Reopened National Practitioner Data Bank restrictions 'protect' disciplined docs

Responding to the backlash to shutting down public access, Health & Human Services on Wednesday reopened the National Practitioner Data Bank (NPDB) but with some restrictions. The NPDB, the national database for medical malpractice reports and disciplinary action on thousands of providers, now has a data use agreement. The agreement spells out that users must only use the data for statistical analysis and specifically not to identify providers.

Started in 1986, the NPDB maintains information of about 800,000 license and hospital disciplinary reports, including past malpractice payments, sanctions, and medical reviews. In September, Health Resources and Services Administration (HRSA) removed its public use data file, ending the 10-year tradition of information transparency. The public use data file (PUF) had de-identified information, but over time, journalists could glean from the data patterns about individual practitioners.

"HRSA is required, by law, to provide the information in a form that does not permit the identification of individual practitioners or health care entities. When we made this decision, we also made clear that we were committed to restoring the PUF to the NPDB website with appropriate protections so that critically important research can continue," HRSA Administrator Mary K. Wakefield said in a Wednesday statement.

Critics argue that, although now available again, the NPDB data under the restrictions is contrary to its intended use. The data user agreement specifies that users cannot use the information in a way that identifies providers or HRSA will ask them to return the data. The data also cannot be reposted or combined with other data to identify providers.

Sen. Charles Grassley (R-Iowa) said in a Nov. 3 letter to HHS Secretary Kathleen Sebelius, "The intent of the legislation that created the PUF was to enhance the quality of healthcare, encourage greater efforts in professional peer review and restrict the ability of incompetent healthcare practitioners to relocate without discovery of previous substandard performance or unprofessional conduct. However, from the documents provided by HRSA it appears that instead of protecting the interest of public health, its purpose was to protect a single physician who had a malpractice suit and disciplinary action filed against him."

Seven journalism organizations, including the Association of Health Care Journalists, also fired back in a letter yesterday to Sebelius, protesting the new rules as "ill-advised, unenforceable and probably unconstitutional."  

"We are committed to further strengthening the utility of the Data Bank, the availability of data that can be used for important statistical analyses, and ensuring that statutory obligations that protect provider confidentiality are maintained," Wakefield said in the statement.

For more information:
- read the NPDB statement
- read the Grassley letter (.pdf)
- read the AHCJ letter (.pdf)

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