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Resources: AHCJ Articles

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Title  |  Date Posted  |  Author

Drilling down into numbers uncovers Marketplace glitch     Posted: 04/07/14

Don Sapatkin
Don Sapatkin

Ten days before the (expected) close of open enrollment, The Philadelphia Inquirer reported that the federal exchange's window-shopping tool – the one that the administration encourages everyone to check before applying for Marketplace insurance – was using the wrong year's poverty-level guidelines. Neither the Obama administration nor any health-care consultants or policy experts that reporter Don Sapatkin could find had noticed it and the site was corrected within hours after the story was posted.

In theory, almost anyone going on the site got slightly incorrect information for 35 days. Most seriously affected, however, were people just above the poverty line in states that have not expanded Medicaid. When they put their information into the tool, it responded: “Not eligible for help paying for coverage.” Many of them may have given up right there and not submitted the actual applications (which were using the correct poverty stats and were assessed correctly). It’s impossible to tell from the notification letter whether errors were made.

Analysis looks at which consumers get better deal in the health insurance exchanges     Posted: 03/24/14

MaryJo Webster
MaryJo Webster

Chris Snowbeck
Chris Snowbeck

When writing about health insurance premiums under the Affordable Care Act, MaryJo Webster and Chris Snowbeck at the St. Paul Pioneer Press found significant premium disparities among rates in the Twin Cities, Rochester, Minn., and nearby western Wisconsin.

These discrepancies raised two big questions: Do such disparities exist throughout the entire United States? If so, who gets the better deal – consumers in the Twin Cities with low premiums and little chance of getting federal tax credits, or consumers in the higher-cost places who benefit from the subsidies?

Maine moves toward using dental therapists to extend care     Posted: 03/24/14

Image by U.S. Pacific Fleet via Flickr.
Image by U.S. Pacific Fleet via Flickr.

Technically trained dental auxiliaries known as dental therapists have been providing care in many countries around the world for decades. 

Dental therapists already work in Alaska and Minnesota, where advocates say the new providers will help get a range of needed services including routine care, fillings and simple extractions to poor and rural communities.

Dentists’ groups have fiercely opposed the idea, saying no one but dentists should be allowed to drill or pull teeth. Now the debate is playing out in Maine, and as the state legislature mulls the dental therapist question, Joe Lawlor and his colleagues at the Portland Press Herald have been keeping readers informed.

Investigation: Officials sent sick, dying homeless people to unlicensed facility     Posted: 03/19/14

Michael LaForgia
Michael LaForgia

Will Hobson
Will Hobson

"A home, but no help" was the fifth story in a seven-part investigative series on Hillsborough County's Homeless Recovery program. Earlier in 2013, Michael LaForgia and Will Hobson of the Tampa Bay Times  had been tipped off that the chairman of the Tampa Port Authority was running an illegal slum trailer park.

That story turned into an investigative project when they learned some of the people living there had been sent there by Homeless Recovery, a government agency that paid their rent with public money. As the reporters started to amass records, it became clear the Port chairman's slum was one of dozens the county had subsidized for years with a steady stream of homeless people, including families with children and veterans, and tax dollars.

Mixing medical evidence with a personal health experience     Posted: 03/18/14

Karen D. Brown
Karen D. Brown

When I was diagnosed with breast cancer following a routine mammogram, my first response definitely wasn’t, “I bet I can get a story out of this.”

Of course, my very first response was not something we can print on a family-friendly website.

But even after I started to gracefully (sort of) accept what I was facing, I wasn’t anxious to write about it. There is a rich literature of illness narratives, and I didn’t feel my own emotional experience was going to add much to what many excellent writers had already contributed to the canon. (See: Barbara Ehrenriech, Joyce Wadler, Peggy Orenstein, to name just a few.) Plus, my own diagnosis – a stage 0 noninvasive cancer called ductal carcinoma in situ (DCIS) – had an excellent prognosis, which thankfully took much of the pathos out of my story.

Questions arise about oversight of pediatric dentists     Posted: 03/18/14

Alia Wong
Alia Wong

The state of Hawaii continues to investigate the death of a three-year-old girl who went into a coma after visiting a dentist’s office. Reporter Alia Wong has also been following the tragic story of the death of Finley Boyle and weighed in with a long Jan. 21 piece for the Honolulu Civil Beat.

Wong brings us up to date on the kinds of questions that are being raised in the wake of the child’s death. She writes in her piece that questions are being raised about whether dentist Lilly Geyer, who was treating Finley, should have been advertising herself as a "children's dentist." She explains that “pediatric dentists do a rigorous and competitive two-year residency program in which they get training in specific skills such as child sedation while general dentists aren’t required to do a residency program.”

Using state exchange data, Chicago journalists estimate the true cost of health insurance     Posted: 03/04/14

Kristen Schorsch
Kristen Schorsch

Andrew Wang
Andrew Wang

When purchasing health insurance, we’re basically buying blind. At the point of purchase, we have no way to know what the total cost will be at the end of the policy period. We know the monthly premium and what we might incur in deductible and co-insurance charges. But the total will be unknown until year end when we can add the premium and out-of-pocket charges together.

So, what is the true cost of one year of health insurance coverage? This is the question Andrew L. Wang and Kristen Schorsch, health care reporters for Crain’s Chicago, set out to answer. It’s a question health care journalists are trying to answer as well because the premium is only one part of a complex calculation that actuaries make for each consumer buying a health insurance policy.

