Organization

Unique identifier for a healthcare organization (i.e. CCN, NPI)

Submitted By: Joel Andress / Centers for Medicare and Medicaid Services (CMS) Center for Clinical Standards and Quality (CCSQ)
Data Element Information
Use Case Description(s)
Use Case Description	Organization/hospital identifiers are necessary for quality measurement to attribute measurement results to a hospital or provider organization. This information is used across CMS quality reporting programs to properly attribute measurement results.
Estimated number of stakeholders capturing, accessing using or exchanging	4,000+ hospitals reporting to CMS currently have a unique identifier (CCN) and all HIPPA-covered providers are required to have an NPI, and exchange this information electronically with CMS for measurement. NPPES/NPI: https://nppes.cms.hhs.gov/#/ CMS CCN: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R29SOMA.pdf#:~:text=The%20CMS%20Certification%20number%20%28CCN%29%20replaces%20the%20term,RO%20assigns%20the%20CCN%20and%20maintains%20adequate%20controls.
Link to use case project page	https://nppes.cms.hhs.gov/#/
Use Case Description	As noted by Keith W. Boone / Audacious Inquiry submitter, organization identification is also crucial to public health reporting, including managing emergency responses.
Estimated number of stakeholders capturing, accessing using or exchanging	Hospitals in the US (Approximately 7000), ambulatory physicians (260,000), Laboratories (260,000),
Link to use case project page	https://bit.ly/SANERBUILD
Healthcare Aims	Improving the health of populations
Maturity of Use and Technical Specifications for Data Element
Applicable Standard(s)	Unique identifiers for organizations/providers are assigned and governed uniformly. NPI: https://nppes.cms.hhs.gov/#/ CCN: https://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R29SOMA.pdf Clinical Laboratory Improvement Amendments (CLIA) for laboratories: https://www.cdc.gov/clia/index.html https://nppes.cms.hhs.gov/#/
Additional Specifications	HL7 FHIR US Core Implementation Guide STU3 based on FHIR R4, Organization Profile and Practitioner Profile must support an identifier (https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-organization.html ) (https://www.hl7.org/fhir/us/core/StructureDefinition-us-core-practitioner.html) Organization and Practitioner Profiles included in the HL7 FHIR Us Core Capability Statement: https://www.hl7.org/fhir/us/core/CapabilityStatement-us-core-server.html
Current Use	Extensively used in production environments
Supporting Artifacts	Organization identifiers routinely captured in EHR systems used by hospitals, providers, and other healthcare stakeholders. Unique identifiers are submitted by providers to CMS via QRDA I and III files and other data architectures from hospitals, providers, health IT firms, and vendors for quality measurement reporting. Available in EHR systems: https://fhir.cerner.com/millennium/r4/entities/organization/#retrieve-by-id , https://fhir.cerner.com/millennium/r4/individuals/practitioner/#retrieve-by-id https://fhir.epic.com/Specifications?api=935 https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/Quality-Programs https://ecqi.healthit.gov/ecqms https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/Quality-Programs
Number of organizations/individuals with which this data element has been electronically exchanged	5 or more. This data element has been tested at scale between multiple different production environments to support the majority of anticipated stakeholders.
Supporting Artifacts	Organization/provider IDs electronically exchanged with CMS for quality measure reporting via QRDA files and other electronic exchange platforms. Identifier tags also traditionally included when exchanging data to any other public reporting or provider-provider exchange for tracing purposes. https://ecqi.healthit.gov/qrda https://www.hl7.org/implement/standards/product_brief.cfm?product_id=492 https://ecqi.healthit.gov/qrda
Potential Challenges
Restrictions on Standardization (e.g. proprietary code)	No challenges anticipated. All HIPPA-covered entities obtain identifiers
Restrictions on Use (e.g. licensing, user fees)	None aware
Privacy and Security Concerns	None
Estimate of Overall Burden	No/low burden anticipated. Identifier information, included in Organization and Practitioner FHIR US Core profiles also required by the US Core Capability Statement and therefore will be stood up by those stakeholders complying with the ONC requirement for the Standardized API for patient and population services.
Other Implementation Challenges	N/A