Improve incentives to keep data 'fresh'

[Michael Wasser]

Here's a progression of my 'beliefs' around the NPI (all in my opinion, clearly)

1. The biggest issues with the NPI is that the data is stale
2. The best way to improve the quality is to incentivize clinicians and their parent organizations to keep their NPI up to date
3. The best way to incentivize this to have the NPI used in many more places/ websites
4. The best way to get the NPI used in more places is by making it as discoverable/ easy to use/ desirable to use as is possible

Some thoughts on how to make it discoverable/ easy to use/ desirable

• Provide easy to use, discoverable documentation on all fields beyond the existing PDFs ... something like the original blue button/ blue button plus developer sites would be fantastic
• While not directly related to data itself, a well-designed landing page for NPPES/ the NPI will make developers feel more confident in their ability to use the NPI
• Provide an HHS sponsored, easy to use clinician search tool (not the existing NPPES registry search site -- think a well designed, user-friendly site that can be indexed by search engines). If a clinician sees their data is out of date or they start getting asked questions about out of date information they found on a gov site -- they could very well start to update it.
• Even better than a simple tool is if HHS starts letting people search for clinician's by carrier networks (the affiliations data is probably the lowest quality part of the NPI today if I were to guess) 
• Market the site through the creation of dead-simple demo applications that anyone can download/ run themselves
• Provide tools to easily import the NPI in to commonly used database technologies in a semi-normalized form
• Potentially provide helper fields such as geo-coded locations as a separate dataset ... a demo app of 'clinicians near me' would be fantastic
• Consider ongoing diffs of the NPI rather than just intra-month diffs (e.g. make it possible to work with much less data to update the database regularly)

Personally, I feel none of what I described above requires any structural changes to the NPI itself. The changes are all geared at increasing the data quality through improved incentives.

[Hack G]

Great points  - I have found some providers with an old practice phone, business fax or practice address that is said to be from 5-6 yrs ago after speaking with the provider. 

The providers should receive regular notifications every X months to update their information, allowing them to update a phone number or practice location with as little friction as possible. I'm sure some providers forget for long periods of time that they have outdated info waiting to be corrected

[Alan Viars]

Hi Michael:

You pretty much nailed it. 

Part of the complexity comes from the fact that NPPES is all providers and PECOS is providers participating in Medicare.  Addresses are in both and have different meanings. Another person in the group suggested creating "facility codes" as a way to distinguish an address from some point of care. Have any ideas there? 

I am working on a NPI profile page that I will send to you.  What exactly needs to be done to make it more easily indexed?

Sincerely,

Alan Viars

On Saturday, February 8, 2014 6:40:33 PM UTC-5, Michael Wasser wrote:

[Michael Wasser]

I don't have great insight into the relationship between PECOS and NPPES. My only thought would be that in general, the simpler the model the better -- especially since there's already plenty of data quality issues with the addresses (again, mostly due to staleness).

The creation of a sitemap.xml file would suffice (http://www.sitemaps.org/protocol.html). Let me know if you'd have any specific questions on how this works. Google and Bing Webmaster Tools are great resources to make sure your sitemap is working properly.

Michael

[eric_...@jsi.com]

In terms of keeping the data up to date – the provider should be required to login and validate or update their NPI data once a year.  They could simply click a ‘validated’ box, and the system should then record the last date the data was validated so it is clear when the data was last reviewed.  Reminders should be sent if that exceeds some period of time (1 - 1.5 years).  Rather than simply incentivizing providers to validate, these NPI numbers should be placed in a suspended state if they are not validated for XX months after the 1 year mark, and have CMS billing held for suspended NPIs to be sure that validation or update happens.  Especially needed is a mechanism to assure that providers within organizations that bill at the organizational level also have a reason to update.

[Darrell DeVeaux]

I know this post is a bit old but still relevant.  Let me pipe in as we had developed a user friendly interface in past AND were using "push" to stick the data in front of providers on a MONTHLY basis that enabled them to modify the data right there in a web UI. We then submitted as an EFIO on their behalf.

I'll augment/disagree with Michael a little here. Incenting the providers to keep their NPI data up to date should be relatively easy....CMS has to use it themselves! If CMS starts using parts of the demographic data (phone, address) for mailings, queries, data on varied CMS operated sites..this will go a long way to this end. Making the NPI itself more widely used will not do that. The NPI is already somewhat widely used and, since the NPI doesn't usually change, that's not what's out of date...it's everything else.

We assumed when this started, that CMS would use some of this demographic info on file for....something at least. Feed it into PECOS? Medicare Compare? The problem isn't technical in nature, it's bureaucracy since the PECOS people want to collect their own data separate from the team upstairs and next door because....well because....

On Saturday, February 8, 2014 6:40:33 PM UTC-5, Michael Wasser wrote: