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Appendix A: Milestones

NPDB Milestones


Practitioner Statement Added to Reports

  • A practitioner with a report in the NPDB could add his or her own statement, which is available to queriers, to the report.
  • NPDB implemented automated fee collection through electronic funds transfer.
  • Individuals and entities that query could preauthorize the NPDB to debit their bank accounts directly for query fees.
  • QPRAC version 2.0 was introduced, allowing the NPDB to respond electronically to queries.
  • HRSA contracted with its second contractor to develop and operate the second- generation NPDB.
  • More than 1.5 million queries were processed, an average of 30,000 per week.
  • More than half of all queries became electronic.
  • Average query response time was 2 to 3 days.


NPDB Collected Its 100,000th Report

  • Since its implementation in 1990, the NPDB collected its 100,000th report.
  • All paper queries, except practitioner self-queries, were eliminated.
  • Voluntary queries, submitted by entities not mandated by law, outnumbered mandated queries for the first time.
  • Responses to queries became more comprehensive. If the subject of a report requested a Secretarial Review (now called Dispute Review), the response for each query included this information as well as the status of the Secretarial Review.


Health Insurance Portability and Accountability Act Enacted

  • The Secretary of HHS, acting through the OIG, was directed by the Health Insurance Portability and Accountability Act of 1996 to create the HIPDB to combat fraud and abuse in health insurance and health care delivery.
  • NPDB users could submit reports and update registration information electronically using QPRAC version 3.0.A blizzard blanketed the Washington, DC, area with 20 inches of snow. Although employees of DPDB's forerunner, the Division of Quality Assurance, were not able to get to work, the NPDB received and processed more than 20,000 queries during the blizzard.
  • More than 2.7 million queries were processed, an average of 52,000 per week.
  • Average query response time was 6 hours or less.


HRSA Coordinated NPDB with HIPDB

  • Because of the NPDB's success, the HHS OIG asked BHPr's Division of Quality Assurance to design, develop, and operate the new HIPDB. By law, the operations of the NPDB and HIPDB were required to be coordinated.
  • NPDB queries generated information about Medicare and Medicaid exclusions.


Health Care Entities Queried More than 15 Million Times

  • State licensing boards, hospitals, and other health care entities queried the NPDB more than 15 million times since 1990.
  • The NPDB collected its 200,000th report.


NPDB and HIPDB Became Web Based

  • Final regulations governing the HIPDB were codified as 45 CFR Part 61.
  • For the first time, the NPDB and the HIPDB began accepting reports and single- name queries using a secure Internet site. This was made possible with the Integrated Querying and Reporting Service (IQRS).
  • More than 3.2 million NPDB queries were processed during the year, an average of 6 queries a minute, 24 hours a day, 365 days a year, or a query every 10 seconds.


NPDB Turned 10 Years Old

  • NPDB celebrated 10 years of successful operations.
  • NPDB entered the new millennium Y2K-trouble free.
  • HIPDB opened for querying.
  • Average query response time was 4 hours.
  • The Data Bank introduced the Interface Control Document Transfer Program, an alternative to the IQRS for large-volume users. This change allowed interoperability between the computer systems of those that query and report and the Data Bank.


Web-Based Self-Query Service Began

  • Improvements were made to the self-query service so that practitioners were able to submit self-query data electronically through the Data Bank's secure website. After transmitting a self-query, the process was completed by printing and mailing a notarized self-query application to the Data Bank. Self-queries were processed within 48 hours and self-query status could be tracked online.
  • BHPr's Division of Quality Assurance was renamed the Division of Practitioner Data Banks.


NPDB Received Recognition

  • The DPDB received an Electronic Government Trailblazer Award for the Data Bank. This award highlighted Federal, State, local, and international government programs that had successfully implemented the most innovative information systems in e-Government.
  • The Data Bank introduced the online Report Response Service for efficient processing of self-queries, while maintaining strict security standards. The Report Response Service allowed report subjects to electronically maintain current address information with the Data Bank; add, modify, or remove Subject Statements; initiate or withdraw disputes; and elevate or withdraw requests for Secretarial Review online. Previously, subjects performed these functions via paper correspondence.


IQRS Introduced Web-Based Entity and Agent Registration

  • The Data Bank introduced online entity and authorized agent registration, replacing the paper registration forms and paper-based registration process. On-screen instructions and help file information provided immediate assistance, enabling simplified online registration.
  • The number of registered users of the Data Bank reached 16,000.


