Journalists turn to Sebelius for access to National Practitioner Data Bank file
Filed under: Government, Health data, Health journalism, Public records
The Association of Health Care Journalists and five other journalism groups appealed to Health and Human Services Secretary Kathleen Sebelius to intervene in the dispute over the Public Use File of the National Practitioner Data Bank and restore access to this important data tool.
HHS Sec. Kathleen Sebelius spoke to journalists at Health Journalism 2010 in Chicago.
AHCJ was joined in its letter to Sebelius by Investigative Reporters and Editors, the Society of Professional Journalists, the National Association of Science Writers, the Reporters Committee for Freedom of the Press and the National Freedom of Information Coalition. The groups have more than 15,000 members.
The U.S. Health Resources and Services Administration removed the Public Use File (PUF) from the data bank website earlier this month because officials believe it was used to identify physicians inappropriately.
The National Practitioner Data Bank is a confidential system that compiles malpractice payouts, hospital discipline and regulatory sanctions against doctors and other health professionals. For years, HRSA has made a public version of it available without identifying information about the health providers.
Letter to Sebelius (PDF)
See how reporters have used NPDB’s public use file to expose gaps in oversight of doctors
Letter to members of Congress (PDF)
HRSA letter to Bavley (PDF)
Articles, editorials about public access to the NPDB public use file (PDF)
Sept. 15, 2011: AHCJ, other journalism organizations protest removal of data from public website
Get the NPDB public use file
Investigative Reporters and Editors, working with the Association of Health Care Journalists and the Society of Professional Journalists, has posted the data for download, free to the public.
The groups took issue with a letter written last week by HRSA administrator Mary Wakefield, in which she defended the decision to remove the Public Use File from the agency’s website.
“We believe the stance taken by administrator Wakefield and HRSA staff is overly restrictive based on the law governing the data bank. We do not dispute that federal law precludes the administration from sharing confidential information from data bank reports, including the person being reported and the institution filing the report. We disagree with HRSA that the Public Use File, removed from the web earlier this month, did this.”
The letter also criticized HRSA’s research protocol under which reporters can now request data from the data bank as intrusive and unfair. The agency’s new web page about the Public Use File and how to make requests for data says: “At this time, a researcher must provide a proposal (including table shells) for their need of data. DPDB will review the request and approve or deny the request for data. DPDB will provide only the variables needed to complete the research.”
“We find it troubling that a federal agency now wants to judge the quality of reporters’ stories and make individual decisions about which one is worthy –perhaps putting officials in the position of denying requests that may make HRSA or the data bank look poor,” the letter said. “We don’t see any provisions in the act governing the data bank that gives HRSA the authority to deny research data as long as it doesn’t identify individuals.”
The groups said they stood ready to meet with Sebelius and work with her on a solution that will provide continued access to the Public Use File.
“Reporters have exposed dangerous lapses in oversight by state medical boards, prompting legislation to increase transparency and improve patient protections,” the letter said. “We hope you will agree that this is a matter of public concern and that you will urge HRSA to change course and immediately restore the Public Use File of the data bank.”
The letter to Sebelius followed a request for assistance to members of Congress last week.
Agency declines to restore public data
Filed under: Government, Health data, Health journalism, Public health, Public records
The U.S. Health Resources and Services Administration resisted demands by three major journalism organizations for the immediate restoration of a Public Use File of the National Practitioner Data Bank, a tool that reporters have used to expose lapses in oversight of troubled physicians.
HRSA removed the Public Use File from the data bank website earlier this month because officials believe it was used to identify physicians inappropriately.
The National Practitioner Data Bank is a confidential system that compiles malpractice payouts, hospital discipline and regulatory sanctions against doctors and other health professionals. For years, HRSA has made a public version of it available without identifying information about the health providers.
In letters to the Association of Health Care Journalists, Investigative Reporters and Editors and the Society of Professional Journalists, HRSA Administrator Mary Wakefield said her agency regretted having to remove the Public Use File from its website and hopes to bring it back in some form “as quickly as is possible.” She did not provide a date.
“The statute that governs the NPDB clearly states that we are obligated to keep data about individual practitioners housed in the NPDB confidential,” Wakefield wrote. “We now know that the PUF in its current form can be manipulated to identify individual practitioners, and therefore were compelled to act.”
Wakefield said HRSA shared the groups’ interest in transparency and patient safety but was compelled to act in the way that it did.
Wakefield was responding to a Sept. 15 letter from the three groups, which called for the Public Use File to be returned online without delay.
AHCJ President Charles Ornstein took exception to Wakefield’s comments, noting that reporters have used the Public Use File responsibly for many years and that the agency only acted after a single complaint from one doctor’s lawyer. He said HRSA has been well aware of how reporters have used the database and even assisted them in their statistical analysis.
“It is not true that the Public Use File can be ‘manipulated’ to identify individuals,” Ornstein said. “Nothing in that data can be used to identify individuals if reporters or researchers don’t already know who the bad actors are. We remain troubled that it appears HRSA is more interested in protecting doctors accused of harming patients than protecting the patients themselves.”
