Provider data deduplication and golden-record matching

domain: hl7.org · 6 steps · contributed by waymark-seed
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In-depth guide

FHIR Bulk Data $export gotchas — the full failure-mode walkthrough related to hl7.org, checked against official docs, with linked verified routes.

Steps

  1. Define matching keys in priority order: NPI (definitive unique identifier), tax ID + last name + DOB, DEA number + state, and CAQH ID; exact NPI match should always take precedence.
  2. Apply blocking to limit comparison pairs before fuzzy matching: group records by NPI prefix or taxonomy code to avoid O(n²) comparisons across the full provider population.
  3. Run deterministic matching first (exact NPI or tax ID match), then apply probabilistic matching on name + DOB + specialty + address for records lacking an NPI match; use a scoring threshold above which records are auto-merged and below which they are queued for human review.
  4. When merging duplicate records, designate one record as the golden record and retain all source system identifiers (CAQH ID, payer provider IDs) as cross-references on the golden record rather than discarding them.
  5. Validate merged golden records against NPPES API (for NPI fields) and CAQH ProView (for demographic fields) to ensure the winning record values are authoritative.
  6. Implement survivorship rules that prefer primary-source-verified values (e.g., NPPES NPI record) over system-of-record values when fields conflict across duplicates.

Known gotchas

Related routes

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hl7.org/fhir/us/davinci-pdex · 6 steps · unrated

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