The resulting analysis shows that the average total cost of coverage for a consumer for one year could be more than triple the monthly payments to an insurer.

Use state public records laws to cover these aspects of health exchanges     Posted: 03/04/14

Katie Kerwin McCrimmon
Katie Kerwin McCrimmon

Colorado health reporter Katie Kerwin McCrimmon is a relative newcomer to AHCJ and she shared some of her experiences in covering Colorado’s state health exchange on AHCJ’s electronic discussion list recently.

She used the Colorado Open Records Act (CORA) “to pry information out of our exchange since I dealt with obstructive PR folks and exchange managers for most of 2013.”

Not all states have the same records laws. Not all the states have structured the exchange governance in the same way. And of course, not all the states are running their own exchanges. But her experiences in Colorado are still instructive in trying to get information released.

Reporter focuses on chronic pain for series on opioid use     Posted: 02/14/14

Lisa Bernard-Kuhn
Lisa Bernard-Kuhn

When The Cincinnati Enquirer set out to look at the societal costs of the deadly opioid crisis, reporter Lisa Bernard-Kuhn was assigned to look at the role of chronic pain.

During more than eight months of reporting, she looked into how doctors measure pain, how effect opioids are at treating pain, patients’ expectations and more.

Here, she explains how she was able to get doctors and patients to talk on the record and shares some of her most useful sources and lessons learned.

Follow-up on dental reconstruction reveals the importance of a healthy smile     Posted: 02/13/14

Marc Ramirez
Marc Ramirez

Marc Ramirez of The Dallas Morning News recently offered readers an update on a story he began to write more than two years ago.

Robina Rayamajhi, a legally blind college student, had not let her visual disability stop her from excelling at the University of North Texas and setting her hopes on a law degree. Yet her crooked teeth were having an impact on her self-confidence. When a group of caring health care professionals from the community joined forces to help her, Ramirez documented the transformation of Robina’s smile.

Here, Ramirez shares some thoughts on how he embarked upon the story and how he developed it. He also offers some good advice to other reporters who might find themselves revisiting a story over time.

Movement away from fee-for-service reimbursements has begun     Posted: 02/11/14

René Letourneau
René Letourneau

Among health plan executives, there’s a lot of talk about moving from volume to value. But identifying what this expression means in practice can be challenging because health plans all define value differently and they are developing ways to deliver more value to their employer and consumer customers.

Despite the challenges, some payers and providers are in fact shifting away from volume-based payments, commonly known as fee for service, and adopting value-based payment methods, as René Letourneau, a senior finance editor with HealthLeaders Media, reported in a recent cover story, Restructuring Reimbursements. She found, for example, that a group of hospitals contracting with a health plan had agreed to have 15 percent of their income based on patient outcomes. As the health plan executive explained, “If you want to change behaviors, you’ve got to change incentives.” Letourneau explained that the risk of not being paid 15 percent of their contracted reimbursement rates if they do not meet certain outcome measures appears to be motivating hospitals to find ways to deliver better care. Here’s Letourneau’s explanation of how she reported this story.

Finding wide variations in health reform implementation between states     Posted: 02/11/14

Beth Kutscher
Beth Kutscher

Modern Healthcare reporter Beth Kutscher watched the differences in Affordable Care Act implementation in her state of Tennessee and neighboring Kentucky. She began to think about what it meant for the hospitals in the two states – and she decided to find out. Here’s how she got her story.

Personal story helps illustrate physiological effects of stress     Posted: 01/14/14

The idea that chronic stress can change how your body and brain work fascinated Dan Gorenstein, a radio reporter at Marketplace, and it sparked the idea for an affecting, memorable piece about poverty and health.

The report pivots on the story of a woman with a troubled past and a painful confession. How did Gorenstein find her, and persuade her to go public? How did he balance her interests with his potentially conflicting interest in pursuing a good story?

The piece also distills a lot of complicated research about chronic stress, decision making and health. But it remains a tight, fast-moving narrative. Here’s how Gorenstein did it.

Finding compelling stories about a fraying safety net in a fast-changing insurance marketplace     Posted: 01/13/14

Jim Doyle, who covers the health care industry for the St. Louis Post-Dispatch, has been working on an ongoing multi-part series on health care access and the fraying safety net. What he found when he traveled around rural parts of Missouri and Arkansas is that while the Affordable Care Act will bring changes in the health insurance marketplace to these area, it only goes so far in helping the poor get access to care. “If you report on rural hospitals, you'll soon recognize the parallels between the health care disparities the poor face in rural areas and in the inner cities and that health insurance reform only goes so far, causing many safety-net organizations to struggle,” he writes. Of particular interest to health care journalists is Doyle’s impressive list of resources he uses to inform his reporting and his willingness to tap a wide variety of sources for his work.

New dental coverage may strain access to care     Posted: 01/13/14

Michael Booth recently wrote about the worsening shortage of dental care in Colorado for The Denver Post, explaining that “hundreds of thousands of Coloradans will have new dental care benefits in 2014 under twin health-reform efforts, but state leaders now must scramble to find providers who will care for them.” It is expected that 335,000 adult Medicaid beneficiaries will gain access to dental care in the spring and that tens of thousands more will join Medicaid rolls under the Affordable Care Act expansion. In addition, thousands of children could get new dental benefits when their parents buy coverage on the state’s insurance exchange, Booth wrote.  But health advocates warn that, if just a quarter of the newly enrolled Coloradans start using their dental benefits, the system will be strained. Here, Booth offers some insights into how things may play out in Colorado, as well as advice to the rest of us who are watching this issue.

