ProPublica guides reporters to check local boards
Filed under: Government, Health data, Health journalism, Nursing, Public records, Tools
For those of you who have followed the ongoing investigation ProPublica’s Charles Ornstein and Tracy Weber have done into nurses and whether states are reporting disciplinary actions, you might have a chance to localize the story.
ProPublica has posted a guide, “Reporting Recipe: How You Can Investigate Your State’s Oversight of Its Nurses and Other Licensed Professionals,” to help reporters and the public check up on what’s happening in their states.
ProPublica editor-in-chief Paul Steiger and managing editor Stephen Engelberg, explain why they are providing the reporters’ techniques and insights:
We hope that others will use the techniques created by Ornstein and Weber to hold local officials accountable. Reporters who look into the local boards that oversee nurses or other health professionals will make new discoveries, some of which will undoubtedly go beyond what we have found. That, in turn, will help others push the story ahead. We hope statehouse reporters, beat reporters, general assignment reporters, bloggers, citizen journalists and others will use this road map.
Use the state-by-state guide prepared by Ornstein (also president of AHCJ’s board of directors) and Weber that shows what information is available to the public in each state and specific things to look for in the records.
They have used the data to identify some states that appear to be inconsistent in reporting disciplinary actions against medical professionals. If you are covering any of these states, you should probably be looking into the story yourself:
- Florida
- Georgia
- Illinios
- Indiana
- Kentucky
- Michigan
- Mississippi
- New Jersey
- Ohio
- Tennessee
- Wisconsin
- West Virginia
High cost of foodborne illness broken down by state
The Make Our Food Safe coalition’s latest study provides a state-by-state breakdown of the cost of foodborne illness, both in absolute and per-capita terms. The report estimates that foodborne illnesses cost about $152 billion each year in America, with the cost being spread fairly evenly across the country.
Hawaii ($553) and Mississippi ($543) suffer the highest cost per capita, while Nevada ($450) and Utah ($448) bear the lightest per-capita load.
The report is the work of former FDA economist Robert L. Scharff, now a professor at Ohio State (bio). You can read the entire 27-page report in PDF form, scan the one-page summary or play with the accompanying interactive map and draw your own conclusions. You can also listen to an MP3 of the related media telebriefing.
AHCJ: Joint Commission site obscures information
In a letter to Mark R. Chassin , M.D., the Joint Commission’s president and CEO, the Association of Health Care Journalists has suggested improvements to the commission’s Quality Check Web site, where many people go to find out whether to trust their local hospital.
The Web site also is a potentially useful tool for health-care journalists. “In a time of change in health care, the ability to do comprehensive research on local hospitals is more important than ever before,” the association’s letter said.
Among the problems identified:
- Hospitals with any level of accreditation are given “The Gold Seal of Approval” – even those whose accreditation is conditional or at risk of being denied.
- It’s difficult to find out which hospitals in a given region have less-than-full accreditation. To check on a hospital’s accreditation status, one has to open each individual profile. The Joint Commission once had a mechanism to sort hospitals by accreditation status, but that is no longer available.
- After a hospital loses accreditation, its past Accreditation Quality Reports are eventually removed from the site, leaving only the facility’s name with no historical record.
- There is no easy way to do a side-by-side comparison of more than six facilities simultaneously.
“The organization that accredits hospitals around the country, and voices support for transparency about hospital quality, has a Web site that obscures the reality of many hospitals’ performance,” said Charles Ornstein, AHCJ president.
Read more about AHCJ’s letter to the Joint Commission.
Reading lists for health care journalists
In her column for Generations Beat Online, AHCJ member Eileen Beal offers a reading list for health journalists and focuses on two books in particular that she believes will help prepare reporters for the first wave of baby boomers, which will hit Medicare next year (scroll down to item 4, “Beal’s Beat”).
Photo by Beverly & Pack via Flickr.The subjects these books cover, doctors’ decisions and statistics, are broad enough to be useful to even those journalists not focused on aging coverage.
Her suggestions include “How Doctors Think,” by Harvard professor and oncologist Jerome Groopman, and “Know Your Chances: Understanding Health Statistics.
In an e-mail separate from her column, Beal pointed out that Covering Health readers also might be interested in an edited, ranked and extensive list of health resource books compiled by the Agency for Healthcare Research and Quality that includes general and specific offerings.
