Multiple Specialties per Provider

[AgnesWW]

What to do when we have more than one specialty per provider

CDM or THEMIS convention?

THEMIS

Table or Field level?

field in PROVIDER table: specialty_source_value

Is this a general convention?

Not a general convention, however sometimes the same strategy may be devised for the other fields - for example most frequent value for race was utilized in some implementations in the past.

Summary of issues

Established convention: If the provider has more than one specialty ETL needs to assign only one in the field specialty_source_value on the PROVIDER record.

Summary of answer

We are selecting the most frequent specialty per provider

*An alternative new method is under the discussion/development: using the assigment based on the specialty hierarchy.

Related links

https://github.com/OHDSI/Themis/issues/43

There was work done on provider specialties hierarchies: https://forums.ohdsi.org/t/new-comprehensive-hierarchy-for-providers-visits-and-place-of-service-specialty-care-site/5633 https://docs.google.com/spreadsheets/d/1A4OFGoJtRCz-G5qju-TrR5UDFX7coXwuRo7Yw5KSslo/edit#gid=0&fvid=66134107

Under this link we read "Specialty is a degree or qualification of a provider (a flesh and blood provider), and the Domain is Provider."

Other comments/notes

Also there was a meeting on January 21, 2022 focusing on modifications to the convention of mapping the specialties https://forums.ohdsi.org/t/cdm-themis-workgroup-meeting-21jan2020/9285/2

There are some notes about mappings

If a Provider has more than one Specialty, there are two options:

1. Choose a concept_id with an “Is a” relationship to the multiple specialties, or,
2. Choose the specialty that occurs most often for the provider. Concepts in this field should be Standard with a domain of Provider. If a provider’s specialty is not represented either as a singular concept or a concept with an “Is a” relationship to the multiple specialties, put a zero in this field and record the specialty in the specialty_source_value. Abover are not published yet on CDM v5.4

• Please use this section to add any other relevant notes or comments. (i.e. if links are not working, something is out of date or deprecated)

Older links quote the convention #3 under provider See Erica's

• https://forums.ohdsi.org/t/multiple-addresses-per-provider-provider-address-differs-from-care-site/5653\ "If a Provider has more than one Specialty, the main or most often exerted specialty should be recorded."

But was commented in the light of work on hierarchies (Gowtham_Rao): "This probably needs to be updated with more specifics - considering the updates to specialty that [@Christian_Reich] is introducing - along with hierarchy."

The provider mappings may have some discrepancies or sometimes need some extra work on the vocabulary side: https://forums.ohdsi.org/t/provider-mappings/13652 The vocab team recommendation for the future was in cases of inambiguity to use the order of vocabularies: Medicare - ABMS - NUCC - HES for mapping of specialties

[MelaniePhilofsky]

Ideas generated on July 18, 2024 call:

1. NPI can be linked to the National Plan & Provider Enumeration System (NPPES) to identify a Provider's specialty. This sometimes contains a Provider's primary specialty. US centric solution, assumes you have a Provider's NPI.
2. Utilize the Provider's primary care site to identify a specialty based on the specialty of the care site. Assumes you have care site information for a Provider and the care site has a specialty associated with it.

We need input on OHDSI/network study use cases which utilize a Provider's specialty. Please comment below with the use cases.