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Forum Spring 2019

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ELDD 2.0


The Exam Licensure and Disciplinary Database is a valuable resource for member boards to ensure public protection. This article is based on a presentation by Seif A. Mahmoud, Managing Director of Information Systems, Federation of State Boards of Physical Therapy, at the 2018 FSBPT Annual Meeting.

The physical therapy regulatory community’s primary purpose is to ensure that patients have access to physical therapy care that is safe and provided by competent practitioners.

One of the tools we use to accomplish our public protection mission is the Exam, Licensure, and Disciplinary Database (ELDD), which gathers all of the disciplinary actions that are taken and all of the licenses that are issued by each member board, as well as all of the exam scores that are reported by FSBPT. Having this information compiled in a single dataset gives us a tool that we can use to know more about any practitioner who is licensed to provide physical therapy care.

FSBPT currently offers three primary services using the ELDD:

    • Disciplinary Notification Service
      • A typical disciplinary notification is an email that goes out to your board administrator that indicates that one of your licensees has been disciplined by a board other than yours. Being notified as this happens across the country is a huge benefit to boards and a huge public protection element.

    • Score Reporting Service
      • Every score report issued by FSBPT will have a section for licenses, and a section for disciplinary actions. This includes reports issued for anyone that has just taken the NPTE or has taken a jurisprudence exam or JAM for your state (as long as it is taken through FSBPT) or for a score transfer. So if somebody is endorsing into your state, you’ll still get a score report and it will contain any known licenses and any disciplinary actions that may be out there.

    • National Practitioner Data Bank (NPDB) Agency Service
      • NPDB is a federal government database where every state board has a legal mandate to report disciplinary actions. If FSBPT is your agent and you report the actions to us, we will forward each disciplinary action to the NPDB on your behalf.

Why should member boards participate in the ELDD? There are three main reasons:

    1. You become aware of what your licensees are doing outside your jurisdiction.

    2. Disciplinary actions you take are communicated to other state boards and follow the licensee as they attempt to seek licensure in other jurisdictions. Therefore, they can’t outrun your discipline and move to another state and perform physical therapy services as though they’ve never been disciplined.

    3. We help increase the quality of your data. As you submit data, we’re able to compare it to data for that same person from other jurisdictions. So we could compare data for someone in Washington to their data from Oregon to their data from California—if two of the three have the date of birth as May 1 instead of January 5, we can give you a notification that says, “You might go back and check your records.”

In addition, you also get to back up your data. There are a lot of services out there that sell you cloud storage so you can back up your data and restore it if the need arises. FSBPT is basically providing that service to the member boards for free.

What does a member board need to do to participate in the ELDD?

    1. When receiving a passing exam score, provide the license number that is issued.

    2. Provide a weekly or monthly list of all licenses to update demographic data.

    3. Alert FSBPT to each disciplinary action the board finalizes.

FSBPT built very sophisticated systems and processes that gather this information, sort through it, and identify records that might be duplicates. But that great system needs input (data) from each member board. Over time, we’ve improved participation in the ELDD quite a bit and we’ve started to see the benefits—we’re now working to improve the reliability of the data.

In order to let states know how well they’re working with the ELDD, we’ve developed a star rating system, with five stars being the best. We have twenty-one five-star states as of the 2018 annual meeting. We’ve come a long way and we are here to help member boards improve and maintain good ratings.

We have enough participation from states, and enough data in the database that we can begin thinking about the next generation of ELDD services (ELDD 2.0).

In general, the world is doing a lot more with data now than at any time in history. We’re using data to inform decisions, we’re using data to better understand our world, and we’re using data to forecast the future. We’re seeing significant advancement in the fields of big data, artificial intelligence, and machine learning. And we’ve started to look at these advancements and how each can be used to improve the ELDD and the public protection services it can offer.

Additionally, the physical therapy regulatory landscape has been evolving. One new factor is the PT Compact—to enact the compact we need to have current, reliable data. Additionally, concerning the eligibility requirements for the NPTE, we need high confidence that a person is not assuming multiple identities to take the exam more times than FSBPT or the member board permits.

