Welcome to AHCJ’s newest members
AHCJ welcomes these new members:
- Deborah Brauser, independent journalist, Clermont, Fla.; @DeborahBrauser
- Shirley Brott, writer, Neonatal Network, Flower Mound, Texas
- Margaret Downing, editor, Houston Press, Houston, Texas
- Debra Dreger, independent journalist, Brandamore, Pa.
- Kristina Fiore, staff writer, MedPage Today, Elmwood Park, N.J.; @kristinampt
- Sara Gambrill, senior editor, CenterWatch, Boston, Mass.
- Beth Howard, independent journalist, Charlotte, N.C.
- David Jackson, reporter, Chicago Tribune, Chicago, Ill.
- Amy Jeter, staff writer, The Virginian-Pilot, Norfolk, Va.
- Jonathan LaPook, medical correspondent, CBS News, New York, N.Y.; @DrLaPook
- Fran Lowry, independent journalist, Palm City, Fla.
- Jennifer Palter, editor-in-chief, Lupus Now, Washington, D.C.
- Ron Shinkman, editor, Payers & Providers, Burbank, Calif.
- Rebecca Voelker, associate managing editor, JAMA Medical News, Chicago, Ill.
- Vanessa Wells, editor, Beson4 Media, Jacksonville, Fla.
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.
Employers, insurers, consumers agree on COBRA
The Miami Herald’s John Dorschner looked into just how much of a hassle it is for laid-off employees to retain health coverage through the federal COBRA program. Along the way, he also noted that the program’s not popular with employers or insurers either.
Dorschner opens with an anecdote that shows just how broken the system is and illustrates the frustrations many are facing.
The Rosens’ case is an extreme example of something that’s happening frequently throughout South Florida: Laid-off workers are struggling through a difficult maze to keep health insurance while insurers and former employers have no interest in helping them beyond what federal and state laws require.
For employers, COBRA means unwanted paperwork and bureaucracy. For insurers, it means unwanted risk.
A key problem for insurers is that young and healthy employees who are laid off tend to reject COBRA, while older and sicker workers grab it. “Typically those who take COBRA coverage cost two to five times [[more] in benefits than a normal employee costs,” LeCompte says.
Despite its flaws, COBRA is seen to provide an important safety net, and the 65 percent federal subsidy for COBRA coverage has been extended to cover those workers laid off before March 1, 2010. Furthermore, the House version of the reform package, at least, has a provision saying that folks could retain their COBRA coverage at least until federal insurance exchanges begin sometime around 2013.
Reports on cold-weather morbidity, mortality
Always one to stay on top of the latest news trends, Poynter’s Al Tompkins takes on the extremely cold weather much of the nation has been experiencing. Tompkins includes some relevant studies and data sets from the CDC’s Morbidity and Mortality Weekly Report, in a bulleted list at the very end. Here, we’ll take a slightly deeper look at some of Tompkins’ selections.
Carbon Monoxide Poisonings Associated with Snow-Obstructed Vehicle Exhaust Systems — Philadelphia and New York City, January 1996 (MMWR 1996; 45(01);1-3.)
According to the review, “Most of these poisonings occurred among children and elderly persons and resulted from exposures in idling automobiles with exhaust pipes blocked by snow.” During one two-day stretch, 21 people who had been found unconscious in running cars were brought to the Jacobi Medical Center in New York. In that spirit, the investigators look at the individual cases of a 4-year-old girl (left in the car because her family thought she was napping), and two older men. In all cases, their primary mistake seems to have been in starting cars surrounded by deep snow without making any attempt to remove the snow first.
Photo by Buzz Hoffman via Flickr
Snow-Blower Injuries — Colorado, New York (MMWR 1983;32(6):77-78.)
The takeaway from this article? Using your hands to clear a snowblower’s clogged exit chute is probably not a good idea.
Public Health Impact of a Snow Disaster (MMWR 1982;31(51):695-696.)
A review of studies related to 1978 storm in New England found that, during the blizzard, mortality rates didn’t increase significantly (though a third of the deaths that did happen were classified as storm-related), and that emergency room visits declined to less than half their normal levels. Hospitals also had supply problems because they could not discharge patients.
