The HHS Health Resources and Services Administration has temporarily pulled offline a public version of the National Practitioners Data Bank, which provider organizations and physician licensing boards use to check for malpractice events, license disciplinary actions and peer review actions.

Organizations representing consumers, researchers and journalists are protesting removal of access to the Public Use Data File, which contains non-identifiable information to analyze trends. HRSA pulled the plug on the public file after a Kansas City Star newspaper reporter used information from the file to collaborate identifiable information already gleaned from court records and other sources about a local physician with a history of malpractice claims.

Reporters have previously used the non-identifiable information to tie loose ends together when writing stories about problem physicians and the failure of regulatory agencies to prevent them from practicing. Three journalist organizations, in a letter of protest to HRSA, cited earlier stories in multiple newspapers.

The organizations also criticized HRSA for threatening the Kansas City reporter with fines if the story was published. "The information reported to the NPDB is confidential and is not to be disclosed or re-disclosed outside of HHS except in furtherance of professional review activities," according to a letter HRSA sent to the reporter. "As specifically required under Federal regulation, any individual who receives information from the NPDB, directly or indirectly, must use NPDB information solely with respect to the purpose for which it was disclosed by HHS. Any individuals who violate the confidentiality provision could be subject to a civil monetary penalty." The newspaper did publish the story.

Once HRSA became aware from the Kansas City reporter of use of the Public Use Data File to collaborate identifiable information found elsewhere, it had no choice but to shut down the site, a spokesperson tells Health Data Management. "We have a responsibility under the law to make sure the information is kept confidential."

HRSA previously said the site would be down for at least six months, but now says that was an initial estimate and the agency is doing everything possible to get data back up quickly while preserving confidentiality.

What follows is a letter that Consumers Union sent Sept. 15 to HRSA Administrator Mary Wakefield:

"This letter is to lodge Consumers Union's Safe Patient Project objection to the September 1 action by HRSA to remove online access to the Public Use Data File of the National Practitioner Data Bank.

"The Public Use File has been used for the past 15 years by researchers to analyze trends and by reporters to provide the public with essential information about medical malpractice, medical licensing disciplinary actions, and peer review actions. Although the law does not require HRSA to post an online version of the data, it just makes good sense to do so. The information by law is public and available to those who request it. Taking this data off line will merely increase the workload of the agency in handling individual FOIA requests for the data.

"Further, the removal of this information - most of which is already public somewhere else - runs counter to the policies of the current administration to 'establish a system of transparency, public participation and collaboration.' President Obama's December 2009 directive specifically requires each agency to 'take prompt steps to expand access to information by making it available online in open formats' 'that can be retrieved, downloaded, indexed, and searched by commonly used web search applications.' The directive further states that "agencies should proactively use modern technology to disseminate useful information, rather than waiting for specific requests under FOIA.

"Unfortunately, this Public Use File is the only comprehensive resource available in the country about physician oversight. It provides information important to consumers -- such as medical malpractice lawsuits, actions taken by medical boards to restrict physicians' practices because of harm to patients, and serious suspensions or revocations of hospital privileges. However, the file does not contain any information that identifies any physician and therefore does not violate confidentiality requirements. The records of individual physicians in the file can potentially be identified only if one already knows from other sources extensive information about the physician and his or her malpractice payments or other actions. Even with these limitations, the Public Use File is a valuable resource for understanding the nature of physicians' practices in America.

"We respectfully request that the NPDB Public Use File be returned to online access immediately."


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