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Participant-Supplied Custom Attribution

Overview

HealthInfoNet allows its analytics participants to share their own custom attribution files (“Participant-Supplied Custom Attribution”), which assigns their patients to unique providers (e.g., MDs, DOs, NPs, PAs, etc.) and/or unique organizations, to inform the type and amount of information they are able to view within their reporting dashboards.

For more information, visit the Attribution Type methodology section.

The following section describes the process by which analytics participants can choose to share custom attribution file(s) with HealthInfoNet.

Process Requirements

In order for analytics participants to share Participant-Supplied Custom Attribution with HealthInfoNet, they must follow these steps:

  1. Confirm and/or request the latest custom attribution Excel template.

  2. Populate the custom attribution Excel template with the desired patient-to-provider-to-organization attribution to inform reporting, per the Field Requirements section below.

  3. Save the custom attribution Excel template:

    1. as a pipe-delimited .csv or .txt file

    2. with a file name of “pmat_[userid]_[source_submitted_site_id]_[today’s date: mmddyyyy]” (e.g., “pmat_TestUser_12345_03062023”)

    3. with all headers included and all required fields populated

  4. Share the populated custom attribution file with HealthInfoNet via an approved and validated delivery mechanism: (a) secure email or (b) Secure File Transfer Protocol (SFTP).

    1. For participants unsure which method to leverage, contact HealthInfoNet’s Customer Care team (customercare@hinfonet.org).

File Field Requirements

The following table outlines the fields included in the Participant-Supplied Custom Attribution template, and each field’s requirements and instructions.

Field Name

Field Description

Required

User Instructions

source_submitted_site_id

HealthInfoNet-assigned identifier that identifies the unique participant organization submitting the patient attribution file.

Valid values are specific to each organization; please contact HealthInfoNet’s Customer Care team (customercare@hinfonet.org) to obtain the appropriate value.

Y

If you are unsure of your organization’s source_submitted_site_id, please contact HealthInfoNet’s Customer Care team (customercare@hinfonet.org).

roster_version1

Participant-defined value that labels each record in the patient attribution file as a way of establishing multiple patient panels for reporting purposes.

Note: The roster_version value(s) used in this file will be queryable via the Attribution Type filter in the reporting dashboards.

Y

Enter a free-text description for the desired roster_version. If this is a new value not yet used for reporting purposes, please alert HealthInfoNet's Customer Care team (customercare@hinfonet.org) before submitting this file.

Participants may choose to include more than one roster_version value in the file as a way of creating multiple patient attribution panels for different use cases. The same roster_version value must be used for all patients who are included within a single patient panel. Variations in format or spelling may result in patients being left off the desired panel.

If the same roster_version value(s) is submitted in multiple files over time, the latest roster_version value received will overwrite the prior version. Only roster_version values that are unique will be retained as unique patient attribution panels.

source_submitted_patient_identifier

Participant-supplied identifier value that identifies a unique patient at the submitting organization. 

Valid values are inclusive of Medical Record Number (MRN) values and other source system identifiers submitted via participants' Admission, Discharge, and Transfer (ADT) HL7 feeds.

Y*

For each patient included in the file, provide their patient identifier value as it is recorded in your organization's EHR system and shared with HealthInfoNet via your organization’s Admission, Discharge, Transfer (ADT) HL7 feeds to ensure the best patient matching outcomes.

*If you do not have a valid patient identifier for a patient included in the file for any reason, enter a bogus value of ‘12345’ to ensure that the record’s demographic attributes are used secondarily for matching purposes.

patient_fname

Participant-supplied first name of the patient.

Y*

If you do not have a valid patient identifier for a patient included in the file for any reason, the patient’s demographic attributes will be used as the primary matching method; all outlined attributes are required to perform a demographic-based match.

*If you do not have all demographic attributes for a patient included in the file for any reason, enter the following bogus values:

  • patient_fname = Test

  • patient_lname = Patient

  • patient_dob = 01/01/1900

  • patient_sex = U

  • patient_address = Test Address

  • patient_city = Test City

  • patient_state = ME

  • patient_zip = 01234

patient_lname

Participant-supplied last name of the patient.

patient_dob

Participant-supplied date of birth of the patient.

patient_sex

Participant-supplied sex of the patient.

Valid values include M, F, X, or U.

patient_address

Participant-supplied street address of the patient.

patient_city

Participant-supplied city/town of residence of the patient.

patient_state

Participant-supplied state of residence of the patient.

patient_zip

Participant-supplied ZIP code of residence of the patient.

attributed_provider_npi

Participant-supplied provider NPI (10-digits) value that identifies a unique provider serving the organization to which patients are attributed for reporting purposes.

For more information about patient-to-provider attribution, visit the Attribution Level & Entity methodology section.

N

If patient-to-provider attribution is desired for reporting purposes, please provide the NPI value of the provider to which each patient should be attributed.

Note: Only NPI values that are found in the National Plan Provider Enumeration System (NPPES) database will be deemed valid for reporting purposes.

attributed_organization_id

HealthInfoNet-defined organization identifier that identifies a unique organization to which patients are attributed for reporting purposes.

Valid values are specific to each organization; see the User Organization reporting dashboard for a full listing of all relevant identifiers to which patients can be attributed at your organization.

For more information about patient-to-organization attribution, visit the Attribution Level & Entity methodology section.

Y

For each patient included in this file, select the desired organization identifier to which the patient should be attributed for reporting purposes.

