Provider Registry & Directory

Viable provider management requires more than just a database of names, links to credentialing systems, and a network of fax machines. According to interoperability guidelines, a comprehensive provider solution should:

• support HPD, ILPD, and ELPD profiles
• track practice locations, roles, and relationships of individual and organizational providers
• interface with credentialing systems
• enable the provisioning process

The NextGate Provider Registry and Directory encompasses these items and establishes a convenient, centralized registry of provider information that the entire enterprise can access and trust. The products simplify the identity process, and tracks the “life cycle” of changing provider profiles, which ultimately improves data accuracy and availability, increases reliability and consistency, and enables more efficient communication across the health care enterprise.

The Provider Registry is the comprehensive store of information about all providers and the services they are authorized to deliver. It aggregates content about entities and individuals from various sources, like credentialing systems, HR systems, state licensing departments, and commercial data feeds, and presents the information in an integrated view.

The Provider Directory is a convenient listing of only the providers that are current participants in the client’s healthcare programs. It presents a subset of data from the Provider Registry in a standards based IHE profile compliant directory providing a straightforward, easy to query list of active provider participants. The narrow focus of the Provider Directory simplifies the search for and exchange of relevant provider information.

A Relation Service links records together virtually to enable more complex associations, drive high-level analytics, and reveal new insights for enhanced decision processing. Relationships can be assigned within a single registry or across multiple registries. Possible relationship types include: Provider/Patient (in general or for a specific encounter), Doctor/Hospital practice rights, and Provider/Research Study.

A Provisioning Service ensures data in the Provider Directory are up to date. Updates to records in the Provider Registry trigger the Provisioning Service to promote content to the Provider Directory.