Reporting on how Catholic hospital mergers affect patient care     Posted: 12/06/13

Nina Martin
Nina Martin

Nina Martin of ProPublica recently wrote about the growing number of health care mergers involving Catholic hospitals – and how that affects care involving reproductive health services including fertility treatments, genetic testing and, in certain states, assisted suicide.

Here’s her story about how she got interested – and how you can get started tracking similar stories in your own communities.

Delving into cost reports reveals financial health of hospitals, amount of charity care they provide     Posted: 12/06/13

Clifton Adcock
Clifton Adcock

Oklahoma Watch, a nonprofit investigative journalism team, recently published a two-part series on hospitals based on financial data obtained for every hospital in the state. The series revealed that between half and three-fourths of small general hospitals in Oklahoma were losing money, and that hospitals had spent only small fractions of their net patient revenues on charity care.

Reporter Clifton Adcock explains how he got the data, with some specific tips on how to find alternative sources for data when government officials are uncooperative and how to make sense of daunting hospital cost reports.

How I did it: Reporting on delays in newborn testing     Posted: 12/06/13

Ellen Gabler
Ellen Gabler

The investigative team of Ellen Gabler, John Fauber and Mark Johnson at the Milwaukee Journal Sentinel used data to uncover a national tragedy: infants dying or becoming permanently disabled because labs don't process their newborn blood tests in time to save them.

The national investigation was based on an analysis of nearly 3 million newborn screening tests from babies in 31 states. They requested records from all 50 states and the District of Columbia

Here, Gabler describes how she got the numbers that led to the multi-part series.

Investigation finds improper spending among organ procurers     Posted: 11/21/13


Andrew Conte


Luis Fábregas

Every reporter knows the stories that organ recovery nonprofits pitch to media outlets, about donors’ families receiving praise from recipients at annual events with flowers, medals and teary speeches.

The Pittsburgh Tribune-Review has covered these stories for years, often reporting some heartwarming stories of turning loss from death into life for someone else. But investigative reporters Andrew Conte and Luis Fabregas started wondering what happens at these organ procurement organizations the rest of the year.

The national investigation, “Donor Dilemma,” revealed that the nonprofits collected $1.2 billion in 2011 from recovering more than 80,000 organs, bones and other tissue. They paid top executives $320,000 a year on average and, in some cases, hired family members to work at their nonprofits. Other nonprofits rented a private jet, threw large retirement parties, bought Rose Bowl Tickets and held a retreat at a five-star oceanfront resort – with the federal government and taxpayers picking up part of the cost.

Halloween a natural time to write about oral health     Posted: 11/15/13

Halloween candySome dentists give out toothbrushes for Halloween. Culberson Boren, D.D.S., in Tyler, Texas, offered to buy back kids candy for a dollar a pound. Melissa Daigle, a reporter for CBS affiliate KYTX paid him a visit.

"A lot of people are trying to get guns off the street," Boren told her. "We're trying to get candy off the street."

Daigle took a break from her work to share a few insights into her piece, which was fun, and at the same time managed to incorporate some useful oral health information.

'Critical access' designation may be in danger for hospitals in your area     Posted: 11/07/13

David Wahlberg
David Wahlberg

In rural areas, the federal Centers for Medicare & Medicaid Services designates more than 1,300 hospitals as being “critical access hospitals.” These facilities get higher reimbursements to ensure that Americans outside of cities and suburbs can get the care they need without having to travel too far. In August, a report from the Office of Inspector General of the federal Department of Health and Human Services recommended that many of these facilities be decertified.

When he learned of the report, David Wahlberg, a health/medicine reporter for the Wisconsin State Journal, interviewed administrators at critical access hospitals in Wisconsin and found that the administrators believed closing these hospitals would have a detrimental effect on care for Medicare patients. The issue of payment for these facilities is important in every state, but particularly in Wisconsin, which has 58 critical access hospitals. Wahlberg also found that, while critical access hospitals will not be decertified soon, they could be in the future.

Wahlberg points out some important issues journalists should be looking into that involve patient care, the local economy and screenings and care for more vulnerable populations.

Reporter follows epidemiological investigation of dental practice     Posted: 10/23/13

When genetic testing concluded that a former patient of W. Scott Harrington contracted hepatitis C at the Tulsa oral surgeon’s office, Tulsa World reporter Shannon Muchmore was there to file the latest installment in an unfolding story she has been covering since the spring.  

The case turned out to be the first documented report of patient-to-patient transmission of the hepatitis C virus associated with a dental setting in the United States, according to Oklahoma state and local health officials. In March, officials started testing thousands of Harrington’s former patients for hepatitis and HIV after an office inspection turned up lax sanitation practices and other violations of the state’s Dental Act. Since then, more than 4,200 people have been tested at free clinics.

Muchmore took some time out from her work on this story to offer AHCJ members an update on what she has found.

Reporter looks at why, how clinic banned drug reps and their samples     Posted: 10/15/13


Markian Hawryluk

Six years ago, a clinic in Oregon made the decision to ban representatives from the pharmaceutical companies. The doctors and staff say goodbye to free samples of expensive drugs, lavish lunches, pens, notebooks, mugs, toys for children and other "benefits."

