nppes modernization project
DESCRIPTION
NPPES Modernization Project. Provider Directories Meeting. Presented By Alan Viars and Richard Gilbert. June 1 9 , 2014. What is NPPES ?. NPPES Provides Individuals and Healthcare Organization a unique identifier for healthcare transactions - an NPI - PowerPoint PPT PresentationTRANSCRIPT
Provider Directories Meeting
Presented By Alan Viars and Richard Gilbert
June 19, 2014
NPPES Modernization Project
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.
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What is NPPES?
• NPPES Provides Individuals and Healthcare Organization a unique identifier for healthcare transactions - an NPI
• NPI records are based on self reported (unverified), information.
• Nearly all payers require providers and suppliers to have an NPI.
• NPPES manages over 4 Million NPIs, and tens of thousands of updates per month.
01/28/2014
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.
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HHS Entrepreneurs
01/28/2014
Program Goal: Attract entrepreneurial talent to work with HHS staff on high-risk, high-reward projects for 13 months
To Date: 9 Projects (from 2 cohorts), 6 Operating and Staff Divisions (ASPA, ASPR, ONC, ACF, CMS, HRSA), 12 External Entrepreneurs , and 29 Internal Entrepreneurs
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.
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NPPES Modernization - Goal
• The goal for NPPES Modernization Project is to improve provider data quality, consistency, and usability for CMS, HHS, and the public.
01/28/2014
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.
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Problem
• Primary information in NPPES, such as provider’s practice addresses and telephone numbers are out of date.
• Providers have little to no incentive to update his or her record. The result is “staleness” of the data.
• Data accessibility and consistency issues exist amongst CMS systems.
01/28/2014
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.
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Project Objectives
• Collect input and feedback from internal stakeholders, providers, data consumers.
• Improve data quality in existing system• Develop a web service for internal and
external users.• Develop a new fully-functional system of
NPPES that makes providers want to keep their data current.
01/28/2014
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.
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High -Level Architecture
• Web Site – The new prototype system based on modern web stack using a 3-tier architecture where database access, control logic, and display logic are separated.
• Develop a framework for managing all provider-like enumerations (NPI, HPID, OEID, etc.).
• Create a series of “micro-services” that can be used for reporting and as well as data feeds for other applications. (e.g. a way for PECOS to fetch addresses, taxonomies, identifiers, and other information from NPESS).
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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.
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Existing System Snapshot
• A circa 2000 technology stack– No major technology refresh or user interface
overhaul since inception.– Tied to outdated web technology.– Complicated, expensive, and difficult to change.– No simple method for system to system
connectivity.
01/28/2014
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.
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New Website and Data Service Snapshot
• A contemporary open source technology stack– Mobile ready – Uses a responsive design to adapt
to smartphone, tablet, or desktop computers.– Designed on technology used to run some of the
webs largest sites.– A RESTFul API– Streamlined interface functionality to maintain
large numbers of provider records.
01/28/2014
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.
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Challenges and Obstacles
• Access to server space for development, testing, and production within CMS.
• Interfacing with existing systems (e.g. I&A, PECOS).
• Network and system constraints slowing and complicating the development process.
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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.
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RESTFul API
• Using a GeoJSON-like approach• Based around a JSON document that contains
all necessary provider info.• Can be expanded and contain extra
information as needed.
01/28/2014
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.
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Pseudo JSON Example
{ number: 123456789, type: "NPI-1", basic: { first_name: "Ada", last_name:"Lovelace", ... }, addresses:[...], taxonomies[...], licenses:[...], identifiers:[...], direct_addresses:[...]}
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INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.
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Launch Plan
Transition Plan
Prototype Updates
Timeline
01/28/2014
Community / Stakeholder Feedback
PrototypeConcept
January2014
April2014
July2014
October2014
December2014
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.
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Prototype Screenshots
01/28/2014
(Draft Images / Work In Progress)
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.
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More Information
• Check out http://npi.io• We are conducting stakeholder interviews by
phone to collect requirements.• The project is open source. We will accept
pull requests.
01/28/2014
INFORMATION NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAWThis information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the fullest extent of the law.
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Questions
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