Grassley blasts HRSA over data removal after seeing letter exchange with doc
Filed under: Government, Health data, Health journalism, Public records
The action taken by the U.S. Health Resources and Services Administration to remove the public version of the National Practitioner Data Bank came only after the urging of a Kansas neurosurgeon with a long history of malpractice payouts, according to records released Thursday by U.S. Sen. Charles Grassley.
The doctor, Robert Tenny, sent six letters to HRSA both before and after the Kansas City Star wrote a story that said he had been sued at least 16 times for malpractice and had paid out roughly $3.7 million since the early 1990s.
Grassley blasted HRSA for making a hasty decision to remove the data bank’s Public Use File from its website without doing independent research and he called for its immediate restoration.
“Instead of conducting its own research into the professional conduct of Dr. Tenny, HRSA appears to have over reacted to the complaint of a single physician based on no evidence other than that he received a call from the press,” Grassley wrote Thursday in a letter to Health and Human Services Secretary Kathleen Sebelius.
The documents released by Grassley also show that HRSA warned 28 hospitals and health plans throughout Kansas about discussing the data bank records of Tenny following the doctor’s allegation that a hospital must have leaked information about him to Star reporter Alan Bavley.
The National Practitioner Data Bank is a confidential system that compiles malpractice payouts, hospital discipline and regulatory sanctions against doctors and other health professionals. For years, HRSA has posted aggregate information from the data bank in a Public Use File that did not identify individual providers.
HRSA officials removed the public file from the data bank website on September 1 because a spokesman said they believe it was used to identify physicians inappropriately. The Association of Health Care Journalists has protested the action, along with Investigative Reporters and Editors, Society of Professional Journalists, National Association of Science Writers, Reporters Committee for Freedom of the Press, and National Freedom of Information Coalition.
Grassley released the documents Thursday in response to a letter he received from HRSA administrator Mary Wakefield.
Among them was an email showing that the data bank’s director quickly notified Tenny’s lawyer about a letter she sent to Bavley threatening the reporter with civil penalties if he ran a story based on information from the data bank. Cynthia Grubbs, director of HRSA’s division of practitioner data banks, forwarded the letter to Tenny’s lawyer, Charles R. Hay, less than three hours after sending the warning to Bavley. (HRSA subsequently backed off its threat against Bavley.)
“HRSA’s response makes it apparent that HRSA simply accepted the complaint of the physician involved at face value and jumped to conclusions about how Mr. Bavley obtained the information,” Grassley wrote. “Once HRSA learned of its mistake, it then compounded the error by shutting down access to information that Congress intended to be public” through the Public Use File.
“All Mr. Bavley did was use publicly available data, and HRSA’s response to that was to shut down access to that data for everyone,” Grassley wrote.
AHCJ President Charles Ornstein, responding to the documents Grassley released Thursday, reiterated his call for HRSA to republish the Public Use File immediately.
“We are past due for HRSA to acknowledge its mistake, apologize and restore access to this file on its website,” he said. “Journalists have used this information responsibly for years to write about questionable physicians, and their stories have led to new laws and regulations that have improved patient protections.”
Ornstein also said the documents released by Grassley “raise troubling questions about HRSA’s due diligence before taking this major action.”
According to the documents, Tenny repeatedly wrote Grubbs, questioning the motives of a hospital that he contends hired a publicist to try to destroy his career and impugning Bavley.
In another letter, he alleged a “coordinated attack.” And in another, he told Grubbs to “stay strong and keep up the good work!”
In response, Grubbs wrote Tenny on Sept. 26, saying, “We have contacted the hospitals and health centers…who have queried on you in the past 6 years to remind them of the confidentiality requirements and the sanctions for violations of confidentiality. We instructed the hospitals to examine their records and report back to us with any potential confidentiality breaches. We will act swiftly to investigate any potential violations of confidentiality.”
In her letter to Grassley, dated Tuesday, Wakefield said HRSA is working toward “a solution that meets its responsibilities regarding confidentiality under the Data Bank statute while reflecting its commitment to facilitating important research.”
“Our goal is to make as much information available as soon as we can, but we do not have a specific timeline at this point,” she wrote.