Markian Hawryluk, a health reporter with The Bend (Ore.) Bulletin, picked up on a recent journal article about the transformation and used that as his inspiration to write about how the clinic made its decision and how it changed the way doctors there practice medicine, as well as how the move impacted the community.

As data is collected under the Physician Payments Sunshine Act, a part of the Affordable Care Act that will require pharmaceutical companies to disclose the money and gifts given to physicians, reporters may start noting similar changes in their area.

Story on 'diaper need' brings a medical study to life     Posted: 10/14/13


Eryn Brown

Medical research can often seem far removed from a local health beat. All the statistics, the jargon, the complicated graphs can make it easy to forget that behind every number there's a real person. In fact, medical studies can be great jumping off points for local stories. The key is finding the people who are at the heart of the research.

We asked health reporter Eryn Brown to share how she recently turned a medical study from Yale University into a poignant local story for the Los Angeles Times. In bringing the research home, she shined a light on the heartbreaking ways low-income mothers have to stretch diapers when they can't afford a steady supply.

The story is part of a recent push in research to "operationalize" poverty by documenting the concrete ways income impacts health and quality of life. These kinds of studies are starting to give us a glimpse into the hardships faced by people on the fringes of society.

Covering pediatric dental benefits     Posted: 09/05/13


Chad Terhune

Pediatric dental benefits are among the 10 essential health benefits included in the Patient Protection and Affordable Care Act.

But offering them on the new health insurance marketplaces scheduled to open Oct. 1 holds challenges for states. Should kids’ dental benefits be sold as standalone plans, separate from medical insurance as they usually are? Should they be bundled with other benefits? Embedded into policies? Is everyone required to buy them? Are parents required to buy them? Will they be affordable?

As I wrote in a recent blog post, Chad Terhune of the Los Angeles Times has done a good job of writing about the complexities of fitting pediatric dental benefits into California’s exchange, “Covered California.”

He was good enough to share his insights into the unfolding story and to offer advice to AHCJ members who might want to see how this issue is playing out in their own states.

Poor oversight of Medicaid managed care programs takes toll on patients     Posted: 08/22/13

Jenni Bergal
Jenni Bergal

When Kaiser Health News hired Jenni Bergal as a freelance contractor, she was given only one assignment: Write about Medicaid managed care. It’s an important topic, with millions more people expected to be enrolled as Medicaid expands under the Affordable Care Act starting next year.

She set out to find out how well the states are overseeing and monitoring the quality of care provided by the managed care plans they contract with, and how states compare with each other. In this article for AHCJ, she explains the challenges in doing so. She also reminds us that even policy stories are about people and shows us how problems in one state's managed care program have affected its residents.

Reporter finds surprising stance on smokers' surcharge     Posted: 08/06/13

Stephanie O'Neill
Stephanie O'Neill

Stephanie O’Neill, a health care reporter for Southern California Public Radio, tells the back story of her report on why California – a state that has taken the lead in combating tobacco – had second thoughts about whether to charge smokers higher insurance premiums as permitted under the Affordable Care Act. The issue put anti-smoking groups, such as American Cancer Society and American Lung Association, in odd alignment with tobacco companies on this matter.

It’s a topic you can explore with legislators, insurers and public health advocates in your state.

Covering the science of water fluoridation     Posted: 07/03/13

Kyle Hill
Kyle Hill

Around the country fights over water fluoridation have made news in recent months.

Public health officials and dentists can show years worth of evidence that fluoride, when present at optimum levels in community water supplies, reduces tooth decay. But opponents protest that fluoride at any level is dangerous.

Late in May, Portland voters rejected a decision to fluoridate the city’s water.

Kyle Hill quickly weighed in on his Overthinking It blog for Scientific American in a piece titled "Why Portland is Wrong about Fluoride."

Hill, a freelance science writer who tackles a wide variety of topics, was good enough to share a few thoughts about his coverage.

Covering health reform's effect on addiction treatment     Posted: 06/20/13

Carla K. Johnson
Carla K. Johnson

Carla K. Johnson, an Associated Press medical writer and AHCJ board member, recently did an insightful piece on how the coverage expansion under the Affordable Care Act would affect treatment for substance abuse and addiction.

She analyzed several sets of federal data to find the current capacity of the addiction treatment system and the number of possible new patients. Armed with the data, she then did another round of interviews with addicts, their families and their treatment providers.

Here she shares how she got her story – and provides tips and sources that can help you explore this topic in your own community.

Geotagging CMS Medicare discharge data to highlight cost differences     Posted: 06/20/13

Tyler Dukes
M. Tyler Dukes

Less than 24 hours after CMS released its Medicare charge data, AHCJ member Rose Hoban and data journalist Tyler Dukes analyzed the data and developed a comprehensive story on cost differences for several of the most prevalent conditions across the state.

Dukes used the statistics to code a map with different colored informational pins so readers could see the numbers for themselves. He explains how he went about creating this interactive tool.

Reporter shares experience covering investigation into dental clinics     Posted: 05/07/13

Shannon Muchmore, health reporter for The Tulsa World, has been leading the pack in covering allegations of lax sanitation practices at the office of oral surgeon Scott Harrington. Amid a steady stream of reports, she took the time to share some of her insights into the complexities of the unfolding drama.

Complaints to attorneys general yield sources for dental investigation     Posted: 04/30/13

David Heath
David Heath

Dollars and Dentists, a joint investigation by David Heath of the Center for Public Integrity and Jill Rosenbaum of PBS Frontline captured a first-place Award for Excellence in Health Care Journalism.

