Whelan: Will HuffPo ruin AOL’s health site?
In the wake of AOL’s acquisition of the Huffington Post, Forbes.com’s David Whelan has taken the time to ask the $315 million health journalism question: What will happen to AOL’s decent health offerings when what he calls HuffPo’s trademark “medical freak show” leap on board?
As fellow Rahul Parikh fans will no doubt be aware, Ariana Huffington’s Post has long been a haven for those who share her non-evidence-based medical beliefs, but to recap, here’s Whelan’s biting comparison of the two sites:
AOL Health is a helpful site with tools for losing weight, Q&A sessions with Harvard Med professors, and a Mayo Clinic-esque databank of ailments and symptoms. It has its share of sensational headlines, overplaying stories on sex and diets. But that’s only a misdemeanor in the world of health journalism.
What’s always been closer to a journalistic felony is the way that the Huffington Post’s health coverage promotes pseudoscience, conspiracy theories and dubious remedies. Rahul Parikh, a pediatrician in the Bay Area who writes for Salon, has done some the best work I’ve seen exposing the looniness. Some examples from his survey: one blogger thinks swine flu should be treated with enemas, another promotes “distance healing”, and comedian Jim Carrey spreads the harmful theory that vaccines cause autism.
Since posting, Whelan received a pointed reply from HuffPo’s senior health editor, who says the site’s days on the fringe are now in the rear-view mirror:
UPDATE: The Huffington Post’s Senior Health Editor, Alana B. Elias Kornfeld, called to say that health articles are vetted by a Medical Review Board: “This has been true since HuffPost Health launched in Fall 2010 as a vertical separate from HuffPost Living where wellness coverage appeared in the past. As such, the acupuncturist referenced in Mr. Parikh’s 2009 Salon article is not the Health editor. Myself and Associate Health Editor, Meghan Neal, are both trained journalists.”
Matthew Herper, also of Forbes, follows up by pointing out that nothing seems to have changed. Today the Post has published a piece written by David Kirby that asserts people believe in a link between autism and vaccines for a reason and thus the debate won’t go away. Part of Kirby’s argument:
I know that many people will say the vaccine issue has been thoroughly investigated and debunked. I honestly wish that were the case, but it simply is not true. All of the “vaccine-autism” studies you hear about investigated just one childhood vaccine out of 14 (MMR), or one vaccine ingredient out of dozens (thimerosal). That is like announcing that air pollution does not cause lung cancer because you looked at carbon monoxide, alone, and hydrogen sulfide, alone, and found no link.
All of the pieces mentioned here are rich with links to other interesting reading about the subject so we encourage readers to explore the subject.
CPI to absorb Huffington Post Fund, health focus to continue
Filed under: Health journalism, Hot Health Headline
The New York Times‘ Tanzina Vega reports that two major news nonprofits, both regulars on this blog, are joining forces to create a heavyweight investigative unit with deep roots in the nation’s capital. The Center for Public Integrity, who we praised most recently for the wide-ranging asbestos investigation they did with the BBC, will absorb the Huffington Post Investigative Fund, which was founded last year. The HuffPo crew will bring with them $2 million in grant money, Vega reported.
Huffington Post Investigative Fund reporters Fred Schulte and Emma Schwartz have come up often in this space, thanks to their dogged coverage of health information technology and the ARRA. Editor Keith Epstein told AHCJ, via e-mail, that the combined organization will build on their efforts.
We’re going to have a strong emphasis on health reporting generally, and we’re excited that part of that emphasis will be continued and even enhanced examinations of the nation’s deployment of stimulus-fueled health information technology.
Health IT moves forward, regulation doesn’t
Filed under: Government, Health policy, Hot Health Headline
Fred Schulte and Emma Schwartz report that while the Obama administration plans to create a digital medical file for every American by 2014, “the administration has established no national mandatory monitoring procedure for the new devices and software. That no process exists to report and track errors, pinpoint their causes and prevent them from recurring is largely the result of two decades of resistance by the technology industry, a review of government records and interviews by the Huffington Post Investigative Fund shows.”
Major HIT malfunctions continue – they focus on one of 10 hospitals in the Trinity Health System in the upper Midwest – and nobody has a grip on their location or frequency. Meanwhile, the administration has issued regulations for HIT implementation that make no mention of safety and quality standards, standards the FDA has been considering for some time.
