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The Data Source Gap – Limited Data Sources Produce Limited Results

January 24, 2019
Leave No Stone Unturned For Patient Safety

Following the minimum compliance requirements for many standards can leave a health care organization exposed to risk on many levels through the data source gap, such as fines levied by the Federal Government, or a damaged reputation through patient endangerment.

When screening health care applicants followed by continuous monitoring, it is critical to see the 360-degree view, historically and currently. Searching a single or a few of the thousands of available data sets and institutions is a risky approach.

The health care industry is characterized by upward or lateral mobility of its provider population. It is common for health care professionals to move, change license types, take on a married name, or work across multiple states with telemedicine.

Not only is it critical to access primary-source data for sanctions, exclusions, debarments or disciplinary actions, but also for any adverse action against a provider ranging from criminal behavior to license expiration. This information should be known through the screening and monitoring process that is designed to leave no stone unturned when it comes to provider transparency.

The two data sources required by most compliance standards are the Office of the Inspector General’s (OIG) List of Excluded Individuals and Entities (LEIE), and the National Provider Data Bank, (NPDB). Relying on only those two data sources to achieve a full 360-degree view of your candidates and staff will leave you with gaps.

The OIG’s LEIE’s results are of providers who are currently excluded. It does not shed light on disciplinary actions or whether the provider has been excluded in the past and trends for adverse behavior. The amount of records is limited, and the historical view only goes back a few years.

Adding a search of the NPDB will enhance your view, but is permissive use only and relies on data to be supplied by its sources. Again, the nature of the data is on final actions rather than data events that fill in the gaps and portray the true character with predictive and historical information.

FACIS®, the proprietary data platform by Verisys Corporation, is an additive data set of exclusions, sanctions, debarments and disciplinary actions run on cutting-edge technology using sophisticated algorithms and automated data acquisition. Supplementing or replacing screening and monitoring searches with FACIS® (inclusive of the LEIE), delivers results derived from some 5,000 primary source publishers including OIG, SAM, FDA, TRICARE, FBI, U.S. DOJ, U.S. Treasury Dept., U.S. State Dept., FHEP, HEAT, state and federal agency news releases and more. FACIS® includes aggregated and verified data going back more than 30 years giving a full longitudinal perspective on an individual or entity.

When turning stones for exclusion discovery, FACIS® offers more than 7.5 million records to search against, while the NPDB is in the neighborhood of 1.3 million records and the LEIE with some 80,000 records.

Work the data in your favor. Here’s why.

Research suggests that at any given time, there are approximately 85,000 health care providers excluded from practicing medicine in the U.S. The NPDB contains records of adverse actions for about 6,000 health care providers leaving the balance of 79,000 high-risk individuals to fly under the radar.

A search using only the NPDB will miss in the neighborhood of 93 percent of excluded or disciplined health care providers. Searching additional databases one-by-one is time-consuming; and to achieve actionable data, verification and aggregation are required—an ongoing task that exceeds the skill level, the time frame, and the budgetary limitations of most health care institutions.

FACIS® delivers real-time, user-friendly results on searches against its robust data set giving you the assurance that you did indeed leave no stone unturned in your commitment to patient safety and sustaining a world-class health care practice or organization.

GAP 1 of “Achieving Transparency Through Closing 5 Critical Gaps in Credentialing”, is brought to you by Verisys Corporation, creator of the most powerful health care data platform delivered by cutting-edge technology providing full transparency that protects your reputation and your patients.

The e-book, “Closing the 5 Critical Gaps: A Guide to Understanding the Issues and Using Data Technology to Improve Provider Transparency to Protect Patients and Reduce Risk” is available to download here.

As an NCQA Certified and URAC Accredited Credentials Verification Organization, Verisys manages all data reports as a Consumer Reporting Agency abiding by federal law set forth in the Fair Credit Reporting Act. Verisys stores and exchanges data from a Tier 3+ secure environment, assures 99.9+% identity resolution accuracy 99.9+% of the time and assures its promises with full indemnification.

Verisys earned and sustains compliance with two international quality standards, ISO 9001:2015, certified for quality of credentialing software and background screening; and, ISO 27001, certified for highest standards of information security and data protection.

The sum of these certifications and accreditations ensures that promises made are promises kept to the world’s highest standards.

Contact us for a demo of FACIS®, and discuss a staged rollout of screening, verifying and monitoring your entire workforce.
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