Mass. won’t post hospitals’ death rates
Filed under: Health data, Hot Health Headline, Public records
The Boston Globe’s Liz Kowalczyk reports that, two years after it was first proposed by a consumer group, the Massachusetts Health Care Quality and Cost Council has decided it won’t publish hospital-wide mortality rates. The problem, it seems, is the lack of an accurate, universal method of computing such numbers.
Health and Human Services Secretary Dr. JudyAnn Bigby, who heads the group that made the decision, said current methodology for calculating hospital-wide mortality rates is so flawed that officials do not believe it would be useful to hospitals and patients and could harm public trust in government.
It appears, Kowalczyk writes, that general hospital mortality rates just aren’t “ready for prime time” quite yet.
The council convened an expert panel, which worked with researchers to evaluate software of four companies for measuring hospital mortality. The problem was that researchers came out with vastly different results when they used the various methodologies to calculate hospital mortality between 2004 and 2007 in Massachusetts, and they could not tell which company’s results — or if any — were accurate.
AHCJ pushes for access to publicly funded research
Filed under: Government, Health data, Health journalism, Public records, Studies
The strong public interest in “direct, free and full text access to research articles” prompted the Association of Health Care Journalists to send comments to the House Oversight and Government Reform committee.
The letter [PDF] was in support of full-text access to the fruits of publicly-funded research to members of Congress considering H.R.5037 – Federal Research Public Access Act of 2009. One section of that bill would require researchers who receive funding from federal agencies to provide free online public access to final peer-reviewed manuscripts or published versions as soon as practicable, but not later than six months after publication in peer-reviewed journals.
While AHCJ did not take a position on the specifics of the bill, the group highlighted the strong public interest in “direct, free and full text access to research articles,” noting that for journalists to be able to provide readers and audiences with accurate and comprehensive reporting, they need to be able to see the full details of research reports, not merely the highlights contained in abstracts or news releases.
“The fundamental principle at issue is the public’s right to examine both the evidence produced by research studies and the methods employed by researchers. When the researchers are supported by taxpayers, the public’s claim is even stronger,” AHCJ’s statement read in part.
The statement took note of the concerns of some publishers who fear the mandate could cut into their income, while also pointing out that other publishers already provide free online access to the full text of research articles within six months of publication.
Related:
Bill would require public access to research
Missouri data disclosure details infection fight
Filed under: Health data, Health journalism, Hospitals, Hot Health Headline, Public health, Public records, Studies, Tools
Missouri law requires hospitals to disclose infection rates for intensive care and certain surgeries. It doesn’t keep that data around for long, but St. Louis Post-Dispatch reporter Jim Doyle still managed to review data from 2005 to 2009.
Robots sanitize an ICU room by spraying hydrogen peroxide vapor into the air at St. John’s Mercy Medical Center.
He found that while numerous local hospitals lagged behind national infection rates, most were improving. A story that could have been a dire assessment of health care-associated infections instead became (mostly) a profile of local hospitals’ drive to cut down on the transmission of such infections. He doesn’t draw a clean line between the state’s monitoring and increased anti-infection efforts, but it’s tempting to read between the lines.
Doyle’s second installment continues the theme, discussing the aggressive, nonstop effort that is required to contain drug-resistant bacteria. Measures range from checklists to room-enveloping antibacterial vapors.
Missouri’s disclosure laws are an important step toward infection fighting, Doyle found, but their narrow definition allows hospitals some wiggle room and may miss serious systemic issues. Speaking of systemic issues, I highly recommend Doyle’s sidebar on why Missouri infection data is so hard to keep around.
FOI request for H1N1 documents still pending
Filed under: Health journalism, Public health, Public records
Eleven months after she filed a Freedom of Information Act request with the Centers for Disease Control and Prevention for documents related to H1N1, CBS News’ Sharyl Attkisson reports that she has finally received a response from the U.S. Department of Health and Human Services.
It states that it has a certain document responsive to my FOI request. The letter says HHS will try really hard to provide the document soon, but that the folks there are very busy so it may take awhile. It says that if I want expedited processing - something I had already applied for a year ago - I should let them know. A phone number was provided in case I had any questions.
Of course the investigative report I was working on is long over, as the bureaucrats must have known it would be by now.
