Conn. site joins online health journalism world
The Connecticut Health Investigative Team, which has nicknamed itself C-HIT, debuted this week with reports on disciplined doctors who are practicing in the state and how often students in the state’s schools are restrained or secluded, information it got through the state’s Freedom of Information Act.
The site, which will concentrate on coverage of health care, safety and veterans, was founded by Lynne DeLucia, a Pulitzer Prize-winning former editor of The Hartford Courant, and Lisa Chedekel, who was an award-winning reporter at the Courant. Covering Health readers likely remember Chedekel as co-author of the 2006 series “Mentally Unfit to Fight,” about mental health in the military.
The “Data Mine” section of C-HIT’s site will host searchable databases. The first two databases on the site have information about the state’s nursing homes and statewide ambulance response times.
Like other online startups we’ve seen recently, the site will distribute its content through partnerships with media outlets in Connecticut and the region.
C-HIT is part of the Online Journalism Project, founded in 2005 “to encourage the development of professional-quality hyperlocal and issue-oriented online news websites.”
The site is working with students in the journalism program at Quinnipiac University in Hamden, Conn.
C-HIT has received grants from the Ethics & Excellence in Journalism Foundation and the Universal Health Care Foundation of Connecticut.
Other similar ventures include Georgia Health News, Health News Florida, the California HealthCare Foundation Center for Health Reporting, Kaiser Health News, ProPublica, California Watch and others that were collectively referred to as a thriving “new journalism ecosystem” in a recent study.
Elizabeth Edwards fervently urged health care journalists to inform the public
Elizabeth Edwards, wife of former presidential candidate John Edwards, passed away today after her long battle with cancer. She advised her husband on his plan for health care reform and later served as an adviser to Barack Obama.
Elizabeth Edwards spoke about health care reform at Health Journalism 2008.
As the keynote speaker at Health Journalism 2008, Elizabeth Edwards urged journalists to make sure candidates told the truth about their health care plans and that journalists have the responsibility to “make the American voting public more informed.”
Edwards said health care reform is “real life with real life consequences if this is put into place.” She talked about living with her diagnosis and her access to the best medical care but said that, on the campaign trail, she met many women with similar conditions who don’t have the resources and care that she does. “Don’t let those people stand alone,” she told the journalists.
AHCJ President Charles Ornstein, a senior reporter at ProPublica, remembers the event:
“I vividly recall, both talking to Elizabeth Edwards and listening to her speech, the passion she had for health care. She told us how fortunate she was to have good health coverage and implored health journalists not to forget those who were not as lucky. She was spirited, witty and direct. I feel fortunate to have met her.”
By then, her husband was no longer in the presidential race but her fast-paced talk focused mainly on John McCain’s health care plan, which she said would not solve the problems in this country.
She pointed to McCain’s plan to allow health insurers to practice nationwide as problematic because states have widely varying regulations that would allow health plans to be based in states with fewer mandates. She predicted patients would experience issues with pre-existing conditions or have high deductibles.
Read more about Edwards’ talk with links to audio, video and a transcript.
Deal on Medicare reimbursement rates in the works
Politico’s Jennifer Haberkorn reports that, by cutting a deal in which customers will have to return more of their excess insurance subsidies after purchasing coverage on exchanges (beginning in 2014), legislators have found the money to prevent a scheduled cut in Medicare reimbursement rates. The reimbursement rate cuts, much opposed by physician groups, have been extended on a regular basis for some time now. The initial cuts had been designed to reduce government health spending. For more on covering the extensions and cuts, see AHCJ’s tip sheet.
For more on this specific deal, here’s Politico’s Haberkorn again:
Under the health care reform law, if a person gets more of a tax subsidy than they’re eligible for, they’d have to repay no more than $250. Families would have to repay no more than $450.
The deal on the table would raise those caps on a sliding scale based on income. The figures haven’t been finalized yet.The changes would free up about $19.2 billion to cover the one-year Medicare patch, according to Congressional Budget Office estimates.
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The changes would impact about 200,000 people, according to a Congressional aide familiar with the estimates.
Progressive Democrats are expected to push back, Haberkorn writes. For more on the political machinations, head on over to Politico.
Age cited as reason for ‘purge’ in FDA press office
Jim Dickinson of Dickinson’s FDA WebView (paid subscription) writes that some recently ousted FDA public affairs officers claim their terminations appear related to their age. The target of their ire is Beth Martino, appointed FDA associate commissioner for external affairs in March.
