Public records shed light on Texas blood samples
Filed under: Health data, Health policy, Hot Health Headline
The Texas Tribune’s Emily Ramshaw got her hands on almost a decade of public e-mails that help show the thoughts and intentions behind the state’s decision to store infant blood samples without parental consent. She also uncovered a previously undisclosed “transfer of hundreds of infant blood spots to an Armed Forces lab to build a national and, someday, international mitochondrial DNA (mtDNA) registry.”
Photo by valleyboy74 via Flickr
Ramshaw published PDFs of the e-mails alongside her story (E-mails, part 1 | E-mails, part 2).
Ramshaw’s report follows officials’ intricate dance around the issue of parental disclosure, as well as their reluctance to publicize the warehousing of the blood samples. Here’s her summary:
For decades, the state has screened newborns for a variety of birth defects, pricking their heels and collecting five drops of blood on a paper card. Until 2002, the cards were thrown out after a short storage period. But starting that year, the state health department began storing blood spots indefinitely, for “research into causes of selected diseases.” Four years later, DSHS began contracting with Texas A&M University’s School of Rural Public Health to warehouse the cards, which were accumulating at a rate of 800,000 a year. State health officials never notified parents of the changes; they didn’t need consent for the birth-defect screening, so they didn’t ask for it for research purposes. The agency’s rationale was that it let parents who asked opt out of the newborn blood screening and de-identified all of the samples before shipping them off.
According to Ramshaw’s sources, baby blood spots are “incredibly valuable” to researchers, and can be useful even when stripped of all identifying information. Yet public perception doesn’t line up with this scientific value in part, Ramshaw says, because scientists are unwilling to even try to explain the use of blood spots because it’s such a controversial topic.
Fortunately, Ramshaw writes, the first steps toward educating the public are now being taken. Parents are being asked for their informed consent when the blood samples are taken, and the state health agency has made a clean break with the past by destroying the earlier blood spots collected without full consent.
Report measures health factors at county level
Filed under: Health data, Health policy, Public health, Studies, Tools
A county-by-county collection of reports set to be released tomorrow could be a good source for local data on a number of health factors. The County Health Rankings, a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, is the first of what is expected to be an annual look at health within each state.
The rankings will “show how counties measure up within each state in terms of how healthy people are, how long they live, and how important factors affect their health, such as tobacco use, obesity, access to healthcare, education, community safety, and air quality,” according to a press release.
A Feb. 17 briefing will include experts representing public health, health policy, education, and business who are expected to discuss the rankings and ways that communities can become healthier. The briefing, which starts at 9:30 a.m. EST, will be webcast. You can RSVP for this event online and a link will be sent to those who RSVP as soon as it’s available. For those in Washington, D.C, the briefing will be at the Columbus Club at Union Station, 50 Massachusetts Ave. NE - you also will need to RSVP.
Speakers are expected to include:
- Risa Lavizzo-Mourey, M.D., M.B.A., President and CEO, Robert Wood Johnson Foundation
- David R. Williams, M.P.H., Ph.D., Norman Professor of Public Health, Harvard School of Public Health
- Patrick Remington, M.D, M.P.H., Associate Dean for Public Health, University of Wisconsin School of Medicine and Public Health
- Andrew Webber, President and CEO, National Business Coalition on Health
- Judith A. Monroe, M.D., FAAFP, State Health Commissioner, Indiana State Department of Health
- Donald Shell, M.D., M.A., Health Officer, Prince George’s County Health Department
(Full disclosure: The Robert Wood Johnson Foundation is one of a number of organizations supporting AHCJ’s educational efforts.)
Update
See how many news organizations have covered the rankings.
Gawande, Google and health systems analysis
Filed under: Government, Health data, Health policy, Hospitals
Earlier this month, New Yorker writer and surgeon Atul Gawande brought his checklist gospel (video) to the President’s Council of Advisors on Science and Technology. Writing for AAAS’ science-policy blog ScienceInsider, Jeffrey Mervis chronicled the encounter, paying special attention to the observations of council member and Google CEO Eric Schmidt.
Google CEO Eric Schmidt. Photo by World Economic Forum via FlickrTo Schmidt, the challenge of creating a system that synthesizes patient history and creates a list of standardized recommendations boils down to a simple “platform database problem,” something he says computer scientists are very good at.
Gawande’s take is that programmers don’t quite understand the vagaries of a typical clinical encounter. The technological capability may exist, but it’s going to be hard to make an information system that is able to generate recommendations brief and practical enough to be of use to a typical super-busy physician who has to suss out six different problems in one 15-minute visit.
