Architecting a National Provider Directory for Healthcare.

The Department of Health and Human Services' vision of interoperability of health information systems promises improved efficiency and patient care quality. This endeavor hinges on solving the challenge of reliable user authentication within this interoperable system. Consequently, the Centers for Medicare and Medicaid Services (CMS) and Oklahoma are building a centralized provider directory pilot to inform development of a National Directory of Health (NDH). In this commentary, the authors identify barriers to implementing a national provider directory based on past efforts to build reliable provider directories and offer important considerations for this undertaking. Key areas to study include motivating directory users to self-validate their information, assisting healthcare stakeholders in complying with upcoming CMS regulations, and exploring a modular design for future expansion of directory functions. Given the likely multi-billion-dollar investment into a NDH and potentially significant returns in administrative efficiency and patient care quality, learning from past efforts is paramount for an effective and sustainable solution.