qry Exchange Restriction

Restriction on use/release of exchanged information

Structures: Extension Definitions

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

Accessibility

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

Associated Servers

Associated Servers

NatlDirEndpointQry Careteam Alias

Alternate names by which the team is known

Communication Proficiency

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

Contactpoint Availabletime

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

Delivery Method

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

Dynamic Registration

Dynamic Registration

NatlDirEndpointQry Practitioner Endpoint Reference

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

Endpoint Type

Type of Endpoint

Endpoint Usecase

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

Funding Source

The sources of funding for a service or organization

NatlDirEndpointQry Healthcareservice Reference

Reference to healthcareservice resource

IGs Supported

IGs Supported document the different types of IGs supported by the Endpoint.

NatlDirEndpointQry Identifier Status

Describes the status of an identifier

Location Reference

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

Network Reference

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

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.

Org Description

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

Payment Accepted

Methods of payment that can be used for a healthcare service.

Practitioner Qualification

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

Rating

Rating

Required Document

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

Secure Endpoint

Is the Endpoint Secured

Secure Exchange Artifacts

Secure Exchange Artifacts

Trust Framework

Trust Framework

NatlDir 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.

Via Intermediary

A reference to an alternative point of contact (NatlDirEndpointQry-PractitionerRole, NatlDirEndpointQry-Organization, NatlDirEndpointQry-OrganizationAffiliation, or NatlDirEndpointQry-Location) for this organization

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.

National Directory Consent Value Set

Codes for use in defining access levels for sharing subsets of constrained content (as an example).

Delivery Methods Value Set

Codes for documenting delivery methods.

Endpoint Connection Types Value Set

Endpoint Connection Types

Endpoint Payload Type Value Set

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

Endpoint Type Value Set

Codes to identify Endpoint Type

Endpoint Usecases Value Set

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

Healthcare Service Category Value Set

Broad categories of healthcare services being performed or delivered.

HealthcareService Type Value Set

HealthCareService type Value Set

Identifier Status Value Set

Codes for Identifier Status

IG Type Value Set

Codes to identify IG Type

Individual and Group Specialties

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

Individual Specialties, Degrees, Licenses, and Certificates Value Set

Individual Specialties, Degrees, Licenses, and Certificates

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.

Language Proficiency Value Set

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

Minimum Endpoint Connection Types Value Set

Minimum Endpoint Connection Types

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.

Non-Individual Specialties, Degrees, Licenses, and Certificates Value Set

Non-Individual Specialties, Degrees, Licenses, and Certificates

Organization Alias Typ 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.

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

Validation Type Value Set

Codes to identify Validation Type

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.

CareTeam Category Code System

This code system contains codes for Care Team Category.

National Healthcare Directory ConsentScopeCodes Code System

This value set includes the four Consent scope codes.

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.

Endpoint Connection Types (additional) Code System

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

Endpoint Payload Types Code System

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

Endpoint Type Code System

Endpoint Type

Healthcare Service Category Code System

Broad categories of healthcare services being performed or delivered

IG Type Code System

IG Type

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.

Language Proficiency Code System

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

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.

Organization Affiliation Role

Codes For Organization Affiliation Role

Provider 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

Validation Type Code System

This code system contains codes for documenting the attributes of the FHIR resource Validation to reflect the business process of validating information in a Healthcare Directory..

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

AcmeQHPGold

Acme of CT QHP Gold Plan

AcmeofCTPremNet

Acme of CT Premium Premium Network

AcmeofCTStdNet

Acme of CT Standard Network

AnonRole

Practitioner role that doesn’t refer to a specific practitioner

BigBox

Organization that Manages 2 of PharmChain’s pharmacies

BurrClinic

Burr Clinic provides service to Hartford Hospital

BurrClinicAffil

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

BurrClinicServices

Burr Clinic Services

CancerClinic

HartfordCancerClinicLLC

CancerClinicLoc

Location1 of Cancer Clinic

CancerClinicService

Cancer Clinic Services

CareTeam1

Burr Clinic’s Care Team

ConnHIE

Connecticut HIE

ConnHIEAffil

Burr Clinic’s affiliation with Conn HIE

Counselor

Counselor Susie Smith

CounselorRole1

Susie Smith is a counselor via Telemedicine

HamiltonClinic

Hamilton Clinic (a Division of Hartford Hospital)

HamiltonClinicAffil

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

HamiltonClinicServices

Hamilton Clinic Services

HansSolo

Solo Practitioner Hans Solo

HansSoloClinic

Location of Hans Solo’s clinic

HansSoloRole1

Hans Solo is a solo practitioner

HansSoloService

Hans Solo Services

HartfordOrthopedicAffil

Hartford Orthopedic Services affiliation with Acme of CT Provider Network and Hartford General Hospital

HartfordOrthopedicServices

Hartford Orthopedic Services

HartfordOrthopedics

Hartford Orthpedic Services is a group providing Orthpods for Acme of CT at Hartford General Hospital

HospERService

Hartford General Hospital ER

HospLoc1

Location1 of Hartford Hospital

HospLoc2

Location2 of Hartford Hospital

Hospital

Hartford General Hospital

JoeSmith

Practitioner Dr Joe Smith

JoeSmithRole1

Dr Smith moonlighting as ER Doc at Hartford Hospital

JoeSmithRole2

Dr Smith Internal Medicine at Burr Clinic

JoeSmithRole3

Dr Smith Admitting Privileges at Hartford General

PatientConsent

Patient that gives consent

PharmChain

Organization that Provides Pharmacy Services

PharmChainAffil1

Organization Affiliation for PharmChain (Retail)

PharmChainAffil2

Organization Affiliation for PharmChain (Compounding)

PharmChainAffil3

Organization Affiliation for PharmChain (MailOrder)

PharmChainCompService

Compound Pharmacy Service provided by PharmacyOrganization A

PharmChainMailService

Mail Order Pharmacy Service provided by PharmacyOrganization A

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

ProviderAttestation

Patient that gives consent

StateOfCTLocation

State of CT Area

VirtualCounselService

Virtual Counseling Service