Abstract
BackgroundAccurate information in provider directories are vital in health care including health information exchange, health benefits exchange, quality reporting, and in the reimbursement and delivery of care. Maintaining provider directory data and keeping it up to date is challenging. The objective of this study is to determine the feasibility of using natural language processing (NLP) techniques to combine disparate resources and acquire accurate information on health providers.MethodsPublically available state licensure lists in Connecticut were obtained along with National Plan and Provider Enumeration System (NPPES) public use files. Connecticut licensure lists textual information of each health professional who is licensed to practice within the state. A NLP-based system was developed based on healthcare provider taxonomy code, location, name and address information to identify textual data within the state and federal records. Qualitative and quantitative evaluation were performed, and the recall and precision were calculated.ResultsWe identified nurse midwives, nurse practitioners, and dentists in the State of Connecticut. The recall and precision were 0.95 and 0.93 respectively. Using the system, we were able to accurately acquire 6849 of the 7177 records of health provider directory information.ConclusionsThe authors demonstrated that the NLP- based approach was effective at acquiring health provider information. Furthermore, the NLP-based system can always be applied to update information further reducing processing burdens as data changes.
Highlights
Accurate information in provider directories are vital in health care including health information exchange, health benefits exchange, quality reporting, and in the reimbursement and delivery of care
Accurate information of provider directory data is vital in health care
National individual provider information was obtained through the National Plan and Provider Enumeration System (NPPES)
Summary
Accurate information in provider directories are vital in health care including health information exchange, health benefits exchange, quality reporting, and in the reimbursement and delivery of care. Maintaining provider directory data and keeping it up to date is challenging. Accurate information of provider directory data is vital in health care. Provider directory data contain important information for many areas of health care such as health information exchange, claim databases, insurance industries [1]. When accurate information is made available, millions of individuals are Inaccurate provider directories can create a barrier to care and raise questions regarding the adequacy and validity of the health care as a whole. Accuracies of provider directories were first raised among dermatologists. It was found that among 4754 total dermatologist listings in the largest plans in 12 metropolitan areas in the United States, 45.5% represented duplicates in the same plan directory. Among the remaining unique listings, only 48.9% of dermatologists were reachable, accepted the listed plan, and offered an appointment for a fictitious patient [2]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
