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 2.0.0-current 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 Relationships

Page standards status: Informative

NDH Resources and Relationships

The NDH IG contains the following resources, which are based on FHIR R4 base 4.0.1 and US Core 6.1.0.

• Endpoint: The technical details of an endpoint that can be used for electronic services
• HealthcareService: The details of a healthcare service
• InsurancePlan: Details of a Health Insurance product/plan provided by an organization
• Location: Details and position information for a physical place
• Network (based on Organization): A healthcare provider insurance network
• Organization: An organization is a formal or informal grouping of people or organizations with a common purpose
• OrganizationAffiliation: Details of relationships between two or more organizations
• Practitioner: A practitioner is a person who is directly or indirectly involved in the provisioning of healthcare
• PractitionerRole: Describes the relationship between a practitioner and an organization. A practitioner provides services to the organization at a location. Practitioners also participate in healthcare provider insurance networks through their role at an organization
• Verification (based on VerificationResult): Provide information on which verification process was performed, what was verified, when the verification took place, who performed the verification, and how it was verified for a given instance of a resource

Overview of NDH - Resource Relationships

Note: the following diagrams provide a high-level view of the relationships between resources used in this IG. They do not necessarily reflect all of the relationships/references between resources.

All Resource Relationships 1

A high-level view of the relationships between resources. In the NDH resource profiles, there is no inherent relationships. Both Organizations and OrganizationAffiliations can declare a network relationship. Consider a scenario where an OrganizationAffiliation, which is part of a Network, is associated with a PractitionerRole through the Organization. This relationship is not automatically inherited by the PractitionerRole. The PractitionerRole must have its own direct link to the Network. Likewise, any network affiliation declared by a PractitionerRole is not automatically inherited by the organization.

All Resource Relationships 2

All resources reference the Endpoint resource.

Practitioner Role Relationships

PractitionerRole describes the relationship between a practitioner and an organization. A practitioner provides services to the organization at a location. Practitioners also participate in healthcare provider insurance networks through their role at an organization.

Organization Affiliation Relationships

Similar to PractitionerRole, OrganizationAffiliation describes relationships between organizations. For example:

1. The relationship between an organization and an association it is a member of (e.g., hospitals in a hospital association)
2. An organization that provides services to another organization, such as an organization contracted to provide mental health care for another organization as part of a healthcare provider insurance network
3. Distinct organizations forming a partnership to provide services (e.g., a cancer center)

Network / Insurance Plan Relationships

A network is a group of practitioners and organizations that provide healthcare services for individuals enrolled in a health insurance product/plan (typically on behalf of a payer).