Reporters use county rankings for analysis
Filed under: Health data, Public health, Public records, Studies, Tools
On Feb. 17, rankings of the relative health of counties in each American state were released by the Robert Wood Johnson Foundation and the University of Wisconsin. The rankings used data from 13 distinct (mostly federal) sources, including the National Center for Health Statistics, the Census Bureau and the Dartmouth Atlas. With that data, researchers computed eight separate composite scores, which were then weighted to produce one overall score. The ratings are navigated by clicking through a national map to the state and county level. Enough clicks will even bring you to the raw data itself. The state only compares counties, not states, because data collection varies from state to state and isn’t always standardized.
It’s a combination of data, analysis and an intuitive interface, and journalists have been quick to localize the story. Many reporters reached beyond the easy numbers (”our county is 67th!”) to use the system for deeper stories.
For example, Robin Erb of the Detroit Free Press dissected the ratings process and how individual factors and disparities played into them before launching into the standard state breakdown.
Writing for Health News Florida, David Gulliver took a broader state view and considered how various socioeconomic factors played into the rankings of Florida counties. Gulliver’s analysis:
The strong-performing coastal counties, like Collier, St. John’s Sarasota, Charlotte, Palm Beach and Broward, all benefit from having heavy concentrations of retirees who have guaranteed health care access via Medicare. …
[Dr. Kevin Sherin, director of public health for Orange County] said that in Florida’s tourism and service industries, workers tend to be transient and less likely to have insurance or consistent primary care.
He noted the low-ranked counties were some of the poorest in Florida, like Union and Bradford in the rural north, and Glades and Okeechobee, with heavy populations of migrant workers. Those counties also tend to have more people who speak only Spanish, Creole or other languages.
Gulliver localized the story on a county level for his Sarasota Health News site.
In USA Today, Mary Brophy Marcus took the national view and looked for broad trends and generalizations. Marcus’ story was accompanied by a map by Frank Pompa highlighting each state’s healthiest and least healthy counties.
Defaulted doctors: Hundreds fail to pay on loans
More than 300 health care providers who received Health Education Assistance Loans made no payments during 2008, despite having earned income that year, according to a new report from the Office of the Inspector General of the Department of Health and Human Services.
These 312 HEAL defaulters earned $13.4 million and owed $47.5 million on their loans in FY 2008. Ninety-eight of these defaulters (31 percent) earned $50,000 or more. These 98 defaulters were responsible for nearly $15 million of the $47.5 million owed.
The program, known by the acronym HEAL, provided federal insurance for educational loans made by private lenders to more than 156,000 graduate health professions students between 1978 and 1998. Loans were available to students in schools of medicine, osteopathy, dentistry, veterinary medicine, optometry, podiatry, public health, pharmacy, chiropractic, health administration or clinical psychology.
The names of borrowers who are in default on their loans are published online in a searchable database quarterly. Information available includes the borrower’s name, discipline, state, amount due, school and date of graduation or separation.
The site says it lists borrowers who:
- had one or more default claims paid by the Department of Health and Human Services (DHHS);
- been excluded from the Medicare program as a result of his or her HEAL default; and
- not had the Medicare exclusion stayed, or lifted, by the Office of Inspector General as a result of entering a settlement agreement.
The site says it was last updated in November 2009, so reporters will need to verify any information found on the site. But it could be a starting place for stories about local health care providers.
New federal caregiver database full of holes
Filed under: Hot Health Headline, Public records, Tools
Tracy Weber and Charles Ornstein are still working with databases of disciplined caregivers, this time exposing gaping holes in the federal database released to hospitals on March 1 (LA Times version | ProPublica version). Weber and Ornstein trace the holes to a lack of reporting by state agencies, and mention California, South Dakota, New Hampshire, Alabama, Delaware, Ohio, Tennessee, Indiana as states whose database entries were demonstrably incomplete. Some states don’t even have a single disciplined caregiver showing up in the federal database even though scores of offenders are listed on those states’ own sites.
The omissions took federal health officials by surprise. Only last month, a spokesman for the agency that oversees the database told reporters that “no data is missing.” Another official said the agency had been “constantly” checking its data against state licensing board websites.
But Friday, the head of the Health Resources and Services Administration (HRSA) acknowledged that records were missing. She said her agency had launched a “full and complete” review to determine what is wrong and how to fix it.
The Department of Health and Human Services has reacted swiftly, Ornstein and Weber report. HHS boss Kathleen Sebelius sent U.S. governors a letter requesting that they identify and correct any holes in the federal database by June 1, at which point any states whose entries were not updated will be named and shamed in an HSS report. HHS will train state staff in compliance and audit the database to make sure everybody’s following the rules. States have, as of yet, not faced any penalties for failing to update the list over the preceding two decades.
Food Environment Atlas full of story ideas, data
Filed under: Health data, Hot Health Headline, Tools
The Food Environment Atlas, produced by the U.S. Department of Agriculture’s Economic Research Service, may be one of the best things to happen to folks who love maps and health statistics.