In the course of the discussion, Gawande and the council also bemoaned the relatively low status of the health systems analyst and brainstormed ways to raise the profile and effectiveness of the specialization.
Grassley questions hospitals for HIT investigation
Filed under: Health policy, Hospitals, Hot Health Headline
Fred Schulte and Emma Schwartz continue to stay on top of the stimulus/health information technology/Sen. Charles Grassley investigation story for the Huffington Post Investigative Fund, this time explaining how and why the Grassley-driven inquiry into plans to spend an estimated $19 billion in stimulus money on HIT is now asking leading hospitals for input on their experiences with EMRs. The reporters also posted a copy of Grassley’s Jan. 19 letter.
Sen. Charles Grassley
Grassley sent the 11-question letter to 31 hospital organizations and requested that they respond by Feb. 16.
At this point, Grassley seems focused on technical issues that threaten patient safety, as well as potential conflicts of interest. Here are some of his more prominent lines of inquiry:
- How hospitals make purchasing HIT decisions.
- Potential financial or incentive-based relationships between HIT vendors and hospitals.
- Whether or not hospitals rely on outside contractors for HIT implementation.
- Procedures for and costs of training staff on new technology.
- Quality control and bug/problem-reporting procedures.
- Communication with tech vendors, peers and government officials.
- The relative liability of vendors and hospitals for HIT-related problems.
Grassley also asked hospitals to “provide a list of HIT problems or complaints that have been identified by or reported to your facility since January 2008 that directly or indirectly impacted patient safety or the delivery of care, including any complications or adverse events that have occurred as a result of HIT product design and/or usability.” He also requested that they “provide examples of contracts with HIT vendors that include non-disclosure clauses” and list any payments or discounts the hospitals received from those vendors.
Related: Fla. docs, vendors battle over EMR headaches
Sammy Mack’s piece for Health News Florida is a lively recounting of the complete meltdown that occurred between a group of Florida doctors and an EMR vendor, one rich in scandalous details like cease and desist letters and collection agencies. Mack’s work highlights the cultural divide between tech-savvy IT specialists and medical professionals and points out that the number of such conflicts is likely to increase as EMR adoption rises. Here’s Mack’s description of one such conflict, a dispute which happens to have a unique connection to journalism, medicine and ethics:
In another complaint against [EMR vendor Joe] Castranova, Dr. Linda Kaplan said she too was surprised by charges on her invoice. When they first met, Castranova recognized her as a former medical editor at the local NBC television affiliate. She said he offered to waive her software and training fees if she would endorse the product.
Kaplan agreed, but she said she was unimpressed with the system once it was installed in her Hallandale Beach office. She was reluctant to drum up business when she wasn’t a satisfied customer.
Kaplan said Castranova was displeased with her lackluster endorsement and locked her out of some 600 patient records on his server. He billed for the software system anyway.
Castranova said he gave her four months’ notice before locking her out – plenty of time to retrieve patient files.
How health reform lost popular support
Filed under: Government, Health care reform, Health policy
Kaiser Health News staff writers, including Jordan Rau, Mary Agnes Carey, Julie Appleby and Phil Galewitz, teamed up to figure out why Americans are so disenchanted with health care reform. After talking to an analyst who admitted that politicians “can do everything right and still fail in health reform,” the reporters set out to figure out what, if anything, went wrong.
The reporters divided the administration’s missteps (and, to a lesser degree, those of lawmakers) into four categories: helping individuals understand how reform tangibly benefited them, threatening Medicare, proposing a number of confusing tax increases, and the lengthy and frustrated deal-making process that preceded the reform bills now under consideration.
Myth surrounds reform’s ‘Safeway Amendment’
Filed under: Government, Health care reform, Health policy
Throughout the health care reform process, politicians have held up Safeway’s health incentive program as a model for future government health plans. The supermarket chain’s program requires employees who fail basic health screenings for blood pressure, weight, and cholesterol to pay higher health insurance premiums. 
Safeway maintains that this policy encourages its employees to make healthy lifestyle changes to in turn lower their health care costs. The Washington Post’s David Hilzenrath looked into the grocer’s impact on proposed health reform plans. Hilzenrath reports on how misconceptions about Safeway’s wellness program could impact public health policy in the U.S. Senate’s proposed Safeway Amendment.
Under a regulation advanced during George W. Bush’s administration, incentives conditioned on meeting wellness targets are limited to 20 percent of the premium – including employer and employee contributions to the premium. The Safeway Amendment would allow employers to increase the stakes to 30 percent, and it would give federal officials license to raise the limit to 50 percent. It would also allow insurers to use the same approach – initially in 10 states and potentially in others.
Employers and insurers would be required to make exceptions for people with extenuating medical circumstances.
