Feds indict doc whose abuses were detailed in 2010 WSJ series
Filed under: Government, Health data, Health journalism, Public records
In The Wall Street Journal, John Carreyrou reports that a physician the paper spotlighted in a data-driven series on Medicare abuses has now been “indicted by a federal grand jury … for allegedly submitting more than $13 million of false claims.”
The article marks the first time the Journal has been able to print the physician’s name (Emma Poroger), even though they’ve been aware of it for more than a year.
The Journal identified Dr. Poroger, a doctor of osteopathy, as having suspicious billing patterns by mining the Medicare claims database, a computerized record of every bill submitted to the program. But her name was withheld in the October 2010 front-page article because Medicare keeps information pertaining to individual doctors confidential under a three-decade-old court injunction.
That injunction stems from a 1979 lawsuit filed by the American Medical Association, the doctors’ trade group, to keep secret how much money physicians receive from Medicare. At the time, the court said doctors’ privacy trumped the public’s interest in knowing how tax dollars are spent.
The Journal’s publisher, Dow Jones & Co., filed court papers this year seeking to overturn the injunction. In September, a federal judge in Florida ruled that Dow Jones’s case could proceed.
Carreyrou also called out a few other physicians featured anonymously in the series whose names had also been made public in various official proceedings.
Related
- Effort to make Medicare data public advances
- WSJ exposes flaws of Medicare’s pay now, investigate later culture
- WSJ explains why Medicare data is hidden
Ohio’s hospital transparency law under fire
Filed under: Aging, Conflicts of interest, Europe, Government, Health care reform, Health data, Health journalism, Health policy, Hospitals, Hot Health Headline, Member news, Public records, Studies, Tools
Thanks are due to blogger and one-time hospital executive Paul Levy for drawing our attention to the Ohio hospital industry’s recent push to overturn much of the state’s recently passed transparency legislation.
The law required hospitals to post performance data, such as infection rates and patient satisfaction, on the Ohio Hospital Compare site.
According to Brandon Glenn’s report in the MedCity News, the hospital industry opposes the site, online since Jan. 1, 2010, because it serves the same purpose as the federal Hospital Compare site.
The OHA supports the new legislation… because it wants to remove “duplicative” reporting requirements on the state’s hospitals. Ohio hospitals already report the same data to a federal Hospital Compare website maintained for the public by the Centers for Medicare & Medicaid Services, said OHA spokeswoman Tiffany Himmelreich.
The new legislation “doesn’t reduce reporting. It just eliminates reporting the same information to two different places,” she said. “We don’t want the public to feel that this is taking a step backwards in terms of data availability.”
For their part, consumer advocates say website maintenance is not an onerous burden, and that the hospital association’s push is part of a larger, statewide antitransparency trend.
As an interesting side note, Glenn found the Ohio Hospital Compare site to be rendered inoperable by apparent bugs on an initial visit but discovered that, after his inquiries to the state health department, the site was put into working order.
String of errors made Stanford patient data public
Filed under: Health data, Hospitals, Hot Health Headline, Public records
In The New York Times, Kevin Sack traces the series of errors and lapses in judgement that led to a large-scale data breach at Stanford Hospital, one which went unnoticed for almost a year. Sack’s lead paragraph neatly encapsulates the whole story.
Private medical data for nearly 20,000 emergency room patients at California’s prestigious Stanford Hospital were exposed to public view for nearly a year because a billing contractor’s marketing agent sent the electronic spreadsheet to a job prospect as part of a skills test, the hospital and contractors confirmed this week. The applicant then sought help by unwittingly posting the confidential data on a tutoring Web site.
Since 2009, when federal law began requiring disclosure of medical data breaches involving more than 500 people, Sack reports that about 330 incidents have been reported on an HHS website. A CSV file of the data is available.
NYT reporters tease hip replacement numbers from difficult data
Filed under: Government, Health data, Health journalism, Hot Health Headline, Public records, Studies
Writing for The New York Times, Barry Meier and Janet Roberts analyzed a particularly tricky batch of federal reports detailing a variety of complaints with popular metal-on-metal hip replacements. They found that, since January, the FDA has received more complaints (5,000-plus) about the devices than it did, total, from 2007 to 2010.
Photo by Michael Simmons via FlickrWhile processing the data, the paper’s staff did their best to parse duplicate reports, international filings and other inconsistencies, but the reporters make it clear that the numbers are still best viewed in general terms. Even so, they demonstrate that the surge in complaints and lawsuits involving metal-on-metal hips — and the resulting mass defection of doctors who once implanted them — signals a broad shift in hip replacement surgery, one of the most common such procedures in the country. It also signals another blow for device manufacturers and patients, and a related windfall for the legal profession.
The vast majority of filings appear to reflect patients who have had an all-metal hip removed, or will soon undergo such a procedure because a device failed after only a few years; typically, replacement hips last 15 years or more.
The mounting complaints confirm what many experts have feared — that all-metal replacement hips are on a trajectory to become the biggest and most costly medical implant problem since Medtronic recalled a widely used heart device component in 2007. About 7,700 complaints have been filed in connection with that recall.
