Metadata for the International Health Workforce: Professional Regulation, Credentialing, and Health Policy Planning

Abstract

Purpose: National health regulatory authorities ensure access to adequate health care by verifying the credentials of health professionals and monitoring of the volume and distribution of the health workforce. This work is made more complex by the growing international mobility of health professionals and is dependent upon timely and accurate data describing professionals in detail; however, there is no accepted standard for exchanging these data. This dissertation takes steps to address this need by identifying the specific data needs of the medical regulatory community and assessing the degree to which existing standards meet the community’s information needs. The overall goal is to identify the unique data needs of regulators while encouraging future interoperability of data describing health professionals. Design and Methods: This study employs a mixed-methods approach combining a document analysis of application forms from 20 international regulatory agencies, a survey of medical regulators, and crosswalk matrices mapping agencies’ required information items together and comparing those items to existing schemas. Multiple methods of data collection from international sources provide a more complete picture of the information needs of the medical regulatory community. The final crosswalk mapping of required elements to three existing metadata schemas was used to assess whether certain topic areas or specific metadata elements are adequately addressed by current standards. Findings: An analysis of 20 international agencies’ documents yielded 1498 application items that could be mapped to 204 distinct metadata elements required by regulators to describe health professionals in support of licensure decisions. An examination of three existing schemas representing agents and their qualifications – the Europass schema, the HR Open Standard, and the MedBiquitous Professional Profile Standard – and creation of a crosswalk matrix mapping their elements to those required by regulatory agencies showed none contained more than half of the metadata elements required. Excluding elements imprecisely matched, the most comprehensive schema addressed only 30.9% of the elements required. Practical Implications: There are many required elements that cannot be represented in existing schemas. In particular, crucial data describing any potentially negative aspects of an individual’s profile, such as disciplinary actions taken against the professional or malpractice payments they have made, are partially or wholly unsupported by any of the schemas examined. Full support of the regulatory community’s information needs would require the addition of certain elements or element sets to existing schemas. Value: This study provides valuable guidance to regulatory agencies in furtherance of an international data standard for their community. Additionally, this work establishes a practical methodology for contextual data standards evaluation based on document analysis.Ph.D., Information Studies -- Drexel University, 201