National Directory of Healthcare Providers & Services (NDH) Implementation Guide
1.0.0-ballot - ballot 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-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

Release Notes

The NDH is develped under the FHIR at Scale Taskforce Project

CMS-2024-Connectathon Build

Version 1.0.0

STU1 ballot Technical Correction

Jira Tickets FHIR- Appllied
41815 Fix Section 27.86.1.4.1 table formatting
41876 Fix Section 27.350.1 Section typo
41878 Rename it as Direct Secure Messaging
41881 Clean up "Distributed Query Implementation Guidance" image
41882 Fix typo in Section 26
41884 Fix UDAP hyperlink
41916 Fix Providers&Services should be 2 words in section 1.1
41940 Remove the cursor from the image
41941 Clean the border lines and remove the Figure 2 mark
41942 Fix typo
41943 Fix the inconsistency in the capitalization of the title/headers
41944 Fix Section 3.3 and 3.4 numbering
41945 Bold SHALL, SHOULD and MAY in section 5.1.1
41946 Remove section 5.1.2 Figure 1 mark
41947 Renumber Section 7
41948 Renumber Section 11
42076 Fix typo
42654 Fix typo in Section 7.2
42645 Remove </code> in Section 5.4.8
42610 Add missing "," in search parameter in Section 3.3.1
42674 Fix typo in Section 3.1.2 Query 5
42675 Fix missing O in _typeFilter=rganization_typeFilter=rganization
42682 Fix typo