…
As problems and questions grow, most surgeons are abandoning the all-metal hips, saying they are unwilling to expose new patients to potential dangers when safer alternatives — mainly replacements that combine metal and plastic components — are available. Some researchers also fear that many all-metal hips suffer from a generic flaw. Current use of all metal devices has plummeted to about 5 percent of the market, though a few of the models are performing relatively well in select patients.
Find health data at Childstats.gov, a clearinghouse for kid numbers
Filed under: Children, Government, Health data, Health journalism, Public records, Tools
Time to add another link to your “federal data clearinghouses” folder, if you haven’t already. Childstats.gov, published by the Federal Interagency Forum on Child and Family Statistics, synthesizes data from the CDC, NCHS, National Children’s Survey, AHRQ, Census and other specialized programs.
Photo by nasa hq photo via FlickrThe site is anchored by its annual report, “America’s Children: Key National Indicators of Well-Being,” and the easy-to-navigate nature of its databases seems to have already inspired some discussion on Twitter, particularly in relation to child homelessness.
Many of the data tools are simply links to general surveys (like AHRQ’s National Healthcare Cost and Utilization Project) that just happen to contain child-related information, but there are some more specifically relevant data sources, the best of which I’ve listed below.
- Data Resource Center for Child & Adolescent Health
- The National Children’s Study
- The National Center for Education Statistics
- Find Youth Info (findyouthinfo.gov)
- Census Child Care data
Reporter finds the story behind food code violations
Filed under: Government, Health data, Health journalism, Hot Health Headline, Public health, Public records
All the time that The Muskegon Chronicle’s Brian McVicar has been spending with his county health department’s inspection records has paid off with a slew of stories, with the most recent turning the spotlight on the thousands of food code violations area businesses have racked up in recent years.
Photo by bookgrl via FlickrFor this particular story, McVicar crunched the numbers on 22,000 violations, 37 percent of them critical, logged over a four-year period. Among the most salient, he writes, were “Raw chicken and crabmeat sitting out at room temperature, food kept past its expiration date, cockroaches, mice and fruit flies living in kitchens, employees not following proper hand washing procedures.”
In addition to the typical rogue restaurants, McVicar found that a wide range of local businesses were guilty of health code violations, including “Schools, hospitals, and food stands found in places such as Michigan’s Adventure Amusement Park.”
With his broad-based, data-oriented methodology, McVicar provides a model for other local reporters looking to move beyond the typical “cherrypick the cockroach horror stories” approach that is so often found in inspection-record stories.
Stories in the series:
- Food code violations rampant; food poisoning outbreaks rare
- Management is key to cleaning up food code violations
- Handwashing, temperature storage key to keeping foods safe
- Are some restaurants allowed to get too many health violations?
- Day in the life of a Muskegon County health inspector
- Food poisoning outbreaks rare, but serious
- Some states grade restaurants based on health inspections
- Food code violations: Public health risk or over-burdensome government regulation?
Data shows disconnect between patient perception, hospital performance
Filed under: Health data, Hospitals, Hot Health Headline, Public records
Sifting through Medicare hospital rating data, USA Today reporters Steve Sternberg and Christopher Schnaars found an enlightening disconnect between patients’ subjective ratings of hospitals and hospital performance on quantitative measures such as death and readmission rates.
“This is a very important finding,” says Donald Berwick, director of the Centers for Medicare & Medicaid Services, adding that though patient-survey data offer critical insights into how it feels to be a patient at different hospitals, patients’ perceptions don’t tell the whole story.
The story is packaged with an infographic that allows readers to look up ratings for local hospitals.
AHCJ resources
- Updated hospital data allows reporters to identify ongoing problems: The release this month of federal data on hospital quality is a good reminder for reporters to give their local hospitals a checkup. To give you a head start, Charles Ornstein, senior reporter at ProPublica and AHCJ’s president, has done some preliminary analysis and points out states in which hospitals fared well and the states where hospitals did poorly.
- Deciphering hospital quality data
- Sorting out hospital rankings
- Making sense of hospital quality reports
- Analyze patient satisfaction surveys to evaluate local hospitals
New life expectancy data can add context
to reporting on local health
A new data release today from the Institute for Health Metrics and Evaluation gives journalists some unique tools to help depict the health of a local population.
Emmanuela Gakidou, M.Sc., Ph.D., the director of education and training for IHME, told a Health Journalism 2010 audience that the institute was working on a project to show health information to the county level.
Just over a year later, the data allow the user to analyze life expectancy for every county in the United States and compare those numbers worldwide.
For example, the data could add context for a journalist following up on a tip from a speaker in an entirely different AHCJ event. In the recent Rural Health Journalism Workshop in St. Louis, Ellen Barnidge, Ph.D., M.P.H., of St. Louis University, discussed efforts in Missouri’s high-poverty Pemiscot County. A quick filter of the spreadsheet data shows men in that county share the same life expectancy – 68.5 – with Mauritius and Indonesia.
The data go back to 1987, allowing a journalist to look at changes over time as well for more than 3,000 counties.