Beth Martino
According to Dickinson, Martino “has conducted an unprecedented purge of senior specialists, all aged over 50, in her office and in the Press Office.” Martino was an aide to Kathleen Sebelius when the HHS secretary was governor of Kansas. Dickinson says his sources allege the removals were made to make room for younger people closer to Martino’s own age, which he cited as 31. “She’s uncomfortable with people who know more than she does,” he quoted some of them as saying.
Ira Allen, who was hired in November 2009 as an FDA press officer, writes about his recent experience; he was told to choose between termination and resignation from the job.
The FDA has been under fire on several fronts over the past several years, including a report that concluded the agency “suffers from serious scientific deficiencies and is not positioned to meet current or emerging regulatory responsibilities,” allegations that the agency ignores whistleblowers and requirements that journalists and FDA employees notify or obtain permission from an agency official to conduct an interview.
Covering Health has sent an e-mail requesting comment to Martino and will share any response.
(H/T to GoozNews)
N.M. midwives deliver a model for rural health
We’ve been following Wisconsin State Journal reporter David Wahlberg’s series on the future of rural health in his state, particularly because Wahlberg’s willing to look pretty far afield for examples that put rural Wisconsin in perspective, and which point to possible solutions to local rural health issues. His latest story, on rural midwifery and child delivery, took him to the mountainous areas around Las Vegas, New Mexico. In a way, it seeks to answer the key dilemma raised in the Montana piece: How do you provide care in areas so remote that the population can’t support an obstetrician and delivery facilities?
Photo by adventurejournalist via FlickrMidwives have the potential to at least answer part of that equation, especially when they are used as obstetrician extenders. New Mexico is the nation’s leader in births overseen by midwives. Midwives account for 31 percent of births in New Mexico, a number that dwarfs the 8 percent national average.
Jaymi McKay, New Mexico’s maternal health program manager, said Hispanic midwives have long been a tradition in the state and activists pushed for midwife-friendly laws decades ago.
New Mexico still faces rural maternity care challenges, as 16 of its 33 counties have no hospital that delivers babies, McKay said. But without so many midwives, “it would be a lot worse,” she said. “They fill an important niche. That happens more in New Mexico than in other places.”
In addition to its culture, the New Mexico system stands out for its midwife licensing procedures. Wahlberg goes into greater detail, but here’s the national perspective:
All states offer licenses for nurse midwives. Most private insurers and Medicaid, the state-federal health plan for the poor, pay for their care.
Just 27 states license other midwives - including Wisconsin, which started doing so in 2006. Ten states ban them. Medicaid covers their care in 10 states, not including Wisconsin, and some private insurers cover them.
Wash. health data now includes infection rates
Filed under: Health data, Hospitals, Public records, Tools
Washington state has solidified its position as a leader in health data transparency with the publication this year of hospital surgery infection rates. The data is broken down hospital-by-hospital and includes numbers for the rates of certain infections following cardiac surgery, orthopedic surgery and hysterectomy, as well as for compliance with infection prevention numbers. For more numbers, including some which have been published for several years now, visit the state hospital association’s transparency center.
The unexpected highlight of this year’s data? A press release, pointed out by blogger and hospital executive Paul Levy, in which the Washington State Hospital Association official proudly announces that “Washington’s hospitals are enthusiastic participants in providing this new information about surgical infection rates.” Credit for this transparency lies with state lawmakers, but the hospitals deserve some props for publicly embracing the effort as well.
Initiatives not improving patient safety; poor implementation to blame
Filed under: Health data, Hot Health Headline, Studies
A large-scale study that followed mistakes in health care delivery at 10 North Carolina hospitals from 2002 to 2007 found that, despite state efforts, there was no improvement in patient safety over the time period. According to The New York Times‘ Denise Grady, the problem lay primarily not in design, but in execution. Even when safeguards were in place, they were not followed.
The study, published in the New England Journal of Medicine, reviewed thousands of patient records and looked for any of 54 red flags that something had gone wrong.
Dr. [Christopher] Landrigan’s team focused on North Carolina because its hospitals, compared with those in most states, have been more involved in programs to improve patient safety.
But instead of improvements, the researchers found a high rate of problems. About 18 percent of patients were harmed by medical care, some more than once, and 63.1 percent of the injuries were judged to be preventable. Most of the problems were temporary and treatable, but some were serious, and a few — 2.4 percent — caused or contributed to a patient’s death, the study found.
