National Directory of Healthcare Providers & Services (NDH) Implementation Guide
1.0.0 - STU1 United States of America flag

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 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

Resource Profile: NDH Base Network Profile

Official URL: http://hl7.org/fhir/us/ndh/StructureDefinition/ndh-Network Version: 1.0.0
Standards status: Trial-use Computable Name: NdhNetwork

Copyright/Legal: HL7 International

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.

Scope and Usage

  • In The National Directory of Healthcare Providers & Services (NDH) IG, individuals and organizations are represented as participants in a Network through the practitionerRole and organizationAffiliation resources, respectively.

  • The Network profile is based on USCore Organization Profile. However, the NPI and CLIA identifier types, which are Must-Support, are clearly intended for provider organizations only and are not expected to be populated for other organization types.

  • The NDH Network and Organization profiles are both based on the Organization profile. To selectively query only Network profiles, search for type = 'ntwk'. To selectively query only Organization profiles, the type parameter is optional. However, you can provide any value defined in the Organization Type Value Set.

  • 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.

  • Note that the relationship between InsurancePlans and Networks is many-to-many. A plan may be associated with multiple networks, and a network may be associated with many plans. In this IG, this is modeled by having InsurancePlans reference networks (directionality of relationship supports this).

  • To use the location-reference extension to indicate a network coverage area, the preferred form of reference is to create a Location instance with the State or region specified, and possibly provide a GeoJSON.

Usage:

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

NameFlagsCard.TypeDescription & Constraintsdoco
.. Organization C 0..* USCoreOrganizationProfile(6.1.0) A grouping of people or organizations with a common purpose
dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources
dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource
dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated
dom-5: If a resource is contained in another resource, it SHALL NOT have a security label
dom-6: A resource should have narrative for robust management
org-1: The organization SHALL at least have a name or an identifier, and possibly more than one
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
ele-1: All FHIR elements must have a @value or children
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:location 0..* Reference(NDH Base Location Profile) Network coverage area
URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-location-reference
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:organization-period 0..1 Period Valid time period for this Network
URL: http://hl7.org/fhir/StructureDefinition/organization-period
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:usage-restriction 0..* Reference(NDH Base Restriction) {c} Usage Restriction
URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-usage-restriction
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... extension:verification-status 0..1 CodeableConcept NDH Verification Status
URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-verification-status
Binding: NDH Verification Status Value Set (extensible)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
.... identifier:All Slices Content/Rules for all slices
..... Slices for extension Content/Rules for all slices
...... extension:identifier-status 0..1 code NDH Identifier Status
URL: http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-identifier-status
Binding: Identifier Status Value Set (required)
ele-1: All FHIR elements must have a @value or children
ext-1: Must have either extensions or value[x], not both
..... use ?!Σ 0..1 code usual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .


ele-1: All FHIR elements must have a @value or children
..... system SΣ 0..1 uri The namespace for the identifier value
ele-1: All FHIR elements must have a @value or children
Example General: http://www.acme.com/identifiers/patient
..... value SΣ 0..1 string The value that is unique
ele-1: All FHIR elements must have a @value or children
Example General: 123456
..... assigner Σ 0..1 Reference(NDH Base Organization Profile) Organization that issued id (may be just text)
ele-1: All FHIR elements must have a @value or children
.... identifier:NAIC ΣC 0..* Identifier NAIC Code
ele-1: All FHIR elements must have a @value or children
us-core-19: NAIC must be 5 digits

Required Pattern: At least the following
..... system 1..1 uri The namespace for the identifier value
Fixed Value: urn:oid:2.16.840.1.113883.6.300
... active ?!SΣ 1..1 boolean Whether the organization's record is still in active use
ele-1: All FHIR elements must have a @value or children
Fixed Value: true
... type SΣ 1..1 CodeableConcept Kind of organization
Binding: Network Type Value Set (required)
ele-1: All FHIR elements must have a @value or children
... name SΣC 1..1 string Name used for the organization
ele-1: All FHIR elements must have a @value or children
... telecom SC 0..* ContactPoint A contact detail for the organization
ele-1: All FHIR elements must have a @value or children
org-3: The telecom of an organization can never be of use 'home'
.... system SΣC 0..1 code phone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required): Telecommunications form for contact point.


ele-1: All FHIR elements must have a @value or children
.... value SΣ 0..1 string The actual contact point details
ele-1: All FHIR elements must have a @value or children
.... use ?!Σ 0..1 code home | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required): Use of contact point.


ele-1: All FHIR elements must have a @value or children
... address SC 0..* Address An address for the organization
ele-1: All FHIR elements must have a @value or children
org-2: An address of an organization can never be of use 'home'
.... use ?!Σ 0..1 code home | work | temp | old | billing - purpose of this address
Binding: AddressUse (required): The use of an address.