The folks at Daily Yonder have put together a little showcase of what the atlas can do, but it’s a testament to the Atlas’ astonishing depth that they’ve only scratched the surface. Want a county-by-county map of the relative price of low-fat milk versus sugary drinks? How about the percentage of households with no car that live more than a mile from the nearest grocery store or even the level of tax charged for salty vending machine snacks? No sweat!
With county-by-county information about food taxes, physical activity, socioeconomic characteristics, rates of diabetes and obesity and lots more, reporters should find a treasure trove of story ideas and data. And the data behind the application is available to download as an Excel file.
Jeff Porter, AHCJ’s resident data guru, says the site features “great underlying documentation and enough info to join up with any county-level data with the same geographic codes.”
The data for the map is collected from the CDC, the National Cancer Institute; the USDA, the National Farm-to-School Network and the Bridging the Gap Program at the University of Illinois at Chicago.
(Hat tip to John Hale at The Rural Blog)
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.
Open government directive bears fruit, databases
Filed under: Government, Health data, Hospitals, Hot Health Headline, Public records, Tools
In December, 2009 Peter Orszag, director of the White House’s Office of Management and Budget, issued an Open Government Directive (original PDF here) requiring a number of agencies to “identify and publish online in an open format at least three high-value data sets” on Data.gov within 45 days. That deadline came on Jan. 22, and the resulting data sets have all been posted online. The beefiest and most immediately useful are those from the Department of Veterans Affairs, but we’ve also included other sets which could prove useful for health care journalists. Descriptions are taken directly from Data.gov.
Department of Veterans Affairs
Veterans hospital report cards and safety reports
The VA has divided report cards (11 categories) and safety reports (4 categories) into topic-specific files, from Infrastructure to Nosocomial Infections. The best way to find what you’re looking for is to visit the Open Government Directive site and then scroll down to “Department of Veterans Affairs.”
FY08 Veterans Compensation and Pension by County
The Compensation and Pension by County dataset is a count of the number of veterans receiving disability compensation or pension payments from the Department of Veterans Affairs. The data is reported at the county level, by age group and by % disability rating.
Social Security disability claims
SSA Disability Claim Data
The dataset includes fiscal year data for initial claims for SSA disability benefits that were referred to a state agency for a disability determination. Specific data elements for each year and state include receipts, determinations, eligible population, and favorable determination rates.
SSA State Agency Workload Data
The dataset includes monthly data from October 2000 onwards concerning initial claims for SSA disability benefits that were referred to a state agency for a disability determination.
USDA nutrition data
MyPyramid Food Raw Data
MyPyramid Food Data provides information on the total calories; calories from solid fats, added sugars, and alcohol (extras); MyPyramid food group and subgroup amounts; and saturated fat content of over 1,000 commonly eaten foods with corresponding commonly used portion amounts.
USDA National Nutrient Database for Standard Reference
The USDA Nutrient Database for Standard Reference, Release 22 (SR22) is the major source of food composition data in the United States and provides the foundation for most public and private sector databases. SR22 contains nutrient data for over 7,500 food items for up to 143 food components, such as vitamins, minerals, amino acids, and fatty acids.
Medicare
CY 2009 MTM Contact List
CMS approved contact list of Part D Sponsors in Medication Therapy Management Program (MTMP) which is in their plans’ benefit structure.
Office of Medicare Hearings and Appeals Claims Listed by State
Total count of Claims received by Region, State and fiscal year. Appeals can be found here.
Part B National Summary Data File
The Medicare Part B National datasets are summarized by meaningful Health Care Common Procedure Coding/Current Procedural Terminology, (HCPC/CPT), code ranges. Each dataset displays the allowed services, allowed charges and payment amounts by HCPC/CPT codes and prominent modifiers.
Other
OSHA Data Initiative - Establishment Specific Injury and Illness Rates
Each year the Occupational Safety and Health Administration (OSHA) collects work-related injury and illness data from employers within specific industry and employment size specifications. This data collection is called the OSHA Data Initiative or ODI. The data provided is used by OSHA to calculate establishment specific injury and illness incidence rates.
What else is there?
The “Tools” section of the site includes widgets and data-mining and extraction tools, applications, and other services to “provide the public with simple, application-driven access to Federal data with hyperlinks.” The “Geodata” section includes federal geospatial data with metadata and links to more detailed Federal Geographic Data Committee (FGDC) metadata information.
The site is soliciting comments about what datasets should be made available, so you can suggest more datasets here. The site also offers a tutorial.
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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