If you are unable to identify an organization of interest in the User Organization reporting dashboard, please contact HealthInfoNet’s Customer Care team (customercare@hinfonet.org).

attributed_organization_npi

Participant-supplied organization NPI (10 or 13 digits) identifier that identifies a unique organization to which patients are attributed for reporting purposes.

N

For each organization selected, enter their organizational NPI value to assist HealthInfoNet in strengthening its roster for future use cases. This field is informational only at this time and will not be used in generating any reporting.

additional_submitter_information_1 

Participant-defined additional field (option #1) that can be used for display in the reporting alongside patients' demographic information.

N

If your organization would like to provide additional information about the patients included in this file that can appear in reporting, please provide that information here.

If this is a new value not yet used for reporting purposes, please alert HealthInfoNet's Customer Care team (customercare@hinfonet.org) before submitting this file.

additional_submitter_information_2 

Participant-defined additional field (option #2) that can be used for display in the reporting alongside patients' demographic information.

N

If your organization would like to provide additional information about the patients included in this file that can appear in reporting, please provide that information here.

If this is a new value not yet used for reporting purposes, please alert HealthInfoNet's Customer Care team (customercare@hinfonet.org) before submitting this file.

Additional Notes:

  1. As part of a participant organization’s affiliation with an Accountable Care Organization (ACO), it may have previously authorized its ACO to access its organization’s patient health information within HealthInfoNet’s services. To confirm whether the appropriate agreements are in place, please verify with HealthInfoNet’s Client Engagement team (clientengagement@hinfonet.org).

    For an organization with the proper ACO authorizations, ACO staff will automatically obtain access to their organization’s encounter-based and/or custom attribution (as applicable) patient information. However, to allow ACO staff to have a single ACO-wide view of its member organizations' information within HARP, an organization is required to leverage the roster_version field in HealthInfoNet’s Participant-Supplied Custom Attribution template by labeling patient records of interest to share with their ACO with a “[ACO Name]” roster_version value.

    To best support ACO reporting needs, participant organizations should complete the following steps:

    1. Notify HealthInfoNet’s Customer Care team (customercare@hinfonet.org) that their organization plans to submit a new roster_version value for their ACO’s reporting needs.

    2. Create a custom attribution file that includes all patients of interest to share with their ACO, and label each record in the file with a roster_version value provided by HealthInfoNet’s Customer Care team. Note: If an organization is already sharing a custom attribution file with HealthInfoNet, the ACO-specific roster_version value can be included in the same file as duplicate records, or can be parsed into a separate file altogether.

    3. Share the custom attribution file containing their organization’s ACO patients with HealthInfoNet via their selected secure file transfer method (i.e., secure email or SFTP).

      For questions, please contact HealthInfoNet’s Customer Care team (customercare@hinfonet.org).

Validation Requirements

Once a Participant-Supplied Custom Attribution file is received by HealthInfoNet, it is processed through a number of automated field-level and cross-field validation checks to ensure file integrity in adherence with the field requirements outlined above. If the file fails on any of the established validation checks, HealthInfoNet’s Customer Care team will alert the participant of the errors requiring remediation prior to a file resubmission typically within one (1) business day of receipt.

Only when all initial validation checks are passed successfully will the file continue processing through to HealthInfoNet’s Person Identity Resolution system, where patient attributes included in the Participant-Supplied Custom Attribution file will be used to attempt patient matching.

  • Only those patients with (a) a deterministic match based on the provided source_submitted_patient_identifier values or (b) a probabilistic match with a “high confidence” threshold based on the provided demographic attributes are included as “reportable” patients within HARP.

    • Patients included within a Participant-Supplied Custom Attribution file who are deceased, but matched by HealthInfoNet’s Person Identity Resolution system, are included as “reportable” patients.

    • Patients included within a Participant-Supplied Custom Attribution file who have opted-out of the Health Information Exchange, but matched by HealthInfoNet’s Person Identity Resolution system, are not included as “reportable” patients.

  • All other patients who cannot be matched (a) deterministically by source_submitted_patient_identifier or (b) probabilistically based on demographic attributes with a “high confidence” threshold are not included as “reportable” patients within HARP.

    • HealthInfoNet’s Customer Care team can provide a list of these “unmatched” patients to participants upon request, if desired.

Once a Participant-Supplied Custom Attribution file has been fully validated and processed, HARP will convert the file’s roster_version values (i.e., distinct patient panels) into new Attribution Type options, and make those options available in the reporting dashboards soon thereafter (typically the next business day following successful processing).

For questions about the status of a Participant-Supplied Custom Attribution file, please contact HealthInfoNet’s Customer Care team (customercare@hinfonet.org).

Attribution Attrition

Over time, patients included within Participant-Supplied Custom Attribution files who were initially validated as “reportable” within HARP (per the patient matching validation requirements outlined above) may drop out of reporting for a number of reasons.

Common reasons why a patient matched at the time of a file’s initial validation/processing may no longer be included within HARP may be because:

  1. The patient has since opted-out of sharing their information with the statewide HIE

  2. The patient has since been identified as having multiple records in HealthInfoNet’s Person Identity Resolution system, and the record they were initially matched with has subsequently been merged into another record. When this merge occurs, HARP no longer recognizes the patient because the record in the Person Identity Resolution system used to initially match the patient ceases to exist.

Participants can remediate patients dropped out of reporting due to merged records in HealthInfoNet’s Person Identity Resolution system by re-submitting a full Participant-Supplied Custom Attribution file inclusive of the patient(s) of interest.

For questions about attribution attrition, please contact HealthInfoNet’s Customer Care team (customercare@hinfonet.org).

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