Proposal for medical/health/lifesci vocab covering US Healthcare insurance networks #1062

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danbri opened this Issue Mar 29, 2016 · 9 comments

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@danbri
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danbri commented Mar 29, 2016 edited

This issue tracks a proposal from David Pourtnoy et al. There is a public Google doc at https://docs.google.com/document/d/1LNew5OEon4uir2D5Zzp0AkUPA7c9nO8reJ_M1pOy-3s/edit?usp=gmail

We should note that the design is explicitly US-centric, and that this can be accommodated within schema.org through our 'hosted extensions' mechanism.

@vholland worked on a draft design last year. This has been somewhat discussed alongside the ongoing work on cleanup of existing schema.org medical/health vocabulary (#492) but note that it is a distinct project, even if it is ultimately published within the same extension (e.g. under health-lifesci.schema.org).

Background (from @dportnoy)

In November 2015, the US health agency Centers for Medicare & Medicaid Services (CMS) enacted a new regulatory requirement for health insurers who list plans on insurance marketplaces. They must now publish a machine-readable version of their provider network directory, publish it to a specified JSON standard, and update it at least monthly. Many major health insurance companies across the US have already started to publish their health plan coverage, provider directories and drug formularies to this standard.

"This schema is well-defined, required by U.S. government regulation, and is already in use. So Version 1.0 should be as close to identical to the official schema that the CMS agency requires as Schema.org would allow."

@danbri danbri pushed a commit that referenced this issue Mar 29, 2016
Dan Brickley Very rough draft started towards #1062.
I started out btw thinking this should be added to a common health-lifesci extension.

Am now thinking it is better for now in its own (healthplan) while we check if other countries might need similar.

Can always integrate later. Anyway, drafting is as a 'pending' extension.
cd0668e
@twamarc
Contributor
twamarc commented Mar 30, 2016

We should maybe think about a health insurance vocabulary with the terms used across various insurance providers not only healthcare insurance. For healthcare specificity this would not be many terms as they just use the diseases terminology/coding systemes (like ICDxx, CPT, etc) together with few linking properties (btw some of them we found in schema.org/Offer). The US seems very specific but am sure we can find convergence with europeans plans

~Marc

@westurner
Contributor

Just lobbing notes over for a tangential (?) use case (and links to links) from https://westurner.org/opengov/us/index#healthcare-gov-hhs-cmms (2015-02) (... https://westurner.org/redditlog/#comment/c93pfhx (2013-03)

Healthcare.gov (HHS CMMS)⬅

Homepage: https://www.healthcare.gov/
Wikipedia: https://en.wikipedia.org/wiki/HealthCare.gov
Docs: https://www.healthcare.gov/developers/
Twitter: https://twitter.com/HealthCareGov

  • TODO: create RDFa vocabulary for health plans
  • TODO: add RDFa to individual plan pages
  • TODO: search engine to index RDFa vocabulary
  • TODO: encourage carriers to add RDFa to describe their servcies
@twamarc
Contributor
twamarc commented Apr 2, 2016

Interesting! Keep it up and keep us posted. thanks @westurner

@westurner
Contributor

nope, that's just talk.

these look great, thanks!
On Apr 2, 2016 9:29 AM, "Marc" notifications@github.com wrote:

Interesting! Keep it up and keep us posted. thanks @westurner
https://github.com/westurner


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#1062 (comment)

@danbri danbri pushed a commit that referenced this issue Apr 11, 2016
Dan Brickley Example (needs updating) for #1062 00cde2f
@dportnoy

This schema is well-defined, required by U.S. government regulation, and is already in use. So Version 1.0 should be as close to identical to the official schema that the CMS agency requires as Schema.org would allow.

@danbri
Contributor
danbri commented Apr 13, 2016

Thanks for the useful background David. I'll copy that into the issue description above too.

@danbri danbri self-assigned this Apr 18, 2016
@henryweimd

Hi there! Scrubbing in. :)

I really like the Benefits sub-type -- an optional section but critical nontheless.

In the U.S., there are two areas of use cases of relevance:

  1. Flagging the tier of the network of the provider (preferred status, often meaning a discount to the consumer)
  2. Signalling the availability of secure electronic health messaging as in HHS's Standards & Interoperability work here. http://wiki.siframework.org/Provider+Directories

Thanks,
Henry

@danbri
Contributor
danbri commented Aug 10, 2016

This is published in pending.schema.org, therefore leaving issue open for ongoing discussion.

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