Data Bank Won Excellence.Gov Award

  • The Data Bank program was awarded the 2004 Excellence.Gov Award. In addition, the Data Bank also was recognized as one of the "Top Five" Federal E-Government Programs of 2004. The awards were bestowed on Federal organizations with outstanding information technology achievements in the public service arena. The Excellence.Gov Award focused on governance models used in e-Government projects that cross organizations.
  • The Data Bank made IQRS report and query histories available to users, enabling them to obtain a summary of subjects queried or reported on over the previous 4 years.


Querying and Reporting XML Service Introduced

  • The Data Bank introduced the Querying and Reporting XML Service (QRXS), an alternative to the IQRS and the ITP for users who want their computer systems to interface directly with the Data Bank.
  • Average query response time was less than 2 hours.
  • The NPDB processed more than 36 million queries since 1991 and maintained more than 375,000 reports.


IQRS Query Workflow Streamlined

  • The IQRS query workflow was streamlined, making submitting queries easier and more intuitive.
  • Average query response time was less than 1 hour.
  • An improved registration renewal process was completed. More than 16,500 entities and agents updated their registrations with the Data Bank using the new procedure.


Proactive Disclosure Service Prototype Launched

  • The Proactive Disclosure Service (PDS) (now called Continuous Query) was implemented on April 30.
  • PDS subscribers received notification of new reports within one business day.


PDS Became a Permanent Service

  • The PDS became a permanent service for automatic and continuous querying of enrolled practitioners in the NPDB and the HIPDB.
  • The PDS successfully completed a full monitoring cycle, including the opportunity for entities to renew their PDS registration. The renewal rate after the first year was 97 percent.


Interface Control Document Transfer Program Phased Out for Querying and Reporting XML Service

  • The QRXS, the next generation interface for high-volume users, started replacing and phasing out the Interface Control Document Transfer Program (ICD ITP).
  • The QRXS uses an industry standard XML format that improves the exchange of data between users and the Data Bank, providing real-time data validation.


Section 1921 of the Social Security Act

  • NPDB began accepting reports and queries required by Section 1921 on March 1. Section 1921 expanded the information collected and disseminated through the NPDB to include reports on all licensure actions taken against all health care practitioners, not just physicians and dentists.
  • The Compliance Branch initiated a rigorous review of adverse or disciplinary actions reporting by State licensing boards and agencies.
  • The Secretary of HHS published for the first time a list of State agencies that failed to meet Data Bank reporting requirements. She also took the unprecedented step of calling on State governors to do their part to assure that State reports to the Data Bank are complete and accurate.
  • DPDB continued to provide State boards with technical assistance to ensure compliance.


PDS Becomes Continuous Query

  • The prototype status for PDS was removed and the name formally changed from PDS to Continuous Query to better capture the true nature of the service, which is the continuous monitoring of enrolled practitioners.
  • By the end of 2011, more than 94 percent of all professions reviewed in the Adverse Licensure Comparison Project were compliant with Data Bank reporting requirements for years 2006 thru 2009. The reviewed professions were nurses, pharmacists, physicians, dentists, physician assistants, podiatrists, psychologists, social workers, chiropractors, optometrists, and physical therapists.
  • DPDB established a dedicated email account for receiving data requests and inquiries, resulting in a more streamlined process for handling inquiries from users and shortening the time for staff to respond.
  • A data use agreement policy was instituted to protect the anonymity of practitioners on whom reports were filed and to establish guidelines regarding how the Public Use File is to be used.


Preparation Activities for Merger

  • Several preparation activities took place in 2012 to get ready for the publication of a Final Rule in 2013 concerning the merger of the HIPDB with the NPDB. These activities included outreach to Federal partners and other users of the Data Bank, technical assistance, revising Privacy Act notices, and updating systems and forms.

Began Providing Web-based Statistical Information

  • A web-based Data Analysis Tool was developed and implemented to facilitate independent analysis of information relating to medical malpractice payments and adverse actions. The tool allows a wide range of users to perform unique analyses that can be customized by State or region, making it possible for stakeholders to identify trends of interest and to target their resources on areas of concern.
  • The Research Branch developed NPDB statistics by State that are available in table and trend plot formats that can be accessed using an interactive map of the United States.