ele-1: All FHIR elements must have a @value or children
Example General: home
.... line SΣ 0..4 string Street name, number, direction & P.O. Box etc.
ele-1: All FHIR elements must have a @value or children
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
.... city SΣ 0..1 string Name of city, town etc.
ele-1: All FHIR elements must have a @value or children
Example General: Erewhon
.... state SΣ 0..1 string Sub-unit of country (abbreviations ok)
Binding: USPS Two Letter Alphabetic Codes (extensible): Two letter USPS alphabetic codes.


ele-1: All FHIR elements must have a @value or children
.... postalCode SΣ 0..1 string US Zip Codes
ele-1: All FHIR elements must have a @value or children
Example General: 9132
.... country SΣ 0..1 string Country (e.g. can be ISO 3166 2 or 3 letter code)
ele-1: All FHIR elements must have a @value or children
... partOf SΣ 1..1 Reference(NDH Base Organization Profile) The organization that manages this network
ele-1: All FHIR elements must have a @value or children
... endpoint S 0..* Reference(NDH Base Endpoint Profile) Technical endpoints providing access to services operated for the organization
ele-1: All FHIR elements must have a @value or children

doco Documentation for this format

Terminology Bindings

PathConformanceValueSetURI
Organization.identifier.userequiredIdentifierUse
http://hl7.org/fhir/ValueSet/identifier-use|4.0.1
from the FHIR Standard
Organization.typerequiredNetworkTypeVS
http://hl7.org/fhir/us/ndh/ValueSet/NetworkTypeVS
from this IG
Organization.telecom.systemrequiredContactPointSystem
http://hl7.org/fhir/ValueSet/contact-point-system|4.0.1
from the FHIR Standard
Organization.telecom.userequiredContactPointUse
http://hl7.org/fhir/ValueSet/contact-point-use|4.0.1
from the FHIR Standard
Organization.address.userequiredAddressUse
http://hl7.org/fhir/ValueSet/address-use|4.0.1
from the FHIR Standard
Organization.address.stateextensibleUspsTwoLetterAlphabeticCodes (a valid code from https://www.usps.com/)
http://hl7.org/fhir/us/core/ValueSet/us-core-usps-state

Constraints

IdGradePath(s)DetailsRequirements
us-core-19errorOrganization.identifier:NAICNAIC must be 5 digits
: value.matches('^[0-9]{5}$')

 

Other representations of profile: CSV, Excel, Schematron

Notes:

Search Parameters

Search Parameter defined by the NDH IG

In order to obtain information related to the Network resource, which is a derivative of the Organization resource, it is necessary to include the type=ntwk parameter in your search query.

SearchParameter Name Type Example
coverage-area reference GET [base]/Organization?type=ntwk&coverage-area.address-state=CT
verification-status token GET [base]/Organization?type=ntwk&verification-status=complete

This search returns networks have coverage in the State of CT.

Search Parameter defined by FHIR Search Parameter Registry and used by the NDH IG

Since there is no direct individual url for each Search Parameter defined by FHIR Serach Parameter Registry, we have provided the following links for you to access more information about them.

SearchParameter Name Type Example
active token GET [base]/Organization?type=ntwk&active=true
address string GET [base]/Organization?type=ntwk&address=123 Ravissant Dr
address-city string GET [base]/Organization?type=ntwk&address-city=Coconut Creek
address-country string GET [base]/Organization?type=ntwk&address-country=USA
address-postalcode string GET [base]/Organization?type=ntwk&address-postcode=12345
address-state string GET [base]/Organization?type=ntwk&address-state=FL
address-use token GET [base]/Organization?type=ntwk&address-use=work
endpoint reference GET [base]/Organization?type=ntwk&endpoint.connection-type=hl7-fhir-rest
identifier token GET [base]/Organization?type=ntwk&identifier=12345
name string GET [base]/Organization?type=ntwk&name=Florida Blue
partof reference GET [base]/Organization?type=ntwk&partof.name=Florida Blue
type token GET [base]/Organization?type=ntwk  

_include Search Parameter

include Example
Organization:coverage-area GET [base]/Organization?type=ntwk&_include=Organization:coverage-area

_revinclude Search Parameter

_revinclude Example
HealthcareService:network GET [base]/Organization?type=ntwk&_revinclude=HealthcareService:network
HealthcareService:new-patient-from-network GET [base]/Organization?type=ntwk&_revinclude=HealthcareService:new-patient-from-network
InsurancePlan:coverage-network GET [base]/Organization?type=ntwk&_revinclude=InsurancePlan:coverage-network
InsurancePlan:plan-network GET [base]/Organization?type=ntwk&_revinclude=InsurancePlan:plan-network
InsurancePlan:network GET [base]/Organization?type=ntwk&_revinclude=InsurancePlan:network
Location:new-patient-from-network GET [base]/Organization?type=ntwk&_revinclude=Location:new-patient-from-network
OrganizationAffiliation:network GET [base]/Organization?type=ntwk&_revinclude=OrganizationAffiliation:network
PractitionerRole:network GET [base]/Organization?type=ntwk&_revinclude=PractitionerRole:network
PractitionerRole:new-patient-from-network GET [base]/Organization?type=ntwk&_revinclude=PractitionerRole:new-patient-from-network