NYT Mag takes deep look at data-driven medicine
Filed under: Health care reform, Health data, Hospitals, Hot Health Headline
David Leonhardt, writing for New York Times Magazine, profiles Brent James and Intermountain Healthcare, the hospital network he helps oversee. Idaho native James has turned the Utah- and Idaho-based network into a world leader using data to make positive changes to medical outcomes. James’ basic process is based on the idea that if there’s variation in treatment, then that variation will produce varied outcomes. He and his people track that variation and those outcomes, “identify variation and then figure out which treatments have not been working.”
Leonhardt’s carefully choreographed piece at once runs deep into Intermountain, and wide across the entire health care reform debate, illuminating how evidence-based medicine works and addressing criticism of it. A few highlights:
- Electronic medical records make James’ work much easier, and much more effective.
- Simply presenting doctors with a well-considered default choice, whether it be electronically or in the form of a pre-written prescription they must choose to either sign or discard, can have a significant positive effect on outcomes.
- Intermountain’s statistics are impressive and numerous. One example: “A protocol for dealing with one broad category of pneumonia cut its mortality rate by 40 percent over several years.”
- Dartmouth Atlas father John Wennberg called James’ work “the best model in the country of how you can actually change health care.”
- Intuition, a cornerstone of medical decision-making, has its place but rarely outperforms data-based decision-making.
- Not every implementation of evidence-based medicine will work. It must be done right. This involves heavy administrative oversight and a careful persuasive approach to dealing with physicians.
- Intermountain’s pioneering work is often rewarded by a hit to the bottom line as their hospitals reduce the need for costly (and profitable) additional procedures.
AHCJ welcomes more than a dozen new members
AHCJ welcomes these new members:
- Jennifer Anderson, independent journalist, Falls Church, Va.
- Michelle Booth, reporter, El Tiempo, Las Vegas
- Renita Coleman, associate professor, University of Texas, Driftwood, Texas
- Nancy Cook Lauer, reporter, West Hawaii Today, Hilo, Hawaii
- Vicky Eckenrode, reporter, Star News, Wilmington, N.C.
- Marnette Federis, independent journalist, Seattle
- Holly Hacker, reporter, The Dallas Morning News, Dallas
- Toni Gerber Hope, health director, Good Housekeeping, New York
- Mark Katches, editorial director, California Watch, Berkeley, Calif.
- Anna Mathews, reporter, The Wall Street Journal, Los Angeles
- Nick Mulcahy, senior journalist, Medscape Medical News, Philadelphia, Pa.
- Lisa Stark, correspondent, ABC News, Washington, D.C.
- Christina Ward, independent journalist, Birmingham, Ala.
- John Wilson, student, Virginia Commonwealth University, Richmond, Va.
If you haven’t joined yet, see what member benefits you’re missing out on: Access to more than 50 journals and databases, tip sheets and articles from your colleagues on how they’ve reported stories, conferences, workshops, online training, reporting guides and more. Join AHCJ today to get a wealth of support and tools to help you.
Tribune investigates nursing home psychiatrist
In the latest installment of the Chicago Tribune’s investigation into Illinois nursing homes, Sam Roe and ProPublica’s Christina Jewett investigate Dr. Michael Reinstein, an impressively prolific prescriber who, in 2007, wrote more prescriptions for clozapine (”a potent psychotropic medication that carries five ‘black box’ warnings”) than all physicians in Texas put together.
In that same year, he prescribed medications to 4,141 Medicaid patients. Furthermore, while the average American doctor sees about 35 patients each with, Reinstein sees an incredible 60 patients each day. Reinstein’s workload may have something to do with the fact that he’s the psychiatric director at 13 different nursing homes, but Roe and Jewett write that the ultimate blame lies on systemic problems in Illinois.
Earlier
New slim guide:
Covering the Health of Local Nursing Homes
Check out AHCJ’s latest volume in its ongoing Slim Guide series. This reporting guide gives a head start to journalists who want to pursue stories about one of the most vulnerable populations – nursing home residents. It offers advice about Web sites, datasets, research and other resources. After reading this book, journalists can have more confidence in deciphering nursing home inspection reports, interviewing advocacy groups on all sides of an issue, locating key data, and more. The book includes story examples and ideas.
