Administrators in Medicine
Common Verification Committee
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Members of the AIM Common Verification Committee
History and Mission of the AIM Common Verification Committee
The CVC was formed after the discussions at the October 22-23, 2002 AIM Fall Meeting in New York City. An agenda topic at the meeting on October 22nd was e-Verifications and Uniform License Verification Form. The comments of the AIM members attending that session ultimately resulted in the need to form the Committee.
Survey Analysis and Recommendations
A board that receives an application for licensure from an individual previously licensed by one or more state medical boards requires verification from each board of the applicant’s licensure status in that jurisdiction. Two elements assure a verification that is most helpful to the receiving board: the sending and receiving boards exchange information on the correct individual and disciplinary information is shared fully.
Boards, in general, are seeking ways to expedite the verification process to save money and improve the speed of licensure. This was the motivation for commencing the Common Verification Committee and for initiating the survey.
The Common Verification Committee survey was initially sent by e-mail to 69 state boards of medicine and osteopathic medicine. Forty-eight medical and/or osteopathic medical boards responded, giving a 70 percent response rate.
This full report of the committee is based on the survey and is divided into five sections that include findings, conclusions and recommendations for consideration by the Board of Directors; the report concludes with overall comments. Only the committee’s recommendations are presented in this report.
The committee’s report was broken into five sections:
I Contact Information on Verification Staff
II Verification Data Elements
III Disciplinary Information of Supporting Documentation
IV Processing Verifications
V Security Concerns with Electronic Verifications
VI How Boards Described an Ideal Verification System
The specific recommendations under each section of the report follow.
I. Contact Information on Verification Staff – Recommendations
1 A spreadsheet with each board and its licensure and verification staff information should be shared with all boards’ licensure staff via e-mail.
2 The attached spreadsheet is available electronically and could be e-mailed to boards.
3 Such a spreadsheet should be updated at least annually; however, it is unclear who would take on this responsibility.
II. Verification Data Elements – Recommendations
1 Minimal data elements should include: name, address, date of birth, license number, license status, issue date, expiration date.
2 The addition of date of birth to the data elements shared on verification would significantly improve the likelihood that the sending and receiving boards are sharing information on the same individual. A birth year would be preferable over no date. If boards feel it necessary, they could seek permission from an applicant to share this information with another board.
3 Boards should consider adding other helpful information, e.g., last name under which licensed, current name if different, and other licenses held.
4 Data on verifications that do not include birth date or social security number should be checked closely with other corroborating information, e.g., AMA profile, to be certain that information has been exchanged on the correct person.
III. Disciplinary information or supporting documentation - Recommendations
1 Boards should make it clear on their verifications if information during certain dates is unavailable.
2 Boards should make it clear on their verifications what information that they do not share.
3 Boards should ideally share all informal discipline, e.g., letters of concern; states unable to share this information should pursue legislation that would allow this exchange.
4 Boards should ideally share investigative information; boards unable to share this information should pursue legislation that would allow this exchange.
5 Boards should share, at a minimum, copies of their public records with each verification.
6 Boards that require another board to submit a special request to receive public records and/or investigative or disciplinary information should consider the following:
a. Getting rid of the requirement if it is not absolutely necessary.
b. Requesting the other department within the same state to send the needed documents to
the requesting board. The requesting board would be saved considerable time and expense
of having to make another request
c. If a special language is necessary on the verification request to get all of the supporting
documentation, making this information known to other states so they can add it to their
IV. Processing Verifications – Recommendations
1 Method of requesting verifications
a. Electronic requests, e.g., e-mail, on-line forms or systems, with credit card payment or
without charge are the fastest way for a physician to request a verification.
b. Boards should accept credit cards as an acceptable payment mechanism if at all possible.
c. Boards should be encouraged to accept any form of request for a verification and eliminate
processes that are unique to the individual board.
2 Time required to process a verification to another board
a. AIM should encourage boards to make verification a higher priority.
3 Electronic transmission of verification information
a. AIM should assist states in understanding the ramifications of electronic transmission of
verification information and in overcoming the weaknesses and barriers.
4 Fees and loss of revenue
a. Boards should become more aware of the role of the fee in revenue generation.
b. AIM should pursue options for verification that would reduce processing time, regardless of
the effect on revenue.
5 Frequency of updating on-line data
a. Boards should be encouraged to provide data that are less than one week old on paper
verifications and on the boards’ websites.
b. Paper verifications and on-line data on a boards’ websites should indicate when the data
were last updated.
c. Boards whose website is hosted by AIM can update their data daily.