Project researchers found that, while people in Japan, Canada and other nations are enjoying significant gains in life expectancy every year, most counties within the United States are falling behind.
The researchers, in collaboration with researchers at Imperial College London, found that between 2000 and 2007, more than 80 percent of counties fell in standing against the average of the 10 nations with the best life expectancies in the world, known as the international frontier.
Women have been especially affected. More than 850 counties in the U.S. have seen life expectancy remain static or go backwards for women since 1997.
The data also offers a breakdown of life expectancy by selected race – black and white – for each county.
The institute is an independent global research center at the University of Washington providing sound measurement of population health and the factors that determine health, as well as rigorous evaluation of health system and health program performance.
ProPublica investigates ties between doc groups, industry
Filed under: Conflicts of interest, Health data, Hot Health Headline, Pharmaceuticals
With an assist from Sen. Chuck Grassley, ProPublica senior reporters Tracy Weber and Charles Ornstein, AHCJ’s board president, have published their latest data-heavy investigation (USA Today version). This time, their journey into the myriad avenues pharmaceutical companies pursue to influence physicians has taken them into the world of professional societies and annual conferences. The duo writes that despite the power of these groups, their dependence upon millions and millions of dollars in industry funding has often slipped under the radar.
Professional groups … are a logical target for the makers of drugs and medical devices. They set national guidelines for patient treatments, lobby Congress about Medicare reimbursement issues, research funding and disease awareness, and are important sources of treatment information for the public.
Their strongest anecdote comes from the Heart Rhythm Society, a group which, in 2010, pulled in about $8 million – half their total income – directly from manufacturers of the drugs and devices their members specialize in prescribing for, or implanting in, patients. The society has started to disclose these relationships, but perhaps not to limit them, the reporters write. “’This is our business,’ said Dr. Bruce Wilkoff, the incoming society president. ‘We either get out of the business or we manage these relationships. That’s what we’ve chosen to do.’”
The companies also pay two-thirds of the society’s board members speaking or consulting fees, a situation Weber and Ornstein found is far from unusual. In addition to these financial conflicts, the reporters gathered some fascinating examples of just how deep industry influence can run. My personal favorite comes from the conference of a well-known collection of cardiologists.
Last month, the American College of Cardiology attached tracking devices to doctors’ conference ID badges. Many physicians were unaware that exhibitors had paid to receive real-time data about who visited their booths, including names, job titles and how much time they spent.
For more examples, I recommend Robert Durrell’s photographs from the 2011 Heart Rhythm Society annual conference, which show dozens of industry-sponsored objects alongside the amount of money each company paid for that particular privilege. Dan Nguyen and Nicolas Rapp put together an infographic that expands upon a similar theme.
Much of the disclosure data the ProPublica team depended on for their reports was released in response to a request for informationGrassley sent out in late 2009. His investigation has started to yield some preliminary results.
There are fledgling efforts to push medical societies toward stricter limits on industry funding: 34 groups have signed a voluntary code of conduct calling for public disclosure of funding and limits on how many people on guideline-writing panels have industry ties.
“The general feeling is that the societies need to be independent of the influence of companies,” said Dr. Norman B. Kahn Jr., chief executive of the Council of Medical Specialty Societies, which helped draft the code.
Spreadsheet lists malpractice claims against VA
In its “FOIA Friday” feature, the Project On Government Oversight reveals a spreadsheet (XLS format) of claims against the Department of Veterans Affairs, including thousands related to medical malpractice.
The spreadsheet lists administrative claims, the first step in the VA’s process for filing claims.
Nick Schwellenbach explains more about the data:
The data provided has details on over 12,000 claims against the VA from 1989 to November 2008, although the data appears largely incomplete for the first several years. Not all of the claims are medical malpractice-related, but several thousand are. There are fields for the VA facility involved, the date the claim was received, the date of the last tort status (where the claim is in the administrative process), the date of that status, alleged negligence descriptions (none exist for non-medical malpractice tort cases), and amount paid out, if any. The spreadsheet is over two years old, so the latest tort status field may be out-of-date for many of these claims.
The spreadsheet includes 16 cases in which more than $1 million was paid out. The descriptions of the allegations are pretty vague but those 16 cases include:
- Failure To Obtain Consent or /Lack Of Informed Consent; Improper Technique; Improper Performance; Improper Management; Delay In Diagnosis; Failure To Treat; Failure To Order Appropriate Medication; Failure To Monitor; Failure To Diagnose (i.e., Concluding That Patient Has No Disease or Condit[ion)]
- Failure To Respond To Patient
- Surgical or Other Foreign Body Retained
- Unnecessary Procedure; Intubation Problem; Improperly Performed Test; Improper Management
It’s worth noting that another recent “FOIA Friday” also was related to health. It was a letter sent by the National Institutes of Health to Emory University “after the media exposed Dr. Zachary Stowe’s cozy financial relationship with GlaxoSmithKline (GSK) while also receiving NIH grants to study antidepressants like GSK’s Paxil in pregnant women.”
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New at HealthJournalism.org
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