STU1 ballot change applied

Jira Tickets FHIR- Appllied
41767 Change value of capabillityStatement.rest.resource.versioning from versioned-update to versioned for all resource behaviors in the capability statements
41768 or endpoint resource remove duplicate Location-endpoint in capability statement revinclude for all capability statements where it appears.
41769 Add Location endpoint search parameter into capability statement.
41770 Create CareTeam endpoint search parameter
41771 Include the Network profile as a supported profile under organization in the capability statements as a SHALL for Exchange and a SHOULD for Exchange Base and Exchange Expanded.
41773 Add a search parameter for Practitioner.endpoint; update the capability statements. 
41774 Add the $export operation to the National Directory API capability statement. Define both server and client conformance.
41812 Fix the inconsistent cardinality in Section 1.12.4 Practitioner Role relationship diagram, add the information why PractitionerRole.network cardinality is 0..1 See more information on FHIR-40262
41841 Remove multipleOr and multipleAnd from SearchParameter endpoint-access-control-mechanism, since the cardinality of the Endpoint.access-control-mechaniam is 0..1
41879 Move the Guidance tab as the first one at the drop down for V&V Standard Tab
41880 Move the Guidance tab as the first one at the drop down for DQ Standard Tab
41883 Remove words "or Tiered-OAUTH" in section 1.13 NDH security
41886 Move the Guidance tab as the first one at the drop down for Exchange Standard Tab
41887 Move the Guidance tab as the first one at the drop down for Attestation Standard Tab
41893 Add NdhNetwork, NdhExNetwork, NdhPnQryNetwork profiles to associated Organization capability statement(s). Add a note for the network-coverage-area parameter, the organization.type = ntwk is needed.
41905 Remove include for organization.identifier.assigner from the capability statement(s)
41906 For each of the includes and revincludes, make the conformance (SHOULD,SHALL,MAY) the same in the search requirements as the capability statement.
41913 Remove organization reverse include for endpoint.identifier.assigner from the capability statement(s)
41914 Change NdhExHealthcareService network extension from NdhNetwork to NdhExNetwork
41915 Remove revers include Practitioner-identifier-assigner from the capability statement(s)
41963 add more guidance regarding the use of point coordinates (longitude, latitude) as an input to a search on the geojson shape for a location.
42007 Add a comment to NetworkCoverageAreaSearchParameter indicating that this search parameter is exclusively for the Network Profile resource.
42020 Add clarification regarding the resource ownership for the PractitionerRol
42021 Add clarification on Relationships Between Different Resources section 1.12.1 All Resource Relationships 1
42022 Add clarification regarding the relationship between InsurancePlan and Networks.
42024 The NDH IG already indicates that a payer may establish a "provisional" practitionerRole in the documentation for section 10.3
42609 Revise Section 1.2, titled "Background," to incorporate a narrative and a diagram that elucidate the relationship between the NDH IG and the Plan-Net IG.
42611 Add the Bulk Data Requirements for client and server in the Section 5.4.1 titled "National Directory API Bulk Data Conformance Requirements".
42612 Update Section 5.4.1, titled "National Directory API Bulk Data Conformance Requirements" to indicate that ndjson is the only format allowed for the _outputFormat parameter.
42644 Update Section 3.7 and Section 3.9
42646 Update Section 26.106.1.3 and Section 26.169.1
42648 Update Section 26.166.1.1
42649 Update Section 26.106.1.3 and Section 26.135.1
42650 Update Section 26.129.1
42651 Update Section 26.106.1.3 and Section 26.182.1
42652 Add ihe.iti.mcsd dependence
42653 Applied the wording suggested in the ticket in the NDH-Security section.
42657 Replace NDH EndpointCommonMimeType Code System with Code System urn:ietf:bcp:13
42672 Add FHIR Communication Security Link as clarification
42673 Create the Endpoint.environmentType extension element to pre-adopt R5 Endpoint.environmentType element
42676 Reword the last paragraph of Section 1.13 titled "NDH Security"
42677 Add a description outlining the intended capabilities of the National Directory API Base.
42276 Using codes from employmentStatus
42277 Using the codes from urn:ietf:bcp:13 build the EndpointCommonMimeTypeVS Value set
42679 Remove the restriction profile from the Attestation Capability Statement; change the Validation profile's conformance from MAY to SHALL in the Attestation Capability Statement.
42681 Rewrite the wording in the first item of Section 3.1.1 "Users and Actors"
42683 Add commercial payers to the list of data sources in Section 11.1.1.2 "Data sources for attestation"
42685 Remove modifier below from practitioner-qualification-issuer search parameter
42684 Add Clarify in section 11.1.2. "Attestation Data Restriction"
42687 Add multipleOr to SearchParameter healthcareservice-new-patient, and practitionerrole-new-patient
42688 Add $export operation to exchange capability statements.
42689 Add unique id "scheduleId" for the specific request
42121 Remove resource prefix from search parameter code; update the capabality statements, and examples accordingly
42129 Add Location.partof search parameter to the capability statements.
42131 For each of the includes and revincludes, make the conformance (SHOULD,SHALL,MAY) the same in the search requirements as the capability statement.
42132 Add special search parameter _filter for handling complex combination queries
42133 Add multipleOr to SearchParameter location-new-patient
42279 Rename Exchange to National Directory API; Distributed Query to Local Directory API
42339 Replace the Introduction 1.1 with the text in the ticket.
42646 Add description to the structure definition regarding use of the extensions and a note to describe potential uses of the trust framework extension
42647 Add HTTP 4XX as an allowed return with an appropriate explanation as to its use
42648 Add guidance that this extension should only be used when the standard for exchange requires the discovery of a public key.
42658 The structure of the Payer Provider Network Query Profiles is the same as the NDH base profiles. However, the "Must Support" conformances are derived from the corresponding DaVinci PDex Plan Net profiles.
42661 Make the National Directory API profile resource.meta as must support.
42672 Remove the referenced bullet point in Section 1.13 – NDH actors SHALL conform to FHIR Communications requirements, as other items in the security section already define appropriate communication requirements.
42676 Change to: "NDH implementers in the US Federal systems SHOULD conform with the risk management and mitigation requirements defined in NIST 800 series documents associated with providing access to PII. The coordination of relevant risk management and the related security and privacy controls - policies, administrative practices, and technical controls - SHOULD be defined in the Data Use Agreements."
42681 Update provider definition to: "Any individual or entity that provides services or goods directly, or in support of, healthcare and/or social care delivery"
42683 Add commercial payers to the list of data source. "data from commercial payers (e.g., UnitedHealth Group, Kaiser Permanente …)"
42686 Remove multipleOr and multipleAnd from SearchParameter practitionerrole-network, since the cardinality of the PractitionerRole.network is 0..1
42690 remove Section 5.4.8 titled "Using List defined resource subsets to be exported"
42837 Add Location identifier, endpoint, name, near, and partof search parameter to the CababilityStatements
42838 Update this search parameter name to CareTeamNameSearchParameter. Replaced the local Careteam-alais extension with FHIR Extension Pack extension
42839 Update this search parameter name to CareTeamNameSearchParameter. Replaced the local Careteam-alais extension with FHIR Extension Pack extension
42877 Add MultipleOr modifier to HealthcareServiceNewPatientSearchParameter
42880 Add special search parameter _filter for handling complex combination queries
42881 Add special search parameter _filter for handling complex combination queries
42882 Update associated search parameters.
42883 Remove "text" modifier from search parameters HealthcareServiceProgramRequirementVaStatusSearchParameter HealthcareServiceSocialServiceVaStatusSearchParameter
42884 Remove "text" modifier from search parameter HealthcareServiceSocialServiceBirthsexSearchParameter
42902 Add HIEInitiator as the value for the OraganizationAffiliation.code in the diagram of "TEFCA -CareQuality -Health Information Exchange"
42903 Add DocShare-federate-in and DocShare-federate-ext as the values for the OraganizationAffiliation.code in the diagram of "TEFCA -CareQuality -Health Information Exchange"
42904 Add the modifiers "above" and "below" to the location and organization search parameters for HealthcareService and PractitionerRole profiles. Also, add the modifiers "above" and "below" to the location, primary-organization, and participating-organization search parameters for the OrganizationAffiliation profile.
42925 See 41771
42926 change the code of the Search parmeter Location-contains to contains from location-contains, to support the chaining.
42927 Remove multipleAnd modifier from all profile verification-status search parameter.
43036 Remove meta version from capability statement, Add Concent search parameters
43037 Add guidance that will point to 7.1 for details on conformance expectations depending on which Exchange standard a directory claims conformance
42965 See 41771
42966 Add guidance on which qualifications should occur at the organization or organizationaffiliation level or possibly both. Expand relevant valuesets to include organization relevant qualifications.
43069 See FHIR-42121
43071 Remove modifier multipleAnd from VerificationResultStatusSearchParameter.
43388 Rebase the NDH to US Core 6.1.0
44725 Change the cardinality of InsurancePlan.ownedBy and InsurancePlan.administeredBy in the NDH Base InsurancePlan profile from 1..1 to 0..1.
44773 Add PractitionerRole endpoint search parameter.
44799 Remove the network research parameters from Organization Profile.
44800 Update the Organization Search Parameter link on the Base Artifacts page.
44801 Remove the duplicated InsurancePlan:plan-network from Organization _revinclude.
44802 Add the missing verification-status search parameter to the CapabilityStatements.
44908 Update the _revinclude for location to CareTeam:location.
44934 Remove _include Practitioner:verification-attestation-who
44966 Remove _include InsurancePlan:plan-coverage-area from CapabilityStatements.
44986 Remove VerificationResult attestation-who should not set multipleAnd
45340 Update the dependencies to hl7.fhir.uv.subscriptions-backport.r4: 1.1.0
45341 Add backport-subscription-status operations and Subscription to the National Directory API CapabilityStatements
45362 Add backport-subscription-status operations and Subscription to the National Directory API CapabilityStatements
45350 Change the WebSocket channel conformance to MAY.

