HHS pushes pause on transparency with NPDB shutdown

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In a hugely controversial move, the Health Resources and Services Administration (HRSA), under the Department of Health & Human Services (HHS), this week announced it is blocking public online access to the once-open National Practitioner Data Bank (NPDB) and had been since Sept. 1. The NPDB, which contains information on malpractice and disciplinary actions of thousands of providers, is indefinitely closed for business if online users want to view the information. Instead, they would find the 15-year old NPDB Public Use Data File, typically updated quarterly, is currently "not available until further notice."

The decision to block the online public file flies in the face of transparency that patient safety advocates--and not to mention HHS--laud.

The decision hasn't gone unnoticed either. Nonprofit advocacy group Public Citizen fought back stating in a Tuesday letter that the "the only comprehensive national source for reliable data on medical malpractice and other matters" should be restored. Public Citizen said that the public Data Bank was especially helpful for healthcare researchers, patient safety experts, and policy analysts to identify trends about malpractice, medical errors, and disciplinary actions.

"We find it ironic that at a time in which other parts of HHS are becoming more transparent and even proposing to make detailed ratings of health care entities and providers available to the public, HRSA appears to be restricting access to information mandated by law to be made public," said Dr. Michael Carome, deputy director of Public Citizen's Health Research Group.

The NPDB's original intent was to be a flagging system for organizations credentialing healthcare professionals. Those national reports about sanctions, for example, prevent a physician who lost a medical license in one state from practicing in another.

In addition, the NPDB previously published an additional online version, which was a stripped-down copy that didn't include identifying information, such as physicians' names. Over the years, however, reporters have gleaned information from the Public Use Data File for articles, pinpointing bad docs using this information, coupled with other research. More specifically, The Kansas City Star reports that HHS pulled the data from its website after learning the newspaper was featuring an article about a local neurosurgeon with information from the NPDB; The Kansas City Star published the article anyway.

Among other media organizations that used the data are the Duluth (Minn.) News Tribune, The Hartford (Conn.) Courant, St. Louis Post-Dispatch, Milwaukee Journal-Sentinel, and West Hawaii Today, according to the Association of Health Care Journalists, the Society of Professional Journalists, and Investigative Reporters and Editors, three media organizations that also protest the removal. Their letter states that some of the resulting articles from the NPDB information have even led to new legislation to protect patients and strengthen physician requirements.

Investigative Reporters and Editors' President Manny Garcia said, "The removal of the Public Use File--whose very name means for public use--eliminates a valuable tool for journalists whose goal is to educate and protect the public. This database has allowed reporters to uncover flaws that have toughened legislation, and without a doubt, saved the lives of patients across the country."

The real question is who was the transparency for? Were patients peaking at the file? It's not likely that individual patients were able to gather information about specific doctors--at least not without the media's help. Perhaps the most useful form of this information was for patient advocacy groups and health researchers, who were looking at the data, not to wag their finger at individuals, but instead to trend health patterns over time in the interest of medicine.

HHS currently is closing off public online access and conducting a thorough analysis of the data field, but it may or may not make the public-use file available after analysis, which can take at least six months, according to Martin Kramer, spokesman for the HRSA, reports The Kansas City Star. In the meantime, the NPDB is required to respond to queries, a notably slower process.

Reporters, patient advocates, and physicians will certainly be watching HHS's next move with the NPDB and other public reporting data. - Karen (@FierceHealth)