Beacon programs offer hope for health IT
Filed under: Government, Health care reform, Health policy, Hot Health Headline
Emma Schwartz and Fred Schulte, the HIT specialists at the Huffington Post Investigative Fund, examine the 15 “beacon” programs involved in a $220 million federal effort designed to demonstrate how health tech can bring better treatment at a lower cost. Twelve of the programs will focus, at least in part, on diabetes in order to explore how much of an impact HIT can have on chronic (and under-treated) diseases.
For more on each program, visit this interactive map.
The grants also offer an early test of a $27 billion gamble by the Obama administration that medical records technology can achieve specific cost reductions and health improvements, critical tenets of health reform.
Hopes are high. In Mississippi, the alliance aims to reduce blood sugar levels in at least one of four patients with diabetes, increase the numbers of people who take their medications as directed and cut the cost of their care by 10 percent – all within the next three years. In Tulsa, Okla., which has the nation’s highest rate of heart disease, another group is hoping that its $12 million grant will reduce preventable hospital visits by 10 percent while saving patients and taxpayers $11 million a year.
Schwartz and Schulte write hopefully of the potential shown by the beacon programs, but temper it with cautionary tales from Florida and various auditor’s offices.
Schulte, Schwartz look for help investigating HIT
Filed under: Health data, Health journalism, Hot Health Headline
Regular readers know that we always keep an eye out for updates from Fred Schulte and Emma Schwartz, the duo from the Huffington Post Investigative fund that refuses to let the Obama administration’s push for health information technology proceed without scrutiny. This time, they’re following up on past work with stories on HIT-related errors and the FDA’s role (or lack thereof) in the policing of HIT.
Their most interesting update, however, concerns their effort to get HIT-related “adverse events” data from the FDA. Schwartz describes the difficulties they’ve run into, how they’ve overcome them, and how readers can help them put the whole puzzle together. It’s an interesting strategy, and an equally interesting primer on the FDA’s tricky “Manufacturer and User Facility Device Experience,” or MAUDE, database. You can also find their own version of the data here, courtesy of Amanda Zamora.
Attending Health Journalism 2010?
Schulte will be speaking about “Tracking health-related stimulus money” during a panel at 4:15 p.m. on Friday. His co-panelists will be ProPublica reporter Michael Grabell and Phil Galewitz, a Kaiser Health News reporter and AHCJ board member.
On Sunday morning, don’t miss the panel “Personal electronic medical records: What will consumers need to know?” featuring:
- Steve Gray, partner, Affiliated Computer Services Healthcare Solutions
- Bala Hota, M.D., M.P.H., chief medical information officer, Cook County Health and Hospital System
- Thomas Layden, M.D., chief, Department of Internal Medicine; professor of medicine, University of Illinois at Chicago
- Moderator: Prerna Mona Khanna, M.D., M.P.H.. visiting clinical associate professor, University of Illinois College of Medicine
Tracking medical errors amid health tech push
Filed under: Government, Health policy, Hot Health Headline
Fred Schulte and Emma Schwartz are still hot on the trail of health information technology at the Huffington Post Investigative Fund, now exploring the timeline and tactics involved in tracking medical errors as part of widespread stimulus-funded HIT adoption. Colleague Amanda Zamora’s companion graphic helps provide both an at-a-glance overview and in-depth understanding of how errors are tracked now and how they will be monitored in the future.
Schulte and Schwarz write that a federal panel hopes to create a national database of HIT-related errors, but that it won’t be functional until 2013, a date many experts fear is unnecessarily distant.
The draft proposal would require doctors and hospitals to report problems as a condition of receiving stimulus money, starting in 2013. The panel, which is expected to finalize the plan next month, also wants to require that manufacturers alert customers when software glitches are discovered and require all users of the systems to undergo safety training
…
But many early adopters, who often have spent a decade or more and tens of millions of dollars working out kinks, say that even additional oversight can’t stave off every potential hazard. And they are becoming increasingly vocal about the downside of rushing into buying the highly complex technology.
“There is a great fear among many people that we are asking organizations to go too far too fast,” said Justin Starren, who directs health technology at the Marshfield Clinic in Wisconsin. “It’s a foregone conclusion that with this many installations that some people will make some mistakes.”