Wakefield’s response came the same day the journalism groups – joined by the National Association of Science Writers, the Reporters Committee for Freedom of the Press, and the National Freedom of Information Coalition – wrote letters to members of Congress asking for their help in getting the old version of the Public Use File restored. The groups would like to see that file regularly updated.
Wakefield said HRSA is reconfiguring the Public Use File to prevent identification of a health care provider or patient, and that researchers and members of the media can request data in the interim on the agency’s website. She also said there would be a call at 1 p.m. Eastern on Oct. 13 to hear from the public about what they would like from the Public Use File.
But Ornstein said it remained unclear how useful the information would be if the agency removes unique identifiers for individuals, which had allowed reporters to see what type of follow-up action was taken against doctors who repeatedly made malpractice payouts or had been disciplined repeatedly by hospitals.
On Wednesday, AHCJ and its partner journalism groups released a report on how reporters and news organizations have used the Public Use File in the past to expose dangerous lapses in oversight by state medical boards. Several of those articles led to new laws and rules to increase transparency and implement patient protections.
“As result of our investigation – and the solid documentation provided by the NPDB, malpractice suits and patient records – Virginia passed a law giving its state medical board more authority to crack down on doctors … ,” wrote Liz Szabo, a USA Today reporter who used the data bank in 2002 while at the Virginian-Pilot. “Patients in Virginia are safer today due to our reporting, and due to the data provided by the NPDB.”
Wakefield noted in her letter that the amount of information in the databank has increased dramatically in the past 18 months. Journalism leaders say what she failed to state was that a huge number of reports came in only after journalists (including Ornstein) showed that state agencies were not reporting discipline to the data bank and that HRSA was not following up on glaring inconsistencies and irregularities.
Wakefield did not address a request by the journalism groups to seek legislation permitting the continued disclosure of the Public Use File in the same form as before it was pulled Sept. 1.
She also did not apologize, as requested, to Kansas City Star reporter Alan Bavley, who was threatened with sanctions if he wrote a story based on information from the data bank. She said Bavley will not be pursued but was reminded that the Public Use File was for “statistical analysis only.”
Ornstein said the issue is larger than Bavley. “The threat to Alan is not a moot point just because HRSA didn’t fine him. Such threats by the federal government could have a chilling effect based on a news’ organization’s ability – and willingness – to stand up to government fines and local lawsuits.”
“There needs to be an apology and a promise that reporters won’t be threatened by the federal government when they plan to report public information,” Ornstein added.
IRE has made available free on its website a copy of the Public Use File, downloaded last month, along with documentation and instructions.
Journalism organizations offer data government blocked from public
Filed under: Government, Health data, Health journalism, Public records, Uncategorized
Another development in the protest by three key journalism groups to the Obama administration’s decision to block public access to a public database of physician discipline and malpractice: Now, Investigative Reporters and Editors, working with the Association of Health Care Journalists and the Society of Professional Journalists, has posted the data for download, free to the public.
The data are posted for the entire U.S. in the original text format with documentation. IRE has also made available state-by-state Excel spreadsheet files.
On Thursday, the groups sent a letter protesting the decision to pull offline a the Public Use File of the National Practitioner Data Bank. The government has made this file available online for years, and reporters have used it to call attention to lax oversight of physicians across the country.
The public version of the database does not identify physicians by name or address, but it does provide other useful information about hospital sanctions, malpractice payouts and state disciplinary actions against every doctor in the country.
“We applaud IRE for making this data available for free to the media, researchers and the public,” said Charles Ornstein, AHCJ’s president. “While the government has decided that this ‘public use file’ should no longer be public, our organizations believe that it continues to be a critical resource. I encourage reporters, even those who have never used it before, to look for stories within it now.”
Journalists have used the data for years to draw attention to troubled physicians and state inaction. Recent examples include the St. Louis Post Dispatch, the Duluth (Minn) News-Tribune and The Kansas City Star. Other examples over the years have included The Hartford (Conn.) Courant and the Raleigh, N.C., News & Observer.
The U.S. Health Resources and Services Administration threatened a reporter from The Kansas City Star with financial penalties if he proceeded to write a story about a local neurosurgeon using information he gleaned from the public version of the database on the agency’s website. The newspaper published its story anyway on Sept. 4. The doctor’s attorney complained to the agency, prompting officials to remove the database from its website on Sept. 1.
Several news outlets - The New York Times, Los Angeles Times, Reuters and the St. Louis Post-Dispatch - are following the story.
AHCJ, other journalism organizations protest removal of data from public website
Filed under: Government, Health data, Health journalism, Public records
The Association of Health Care Journalists, joined by the Society of Professional Journalists and Investigative Reporters and Editors, sent a letter to the Obama administration today protesting its decision to pull offline a public database of physician discipline and malpractice payments.
Read the letter sent by the journalism organizations to Mary K. Wakefield, administrator of the Health Resources and Services Administration.