The report, which aired last summer, explored the dearth of care for millions of poor children and adults and raised serious questions about the business practices of dental chains that serve Medicaid children and the elderly.

Mary Otto, AHCJ's oral health topic leader, caught up with Heath at Health Journalism 2013 in Boston and he shared some reflections on the making of the project.

Paying careful attention yields story on business, marketing of dental practices     Posted: 04/12/13

Amy Jeter
Amy Jeter

Amy Jeter of The (Norfolk) Virginian-Pilot, looked at the impact of the financial downturn on dental practices and how the practices were working to counteract that.

She found people are getting phone calls, texts and emails from dentists to not only remind them of appointments but also to wish them a happy birthday and offering awards for referrals and deals through Groupon. Jeter shares with AHCJ a few insights on how the story evolved.

Readmissions, the drug store and a sleep-deprived patient     Posted: 04/04/13

Eric Whitney
Eric Whitney

Colorado Public Radio's Eric Whitney recently reported on a new program involving Walgreens pharmacists that is intended to help hospitals reduce readmission rates. It seemed like a straightforward story about improving patient care and new business opportunities created by the Affordable Care Act.

Not so straightforward was the improvising Whitney had to do when things started going awry. He writes about the challenges of putting together a piece for radio, what went wrong and how he was able to pull it all together.

As Whitney writes, there are innovative strategies being tried across the country. Broad reporting on the topic will help audiences better understand one place where health care is failing, and why solutions aren’t always simple.

Focus on freelancing: Keys to negotiating fair contracts     Posted: 03/28/13

Irene Wielawski
Irene Wielawski

There’s no shortage of war stories among freelancers about the kinds of contracts they’ve been asked to sign. Some go on for pages, others are marvels of straightforward simplicity. The worst ones demand – in addition to a well-researched, cogently written and accurate story – guarantees against any error that could possibly occur along the road to publication.

Veteran freelancer Irene Wielawski says it took her years to figure out how to build into standard contracts the tools she needed to protect the integrity of her work. Now she uses that experience to advise other freelancers on what things to avoid when negotiating a contract and why.

When the study’s not the story     Posted: 03/07/13

Salynn Boyles
Salynn Boyles

Writing about medical research can be a pretty straightforward task. But then there are times when a study that doesn't tell the whole story. These studies share common red flags – they're usually funded by drug or device manufacturers, they're eagerly promoted, and they typically ignore other studies with conflicting results.

Award-winning freelancer writer Salynn Boyles shows us how she spotted one such study and did the legwork to add background and balance. The end result was a story she says took more effort, but ultimately reflected told a bigger truth about one kind of weight loss surgery. Another bonus: It was more fun to write.

'A Life Hijacked:' Long-term project documents man's saga with Alzheimer's     Posted: 01/30/13

Gary  Rotstein
Gary Rotstein

Gary Rotstein, the Pittsburgh Post-Gazette’s age beat reporter, has been following and writing about Alan Romatowski, a man with early-onset Alzheimer’s disease since July 2008. His series, updated each Thanksgiving weekend, is a long-running chronicle of Alan's experiences, his decline, the impact on his family and others, to show what so many American families increasingly experience among the 5 million-plus dementia cases.

Rotstein writes for AHCJ about how the project got started, how he's handled telling the family's story sensitively and the kinds of stories he has written about Romatowski and his family.

Deadline management for medical research news     Posted: 01/11/13

Daniel J. DeNoon
Daniel J. DeNoon

Deadline in a few hours? “Don’t panic” is bad advice. It’s not even possible when deadline looms and nobody has called you back. Managing that hot little ball of panic is key. Think of it as a controlled nuclear reaction from which you can draw energy.

Award-winning health reporter Daniel J. DeNoon shares his strategy for writing a news story about a journal article on deadline.

Race to electronic health records may come with a price     Posted: 11/27/12

Fred Schulte
Fred Schulte

Amid all the enthusiasm over increasing the use of information technology in health, politicians and policy makers paid little attention to the implications of a gold rush sparked when billions of taxpayers’ dollars suddenly came up for grabs. Hundreds of medical technology companies scrambled to sell digital systems — often by promising doctors and hospitals they could boost revenues by billing higher rates to Medicare and other health insurers.

The fallout from those early decisions could be coming back to haunt taxpayers, according to a three-part investigative series from the Center for Public Integrity. The series documented that thousands of medical professionals steadily billed Medicare for more complex and costly health care over the past decade — adding $11 billion or more to their fees — despite little evidence elderly patients required more treatment.

Reporter Fred Schulte explains how the project came about, how the Center did its reporting and provides plenty of background on medical coding, Medicare billing and the potential fallout as health care providers install and use electronic systems.

Reporter chases down cost of new tax break for investor-owned hospitals     Posted: 11/27/12

CAPTION
Carla K. Johnson

When Illinois Gov. Pat Quinn signed into law a tax break for investor-owned hospitals last spring, there was no official analysis of how much it would cost the state in lost revenue. Carla K. Johnson, a medical writer with The Associated Press, thought that was odd and that the tax break itself was unusual.

When she asked aout the cost of the tax break, a spokesman for the Illinois Hospital Association met her questions about the cost of the tax break with answers like, "That's difficult to say." The Illinois Department of Revenue spokeswoman said that department was never asked for an official estimate.

