National Practitioner Data Bank

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The National Practitioner Data Bank ("the NPDB") is a database operated by the U.S. Department of Health and Human Services that contains medical malpractice payment and adverse action reports on health care professionals. Hospitals and state licensing boards submit information on physicians and other health care practitioners, including clinical privileges restrictions, actions against physicians' licenses, and medical malpractice payments that is kept in the NPDB database. Only authorized users (e.g. hospitals and state licensing boards considering a physician's application for hospital privileges or a state medical license) are permitted by statute to "query" this information in the NPDB.

Contents

The NPDB was created by Congress with the primary goals of improving health care quality, protecting the public and reducing health care fraud and abuse. The NPDB is managed by the Bureau of Health Workforce of the Health Resources and Services Administration in the U.S. Department of Health and Human Services. Before May 6, 2013, the Data Bank comprised the National Practitioner Data Bank and the Healthcare Integrity and Protection Data Bank. The two were consolidated by Section 6403 of the Affordable Care Act of 2010, Public Law 111–148.

In enacting, the National Practitioner Data Bank-enabling legislation, the Health Care Quality Improvement Act of 1986, Congress intended for physicians to receive "full due process rights with notice and representation". (Statement of HCQIA lead sponsor Ron Wyden)

Information Collected

Any negative action or finding by a Federal or State licensing and certification agency that is publicly available information
Civil judgments or criminal convictions that are health care-related

Access

Access to the information is limited, and is not available to the general public. It is provided to hospitals, other health care entities, professional societies, state and federal licensing and certification authorities (including Medical and Dental Boards), and agencies or contractors administering Federal or State health care programs.

In addition, individual healthcare providers can obtain access to their own records; this information is also in some cases available to those who may be suing them. Researchers may also obtain statistical data, but not data on individuals.

Anonymized data

Public access is available which contains no identifying information. In 2011, this access was removed after someone was able to identify a doctor in the database, but it was restored thereafter. [1]

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<span class="mw-page-title-main">Physician</span> Professional who practices medicine

A physician, medical practitioner, medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through the study, diagnosis, prognosis and treatment of disease, injury, and other physical and mental impairments. Physicians may focus their practice on certain disease categories, types of patients, and methods of treatment—known as specialities—or they may assume responsibility for the provision of continuing and comprehensive medical care to individuals, families, and communities—known as general practice. Medical practice properly requires both a detailed knowledge of the academic disciplines, such as anatomy and physiology, underlying diseases and their treatment—the science of medicine—and also a decent competence in its applied practice—the art or craft of medicine.

<span class="mw-page-title-main">Emergency medicine</span> Medical specialty concerned with care for patients who require immediate medical attention

Emergency medicine is the medical speciality concerned with the care of illnesses or injuries requiring immediate medical attention. Emergency physicians continuously learn to care for unscheduled and undifferentiated patients of all ages. As first-line providers, in coordination with Emergency Medical Services, they are primarily responsible for initiating resuscitation and stabilization and performing the initial investigations and interventions necessary to diagnose and treat illnesses or injuries in the acute phase. Emergency physicians generally practise in hospital emergency departments, pre-hospital settings via emergency medical services, and intensive care units. Still, they may also work in primary care settings such as urgent care clinics.

In the United States, a health maintenance organization (HMO) is a medical insurance group that provides health services for a fixed annual fee. It is an organization that provides or arranges managed care for health insurance, self-funded health care benefit plans, individuals, and other entities, acting as a liaison with health care providers on a prepaid basis. The Health Maintenance Organization Act of 1973 required employers with 25 or more employees to offer federally certified HMO options if the employer offers traditional healthcare options. Unlike traditional indemnity insurance, an HMO covers care rendered by those doctors and other professionals who have agreed by contract to treat patients in accordance with the HMO's guidelines and restrictions in exchange for a steady stream of customers. HMOs cover emergency care regardless of the health care provider's contracted status.

In the medical profession, a general practitioner (GP) is a physician who treats acute and chronic illnesses and provides preventive care and health education to patients of all ages. Their duties are not confined to specific fields of medicine, and they have particular skills in treating people with multiple health issues. They are trained to treat patients to levels of complexity that vary between countries.

<span class="mw-page-title-main">Health care</span> Prevention of disease and promotion of wellbeing

Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment, amelioration, or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health professionals and allied health fields. Medicine, dentistry, pharmacy, midwifery, nursing, optometry, audiology, psychology, occupational therapy, physical therapy, athletic training, and other health professions are all part of health care. It includes work done in providing primary care, secondary care, and tertiary care, as well as in public health.

A medical license is an occupational license that permits a person to legally practice medicine. In most countries, a person must have a medical license bestowed either by a specified government-approved professional association or a government agency before they can practice medicine. Licenses are not granted automatically to all people with medical degrees. A medical school graduate must receive a license to practice medicine to legally be called a physician. The process typically requires testing by a medical board. The medical license is the documentation of authority to practice medicine within a certain locality. An active license is also required to practice medicine as an Assistant Physician, a Physician assistant or a Clinical officer in jurisdictions with authorizing legislation.

Medical privacy or health privacy is the practice of maintaining the security and confidentiality of patient records. It involves both the conversational discretion of health care providers and the security of medical records. The terms can also refer to the physical privacy of patients from other patients and providers while in a medical facility, and to modesty in medical settings. Modern concerns include the degree of disclosure to insurance companies, employers, and other third parties. The advent of electronic medical records (EMR) and patient care management systems (PCMS) have raised new concerns about privacy, balanced with efforts to reduce duplication of services and medical errors.