Stories using the NPDB
The Kansas City Star
• Doctors with histories of alleged malpractice often go undisciplined
• Obama’s HHS shuts down public access to doctor malpractice data
Duluth (Minn.) News Tribune
• AHCJ article: Duluth News Tribune exposes malpractice allegations
• As Duluth hospital reaped millions, surgeon racked up complaints
• Multiple allegations against former St. Luke’s doctor
• Ailing patients speak out about former Duluth doctor
• Wisconsin restricts former Duluth doctor’s license
• In Texas, former Duluth surgeon may be sanction-free
• Federal database of malpractice cases doesn’t make public doctors’ names, or where they practice
Propublica
States Fail to Report Disciplined Caregivers to Federal Database
St. Louis Post-Dispatch
• Reporters encounter hospital’s lack of transparency
• Tip sheet from Bernhard & Kohler on researching health professionals.
• Award entry: Who Protects the Patients?
• Serious medical errors, little public information
• Caution urged with facedown restraints
• Doctor lost hospital privileges but kept clean record
• Girl, 16, dies during restraint at an already-troubled hospital
Milwaukee Journal-Sentinel
• Dangerous Doctors
• AHCJ article: Records show ‘dangerous doctors’ rarely face discipline
• Tip sheet from Gina Barton on state oversight of health professionals
Connecticut Health Investigative Team
• Disciplined Docs Practice Freely In State
West Hawaii Today
• Medical malpractice in Hawaii
• Diagnosis-related claims among top reasons for suit
Public Citizen
• Hospitals avoid reporting disciplined docs: The nonprofit group released a report showing that hospitals nationwide are taking advantage of loopholes to avoid reporting disciplined physicians to a national database. The Miami Herald’s John Dorscher, the Detroit Free Press’s Patricia Anstett and the Contra Costa Times‘ Sandy Kleffman reported local versions of the story that are no longer available online.
Earlier stories about access to NPDB:
• Data Mine reports on access to practitioner data: The Center for Public Integrity focuses on the National Practitioner Databank and the lack of public access to information in the database.
• Access to list of disciplined health workers in limbo: NPR’s Joseph Shapiro looked into the status of the Healthcare Integrity and Protection Data Bank.
• Public Citizen posted an open letter to HHS Secretary Kathleen Sebelius explaining why the database is important, and details the consequences of keeping it under wraps.
AHCJ, SPJ and IRE called for the government to immediately restore access to the Public Use File of the National Practitioner Data Bank. The government has made this file available online for years, and reporters have used it to call attention to lax oversight of physicians across the country.
Pursuant to the law, the public version of the database does not identify physicians by name or address, but it does provide other useful information about hospital sanctions, malpractice payouts and state disciplinary actions against every doctor in the country.
As an example, the database would allow a reporter or researcher to discover that certain, unnamed physicians have been sanctioned repeatedly by their hospitals but never were disciplined by their state’s medical board. It would also be possible to find doctors with lengthy trails of malpractice who continued to enjoy clear licenses.
The groups also expressed their deep disappointment that the U.S. Health Resources and Services Administration threatened a reporter from The Kansas City Star with financial penalties if he proceeded to write a story about a local neurosurgeon using information he gleaned from the public version of the database on the agency’s website. The newspaper published its story anyway on Sept. 4. The doctor’s attorney complained to the agency, prompting officials to remove the database from its website on Sept. 1.
The government said that it had to act now because reporters were able to link information in the data bank to specific doctors, and the law prohibits the public use file from identifying doctors. A HRSA spokesman said the data bank will be offline for at least six months and may never return unless the physician privacy concerns are adequately addressed.
AHCJ President Charles Ornstein said he was puzzled by HRSA’s sudden action because reporters have used the public version of the data bank for years to assist in their reporting and learn additional details about physicians they already had been researching.
“We are troubled that the Obama administration appears to have placed the interests of physicians ahead of the safety of patients,” Ornstein said. “Attempting to intimidate a reporter from using information on a government website is a serious abuse of power.”
Stories written by reporters using the public version of the National Practitioner Data Bank have drawn attention to troubled physicians and state inaction. Recent examples include the St. Louis Post Dispatch, the Duluth (Minn) News-Tribune and the Star. Other examples over the years have included The Hartford (Conn.) Courant and the Raleigh, N.C., News & Observer.
Some of these stories have resulted in new legislation and other steps that protect patients, by increasing transparency and sometimes toughening requirements on doctors.
The groups wrote that if HRSA determines the public version of the database violates the law in any way, it should seek swift legislative changes to remedy the problem and once again make the database available.
“In one stroke, the very administration that promised greater transparency not only excludes information of obvious public value to patients across this country but threatens legal action against a reporter for using public records,” said SPJ President Hagit Limor. “This is clearly outrageous.”
IRE President Manny Garcia said, “The removal of the Public Use File - whose very name means for public use - eliminates a valuable tool for journalists whose goal is to educate and protect the public. This database has allowed reporters to uncover flaws that have toughened legislation, and without a doubt, saved the lives of patients across the country.
“We are also stunned that a public servant has the hubris to threaten a health care reporter for doing his job. HRSA should be delighted that journalists are using public information to help saves lives, but in this instance the response is: get lost or get fined.”
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