Johnson, determined to figure out the cost, delved into records to calculate the amount of the tax break and discovered that, during a time of fiscal crisis, legislators had passed a bill that costs the state millions of dollars. Read how she arrived at the estimated cost and how it informed her reporting on the tax break.

'Dollars and dentists:' Investigating the dental care crisis in the U.S.     Posted: 09/18/12

Jill Rosenbaum

Jill Rosenbaum

Dollars and Dentists” a joint project of PBS Frontline and the Center for Public Integrity, looked at the consequences of a broken dental care system.

The project reveals the consequences of a ruptured dental care system and investigates how a new breed of corporate dental chains are filling the gaps. Reporters counted at least 14 major chains, owned by private equity groups. But, they discovered that because they are largely owned or backed by private equity firms, there is little publicly available information about them.

In this piece, Frontline Producer Jill Rosenbaum shares how the investigation got started, where they found data, who the key sources were and some ideas of stories that are ripe for coverage.

Reporters can use hospital readmission data to explore key issues     Posted: 09/06/12

Jordan Rau
Jordan Rau

The Affordable Care Act honed in on hospital readmissions because many health policy experts believe they’re symptomatic of the broad dysfunction of the health care system where providers don’t work with each other as patients pass from one setting, like a hospital, to another, like a primary doctor’s oversight or a nursing home.

Readmissions penalties that begin in October are intended to prod hospitals to start making sure patients get the care they need after they walk out the door. It’s a nice window into many of the most important issues in health care, including cost, access and disparities.

Jordan Rau, of Kaiser Health News, explains the penalties, the readmission data and offers tips on how to use the data to write about hospitals with specificity and authority.

Author makes transition from print to blogging     Posted: 08/23/12

Howard Gleckman
Howard Gleckman

Howard Gleckman, formerly a senior correspondent in the Washington, D.C. bureau of Business Week, explains his metamorphosis into a blogger who focuses on long-term care, health policy and tax policy. While at Business Week, he covered two beats that seemed disconnected but were not – tax and budget policy and health policy. But, as Gleckman points out, we’ve all learned in recent months that tax and health policy turn out to be closely linked.

Gleckman discusses the range of topics he covers, the value of feedback he receives through his social media efforts, how much time he spends on various projects and more.

Documentary reveals struggles of aging LGBT community     Posted: 08/16/12

Stu Maddux
Stu Maddux

For a generation of lesbian, gay, bisexual and transgender adults now in their 60s, 70s and 80s, silence was, for a long time, a way of life. Often they struggled with fear, shame, and isolation, along with a deep-seated distrust of authority and a dread of discrimination.

Growing old and becoming ill and dependent can stir up painful feelings. Am I a worthwhile person? Will others stay by me or abandon me if I show them who I really am? Can I trust that I won’t be judged? Will I be treated well if I display my vulnerability, or do I have to put up my guard?

Filmmaker Stu Maddux, a former television journalist, anchor and producer, takes us inside this world in Gen Silent, a film that profiles six LGBT seniors and the issues they’re facing as they age. Maddux recently spoke at length with AHCJ topic leader Judith Graham about making this film and we share highlights of that conversation.

Tracking antipsychotic use in nursing homes     Posted: 07/17/12

Kay Lazar
Kay Lazar

Research published in 2010 found that patients newly admitted to nursing homes with some of the highest rates for prescribing antipsychotics were significantly more likely to receive the drugs than patients entering homes with the lowest prescribing rates – regardless of whether they had conditions that warranted use of the drugs.

The Boston Globe project, “A rampant prescription, a hidden peril,” aimed to pull back the curtain on a long-running but shrouded practice in many nursing homes of using antipsychotic drugs to sedate residents, particularly those with dementia who often have challenging behaviors.

Reporter explores difficult end-of-life questions through father's death     Posted: 07/13/12

Lisa Krieger
Lisa Krieger

It took months for Lisa Krieger to decide to write about her father’s death and minutes for readers to begin responding after her article appeared in the San Jose Mercury News.

At the center of Krieger’s unflinching account of her father’s last days is an uncomfortable question: “Just because it's possible to prolong a life, should we?”

Hundreds of readers wrote in to thank Krieger for sharing her story and going beyond the “death panel” rhetoric that so often stifles honest discussion of end-of-life concerns. Her work demonstrates that reporters can sometimes tell the story from an unusual perspective – their own – and touch readers in a different way than would be possible with more traditional coverage.

Health care blessing or blueprint for a scandal?     Posted: 07/10/12

Frederik Joelving
Frederik Joelving

The risks and benefits – both physical and fiscal – of cancer screening have become a burning topic, and have been absorbed into the endless political controversies surrounding the health reform law.

Are certain tests "essential benefits" or a boondoggle that can actually do more harm than good? And if they are deemed "unessential," then someone who disagrees inevitably uses the "R" word (rationing.)

We asked Reuters Health reporter Frederik Joelving to share how he reported on a high-profile doctor touting a new screening test. The test may be quicker and cheaper than the standard procedure, but hasn’t been proven to help anyone.

N.C. hospitals make big money while suing vulnerable patients for rising costs of care     Posted: 07/04/12

In 2009, as the debate about health care reform picked up steam in Washington, D.C., an editor at The News & Observer in Raleigh, N.C., posed a question: Should the newspaper take a deep look at the cost of health care?