Schulte will be taking part in a panel about “Tracking health-related stimulus money” at Health Journalism 2010. Joining him on the panel will be ProPublica reporter Michael Grabell and Phil Galewitz, a reporter for Kaiser Health News and member of AHCJ’s board of directors.
FDA to regulate health information technology?
Fred Schulte and Emma Schwartz, the Huffington Post Investigative Fund duo who have made it their business to stay in front of all stories related to the federal push for the adoption of health information technology, now look at the possibility of federal regulation of health IT.
Schulte and Schwartz write that “In the past two years, the agency has received reports of six patient deaths and several dozen injuries linked to malfunctions in the systems,” and officials say those voluntary reports represent just the tip of the iceberg. In case you’re interested, here are the transcripts from the relevant government hearing.
… digital medical systems are not risk-free. Over the past two years, the FDA’s voluntary notification system logged a total of 260 reports of “malfunctions with the potential for patient harm,” including 44 injuries and the six deaths. Among other things the systems have mixed up patients, put test results in the wrong person’s file and lost vital medical information.
Schulte and Scwartz summarize the three possible regulatory approaches outlined by officials:
- Option 1: FDA requires HIT makers to register, submit safety reports and correct problems.
- Option 2: FDA requires HIT makers to report safety concerns and sets minimum quality guidelines.
- Option 3: FDA makes HIT “subject to the broader regulatory actions that new medical products must face before they ever reach the market.”
Many manufacturers argue that such regulation could be counterproductive.
The manufacturers of the systems generally have opposed regulation by the FDA, arguing in part that imposing strict controls would slow down the government’s campaign to spur widespread adoption of the technology.
Regulation will not necessarily create a “safer” electronic medical record “and might actually limit innovation and responsiveness when it is needed most,” Carl Dvorak, executive vice president of Epic Systems Corporation, a Wisconsin-based company that builds the systems mainly for hospitals and large medical practices, said in his prepared testimony for Thursday’s hearing. The hearing is being held by an advisory group created by the stimulus law.
Government Health IT also is following the issue and points to some problems the Veterans Health Administration has run into and how it dealt with the lapses.
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.
Federal EMR budget slashed, switchover delayed?
Fred Schulte and Emma Schwartz have put together the latest installment in the Huffington Post Investigative Fund’s ongoing look at electronic medical records, this one focusing on how budget cuts could make it more difficult to meet the administration’s targets for nationwide adoption of electronic records.
In May, budget officials estimated they would spend up to $47 billion in stimulus money to help doctors and hospitals purchase the systems. But in a press briefing on Wednesday, officials said that figure had been chopped nearly in half to between $14.1 billion and $27.3 billion.
A program like this has never been done on this national scale,” Tony Trenkle, who directs the office of e-health standards and services for the federal Centers for Medicare and Medicaid Services, told the Huffington Post Investigative Fund in an interview.
Daschle pushes health IT to Obama, clients profit
Filed under: Conflicts of interest, Hot Health Headline
South Dakota Democrat and former Senate Majority Leader Tom Daschle is not registered as a lobbyist, and has not held public office since he lost a re-election bid in 2004. Instead, Fred Schulte and Emma Schwartz report for the Huffington Post Investigative Fund, that Daschle has existed in a nebulous limbo that’s allowed him to pivot deftly from pushing electronic medical records as an almost-HHS secretary to helping private firms profit handsomely from their implementation.
Daschle, as Obama’s first choice to head the Department of Health and Human Services last year, was a forceful advocate for using billions of dollars in economic stimulus money to help doctors and hospitals buy electronic medical records systems.
Tax problems led him to withdraw his name from consideration for the cabinet post. Then, a few weeks after Obama signed off on a stimulus plan that provided some $45 billion for digitizing the health system, Daschle began assisting private clients seeking to profit from the new law.
Public interest groups take issue with Daschle’s activities:
“He was in a position to drive public policy and develop connections within HHS that could provide his clients with an unfair competitive advantage in receiving taxpayer dollars, at the same time he and his firm benefits from his previous activities,” said Scott Amey, a lawyer with the Project on Government Oversight.
In the rest of the solid, in-depth piece, the reporters track both the breadth of Daschle’s influence (he has the ear of the president) and the impact he’s had on bottom lines across corporate America.
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