The findings were a disappointment but not a surprise, Dr. Landrigan said. Many of the problems were caused by the hospitals’ failure to use measures that had been proved to avert mistakes and to prevent infections from devices like urinary catheters, ventilators and lines inserted into veins and arteries.
Problems cited in the study include a lack of electronic medical records, doctors and nurses regularly working long hours and poor compliance with even simple interventions such as hand washing. Proposed solutions include computerized drug ordering systems and a mandatory nationwide monitoring system.
Value-based plans use disincentives, not denials
Filed under: Health care reform, Hot Health Headline
Michelle Andrews at Kaiser Health News is exploring value-based health insurance plans, a growing field that bases its reimbursement rates on how effective it believes certain treatments are. Under these models, for example, things like cholesterol-lowering drugs and help with weight management are provided free, while things like MRIs and back surgery come with hundreds of dollars in added penalties. In other words, instead of denying treatments of dubious efficacy, they keep them available but ask the patient to shoulder more of the burden.
The principle behind it is a familiar one.
A landmark 1982 study showed that as out-of-pocket costs rise, consumers spend less on health care services. But they scrimp not just on care that’s ineffective or unnecessary but also on care that they need, treatment that’s highly effective at addressing their condition.
To help us understand the system, Andrews profiles a recent large-scale implementation in Oregon. She focuses on the disincentives, or “sticks.”
In October, 155,000 Oregon public education employees and their dependents began to experience this stick approach. Their plans already offer carrots: free preventive care and low-cost or free generic drugs for chronic conditions. But starting in October members will be charged an extra $500 if they get services that the state Educators Benefit Board has determined are overused or “preference sensitive” to patient choice, including spinal surgery, knee and shoulder arthroscopy, hip and knee replacement and upper endoscopy exams. Patients will pay an extra $100 for advanced imaging tests and sleep studies.
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People are willing to compromise, says Marge Ginsburg, executive director of the Center for Healthcare Decisions, a Sacramento-based nonprofit that studies how consumers make health care choices. They’re open to “the idea that yes, it’s still available to you, but it’s going to cost you more,” she says.Outright denials, on the other hand, don’t sit so well. “People are really unhappy if you draw a line in the sand.”
New database links journalists, trauma research
There’s a reason the folks from the National Library of Medicine are fixtures at AHCJ events: Medical research is an art that takes years to truly master. In an effort to ease that learning curve, at least in their area of expertise, the Dart Center for Journalism and Trauma has put together a tool they’re billing as “the definitive bibliography of scholarship on journalism and trauma.” The DART Research Database is a thorough list of articles that is easy to sort and sift through.
Browsing a carefully curated selection like this isn’t like punching words into Google Scholar or an NLM tool, there aren’t enough sources to make keyword searches rewarding. Instead, use the database by clicking on “Advanced Search” and narrowing by “Trauma / Survivor Type,” “Psychological Disorders Discussed” or “Article content.”
A note for AHCJ’s student journalists: Choose your favorite category, click the big red “GO” button, and you’ll immediately be the proud owner of all the key secondary sources needed for a sizable paper or thesis. It’s in this sort of academic implementation that the database truly shines. After all, this is fundamentally a database of articles about journalism, not one of articles to use in works of journalism.
Reporter uncovers $86 million from insurers to fight reform
Filed under: Health care reform, Health journalism
The flow of money into politics in general, and health reform in particular, has been thoroughly opaque this election season, yet Bloomberg’s Drew Armstrong has still managed to pull back the curtain and figure out that insurers gave $86 million to the U.S. Chamber of Commerce, which then lobbied heavily to either hamstring reform or to reshape it in the insurers’ favor. Armstrong traced the money to America’s Health Insurance Plans through classic reporting tools: public records and well-placed sources.
Tax forms require organizations to list only the amounts granted or received from other groups, not the organizations’ identities. Health insurers expressed opposition to parts of the health-care legislation while they conferred with congressional Democrats writing the bill and the White House. At the same time, the Chamber of Commerce was advertising its opposition.
The Chamber spent $45.5 million on a campaign against the bill in 2009, according to TNS Media Intelligence/Campaign Media Analysis Group, an Arlington, Virginia-based company that tracks political advertising.
The Chamber began in March 2010, weeks before the bill became law, another $10 million effort focused on pressuring lawmakers to vote against the bill. Blair Latoff, a spokeswoman for the Chamber, wouldn’t say how much of the money was spent in 2009 and how much, if any, was used in 2010.
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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