Supporters of the amendment maintain that it will encourage private-sector employees to monitor and improve their health. Dissenting organizations, including the American Heart Association and the American Cancer Society, suggest that the legislation will unhinge a central tenet of health reform: That an individual’s health status will no longer impact premiums.
Safeway credits its internal health plan for keeping the company’s health care costs nearly steady between 2005 and 2009. An external survey of 1,700 employers revealed that companies’ health care costs increased by 30 percent in the same time period, on average.
Hilzenrath reports that “a review of Safeway documents and interviews with company officials show that the company did not keep health-care costs flat for four years. Those costs did drop in 2006 – by 12.5 percent. That was when the company overhauled its benefits, according to Safeway Senior Vice President Ken Shachmut.”
AP looks at drug resistance worldwide
Filed under: Health policy, Hot Health Headline, Public health
The Associated Press has neatly wrapped up its wide-ranging look at drug resistance and the threat it poses to global health into a flash-based multimedia presentation. The presentation consists of stories, infographics, videos and a photo/audio slideshow.
The two videos explain drug-resistant strains of various infectious diseases. The first looks at the wide availability of powerful antibiotics without guidance or prescription, addresses the problem as it has emerged both in the United States and in locales like Mexico and the Philippines. The second, which is about the use of antibiotics in large-scale livestock operations, relies on just one source, Dr. Craig Rowles of Elite Pork Partnership.
The AP uses infographics to establish the spread and scope of the problem, relying heavily on various world maps. I particularly like the timeline that accompanies the malaria graphic (click “statistics” in the upper right, then “malaria”); it shows the span of time from when each malaria-fighting drug was introduced to the date at which a resistant strain emerged.
Finally, they drive the problem home with three strong anecdotes, including a Southeast Asian boy with drug-resistant malaria, a man fighting the drug-resistant tuberculosis that killed his HIV-positive partner, and a woman who lost an infant daughter to MRSA.
Stories in the series:
- New form of malaria threatens Thai-Cambodia border
- South African doctor sees drug-resistant HIV
- First case of highly drug-resistant TB found in US
- Solution to killer superbug found in Norway
The package is accompanied by this video.
Reform bills would benefit Indian Health Service
Filed under: Government, Health care reform, Health policy
Mark Trahant, writing for InvestigateWest, points out that, because it’s in both the House and Senate versions of the bill and thus safe in conference committee, the reauthorization and extension of the Indian Health Care Improvement Act will pass as long as the larger reform package does.
The Parker Indian Health Services Hospital in Parker, Ariz. Photo by churl via Flickr.Originally enacted in 1976, the IHCIA has, in various iterations, been the primary vehicle for the delivery of health care to the country’s American Indians and Alaska Natives.
The latest version of the bill would adjust the Indian Health Service budget to account for medical inflation and population growth, increase efforts to recruit and retain health care professionals, introduce coverage for long-term care, improve youth suicide prevention programs and encourage innovation that will help provide easier access to health facilities.
List of lists: Top health stories of 2009
The end of the year brings us list after list of the best or top health and medical stories. Some of the more interesting:
USA Today: New bugs, scary food, bad drugs and a quiz: Test your knowledge of the year’s top health stories
HealthLeaders Media: 10 Weird Healthcare Stories of 2009
Fox News: Top Health Stories of 2009
Harvard Health Letter: The top health stories of 2009
CBS News: Top medical stories of 2009
ReportingonHealth’s William Heisel lists his favorite health stories of 2009
And a couple of organizations declared the end of the decade with their lists:
MSNBC.com: Top 10 health stories of the decade
Associated Content: Top Health Stories of the Decade and Why
Calif. SSI payouts insufficient, lacking in oversight
Capital Public Radio’s Kelley Weiss explored how cuts to California’s Supplemental Security Income were impacting older disabled Californians and, in a second story, the lack of oversight in the massive state program. According to Weiss, the state doesn’t track how the money is spent by recipients or whether the $845 a month is enough to live on. Weiss even found recipients who admitted using the money to buy everything from beer to crack cocaine.
“I don’t have any, I don’t have any background on this…yeah, we’ll have to set up a different time for that.”
-
Health Journalism 2010, AHCJ's annual conference, features a world-class program with story ideas, sources, stronger reporting skills, chances to meet newsmakers and network with other journalists.
- Health and education: Covering these intersecting beats
- Reporting on the business of health care
- Health reporting resources for journalists on state and local government beats
- Shortened Lives: How location, lifestyle affect health
- Covering a complex story for the long haul
- Aging in the 21st Century: Presentations and tip sheets
- AHCJ calls for better information from Joint Commission Web site
