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Optimizing Provider Registration with HPD Plus and XD* Metadata in esMD Framework

This approach outlines a comprehensive strategy for supporting multiple transport protocols, including SOAP and SMTP, to meet esMD requirements through HPD Plus. It details how to handle provider registration requests and responses using XD* metadata, enhancing data sharing while ensuring compliance with identity assertion and auditing standards. By leveraging the strengths of HPD Plus with XD* and traditional directory services like LDAP, the proposed method effectively addresses provider identification and registration challenges, ensuring the system's flexibility and security.

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Optimizing Provider Registration with HPD Plus and XD* Metadata in esMD Framework

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  1. esMD HarmonizationUse Case 1: Initial Technical Approach HPD Plus Erik Pupo

  2. Goals of Approach • Support multiple transport protocols to meet esMD requirements, including existing protocols already supported in Meaningful Use • SOAP (Exchange) • SMTP and SMIME (Direct) • XD* used to provide data sharing metadata • HPD Plus used for registration request and response provider information • Use additional infrastructure profiles for asserting identity, auditing and digital signatures, if required • IHE XUA (potential use of SAML as additional mechanism for identity – along with X.509 certificates) • IHE DSG (to convey a signature) • IHE ATNA (for auditing)

  3. Overview of approach • Assume Internal Systems are capable of sending, receiving, and processing registration information aligned to HPD Plus, but not necessarily using an LDAP client or server • Wrap XD* metadata around a registration request or response document (transport-specific) • How does the data get there? • Use XD* to augment potential gaps in HPD Plus schema • Map data to HPD Plus for the registration request (content-agnostic) • What does the payer/payer contractor need to know to register a provider to receive eMDRs? • Map data to HPD Plus for the registration response (content-agnostic) • What does the provider need to know after attempting to register with a payer/payer contractor?

  4. Use of XD* for data sharing metadata • XD* profiles and associated metadata serve as possible candidate for data sharing metadata • XD* Metadata with SOAP or SMTP (push request and response from internal systems as XML aligned to HPD Plus) • See Harmonization presentation from 6/27 for details about XD* metadata

  5. Describing the Request/Response Message Use XD* metadata for data elements that help define the message. Additional metadata is supported or required by XD* profiles, such as Author and Intended Recipient. This may duplicate some information from payload.

  6. Background on HPD Plus • The HPD Schema extends LDAP organizationalUnit(OU) containers to organize information on Providers, including: • Healthcare Organization and Provider Identification, Demographics, Specializations, etc. • HPD Plus is an extension to HPD with additional entries to better support needs identified in the S&I Framework’s Provider Directory Initiative, including: • Electronic Service Information (ESI) • Provider Directory Information • Individual Provider and Organizational Provider relationships • A major difference between HPD Plus and LDAP is the requirement for a specific persistence mechanism. • LDAP requires an LDAP server for persistence. • HPD Plus decouples LDAP from a specific persistence mechanism. This allows, for example, an implementer to use a Relational Database model without an LDAP server.

  7. Background on DSMLv2 • Traditionally, LDAP was used in a client server environment • However, there is value in sharing directory information without an LDAP server. • DSMLv2 is a systematic translation of LDAP’s ASN.1 grammar into XML-Schema • Provides guidance on binding to SOAP or a simple data file • DSMLv2 represents the operations that an LDAP directory can perform and the results of such operations • DSMLv2 supports search, add, modify, delete, and extended request operations • esMD could use these operations to represent the Registration Request Type (new, update, terminate) • HPD/HPD Plus include guidance on using DSMLv2 and SOAP • The esMD registration request and response can use DSMLv2 to express an HPD Plus query or response as XML documents wrapped in XD* metadata.

  8. LDAP Terminology • An LDAP directory tree consists of related Entries • Entries are composed of one or more Object Classes • An Object Class is a collection of attributes • Attributes store data and define data type. • Each attribute has a name and belongs to an Object Class. • Object Classes define: • Whether an attribute it is mandatory (MUST) or optional (MAY) • The hierarchy of object classes and thus inheritance

  9. Request/Response: Provider Information

  10. Request/Response: Registration Request Information

  11. Request/Response Provider Directory Information

  12. Response: Request Status

  13. Request/Response: Message Signature Approach 1

  14. Request/Response: Message Signature Approach 2 Create an external object (which we would call a DSG document) that would be used to capture a digital signature and x.509 certificate.

  15. Summary of Analysis • HPD Plus, combined with XD* metadata and SOAP header, is capable of representing majority of the Use Case 1 data set requirements for the registration request • The addRequest, modifyRequest, modDNRequest, and delRequest result in an LDAPResult response which includes status codes for the request but no provider information • Possible to define extendedRequest specific to esMD needs • Need to clarify Signature Artifact requirements

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