STU1 ballot change applied for terminology issues

Jira Tickets FHIR- Appllied
42240 Using codes from CodeSystem-v2-0066
42241 Using urn:ietf:bcp:13 codes in the NDH local value set EndpointcommonMineTypeVS remove this NDH local EndpointCommonMineTypeCS Code System.
42243 Using the codes from MCSD Endpoint Types for the NDH Local Value set, remove this NDG local code system add dependency with ihe.iti.mcsd
42244 See the details in [UP-505] Add "Not Applicable" to THO "Endpoint Payload Type" Code System - Jira (hl7.org). Using not-applicable code from http://terminology.hl7.org/CodeSystem/data-absent-reason Code System. Remove this NDH local code system
42245 No longer needed.
42247 Using the codes from http://terminology.hl7.org/CodeSystem/service-type Remove this NDH local Code System.
42248 See details in UP-503. Keep using NDH local ConsentCategory Code system.
42249 In R5, directory-related consent will be introduced. For now, the NDH IG will use its local code system. Eventually, the NDH will transition to the R5 code system and phase out the NDH IG code system.
42254 Adopt the practitionerRole code from US 6.1 (SNOMED) and provide a slice to align with codeset used by PlanNet.
42260 Developed a local code system containing those codes and incorporated them into this value set.
42261 Using the codes from urn:ietf:bcp:13.
42262 See details in UP-505Use the code from the Data Absent Reason Code System instead of the code from the NDH IG local code system.
42263 The NDH IG no longer profile the value set of the healthcare service program codes.
42264 See details in UP-486. No longer profile the Healthcare Service Referral Method.
42265 Update the HealthcareServiceType Value Set with the codes from THO Code system instead of from NDH IG local Code System.
42267 See details in UP-504. Keep using NDH local Consent Scope Value Set.
42270 Using THO verificationresult-communication-method code system
42251 Using THO verificationresult-communication-method value set
42250 See details in UP-504. Keep using NDH local Consent Scope Code System.
42656 Update age range, Children Age range 3-12 years, Teens Age range 13-19 years
UP-497 Replace Ndh local language proficiency code system and value set with THO code system and value set
UP-494 Replace Ndh local credential status code system and value set with THO code system and value set
UP-495 Replace Ndh local delivery methods code system and value set with THO code system and value set
UP-520 Replace Ndh local Insurance Coverage Type local system and value set with THO code system and value set
UP-501 Replace Ndh local InsurancePlan plan type code system and value set with THO code system and value set
UP-500 Replace Ndh local Insurance Product Type code system and value set with THO code system and value set