To solve these problems, the authors recommend that officials ask folks not to drive during storms (and to bring emergency supplies if they do), and to create a “rumor clearinghouse” to investigate reported hazards and outbreaks. They also suggest that overcrowded hospitals can use emergency vehicles to bring discharged patients home.
Unintentional Carbon Monoxide Poisoning Following a Winter Storm — Washington, January 1993 (MMWR 1993; 42(06);109-111.)
Most of the 44 patients studied were members of ethnic minority groups, and half didn’t speak English. In 65 percent of the cases, the cause was burning charcoal briquettes. All those incidents, the study noted, involved racial/ethnic minorities.
Work-Related Injuries Associated with Falls During Ice Storms, January 1994 — National Institutes of Health (MMWR 1995; 44(49);920-2.)
The review found that, during ice storm season, workers tend to fall outdoors more often than usual. Slightly more interesting is that the workers in this study were NIH employees on NIH campuses.
Report looks at disclosure of adverse events
Filed under: Government, Health data, Pharmaceuticals, Public records
Adverse events that harm patients are publicly reported unevenly, according to a report from the inspector general for the Department of Health and Human Services.
The report reviewed the public disclosure of the information by state adverse reporting systems, patient safety organizations and the Centers for Medicare & Medicaid Services. As the report points out, reporting such events can help educate health care providers about why such events happen and how to prevent them.
The report (Adverse Events in Hospitals: Public Disclosure of Information about Events OEI-06-09-00360) does highlight seven state systems that are disclosing more information than others: Maryland, Massachusetts (both the Board of Registration in Medicine and the Department of Public Health), Minnesota, New Jersey, Oregon and Pennsylvania.
The inspector general points to those systems as models:
The disclosure practices of the seven State systems with more extensive disclosure can serve as models for other entities. These systems disclose analysis of the causes of events, evidence-based guidance for reducing occurrences, and information about demonstrated improvements by hospitals. This type of information, if disseminated by other State systems and entities that receive adverse event information, could help to improve patient safety.
The report provides some useful information for journalists about what information is publicly reported and AHCJ is, of course, gratified to see a government report that advocates public disclosure of patient safety information.
Cheryl Clark of HealthLeaders Media wrote about the report.
Residents put dispute with Bronx hospital online
Interns and residents at St. Barnabas Hospital in the Bronx are attempting to formally organize in response to what they believe are poor, unacceptable working conditions.
As part of their effort, they have launched “Examining St. Barnabas,” a site that solicits community input, rounds up (mostly unfavorable) coverage about the hospital and adds a sort of disgruntled-employee spin to St. Barnabas-related issues. It’s an interesting nexus of special interest and community service, as well as a window into the workings of a sometimes troubled hospital. The effort also has a presence on Twitter as @examinebarnabas.
FDA documents for most-popular drugs not online
Filed under: Government, Pharmaceuticals, Public records
Nancy Watzman, writing for the Sunlight Foundation Reporting Group, has found that, because the Food and Drug Administration only makes approval background documents available for drugs approved after 1997, safety and efficacy information for nine of the 25 most-prescribed drugs is not available online.
The article points out that doctors base their treatment decisions on information in peer-reviewed articles, where drug companies have little incentive to publish negative information. The studies the FDA uses to make approval decisions, however, may have more complete and balanced information that would be useful to doctors and consumers.
Watzman reports that the FDA apparently receives such documents electronically, then prints them out, redacts them by hand (using white out!) and then scans them and saves them as PDF documents that are not searchable.
The report includes a list of the 25 most-prescribed drugs and highlights those for which FDA review documents are available online.
Agency releases latest ‘Profile of Older Americans”
The U.S. Department of Health and Human Services Administration on Aging has released the 2009 version of “A Profile of Older Americans” (PDF), a summary of data taken from the Census and NCHS. 
This year’s version focuses heavily on the demographic’s growth, but includes something for everyone.