Attkisson says she called the number provided in the letter and left a message several weeks ago and has yet to hear back. Her initial request was prompted by the CDC’s decision to stop testing and tracking H1N1, something her sources told her was hasty and more about influencing the public’s perception of the illness than it was about public health.
Earlier: Freedom of Information: Stalled at CDC and D.C. Government (Oct. 27, 2009)
Related
- Health journalists cite uneven disclosure of H1N1 deaths across country
- AHCJ calls on new administration to improve access to federal experts
Hearing on public access to research will be online
Filed under: Health data, Health journalism, Public records, Studies
Representatives of a number of medical- and publishing-related organizations will testify today at a hearing on “Public access to federally funded research” before the Information Policy, Census and National Archives Subcommittee of the U.S. House of Representatives’ Committee on Oversight and Government Reform.
You can catch the webcast of the hearing at 2 p.m. EDT. Update: It appears the hearing is not being webcast.
(Hat tip to the Electronic Frontier Foundation for the webcast link.)
Earlier
- Bill would require public access to research
- AHCJ: Proposal would be blow to public access
- Progress on open access issue not what it seems
HIPAA’s role in transplant story, correction
Filed under: Health journalism, Hospitals, Public records
The Village Voice says things are rather tense at the New York Post after it incorrectly reported on Monday that an alleged killer received a liver transplant at New York-Presbyterian Hospital. Frederik Joelving of Reuters Health reported on Tuesday that the hospital denied the transplant had taken place there.
Cover of Monday's New York Post.
That was followed by a correction in the Post on Wednesday morning. The original story is no longer available on the Post’s site but is available through Google’s cache.
According to the Village Voice, which quotes unnamed sources in the Post newsroom, “Rupert Murdoch was so enthralled with the story when it ran, that he called Post editor-in-chief Col Allan to personally congratulate him on it.” It also says the tip for the story came from Allan.
Because of the Post’s story, the hospital eventually had to deny that Johnny Concepcion, accused of killing his wife, received a transplant there after eating rat poison in a suicide attempt. Hospital comments on whether a patient has been treated are fairly unusual as hospitals try not to run afoul of the privacy rules outlines in the Health Insurance Portability and Accountability Act.
In fact, the Post’s correction says the hospital declined to comment before it published the original story, citing HIPAA, but that “Curiously, the hospital now sees itself free to publicly discuss Concepcion’s case.”
Speaking of HIPAA, The Reporters Committee for Freedom of the Press recently released “FERPA, HIPAA & DPPA: How federal privacy laws affect newsgathering,” a guide to federal privacy protection laws.
The section on HIPAA explains the history of the privacy rules, the Standards for Privacy of Individually Identifiable Health Information, and discusses how it has been misunderstood and misused to keep information from reporters. AHCJ President Charles Ornstein, a senior reporter at ProPublica, is quoted extensively and offers examples of its misapplication. The piece also outlines what the law does allow.
Bill would require public access to research
Filed under: Health journalism, Public health, Public records
Federal agencies would be required to develop policies allowing timely, free, online access to government-funded research under a bill, the Federal Research Public Access Act of 2009 (H.R.5037), moving through the U.S. House of Representatives. A hearing on the subject is scheduled next week (PDF) before the Information Policy, Census and National Archives Subcommittee of the Committee on Oversight and Government Reform.
Pennsylvania Democrat Mike Doyle is sponsoring the bill. Similar legislation was introduced last year but failed to make it through the process.
The bill is supported by the Scholarly Publishing and Academic Resources Coalition and its Alliance for Taxpayer Access, which reports the hearing is open to the public and will be at 2 p.m. on July 29 in the Rayburn House Office Building, room 2154. A list of organizations opposing the bill is at www.openbiomed.info, taken from a letter (PDF) to the Committee on Oversight and Government Reform. Doyle’s site carries text of a letter signed by a number of research universities in support of the bill.
The bill, which would apply to 11 agencies “with extramural research expenditures of over $100 million,” would require that the policies apply to researchers who work for the agencies as well as those funded by the agencies. Specifically, the bill calls for:
- free online public access to final peer-reviewed manuscripts or published versions as soon as practicable, but not later than 6 months after publication in peer-reviewed journals;
- production of an online bibliography of all research papers that are publicly accessible under the policy, with each entry linking to the corresponding free online full text
- long-term preservation of, and free public access to, published research findings
That would require public access to research similar to what’s required by the NIH’s Public Access Policy that was made permanent last year.
