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Querying the NPDB

The statutes and regulations authorizing entities to query the NPDB were described in Chapter 2 (See Table 3 for details).

The NPDB can be queried using a One-Time Query or Continuous Query. When using the One-Time Query method, entities submit individual queries on a practitioner or entity and receive a copy of reports stored on the practitioner or entity at the time of the query.

To use Continuous Query, entities must first enroll their practitioners in this service. Entities with enrolled practitioners receive copies of reports stored on their practitioner(s) and automatically receive notice of new and updated reports in real time. Entities enroll practitioners for one year and may renew that enrollment annually.

Queries submitted by either method may or may not receive a matched report. Matched reports are generated when the information on the query matches information on an active report stored in the Data Bank.

Table 3: Entities that Query the National Practitioner Data Bank

Entity Query
State Medical and Dental Boards Optional.
State Licensing Boards for Other Health Care Practitioners Optional.
Hospitals Required to query on all applicants for medical staff appointments or when granting, adding to, or expanding clinical privileges, and every two years to review clinical privileges, and as needed.
Health Care Entities* Optional.
Professional Societies that Follow a Formal Peer Review Process Optional.
Health Care Practitioners May self-query.
Medical Malpractice Payers Prohibited.
Peer Review Organizations Prohibited.
Quality Improvement Organizations Optional.**
Private Accreditation Organizations Prohibited.
State Medicaid Fraud Control Units and Law Enforcement Agencies Optional.**
Agencies Administering Federal Health Care Programs and their Contractors Optional.**
State Agencies Administering State Health Care Programs Optional.**
State Agencies that License Health Care Entities Optional.**
U.S. Comptroller General Optional.**
Plaintiff's Attorneys May query when a hospital failed to make a mandatory query of a practitioner and both the hospital and practitioner are named in a medical malpractice action.

*Health care entities or organizations must provide health care services, directly or indirectly, and follow a formal peer review process for the purpose of furthering quality health care.

**These organizations and agencies may receive only information reported to the NPDB under Section 1921.

One Time Queries

Between 2003 and 2012, the number of One-Time Queries increased from 3.3 million to 4.3 million (Figure 3). The number of One-Time Queries that matched to reports increased from 445,004 in 2003 to 604,889 in 2010; the number declined in 2011 and then increased in 2012 (577,565 and 592,230 respectively).

Figure 3: One-Time Queries, 2003 - 2012

One-Time Query Bar graph

Continuous Query

The Data Bank introduced Continuous Query in May 2007 in response to growing interest from the health care community for ongoing practitioner monitoring. Organizations that enroll their practitioners in Continuous Query receive an initial query response, followed by continuous, around-the-clock monitoring on their practitioners. Continuous Query is popular with users for its prompt and automatic notices of new information, its ease of use, and the time it saves by effectively automating querying. As a result, Continuous Query usage among all types of organizations, big and small, has grown substantially since 2007.

Between 2008 and 2012, the number of Continuous Query enrollees increased dramatically from 206,128 to 1,202,472 (Figure 4). At the same time, the number of enrollees that matched to reports increased from 22,695 to 165,743 for the same time period.

Figure 4: Continuous Query Enrollees, 2008 - 2012

Continuous Query Bar graph

Figure 5: Queries Matched to Data Bank Reports by Query Type, 2008 - 2012

Query Result Matching Graph

Between 2008 and 2012, the trend in the match rates for One-Time Queries and Continuous Queries did not differ substantially (Figure 5). The match rate for One-Time Queries showed a slow decline from 14.1 percent to 13.7 percent. For the same time period, match rates for Continuous Queries increased slightly from 11 percent to 13.8 percent.

Figure 6: Continuous Query Timeline

Graphical Timeline of Continuous Query

A History of Continuous Query

2007

Launched

  • Continuous Query launched May 1 as a protype.
  • First report notification is sent on May 9.
  • Meets legal requirements for querying the Data Bank.

2008

111,670 enrollments

  • On 1st anniversary Continuous Query has 328 subscribing organizations.
  • The Veteran's Administration enrolls 60,000 practitioners nationwide.

2009

375,551 enrollments

  • The Joint Commission and NCQA publish endorsements of Continuous Query, citing specific querying and credentialing requirements fulfilled by service.
  • Available to Querying and Reporting XML Service (QRXS) users.

2010

579,729 enrollments

  • Monthly email summarized upcoming enrollment renewals, new subjects enrollments, and report disclosures.
  • Report Disclosure enhanced to include viewed date, sorting, and disclosure history printing.

2011

786,975 enrollments

  • Federal Register Notice announces end of protype stratus, and name change from Proactive Disclosure Service (PDS) to Continuous Query.
  • Query Option workflow consolidated to increase visibility

2012

1,128,418 enrollments

  • The Florida Division of Medical Quality Assurance moves to enroll all 87,000 practicing health care workers statewide.
  • Passes 1 million enrollments.

Below are some of the most often cited benefits of using Continuous Query:

  • The timeliness of report disclosures enables organizations to respond proactively to adverse actions as they occur, instead of waiting until re-credentialing time.
  • No need to submit One-Time Queries on enrolled practitioners. Organizations are automatically notified of new or changed reports within one business day of the Data Bank's receipt.
  • Flexible enrollment and renewal options include automatic renewals, the ability to schedule enrollment termination dates, and a variety of sorting and filtering capabilities to simplify tracking of enrolled practitioners.
  • Provides organizations with cost-effective savings in staff time spent on querying while keeping them systematically informed about reportable incidents on their enrolled practitioners - including adverse licensure and privileging actions, Medicare and Medicaid exclusions, civil judgments, criminal convictions, and medical malpractice payments.
  • Can enhance the hiring practices of health care organizations and fulfill certain legal and accreditation requirements.

These features help to explain the increase in Continuous Query enrollments since its 2007 introduction.