Health Market Science's Dr. Michael Nelson Article Featured in JHIM

Winter Issue of HIMSS Journal focuses on HIE Provider Verification

King of Prussia, PA, - January 19, 2011 - Health Market Science (HMS), a leading source for healthcare provider data and solutions, today announced an article by Dr. Michael L. Nelson, DPM and product marketing manager at HMS, was featured in the Winter 2011 issue of JHIM. Health Information Exchange: Case Studies in Interoperability and Integration is the focus of the issue. JHIM is the member journal for HIMSS--Healthcare Information and Management Systems Society. Nelson's article titled "HIE Provider Verification - The Privacy and Security Elephant in the Room" was one of five selected for the issue that explore barriers, regulations, overviews and lessons learned.

"These contributions and case studies provide useful knowledge and analysis on the various approaches, philosophies and frameworks of health information exchanges," states HIMSS in a recent promotion for the issue. "This issue of JHIM also includes a variety of columns and articles on economics, trends in health IT, education, informatics, technology and legal issues." Members can read the article by signing in at the HIMSS Member Center.

Nelson's article addresses the Federal Health Information Technology Strategy for Privacy and Security requires that HIEs:

  • Improve privacy and security protections for health information
  • Prevent unauthorized or inappropriate access

"Before authorizing a provider to access PHI, an HIE must consider if the provider has active license and DEA privileges, his specialty and whether he is sanctioned anywhere in the U.S. This information changes frequently and providers are lax about reporting updates," advises Nelson. "Healthcare providers have 2 identities: a personal identity and a professional identity. Multifactor authentication and/or digital certificates authenticate a personal identity assuring that a person is who he says he is, but they do not verify that a provider's professional credentials are up to date and acceptable."

The paper discusses an "Identity Ecosystem" which places such a burden on each stakeholder within an HIE as part of a "Fabric of Trust". However, hospitals and health plans only check a provider's credentials every 2-3 years and unfamiliar providers may request HIE access remotely. "Trust" is only reliable across small communities. As HIEs expand and interconnect across regions and states, the "fabric of trust" is stretched to the point of tearing. To avoid inappropriate access to PHI by a provider with questionable credentials and/or professional sanctions, an HIE should put in place a Master Provider Index which crosswalks provider data across all 50 states and which continually aggregates primary sourced provider data from state license boards, the DEA, SSA and the OIG as part of a consolidated provider "Golden Record" which is accessible in real time through a web service. HIMSS members can read the article by signing in at the HIMSS Member Center.

About Health Market Science

Founded in 1999, Health Market Science (HMS) is dedicated to providing the most accurate and useful data solutions to pharmacy, pharmaceutical, medical device manufacturers, health care providers, hospital systems, pharmacy benefit managers, and other segments of the healthcare and life science markets. Our entire organization is focused on the quality of the solutions we deliver which starts with a relentless pursuit of acquiring, analyzing and cleansing more than 2,000 disparate data sources. HMS has the experience, technology, people, and processes to deliver the most accurate, timely healthcare provider MasterFile available in the market. With more than 140 employees, HMS uses innovative technology and domain expertise to help our clients comply with evolving federal and state based laws, reduce operational costs and maximize market opportunities. For more information, visit