Licensure means a restricted practice or a restriction on the use of an occupational title, requiring a license. A license created under a "practice act" requires a license before performing a certain activity, such as driving a car on public roads. A license created under a "title act" restricts the use of a given occupational title to licensees, but anyone can perform the activity itself under a less restricted title. For example, in Oregon, anyone can practice counseling, but only licensees can call themselves "Licensed Professional Counselors." Thus depending on the type of law, practicing without a license may carry civil or criminal penalties or may be perfectly legal. For some occupations and professions, licensing is often granted through a professional body or a licensing board composed of practitioners who oversee the applications for licenses. This often involves accredited training and examinations, but varies a great deal for different activities and in different countries.

Medical malpractice is professional negligence by act or omission by a health care provider in which the treatment provided falls below the accepted standard of practice in the medical community and causes injury or death to the patient, with most cases involving medical error. Claims of medical malpractice, when pursued in US courts, are processed as civil torts. Sometimes an act of medical malpractice will also constitute a criminal act, as in the case of the death of Michael Jackson.

A credential service provider (CSP) is a trusted entity that issues security tokens or electronic credentials to subscribers. A CSP forms part of an authentication system, most typically identified as a separate entity in a Federated authentication system. A CSP may be an independent third party, or may issue credentials for its own use. The term CSP is used frequently in the context of the US government's eGov and e-authentication initiatives. An example of a CSP would be an online site whose primary purpose may be, for example, internet banking - but whose users may be subsequently authenticated to other sites, applications or services without further action on their part.

Health technology is defined by the World Health Organization as the "application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures, and systems developed to solve a health problem and improve quality of lives". This includes pharmaceuticals, devices, procedures, and organizational systems used in the healthcare industry, as well as computer-supported information systems. In the United States, these technologies involve standardized physical objects, as well as traditional and designed social means and methods to treat or care for patients.

Patient safety is a discipline that emphasizes safety in health care through the prevention, reduction, reporting and analysis of error and other types of unnecessary harm that often lead to adverse patient events. The frequency and magnitude of avoidable adverse events, often known as patient safety incidents, experienced by patients was not well known until the 1990s, when multiple countries reported significant numbers of patients harmed and killed by medical errors. Recognizing that healthcare errors impact 1 in every 10 patients around the world, the World Health Organization (WHO) calls patient safety an endemic concern. Indeed, patient safety has emerged as a distinct healthcare discipline supported by an immature yet developing scientific framework. There is a significant transdisciplinary body of theoretical and research literature that informs the science of patient safety.

Health information management (HIM) is information management applied to health and health care. It is the practice of analyzing and protecting digital and traditional medical information vital to providing quality patient care. With the widespread computerization of health records, traditional (paper-based) records are being replaced with electronic health records (EHRs). The tools of health informatics and health information technology are continually improving to bring greater efficiency to information management in the health care sector.

The Healthcare Quality Improvement Act of 1986 (HCQIA) was introduced by Congressman Ron Wyden from Oregon.

The French health care system is one of universal health care largely financed by government national health insurance. In its 2000 assessment of world health care systems, the World Health Organization found that France provided the "best overall health care" in the world. In 2017, France spent 11.3% of GDP on health care, or US$5,370 per capita, a figure higher than the average spent by rich countries, though similar to Germany (10.6%) and Canada (10%), but much less than in the US. Approximately 77% of health expenditures are covered by government funded agencies.

Clinical peer review, also known as medical peer review is the process by which health care professionals, including those in nursing and pharmacy, evaluate each other's clinical performance. A discipline-specific process may be referenced accordingly.

<span class="mw-page-title-main">Healthcare in India</span> Overview of the health care system in India

India has a multi-payer universal health care model that is paid for by a combination of public and private health insurance funds along with the element of almost entirely tax-funded public hospitals. The public hospital system is essentially free for all Indian residents except for small, often symbolic co-payments in some services. At the federal level, a national publicly funded health insurance program was launched in 2018 by the Government of India, called Ayushman Bharat. This aimed to cover the bottom 50% of the country's population working in the unorganized sector and offers them free treatment at both public and private hospitals. For people working in the organized sector and earning a monthly salary of up to ₹21,000 are covered by the social insurance scheme of Employees' State Insurance which entirely funds their healthcare, both in public and private hospitals. People earning more than that amount are provided health insurance coverage by their employers through either one of the four main public health insurance funds which are the National Insurance Company, The Oriental Insurance Company, United India Insurance Company and New India Assurance or a private insurance provider. All employers in India are legally mandated to provide health insurance coverage to their employees and dependents as part of Social Security in India.

Credentialing is the process of establishing the qualifications of licensed medical professionals and assessing their background and legitimacy.

The Bureau of Health Workforce is a part of the Health Resources and Services Administration (HRSA), of the United States Department of Health and Human Services. HRSA programs train health care professionals and place them where they are needed most. Grants support scholarship and loan repayment programs at colleges and universities to meet critical workforce shortages and promote diversity within the health professions.

Medical malpractice is a legal cause of action that occurs when a medical or health care professional, through a negligent act or omission, deviates from standards in their profession, thereby causing injury or death to a patient. The negligence might arise from errors in diagnosis, treatment, aftercare or health management.

References

  1. Wang, Marian (2011-11-10). "How Complaints From a Single Doctor Caused the Gov't to Take Down a Public Database". ProPublica. Retrieved 2019-06-15.

National Practitioner Data Bank

PD-icon.svg This article incorporates  public domain material from the United States Department of Health and Human Services website http://www.npdb.hrsa.gov/topNavigation/aboutUs.jsp .