AHCJ publishes these reporting guides, with the support of the Robert Wood Johnson Foundation, to help journalists understand and accurately report on specific subjects.
Recent workshop
AHCJ’s Aging in the 21st Century workshop, held Oct. 16 and 17 in Miami, addressed many topics raised by the Tribune’s reports, as well as the changing picture of aging Americans and key research and issues related to this growing population. Tip sheets and presentations from that workshop are available to AHCJ members, as are these related tip sheets:
- Aging Nation: Troublesome Health Care Issues
- Headlines an advocate for seniors would like to see
- The impact of aging upon health care
- Covering nursing homes and other issues of aging
- How will retiring boomers affect the national health agenda?
- You Can Run, but You Can’t Hide: Policy and Problems in Long-Term Care
- Biology of Aging: Sources and Resources
Report says food-borne illnesses hit kids hardest
With the Senate expected to consider food safety legislation that gives the FDA additional oversight and enforcement powers, two organizations have turned a spotlight on the issue.
Poll and research data released today from the Make Our Food Safe Campaign and the Center for Foodborne Illness look at the long-term impacts of acute food-borne disease [Summary | Full report] and what the public thinks should be done to improve safety. The Center for Foodborne Illness says its report demonstrates the need for the reform of what it calls America’s “broken” food safety system.
According to CFI’s report, long-term effects are most likely to hit children, the elderly and the immune-suppressed.
The Make Our Food Safe campaign polled four states (Nevada, New Hampshire, North Carolina and Ohio) and found support for the federal government enacting new food safety measures, such as:
- Report tests that show contamination
- Tracing system
- Standards for produce growers
- FDA mandatory recall authority
- Equal food safety standards for imports
- Broad access to food company records
- FDA inspections every 6-12 months
The Make Our Food Safe campaign is a coalition of public health organizations, consumer organizations, and groups representing the families of victims of food-borne illness, including the American Public Health Association, Center for Science in the Public Interest, Consumers Union and others. The Center for Foodborne Illness is a nonprofit organization funded by donations from individuals and corporations, including one that specializes in food safety products and services, as well as the Produce Marketing Association and ConAgra foods.
Related
Hospital says it gives content to short-staffed media
Filed under: Conflicts of interest, Health journalism, Health policy, Hospitals
Lindsey Miller of Ragan Communications Inc., a publisher of corporate communications, writes that Boston’s Beth Israel Deaconess Medical Center has found a way to “spread its message“ – by providing content to the area’s short-staffed television stations. [Update: The link to that article has since been moved behind a pay wall.]
The hospital’s director of marketing communications says she has flipped the problem of reduced local medical reporting due to layoffs to her advantage by providing features and experts to help fill the gap, particularly at TV stations such as Boston’s Fox affiliate.
- For example, Beth Israel’s hand surgery numbers had been down lately, so [director of marketing Rhonda] Mann pitched a four- to five-minute segment on carpal tunnel syndrome, making one of the hospital’s surgeon available to talk about the condition. Now, every month or so, the station brings in someone from Beth Israel to present common health tips. Doing so fills time and gives anchors a topic to promote for the next day.
Mann says stations are looking for health content “because a lot of the first people laid off covered a beat, health in particular. She provides examples of how she helps producers:
- To fill that void, Mann pitches health topics of general interest — such as back pain, headaches, heartburn — and boils them down into five easy-to-remember tips or facts. She also makes it easy for the station by offering to do the work.
A quick search of the WFXT-Boston Web site found a number of stories featuring the hospital’s doctors:
AHCJ left phone and e-mail messages with the station yesterday in an attempt to get its comments. If we hear from the station, we will update this post.
According to the article, Mann also provides health content, from hospital publications, to TuBoston, described as “the largest Spanish newspaper in New England.”
AHCJ and the Society of Professional Journalists have urged news outlets to avoid arrangements with hospitals that improperly influence health coverage, saying unethical partnerships interfere with independent news coverage of health care. That includes broadcasting news or interviews prepared by hospitals.
