Tuesday, December 1, 2020

Modernizing US health provider sites to improve directory accuracy

The world's attention has turned to healthcare this year, with many initiatives exploring the use of open data and standards. Schema.org has made a number of efforts already to contribute to the global Coronavirus response, including the creation of SpecialAnnouncement markup, improvements around events, jobs, hospital reporting, and other schemas to reflect our changed reality. 

This week we have invited longstanding Schema.org collaborator Aneesh Chopra to provide an introduction to some important developments in the United States, where Schema.org is being used to improve the accuracy of information about healthcare provider directories. 

Guest post by Aneesh Chopra, former U.S. CTO (2009-2012) and President/Co-Founder of CareJourney:

Just over 9 years ago, the schema.org community launched a markup for JobPostings, an important resource to meet a call to action in helping veterans find jobs that valued their skills. During the early months of the pandemic, this community responded with an important upgrade to the nation’s health IT infrastructure to democratize access more trusted health information online.

Today, at an API Summit hosted by the Office of the National Coordinator for Health IT, Kathy Hempstead of the Robert Wood Johnson Foundation announced an open collaboration that builds upon the same regulations and industry standards to improve another important aspect of the consumer health navigation experience - searching for timely, accurate provider directory information.

For many Americans, finding a health plan that includes their trusted providers is critically important, but often requires tedious work looking up each plan’s provider directory. Sadly, as CMS found in a recent review, nearly 50% of provider directories contained inaccuracies regarding whether the provider was accepting new patients, practicing at the address listed, or reachable via the listed phone number. 

Regulators have attempted to solve these problems by imposing penalties on government-sponsored plans for inaccurate information, but an additional solution may be at hand. A provision embedded in CMS’ interoperability regulations requires government-sponsored health plans to publish machine-readable access to timely directory information by July 2021. In an effort to reduce administrative burdens, a multi-stakeholder collaborative is looking to both improve the quality of physician websites to include this information and to enable health plans to source timely, accurate information from them to comply with the rules.

Similar to the work that was done to make it easier for consumers to find COVID announcements on physician websites, such as testing availability, revised office hours or telemedicine services, this collaborative will work to standardize how to publish structured provider directory information. To further simplify the search experience, providers can now publish their website URL when updating their “digital contact information” on CMS’ NPPES NPI Registry.

Adding structured data from a provider’s website to the portfolio of tools health plans use today – including plan-agnostic reporting tools, “secret shopper” visits, mailings, and a number of emerging data-driven solutions – should result in a reduction in the administrative burden of updating physician directories. Directory maintenance is burdensome. The average practice has over 20 health plan contracts and directories to maintain with over 50% of these updates being conducted via phone or fax. According to a 2019 CAQH (Council for Affordable Quality Healthcare®) report, the average practice spends $1,000 each month for directory maintenance. Yet at the same time, physician practices find value in online marketing as a way to attract new patients, and invest an average of $650 per month to design websites and optimize search results, according to a study by Zocdoc. A web standardization effort will therefore have multiple benefits. It will allow physicians to more efficiently communicate useful information via search engines that can also be used to populate health plan directories and to meet regulatory compliance, thus reducing administrative burdens. 

CareJourney, with support from The Robert Wood Johnson Foundation, seeks to engage public and private sector stakeholders in an effort to accelerate the development and adoption of schema.org web standards for physician information, and to curate a portfolio of tools to structure this information on a practice’s website. Our goal is to improve consumer access to provider information while lowering physician burden. We anticipate the following benefits: 
  • Increased consumer access to high-quality, accurate provider information, such as whether a doctor, practicing at this location, is seeing new patients from my plan.
  • Consistent webpage documentation and maintenance practices that are sufficient to meet health plan regulatory requirements
  • Improved search engine results by leveraging the structured website markup 
This effort will benefit from the active participation of the healthcare community and we welcome additional participants to play a part in our initiative. Assistance in testing and providing feedback on the proposed web standards will be critical and extremely helpful in further promotion and adoption. Once the resulting open information and markup instructions are freely available, we welcome assistance in the widespread dissemination. Finally, we are grateful the prominent search engines are engaged in a process for site maintenance that ensures physicians keep their websites properly structured at the lowest possible administrative burden.

Thank you, in advance, for your interest in advancing this important work! Please sign up here to participate!