A series of interviews and some database work led to a memo directing the coverage to concentrate on hospitals and a key decision: Ask colleagues at The Charlotte Observer to join. North Carolina's two biggest hospital systems were based in Charlotte. The biggest, Carolinas HealthCare System, was suing thousands of its patients each year for payment. If the two papers worked together, they could pull off a series that could run statewide, with more reach and impact.

Here, investigative reporter Joe Neff from The News & Observer, investigative reporter Ames Alexander and medical writer Karen Garloch from The Charlotte Observer share how they reported the five-day series, the most useful sources and their reporting strategies.

How Britain’s new health law got through Parliament     Posted: 06/27/12

Most health care professionals vociferously opposed Britain’s new Health and Social Care Act in the final few months as the House of Lords debated its fate.

Opposition was especially strong from family doctors (GPs), who, on the face of it, should have seen themselves as beneficiaries of new powers and control, but most of whom have seen the proposals as a threat to them and to the National Health Service.

Britain passes NHS reforms amid controversy     Posted: 06/27/12

The British government’s highly controversial “Health and Social Care Act” finally completed its bruising 15-month journey through the Houses of Parliament in March, in the teeth of opposition from doctors, nursing unions, public health professionals, and mounting public concern. The debate on the merits and implications of the proposals is far from over.

John Lister, AHCJ's European web coordinator, explains the restructuring of the publicly funded National Health Service, which will shift the pool of taxpayers’ money used to purchase services.

Columnist writes about intersection of finance, aging and health     Posted: 06/22/12

Mark Miller
Mark Miller

What is it like to be a columnist covering the aging beat?

We asked Mark Miller, who writes twice weekly for Reuters and monthly for Morningstar.com.

Miller is an experienced business and financial journalist who examined demographic trends several years back and realized that writing about aging would be an in-demand specialty.

Since Medicare is such an important issue for anyone age 65 or older, Miller gave himself a crash course on that government health care program. His columns on Medicare are some of his best-read pieces.

Miller know that writing about health will be an important part of his work going forward and recently joined AHCJ to connect with other journalists and pick up story ideas. We welcome the voice and experience that he brings.

Health beyond prayer in faith-based congregations     Posted: 06/20/12

Health professionals gave examples and perspectives on how religion and health intertwine at the annual conference of the Association of Health Care Journalists, held recently in Atlanta.

Miriam Burnett, M.D., M.Div., M.P.H., the connectional medical director of the African Methodist Episcopal Church, discussed conducting research several years ago on the influence of African traditional beliefs and its influence on African American health practices today. She said that people who don’t have health insurance and have low self-esteem often feel like they are non-beings.

At Blue Skies Ministries in Marietta, Ga., the approach to ministering to children with cancer and their families is a one-week respite from the physical, financial and emotional difficulties to a retreat at the beach for hope and healing through spiritual renewal.

Embedded reporter takes multifaceted look at end-of-life issues     Posted: 06/05/12

The Toronto Globe and Mail treated readers last year to an unusually intimate look at issues that arise at end of life. Lisa Priest, lead reporter for the newspaper’s series, spent 10 weeks embedded in a critical care unit at a local hospital, where she tracked the experiences, thoughts and feelings of patients, family members, doctors and other medical staff. Here she describes some key questions that arose as she embarked upon this multimedia project, and the inspiration that she felt at being privy to some of life’s deepest, rawest moments.

Freelance: Managing workflow and workload     Posted: 06/01/12

The freelance life offers many perks: no commute, the freedom to adapt your workload to your lifestyle, job security and freelancers can’t get laid off – if you lose one gig, another will come along.

Those advantages are tempered by changing compensation schemes. Now, writers are “paid” in the currency of influence. Platforms such as blogs offer high visibility and perhaps the opportunity to exercise your passion but with less payment than other opportunities.

Freelancers not only need to find, research, and write stories, they need to promote their work on social media, all tasks that are uncompensated financially.

Health Journalism 2012 panelists Maryn McKenna, Paul Raeburn, and Irene Wielawski offered ways to cope with heavy workload of paid and non-paid gigs.

NASA collaborations bring medical innovations down to earth     Posted: 06/01/12

You might know about the culinary delights – everything from Tang to freeze-dried ice cream – the space program has added to the American lifestyle. But NASA's Glenn Research Center, just outside Cleveland, has been making significant contributions to health care innovation and medical device development since 1977.

Astronauts’ experiences in space have led to medical innovation, ranging from cataract detectors to a special harness – specifically designed with the anatomical needs of women in mind – used for treadmill workouts in the zero gravity of space.

Jerry Myers Jr., Ph.D., chief of the bioscience and technology branch at the Glenn Research Center, explained many of these devices and innovations journalists on May 22, at an event hosted by the Association of Health Care Journalists' new Cleveland-area chapter.  The Cleveland chapter of SPJ co-sponsored the event.

Food safety: Getting beyond the annual food scare     Posted: 05/28/12

Food is making people sick more and more often. Last year, there were three major outbreaks from contaminated food, including Listeria in cantaloupes, E. coli from organic sprouts and Salmonella from ground turkey meat. Combined they resulted in 46 deaths. 

The article addresses the severity of food safety problem, including consequences, factors relating to the problem and possible approaches to resolve the issue.

New understandings in the science of addiction and treatment     Posted: 05/28/12

Could your brain be making you fat? Actually, it's a possibility. According to panelists, there are physical, chemical and biological differences in the brains of people with addictions versus people without. The article introduces some of new understandings in the science of addiction and treatment. 

