Network Requirements

Use Case

Under HIPAA, the use and disclosure of protected health information (PHI) is permitted for activities related to Treatment, Payment, and Healthcare Operations (TPO). The health data exchanges that Zus partners with may put in place additional requirements to access patient data. Specifically, our EHR network partners require an active treatment relationship, as well as satisfaction of data reciprocity, and our pharmacy-sourced medication partner requires a relationship with a prescribing provider. During your sales and implementation process, a Zus team member will verify your use case to ensure access to the appropriate packages.

Patient Demographics

The following demographics are required in the Patient resource to enroll a patient in data services or complete a one-time query:

  • First name
  • Last name
  • Date of birth
  • Gender
  • Address line 1
  • City
  • State
  • Zip (5 digits or 5-4, separated by a hyphen).

We also recommend including the following fields to maximize your patient match rate in Zus's data ecosystem:

  • Phone
  • Email

Finally, your relationship with the patient must be indicated as active by setting the Active flag to true (see Establishing Patient Relationship). An attempt to enroll or query a patient that is inactive will automatically set the relationship to active.

Provider relationship

As part of enrolling a patient in a package or initiating a one-time query, customers will need to also provide a treating provider's information, including a name, valid NPI, and role.

Reciprocity

Several of Zus's data exchange partners require reciprocity from participating entities. Zus (and our network partners) monitor customer adherence to these best practices and may reach out to your team to discuss improvement opportunities.

  • Timeliness: Best practice is to contribute data in advance of querying whenever possible. In cases where patients have not yet been seen, organizations may contribute minimal data (e.g. upcoming appointment) in advance and follow up with richer clinical data within 30 days of the appointment.
  • Frequency: Your users and the network want fresh data! Best practice is to continuously incorporate new and updated data into the ZAP.
  • Comprehensiveness: The usefulness and impact of clinical data is dependent on how rich and comprehensive it is. If you and your team are power users of the ZAP, please consider contributing data in the same spirit of comprehensiveness (it’ll make your experience better too!).
  • Uniqueness: At Zus, we’re pro’s at handing duplicates, but can’t say we love β€˜em. Whenever possible, contribute data that is unique about the patient - not what is already reflected in the ZAP.
  • Provenance: When, where, and who documented data matters.

For more information on how to contribute data to the Zus platform, see Adding Your Data.