Related
AHCJ: Proposal would be blow to public access
J-S settles records suit; docs rebel against COI rules
Filed under: Conflicts of interest, Health journalism, Hot Health Headline, Public records
As a result of the Milwaukee Journal Sentinel’s now-settled lawsuit against the University of Wisconsin, John Fauber was able to review newly public e-mails which show just how angry a segment of the faculty became when faced with the university’s new, stricter conflict of interest regulations. The regulations came, of course, in the wake of Fauber’s investigative reporting on the subject.
The newspaper’s lawsuit argued that the faculty comments were public records under Wisconsin law and sought a court order to obtain them. To settle the lawsuit, the newspaper agreed to accept the 41 e-mails with the names of the doctors blacked out. The foundation also provided a separate list with the names of the 28 doctors who wrote the e-mails.
The (UW Medical Foundation) also agreed to pay the newspaper’s attorneys’ fees of about $12,400.
The e-mails make for good reading, and Fauber wastes no time in deploying the liveliest phrases in his story.
For example, some physicians complained about the 18-month exemption for orthopedic surgeons and other implanters of medical devices, including one who said “Allowing our docs to shill for device companies is a complete perversion.” An orthopedic surgeon responded with a different take, saying it was “clearly ridiculous” to limit his hourly take from device makers to just $500.
For an explanation from Fauber on how he has been able to consistently produce groundbreaking stories on the conflict-of-interest beat, see the article he wrote for AHCJ.
Agreement lets disciplined nurses work in 24 states
Filed under: Health data, Health journalism, Nursing, Public records
ProPublica’s Tracy Weber and Charles Ornstein are back on the disciplined caregivers beat, this time cooperating with USA Today to expose a licensing gap that makes it easier for disciplined nurses to find work in other states. The licensing agreement in question was signed a decade ago as 24 states agreed to recognize each other’s licenses in an attempt to alleviate care shortages by allowing nurses to work where they are needed most.
In some cases, nurses have retained clean multistate licenses after at least one compact state had banned them. They have ignored their patients’ needs, stolen their pain medication, forgotten crucial tests or missed changes in their condition, records show.
Critics say the compact may actually multiply the risk to patients. There is no central licensing for the compact, so policing nurses is left to the vigilance of member states.
Outside the compact, each state licenses and disciplines its own nurses. But within it, states effectively agree to allow in nurses they have never reviewed.
Ornstein and Weber found numerous instances in which a caregiver disciplined in one state was able to work for an extended period in another without being red-flagged, and are helping spark a debate over the costs, benefits and implementations of such agreements.
Outpatient inspections show serious lapses
Filed under: Health data, Health journalism, Hospitals, Hot Health Headline, Public records, Studies
AP medical reporter and AHCJ board member Carla K. Johnson used FOIA requests to uncover a wealth of infection-control violations at outpatient clinics in Illinois. The majority of Illinois ambulatory centers have yet to be inspected under the tough new rules, but 76 percent of those which have been inspected also have been cited. The inspections are part of a national push to increase the oversight of ambulatory care centers.
Previously, inspectors from the Illinois Department of Public Health visited the centers about every seven years. But the state last year began more vigorous and frequent inspections of outpatient surgery centers, following directives from national health officials. The state now plans to inspect a third of Illinois centers each year, said Karen Senger, a supervisor in the Health Department’s Division of Health Care Facilities and Programs.
The crackdown resulted from a hepatitis C outbreak in Las Vegas believed to be caused by unsafe injection practices at two now-closed clinics.
Johnson’s state request turned up a laundry list of specific violations, all of which she summarized in one nifty sentence: “The five-second rule appears to be alive and well in Illinois same-day surgery centers, where medical staff were observed picking up items that had fallen to the floor and behaving as if they weren’t contaminated by germs,” Johnson wrote. In an e-mail to Covering Health, Johnson said her story should be easy to localize and explained just how she obtained the inspection reports and why they are now available.
I FOIA’d state inspection reports (CMS-2567s) for ambulatory surgery centers in Illinois that were cited for deficiencies in infection control during the past 12 months. States have been directed by HHS to use a new audit tool to look for infection control problems, following an outbreak linked to two centers in Las Vegas.
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Spend a week at the CDC studying public health, meeting sources. Apply for the AHCJ-CDC Health Journalism Fellowships today!
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