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NPDB Insights

Is It Reportable?

Is It Reportable image

A hospital repeatedly reminded a physician to update his medical records in a timely manner. After there was no change in the physician's behavior, the hospital initiated an investigation, which revealed that the physician had more than 300 incomplete medical records. As a result, the hospital took a professional review action to suspend the physician's clinical privileges for 60 days, citing professional misconduct. Because there was no actual patient harm, should this be reported to the NPDB?

It depends. A clinical privileges action must be reported to the NPDB if it is the result of a professional review action related to professional competence or conduct that adversely affects, or could adversely affect, the health or welfare of a patient and lasts for a period longer than 30 days. Whether a practitioner's behavior affects or could affect patient health or welfare is a determination that generally must be made by the entity taking the action. If, in the opinion of the Medical Executive Committee (MEC), the physician's lack of attention to updating medical records in a timely manner could adversely affect the health or welfare of a patient, and the action is the result of a professional review, the action must be reported to the NPDB.

Check Out the NPDB's Reporting Guide Series

The NPDB has completed its redesign of infographic guides that show, using a visual format, the criteria for reporting the following items to the NPDB:

These redesigned guides also illustrate when it is appropriate for the reporting organization to modify a report by correction, void, and more. Stay current with NPDB Insights for more helpful information about querying and reporting to the NPDB!

Continuous Query Helps You Stay Current with Practitioners

Continuous Query Clock Image Stay updated on practitioner report changes by activating Continuous Query. Have your organization's Data Bank administrator sign in, go to Administrator Options, select Activate Continuous Query, and then complete the information on the page. For detailed instructions, review How to Activate Continuous Query.

Things you might not know about Continuous Query:

  • You get the same response as One-Time Query, and for the same price ($2), but with a full year of follow-up notifications about any new or updated reports.
  • You can update practitioners' information at any time during the enrollment period.
  • You can choose to automatically renew your enrolled practitioners, or renew them on your own.
  • Activating Continuous Query does not automatically query every practitioner in your subject database. Activating simply allows you to enroll the practitioner(s) of your choice when you are on the querying page.
  • You are only charged $2 once per year, per practitioner, no matter how many notifications you receive on an enrolled practitioner.
  • Continuous Query is endorsed by and meets legal and accreditation requirements for querying the NPDB, including recognition from The Joint Commission, NCQA (National Committee for Quality Assurance), URAC, and CARF International.

See "3 Reasons to Activate Continuous Query," for a quick printable infographic on Continuous Query. For more general information, see the page How to Use Continuous Query to get started today!

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Previous editions of NPDB Insights are available in our archive.