In a similar vein, if we gather a lot of information from five different states, someone might be licensed in all five of them. But if we don’t have a true identifier that lets us pick out that person’s license in all five of those states, we’re going to bring that data together and there will be five records for that person. And if they’re not tied, we won’t know to notify the other four states if that person is disciplined by one of them.

Managing the licensee’s identity across the member states is very important in this age of mobility, so FSBPT introduced a concept called the FSBPT ID. We need to be able to identify each person from the time they enroll in a physical therapy education program, all the way through their retirement. We tried to use social security numbers and dates of birth, but there are privacy concerns around social security numbers and birth dates are not unique.

That brought us to the FSBPT ID. Unfortunately, some licensees probably have seven or eight different FSBPT IDs—we’re trying to consolidate those into one FSBPT ID per person. Once we get these consolidated, we’ll be able to use the FSBPT ID as the primary identifier going forward.

Any time you introduce a systemic change like this, it takes time to deal with your historical data. Generally speaking, the people who are graduating from PT or PTA school today are only going to have a single FSBPT ID. But the people who have been in practice for many years will likely need to have their records cleaned up. To help with this effort, we’ve introduced a licensee self-service portal. Now, when purchasing an exam or a compact privilege, a licensee will log in using their FSBPT ID and we provide a list of their known licenses for review. We want all of the students and licensees to use their FSBPT IDs when engaging with FSBPT. We have tools on the website to help users find their FSBPT ID and set up passwords.

We are also working to make sure PT and PTA education programs are empowered to issue new FSBPT ID numbers to their students early in their professional education. Program directors are asked to validate graduation, which has become a requirement to sit for the NPTE.

Through this process, each PT or PTA school is creating an account for their students, and that account can live with the student through graduation and through the NPTE. We can then provide that same FSBPT ID to the jurisdictions where they want to be licensed, and that can be the basis of their identity going forward. By creating accounts for each student and letting the ELDD know when each will graduate, we’re able to forecast the number of new PT and PTAs that are expected to enter the profession each year.

Another evolution for all health care professions is the Minimum Data Set (MDS). Initially promoted by Health and Human Services, the objective of the MDS was to collect health care workforce data. It’s a small survey that we hope gets completed at each renewal by each licensee. The idea is that we want to get a better understanding of where each PT or PTA spends their time in practice. We ask each licensee the percentage of time spent serving people of different age groups (pediatrics  through geriatrics) and their practice settings (stand-alone clinic  through hospital). This information allows us to better understand the profession and how our licensees interact with the patient population. We also ask a key forward looking question: Do you expect that your time commitment will increase, decrease, or stay the same in the next year? The answer to this gives us early indicators about future trends.

Finally, we’re also looking at coursework evaluations. This helps us track and assign an FSBPT ID to anyone coming into the profession from a non-CAPTE school. Using this process, we’re able to control the entry points and prevent the creation of additional duplicate FSBPT IDs.

The ELDD is a great tool and we have many efforts in place to collect additional data. But, in order to truly protect the public, we need to use that data. We are in the early phases of analyzing the data and identifying potential trends.

By looking at licenses, compact privileges, and MDS data, we should be able to identify shortages and surpluses, both across the membership and within certain areas. Unlike individual jurisdictions, FSBPT can look at border areas. For example, maybe we can see that even though North Dakota has no licensees in southern counties, South Dakota has a surplus of licensees next to those counties. Therefore, we’re able to support policy decisions through research in support of our mission to protect the public.

 

Seif A. Mahmoud

Managing Director of Information Systems, Federation of State Boards of Physical Therapy

Seif A. Mahmoud is responsible for overseeing the Information Management and Technology assets of the Federation of State Boards of Physical Therapy (FSBPT), the Foreign Credentialing Commission on Physical Therapy, and the International Network of Physiotherapy Regulatory Authorities. His education includes a Bachelors of Science in Information Systems from the University of Texas at Arlington. Prior to joining the FSBPT staff in 2002, Seif provided consulting services in the fields of electronic commerce, web-based corporate operations, and business partner integration.

 

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