Spotlight on health care quality, measures
Filed under: Health policy, Public health, Studies
The April issue of Health Affairs focuses on the quality of health care in the United States. Some highlights of the issue, which was sponsored by the Robert Wood Johnson Foundation:
- analysis and commentary on improving performance measures
- research that found the methods currently used to gauge patient safety actually missed 90 percent of the adverse events
- the cost of errors and adverse events
- research on measuring quality
- lessons to be learned from other countries
- how pay-for-performance has affected quality
- several case studies of how quality has improved in specific institutions
Those of you who attended Health Journalism 2010 might be particularly interested in an update from Peter J. Pronovost, M.D., who was the keynote speaker at last year’s conference. In this issue of Health Affairs, Pronovost writes about the advances in reducing central line-associated bloodstream infections – which he discussed at last year’s talk.
Remember, AHCJ members receive free access to Health Affairs. If you haven’t already signed up for access, be sure you take advantage of that benefit.
Research into ‘chemobrain’ making progress
In the most recent issue of Cure, AHCJ member Elaine Schattner, M.D., examines “chemobrain,” a term used to describe cognitive changes that some patients experience during and after a chemotherapy regimen.
Schattner interviewed medical professionals and cancer survivors to shed light on “chemobrain,” which isn’t included in the Diagnostic and Statistical Manual of Mental Disorders. She cites several studies that link cognitive decline to both chemo and hormone therapies in men and women.
It took decades for research on chemobrain to gain traction, says Tim Ahles, PhD, a behavioral psychologist who leads the neurocognitive research lab at Memorial Sloan-Kettering Cancer Center. Ahles says investigators have had a tough time applying science to cancer patients with such a range of cognitive complaints and diverse diagnoses. In addition, patients often suffer from accompanying problems, such as anemia, pain, depression and other illnesses that can affect brain function.
Another doctor who has been studying the condition acknowledges that patient advocacy has helped move the research forward. But research is hindered by variations in the forms, doses and regimens of chemo, as well as “the fact that the condition lacks a precise definition and has a variety of symptoms that are subjective and vague.”
Series brings readers’ perspectives to obesity story
Weight loss and obesity stories are a pillar of health journalism and a flashpoint for reader interest, but they have been so thoroughly covered by local and national stories that they generally only hit the headlines when new treatments or alarming obesity statistics bubble up to the fore.
Photo by bookgrl via FlickrWith that in mind, we bring you The (Raleigh, N.C.,) News & Observer’s “Frontiers of Fat” series, which brings together the personal weight-loss perspectives of readers and reporters and up-to-date reporting that explores the current state of nutrition research. By adding local voices and centering the whole thing around a New Year’s Day kickoff, the newspaper created a way to get back to the fundamentals of the nutrition discussion while still creating something newsworthy and relevant.
Speaking of relevance, the newspaper is keeping momentum of the series going with updates on both its staff and reader-contributed weight loss blogs, accompanied by timely yet context-rich news stories. On the landing page, the updates are accompanied by interactive components like a calorie counter and a BMI calculator.
The series also snagged Associated Press Managing Editor’s Innovator of the Month honors for March.
Drug-funded research group failed to disclose ties to makers of painkillers
In his latest conflict of interest investigation, Milwaukee Journal Sentinel reporter John Fauber takes on a challenge that, even by his standards, is an ambitious one.
He attempts to show the effect pharmaceutical money and the local researchers who received it had on national opinions toward powerful prescription painkillers and how it all influenced the American epidemic of opiate abuse.
He focuses on the University of Wisconsin Pain and Policy Studies Group, which has received millions from painkiller manufacturers while publishing drug-friendly research and warning against increased regulation of OxyContin and its ilk. Many of these millions, Fauber found, appear not to have been disclosed in relevant publications even as the group was paving the way for the rapid rise of painkiller prescriptions in America.
The drugs had initially been approved for a very narrow range of uses, but became extremely popular as off-label use for the management of chronic pain spread like wildfire. It’s not easy to draw clean lines between the Wisconsin group and off-label use, but Fauber’s deft investigative work and careful sourcing make a strong case.