Skip to page 3 if you’re just looking for the ever-popular list of interesting numbers related to the 65-and-over set, or check the following page for the narrative version. Highlights include a map marking states based on “Persons 65+ as a percentage of total population” (it’s lowest in Alaska and Utah and increasing rapidly throughout the Mountain West), state-by-state 65+ population numbers, and health insurance coverage numbers.
You’ll even find numbers on poverty, caregivers and breakdowns of the numbers of elderly Americans who are limited in walking, eating, bathing, dressing, etc.
NYT’s Schwarz discusses football concussion beat
For the Columbia Journalism Review, Brent Cunningham talked to The New York Times‘ Alan Schwarz about his work as the nation’s leading (and probably only) full-time football head injury reporter. Schwarz, whose work covering concussions brought him to the Times in 2007, talks about how he got started on the beat and how his work has impacted the sport as a whole.
It’s all interesting stuff, especially when he discusses how his background in mathematics has helped him report on sports injuries and medicine, but the real payoff comes when Cunningham finally gets Schwarz to divulge his personal stance on concussions in youth football. It’s a crystallization of all Schwarz has learned, as well as a delicate balancing act between his personal and professional ethics.
Photo by Eagle102.net via Flickr
CJR: Let’s assume for a minute that your son, who you said is three years old, is actually ten years old and he is clamoring to play Pop Warner football. Would the fact that you would then have to decide disqualify you from covering the story?
Schwarz: No, it wouldn’t disqualify me, though of course that’s up to my editors. But there is something about working here—and I’m not saying we’re better than everyone else, blah, blah, blah—but there is something that really inspires you to do the right thing, and to do the thing that helps you to cultivate the trust that allows readers to take you seriously. So I would probably let him play because if I didn’t it would compromise the reporting. It would compromise the trust that others and even the league may have in me. Now, I would not send him out to slaughter, but getting one concussion is not that big of a deal—it just isn’t. And to suggest otherwise is incredibly irresponsible. So if my kid gets one concussion then yeah, he doesn’t play anymore probably. But to not allow him on the field is, frankly, an overreaction. And if I didn’t allow him to play then yeah, it would be harder to cover the story, if only in my own mind. I believe that the cost to others of my not being able to cover this story as well would be greater than the cost of my kid getting one concussion and never playing again. I’m a very mathematical guy. I follow certain precepts. And those are the things that make sense to me. And I can’t tell my kid he can’t play, because then what am I going to tell the league? What am I going to tell my editors? It doesn’t work. It’s dissonant.
Related
- Tip sheet: Concussions in young athletes
- Tim Tebow’s head fuels concussion debate
- Technology in play to help make football safer
- Brain damage caused by football is cumulative
- ‘Playing through’ concussions is damaging
Federal EMR budget slashed, switchover delayed?
Fred Schulte and Emma Schwartz have put together the latest installment in the Huffington Post Investigative Fund’s ongoing look at electronic medical records, this one focusing on how budget cuts could make it more difficult to meet the administration’s targets for nationwide adoption of electronic records.
In May, budget officials estimated they would spend up to $47 billion in stimulus money to help doctors and hospitals purchase the systems. But in a press briefing on Wednesday, officials said that figure had been chopped nearly in half to between $14.1 billion and $27.3 billion.
A program like this has never been done on this national scale,” Tony Trenkle, who directs the office of e-health standards and services for the federal Centers for Medicare and Medicaid Services, told the Huffington Post Investigative Fund in an interview.
Lack of vaccinations may hurt ‘herd immunity’
USA Today’s Liz Szabo writes about experts’ fears that unvaccinated children will lead to outbreaks of some infectious diseases.
Experts say that parents may be reducing children’s “herd immunity” – keeping germs out of circulation by vaccinating kids. As an example, Szabo tells the story of one child who has a rare immune deficiency and developed meningitis.
Thanks to the success of vaccines, few parents today know anyone who has become sick with a serious contagious disease, says William Schaffner, an infectious-disease expert at Vanderbilt University School of Medicine. Instead, parents are often concerned about chronic illnesses, such as asthma, allergies or autism, which don’t have a clear cause.
Szabo cites statistics from The New England Journal of Medicine that show the number of children who are exempt from immunization requirements has gone up 50 percent from 1991 to 2004.
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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