In addition to calling for restoration of the public file, Grassley asked for an immediate briefing by the HRSA official responsible for the decision to remove it in the first place.
Mass. health journalism fellows named
Ten journalists were named to the 2009 class of the Health Coverage Fellowship sponsored by the Blue Cross Blue Shield of Massachusetts Foundation.
Fellows include: Jennifer Berryman, WCVB-Boston, Ceci Connolly, The Washington Post; Andy Dworkin, The Oregonian; Latoyia Edwards, New England Cable News; Megan Hall, WRNI-Radio, Providence, R.I.; Josie Huang, Maine Public Broadcasting; Ralph Jimenez, Concord (N.H.) Monitor; Aaron Nicodemus, Worcester, Mass., Telegram & Gazette; Sacha Pfeiffer, WBUR-Radio, Boston; and Lisa Wangsness, The Boston Globe.
The fellows will focus on health care issues ranging from uninsured to mental illness, ethnic and economic disparities and environmental health. They’ll also examine public health scares, such as avian flu.
The program, led by former Globe reporter Larry Tye, runs for nine days starting Friday at Babson College’s Center for Executive Education in Wellesley. Other supporting organizations include Maine Health Access Foundation, New Hampshire’s Endowment for Health and the Northwest Health Foundation.
Obama picks Daschle to head HHS
Former Senate Minority Leader Tom Daschle (D-S.D.) has accepted the position of Health and Human Services secretary in the coming Obama administration, Roll Call quotes Democratic sources as saying. Daschle was also considered for White House health care czar, reports Politico, but the Obama transition team thought he could be more effective with secretary status. “Of all the proposals that Obama wants to enact, health care requires the most input and tough negotiations,” one of the Democratic officials said. “No one knows the House and Senate like Tom Daschle.”
Tom Daschle
If confirmed, Daschle will replace Mike Leavitt in overseeing a $707 billion budget and 64,000-plus employees across numerous government agencies and health programs. Reporters can always check out his book, “Critical: What We Can Do About the Health Care Crisis,” published in February, for clues as to his thinking.
Update: Jacob Goldstein of The Wall Street Journal’s Health Blog offers a summary of Daschle’s views on health care as expressed in his book, “Critical.”
Pharmaceuticals scared of online social media
Jim Edwards writes in Brandweek about why pharmaceutical companies have avoided online social media, such as bulletin boards, chat rooms and blogs, and the pressure to change. Drug companies worry that “user-generated content will include complaints about injuries caused by their drugs’ side effects. The law requires these “adverse events” to be reported to the FDA. The FDA’s adverse-event databases are regularly combed by lawyers looking for potential class-action suits.” Brand managers find themselves caught between the legal and regulatory departments and the marketing agencies. One marketer says companies must change attitudes that have said “there’s safety in ignorance” and instead must embrace ways to look for adverse events.
LA reporting team moves to New York
Charles Ornstein and Tracy Weber have taken their award-winning partnership to ProPublica as senior reporters. The duo helped deliver a Pulitzer Prize in public service journalism to the Los Angeles Times in 2005 for coverage of poor management and dangerous care at King/Drew hospital.
Ornstein
Now, they’ve written about gaps in the oversight of nurses with criminal records in California—a collaboration between ProPublica and the LA Times. Says Ornstein about moving into the nonprofit journalism world: “It’s not as different as you may think. I’m working with extremely talented colleagues, and everyone here is committed to accountability journalism. Hopefully this is a way forward for our industry.”
Racial/ethnic health disparities among disabled
A study in the Oct. 3 edition of the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report (MMWR) highlights findings on the health of people with disabilities. The study shows that among adults with a disability, black, Hispanic and native Americans report fair or poor health at higher rates than white and Asian Americans. Overall, adults with a disability were less likely than those without disabilities to self-report excellent or very good health (27.3% vs. 60.3%), and more likely to report being in fair or poor health (40.1% vs. 9.8%). The study used data from the 2004-06 Behavioral Risk Factor Surveillance System (BRFSS), the largest telephone survey conducted annually by each state and territory’s health departments. Access the full report online.
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