Related
An inside view of writing for New York Times’ Magazine
On the blog The OPEN Notebook, New York Times Magazine contributor Robin Marantz Henig spoke frankly with Jeanne Erdmann about everything that went into her piece, “Understanding the Anxious Mind.” A few years have passed since the piece’s publication, which might help explain why the reporter was willing to give such a thorough postmortem.
Highlights include:
- The difference between a magazine article and a master’s thesis.
- How to trick your agent into letting you write a book about Valium.
- Dealing with a jumpy editor spooked by your previous false starts.
- This sentence: “It was difficult to get the right kind of anxious people to interview.”
- The difficulties that even a veteran writer has in pitching New York Times Magazine and the letters to prove it.
- 15-20 drafts, and that’s before the NYT demanded another three or four rewrites.
Coverage of insurance exchanges needs context
Filed under: Government, Health care reform, Health journalism
During the past few days, I have read quite a bit of local coverage about health insurance exchanges from about 10 different states (some “blue,” more “red.”) I was looking for good stories to hold up as an example of what’s at stake here.
New tip sheet
Affordable Care Act: The politics of health care, year two
The Affordable Care Act just hit the one-year mark, but that’s not likely to change the political dynamic in D.C. and many state capitals. Indeed, it may intensify as the 2012 campaign approaches. Following the complex legislative and budgetary procedures in Congress from a distance can be daunting. Joanne Kenen, AHCJ’s health care reform topic leader, has written a brief guide to some of what’s unfolding and likely to unfold in the next year or two.
I did not read every single state story from the whole country so maybe I missed something great. But I did read enough to conclude that most of the stories, unfortunately, were awfully heavy on process. They described political finger pointing: Republicans say no, Democrats say yes, the state legislature equivalent of he-said, she-said . There was very little explanation to readers about what exchanges are, and what kind of decisions states have to make about them , what’s at stake or why the heck the reader should care.
In case you are tempted to say it’s too complicated to explain in a short daily story: Look at Felice Freyer’s March 31 story in The (R.I.) Providence Journal. That is a short daily story, not a big takeout. But see how much context and explanation she was able to weave in with a deft clause here and there.
Sarah Kliff, of Politico, takes a slightly different tack that is also useful. It’s not a policy story, but politics, a state roundup. She makes two good points, which might help some of you covering the politics of implementation in your own state. First, how successful the Tea Party has been in driving the state-level implementation conversation to the right, and second “a widening rift within the Republican party, between those who say states should implement the law, retaining more power as it moves forward, and others who favor completely opting out of a law they because they believe it to be unconstitutional.”
I pulled together some resources about exchanges for the tip sheet on covering the first anniversary of reform. I’ll gather some more for a future update. If you see more good articles on the exchange, let me know by sending a note to joanne@healthjournalism.org.
Presidents of AHCJ, SPJ call for more openness from Obama administration
The presidents of the Association of Health Care Journalists and the Society of Professional Journalists published an op-ed in The Washington Post this morning, criticizing the lack of openness within the Obama administration and calling on officials to improve the flow of information to journalists and the public.
Charles Ornstein
“Democrats criticized the Bush administration for not making decisions based on the best science,” wrote AHCJ’s Charles Ornstein and SPJ’s Hagit Limor. “But the Obama administration now muzzles scientists and experts within federal agencies. When they are allowed to talk about important public health issues, a chaperone often supervises every word. These constraints keep the public from learning whether decisions are science-based or politically motivated.”
AHCJ has been very active in advocating for government openness, including a recent series of meetings in Washington, D.C., with officials from the U.S. Department of Health and Human Services and its related agencies. The organization has urged the FDA to re-examine a policy that prohibits reporters from sharing embargoed materials with sources before the embargo lifts for the purpose of obtaining outside comment and context. Board members from AHCJ also have worked with state health directors to encourage dissemination of more information during public health outbreaks.
“We remain hopeful that our ongoing conversations with HHS and its agencies will help improve the current climate, which isn’t working for journalists or the public,” Ornstein said. “Our members are interested in timely, meaningful responses to their questions, additional access to scientists and health experts, and speedier responses to their Freedom of Information Act requests.”
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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