Slip of the needle brings fallout, tough decisions
Filed under: Hospitals, Hot Health Headline, Nursing
Writing for The New York Times, AHCJ member Sibyl Shalo Wilmont shares the chain of events that followed when she accidentally injected herself with a drop of a patient’s blood.
A quick test showed the patient was likely negative for HIV, but Wilmont still had to decide whether or not to undergo post-exposure prophylaxis, a grueling cycle of treatment that would continue for at least a month. Wilmont had covered post-exposure prophylaxis as a journalist and her knowledge for that helped guide her decision.
BPA linked to problems in factory workers
Scott Hensley, on NPR’s newly christened “Shots” health blog, points us to a five-year study of men who work in Chinese factories that make bisphenol A or use it to make other products.
Photo by How can I recycle this via Flickr
The study found that “Men exposed to high levels of BPA on the job had a much greater chance of sexual problems than men who weren’t.” The factory workers are exposed to much higher levels of BPA than the average American, so research into how low a level of exposure might affect the human reproductive system must be done.
There are concerns that BPA is a threat to human health. Some studies have linked it to cancer, diabetes and developmental damage in animals, while other studies have not found such a link. Meanwhile, researchers have charged that studies showing a link were flawed. And, of course, the laboratory research is limited to animals. The controversy has extended to how the chemical has been covered in the media.
Tracking H1N1 shots, in Texas and beyond
Filed under: Health data, Hot Health Headline, Public health
Jeffrey Weiss of The Dallas Morning News reports that he was able, via an open records request, to get a full list of organizations in Texas that have requested H1N1 vaccines, as well as list of all shipments ordered. The list doesn’t include any public health departments, and is led by large hospitals and mass vaccinators.
On a national scale, the HHS-maintained flu.gov has an updated list of the number of doses of H1N1 vaccine that have been shipped to states, territories and regions thus far. And for your readers or viewers who are trying to get the shots, Google has a flu shot finder map for both H1N1 and seasonal flu vaccines.
Wis. researchers didn’t disclose conflicts to journals
Filed under: Conflicts of interest, Hot Health Headline
Milwaukee Journal Sentinel reporter John Fauber reports that conflicts of interest that local researchers disclosed to the university were not always disclosed when those researchers’ work was published.
Their investigation, a “spot check” of about 40 researchers, uncovered at least nine conflicts, such as the cancer specialist (bio) at the University of Wisconsin who “co-authored a medical article on TomoTherapy, a radiation therapy system developed by researchers at the university.” The article failed to mention that the physician had disclosed the university that he’d make $20,000 in 2008 consulting for TomoTherapy, and that he owned TomoTherapy stock options.
Fauber explores the causes of these failures to disclose conflicts of interest, which include systemic weaknesses in both research and publication and reliance on an “honor system.” He talks a little about his reporting method; it’s the sort of story that can be localized by anyone whose local university has a conflict of interest disclosure policy.
Lieberman: Work got better with blogging
Heath Meriwether of the CUNY Graduate School of Journalism’s Write Stuff blog interviewed AHCJ Immediate Past President Trudy Lieberman about her transition from print outlets (including the Detroit Free Press and Consumer Reports) to blogging on cjr.org.
Lieberman
Lieberman said that once she made the jump to blogs and embraced the new format, her “work only got better.” She let loose and relied on her experience and reporting skills to “cut through the BS and be totally honest.”
The discussion includes a number of technical writing tips for bloggers, as well as a stern reminder that blog posts must be reported just as exhaustively as any other sort of journalism.
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Awards for Excellence in Health Care JournalismDeadline: Feb. 3
- How I did it: Falsified charts in nursing homes linked to patient care
- Access Denied: Looking at a lack of health care availability
- Transparency & medical errors: Public reporting of patient harm is a potent force
- Focus on freelancing: Tips for buying liability insurance
- Why do some patients get stuck in hospitals for weeks, months?
- Investigate health professionals and the boards that regulate them
- Presidents of AHCJ, SPJ call for more openness from Obama administration