V. Security Concerns with Electronic Verifications – Recommendations
1 A unique identifier would assist boards in assuring that an electronic verification is actually coming from another board and that data have not been changed en route.
2 Digital ID’s or digital certificates could be used to address concerns of elimination of the use of a seal, signature, and notary, for the assurance of the authenticity of the data.
3 Encryption of documents en route would insure that non-public data would remain secure while en route to another destination over the net. (Entrust is a well-known security company that could provide such security solutions. Internet explorer 6 has 128 bit encryption built into its programming to add additional security as well.)
4 Boards should look at the accuracy and currency of data on their website as an ongoing board responsibility to other state boards and see that is assigned to personnel for maintaining records and equipment.
5 Securing particular sections of the website and deciding what information to post and what information should not be posted would help to limit the harvesting of information for illicit purposes. Also, having password-protected access will provide more security.
6 Boards should establish standards for software, equipment, and scanning methods that protect the board’s site from virus attacks and hackers.
VI. How Boards Described an Ideal Verification System – Recommendations
1 AIM should add verifications to the Golden Rule and encourage boards to make verification of licensure a priority. Paper verifications should be processed within five days.
2 AIM should encourage boards to make credit card payment available if a verification fee outside of the application for licensure fee is involved.
3 AIM should encourage boards to put their public disciplinary records on-line so that other boards can retrieve the data.
4 AIM should facilitate the organization of a self-selected group of boards that want to send/receive verifications electronically and that group’s exploration of the issues involved. AIM should have this group report their findings to the membership.
5 AIM should facilitate the organization of those boards that utilize data on other boards’ websites for verification purposes to identify the strengths and weaknesses of the systems. AIM should assist this group in reporting to the membership of their findings.
6 AIM should explore technology options that would support utilization of state-based data, e.g., through Docfinder, but rely on a centralized method for accessing the data. Authentication and security issues of such a system should be addressed.
The Common Verification Committee’s Overall Comments
Boards have clearly moved beyond the Committee’s original intent of identifying a common verification form. Boards are open to considering electronic alternatives for verification; however, no clear path is emerging. The strongest two alternatives to paper verifications appear to be 1) accepting the data another board has on its website or 2) pursuing a board-based, web-based approach through AIM. It is clear that further study is essential. Not only the technology should be explored but also the issues of authentication and security. Universal adoption of one or two electronic solutions for boards will rely on the ease of use; accuracy of the data; the availability of disciplinary information; the balance between the cost and savings as it relates to the technology, staff time and lost revenue; and a board’s sense of control.
Proposal of an Ideal Licensure Verification System:
A Board-Based, Web-Based Approach
The Common Verification Committee presents its proposal for the ideal Licensure Verification System.
A Creation of a central data bank of license information.
Licensure verification information would be disseminated from a central data bank rather than from the individual licensing boards.
B The transmittal of information to and from the central data bank would be fully electornic.
C In order to participate, the boards would need to meet certain standards, including:
1 Each board must be able to transmit information to the LSDB on a daily basis.
2 That information must be upgraded on a daily basis or in real time.
3 The following minimum identifying information must be provided by the for its licensees: name, address, date of birth, license number, license status, issue date, expiration date.
4 The boards would provide an explanation of the data they have submitted i.e., what is included or not included regarding disciplinary actions, pending actions, and investigations.
5 The boards would provide a statement certifying that the information which is obtainable from the central data bank is exactly the same information as would be released directly from the board’s office.
6 The information submitted by the individual state boards would include copies of all relevant documents pertaining to the disciplinary or licensure actions it has reported.
D Upon submitting an application for a license in a particular state applicants would be instructed to contact the central data base to verify the status of their past and current licenses. This verification would, of course, include a complete license history including license denials and withdrawals.
E The applicant would provide the central data bank with a list of all the states where the applicant has ever applied for a license.
F The applicant would pay a set fee per verification that would include a small fee per verification to support the central data bank.
G The applicant would pay by credit card.
H The central data bank would immediately transmit licensure verification information to the state
board where the applicant is seeking licensure.
I Once each month the central data bank would issue a check to each state board whose data was accessed during the proceeding month. The state board would receive the verification fee less a percentage to be retained by the central data bank to fund its operation. (E.g., $25 verification fee to the physician, $20 of which is paid to the state queried and $5 retained by the data bank as operations costs.)
A schematic of the structure of the Central License Data Base follows: