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.
Doctors operated by flashlight, workers scrambled in tornado-ravaged hospital
As you probably know, St. John’s Regional Medical Center in Joplin, Mo., sustained serious damage in the May 22 tornado that struck that town. Stories about what happened inside the hospital in that 45 seconds and the ensuing moments have started to emerge.
Tornado damage in Joplin, Mo. Photo by KOMUnews via Flickr
An emergency room doctor writes about diving for cover and then treating injured patients with limited supplies and only light from a flashlight he held in his mouth as he worked. Photo galleries on Flickr have images showing the damage inside and outside the hospital, as well as the MASH unit that was set up.
Outpatient Surgery Magazine has the tale of an orthopedic surgeon who was in the middle of surgery when the tornado hit. He and his team finished the surgery with a flashlight and while standing in several inches of water. “The doctor who trained me thought it was important to know how to do surgery the way they used to, with manual instruments,” said Dr. Smith. “That should be a part of everybody’s training.” (Hat tip to @JJacksonJr for pointing this piece out.)
Courtney Hutchison, of the ABC News Medical Unit, looks at tornado preparedness for hospitals, especially the failure of the backup generator. As one expert points out, generators need adequate ventilation, which means they are usually near an exterior wall and vulnerable to tornadoes.
A New York Times story describes the frantic race to move patients before the tornado struck and then the aftermath, which included treating patients in the parking lot and using a bus and the beds of pickup trucks to take patients to other hospitals.
St. Johns’ Med Flight manager was briefly sucked out of the hospital:
Suddenly, the glass doors he was holding onto – the ones with the 100-pound magnet to keep them locked – were pulled open. [Rod] Pace was sucked outside briefly and then pushed back in like a rag doll but held on to the handles.
Engineers have started examining the hospital to decide whether it can be salvaged.
In the St. Louis Post-Dispatch, Blythe Bernhard tells the story of a St. Louis doctor, Brian Froelke, who is chief medical officer for the Missouri disaster medical team. That team, of about 40 health care providers, set up a 30-bed tent to serve as a replacement emergency department. Listen to Froelke discuss his experience treating tornado-related injuries. One doctor who was in the hospital when it was hit compared the scene to Haiti after last year’s earthquake.
Thomas Burton of The Wall Street Journal writes about the chaos that the town’s other hospital experienced. It was thrown into darkness and inundated with patients.
Joy Robertson of KOLR-Springfield, Mo., served as a member of the Federal Disaster Mortuary Response Team for several years and responded to the World Trade Center after 9/11. She explains (about halfway through the story) how the morgue operations work in mass fatality disasters and how victims are identified.
Why California hospitals can charge so much
Filed under: Health data, Health journalism, Public records
California hospitals, especially those in the Bay Area, seem to be able to set prices with impunity, a fact we know in part because the state requires an unusual level of hospital finance disclosure. This week, Kaiser Health News reporter Jordan Rau took advantage of the available records and dug through hospital spending databases and a long list of sources to figure out just what gave certain hospitals the leverage to charge so much more than competitors offering equivalent services. For a quick review of the data unleashed by this law, I recommend reviewing the map and charts that ran alongside the story.
As you might expect, the underlying explanation is complicated. When Rau asked the hospitals why prices were rising, he got a familiar refrain. They blamed it on the need to make up for low Medicare and Medicaid reimbursements, as well as charity care, and reminded him that technology is expensive and that their particular patient populations were unusual in ways that naturally obliged them to charge extra.
Those are certainly all part of the equation, but Rau investigation seems to point in another direction: Garden variety economic clout.
State laws have inadvertently given hospitals even more leverage. California requires health maintenance organizations to have “adequate networks” that offer all major specialties reasonably close to where patients live. Lisa Rubino, president of Molina Healthcare of California, an insurer, says the law makes it difficult for insurers to drop big hospitals from their networks.
“You have to work with them or make a strategic decision to get out of the area because they can dig in,” says Rubino.
Rau elaborates on this idea in a companion piece on NPR’s health blog, in which he points out how the industry has deftly squashed two different efforts to increase transparency in their pricing practices.
Some Mass. hospital quality measures online
Elizabeth Cooney, writing on White Coat Notes, alerts us to a change in data provided by the Massachusetts Hospital Association and the Massachusetts Organization of Nurse Executives.
PatientCareLink, the new site, adds examples of hospitals improving their performance and, for patients, gives advice on choosing a doctor or hospital, according to Cooney.
The site allows you to view hospital staffing plans and performance measures, such as prevalence of bedsores, patient falls, heart attack care, pneumonia care and surgical care.
Some of the data comes from Hospital Compare (also participating hospitals. And there’s no apparent way to download the data for analysis, as you can from the Hospital Compare site (and AHCJ).
Of course, ratings of Massachusett’s hospitals also are available from the Massachusetts Health Care Quality and Cost Council.
Hospital apologizes after banning newspaper
Filed under: Health journalism, Hospitals, Hot Health Headline
The Hackensack University Medical Center has apologized to The (Bergen County, N.J.) Record for banning its sale on hospital grounds and pulling ads from its publications in what appeared to be a reaction to an article about the hospital’s board.
The paper reports that a statement released by Rubenstein Associates says, “The leadership of the Hackensack University Medical Center Board of Governors consulted with the hospital administration and everyone agreed to reverse the decision regarding The Record.”
The New York Times reports that, after the “article about the hospital’s reaction was published, [Malcolm A. Borg, chairman of the North Jersey Media Group,] said he received apologetic phone calls from some members of the medical center’s board.”
The hospital has requested that newspaper deliveries resume but, as of Friday, hospital representatives had not been in touch about resuming the advertising.
The Times reports that Borg’s daughter serves on the hospital’s board but he says she recused herself from most decisions involving the newspaper.
Hospital cancels ads, bans paper after story
The Hackensack University Medical Center, apparently unhappy about a story about its governing board, has pulled advertising from The (Bergen County, N.J.) Record and banned the newspaper from hospital grounds.
The hospital requested that its ads on NorthJersey.com be removed immediately, asked to cancel its online advertising contract and canceled all ads from several community newspapers owned by The Record’s publisher, North Jersey Media Group.
It also told the paper to remove its vending boxes, to stop delivering to the hospital gift shop and canceled delivery of a magazine published by North Jersey Media Group.
The actions followed publication of a story on Sunday that “detailed how various board members help to underwrite Bergen County’s Democratic leadership and how several trustees do business with the hospital — a practice prohibited at some North Jersey hospitals.”
Malcolm A. Borg, chairman of the board of North Jersey Media Group, expressed regret that The Record will not be available to the public at the hospital.
“This retaliation is a real shame and is censorship,” Borg said.
He also noted that no one at the hospital has told the newspaper that any of their stories have been inaccurate. A hospital spokeswoman declined to connect the medical center’s actions to Sunday’s story.
“We constantly evaluate and change our media plan to be certain we are effectively positioning our message and that it is cost-effective,” spokeswoman Nancy Radwin said Thursday.
Len Bruzzese, executive director of the Association of Health Care Journalists, questioned the hospital’s actions.
“If sunshine and openness are the best disinfectants for business and government dealings, then you have to question what a hospital has in mind when it flips off the lights and closes the windows,” Bruzzese said.
Update
The hospital has apologized for its actions and requested that the newspaper resume delivery. Read more …
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