Gone without a case: Suspicious elder deaths rarely investigated     Posted: 05/21/12

A.C. Thompson

A.C. Thompson

At the end of last year, ProPublica turned a spotlight on seniors who perish from abuse, neglect, or other forms of mistreatment – deaths that are almost never investigated by coroners or medical examiners.  

Who knew that doctors can fill out death certificates in most states without ever seeing an elderly patient’s body and determining what actually happened to the person?

Experts told ProPublica that the failure to examine suspicious senior deaths reflects denial as well as prejudice.

"We're where child abuse was 30 years ago," said Dr. Kathryn Locatell, a geriatrician who specializes in diagnosing elder abuse. "I think it's ageism -- I think it boils down to that one word. We don't value old people. We don't want to think about ourselves getting old."

Here, ProPublica’s A.C. Thompson describes how reporting for this story evolved and how it fits into the news organization’s broader investigation of coroners and medical examiners, a joint project with PBS “Frontline” and NPR.

Moves to address access to dental care     Posted: 05/15/12

When asked to list the top challenges in rural health care, almost all respondents to a survey listed dental care in the top three, according to David Wahlberg, a reporter for the Wisconsin State Journal who moderated the Health Journalism 2012 session on “Moves to address access to dental care.”

Panelists explained the reasons behind the shortage of dental care, as well as looking at models that may prove effective at increasing access to care.

Adults with autism face options, barriers     Posted: 05/15/12

A panel explored employment models for adults with autism and techniques to reduce workplace challenges during “Is the Workplace Prepared for an Increase in Adults with Autism?” at Health Journalism 2012.

Panelist Arni Klin, Ph.D., director of Atlanta’s Marcus Autism Center, said roughly half of autistic adults possess the intellectual capabilities “to attain paid employment” and that “a sizeable group” possesses special skills to make important contributions to society. “Individuals with autism function best in predictable, supportive, rule-governed environments,” such as those that require technical or computer expertise, he explained.

Future of artificial intelligence in patient care     Posted: 05/15/12

Banish any notions of artificial intelligence fueled by sci-fi films. One day soon, doctors will use artificial intelligence to diagnose and treat disease.

That was the crux of the “Future of Artificial Intelligence in Patient Care” panel at Health Journalism 2012.

Identifying disparities in diagnosis and treatment     Posted: 05/15/12

People traditionally think of health disparities in terms of race. But numerous other factors contribute to the sharp differences in life expectancy and disease rates in the United States, said speakers at Health Journalism 2012 in Atlanta.

The panelists discussed recent innovations that have the potential for reducing inequalities and offered a list of questions that reporters should ask about any new technology. One panelist emphasized looking beyond the common myths to find the real reasons that some groups are under-represented in clinical trials.

Freelance: Mapping successful business plans and models     Posted: 05/15/12

Successful freelancers often travel very different paths to find their distinct pots of gold.

At the same time, the three panelists from the Health Journalism 2012 panel “Mapping successful business plans and models" all shared a common theme: find the path that works for your unique personality and business. The panelists not only offered useful tips for running a business but were forthcoming about what they make and how they decide what to charge for their work.

Explosion of hospital quality data creates opportunities for journalists     Posted: 05/15/12

An explosion of hospital quality data initiatives gives health care journalists unprecedented opportunities to report on the quality of care provided by hospitals in their communities, with more such programs anticipated in coming months.

Ashish Jha, M.D., M.P.H., professor of health policy and management at Harvard School of Public Health, and Charles Ornstein, president of AHCJ’s board of directors and a senior report at ProPublica, reviewed some of the major quality reporting initiatives, with their pros and cons for health care journalists at a Health Journalism 2012 panel.

Diabetes' impact on diverse populations     Posted: 05/15/12

The statistics on diabetes are staggering. The disease already affects 8.3 percent of Americans, and that number could climb to one in three by 2050, according to experts on a Health Journalism 2012 panel.

The panelists discussed the economic toll of diabetes, risk factors, prevention and screening pregnant women for gestational diabetes, as well as community outreach efforts to educate and help diverse populations.

Economic determinants of child health     Posted: 05/14/12

One of every five kids in the United States is living in poverty and families with children under age 6 are more likely to be poor than those without. In our economic climate, this isn’t news. The connections between poverty and health also have been covered, so how can journalists find fresh angles on the topic?

One way is to look “upstream” at how communities are addressing socioeconomic factors that contribute to health problems.

Pitches that are a hit with editors     Posted: 05/14/12

Stalking an editor or a story, making clear and concise pitches, showing your knowledge of a subject and demonstrating you know your targeted publication well are all tips that editors had for independent journalists at a Health Journalism 2012 panel.

Evaluating medical evidence for journalists     Posted: 05/14/12

Journalists Gary Schwitzer and Ivan Oransky, M.D., had many examples to illustrate that the media too often exaggerates the benefits of drugs or medical therapies, while downplaying the harms, during the panel “Evaluating medical evidence” at Health Journalism 2012.

Hepatitis: New battle lines in a war on a silent killer     Posted: 05/14/12

What if you were sick but didn't know until it was too late? That's the case for more than 3 million Americans who have hepatitis C, a viral disease that causes swelling of the liver, which can lead to liver cancer.

Panelists at Health Journalism 2012 discussed why health professionals are seeing an increase in the disease, why it is going undiagnosed and the economic impacts of the disease.

Covering Medicare for the man on the street     Posted: 05/10/12

As our population ages and health care costs rise faster than inflation, health policy experts fear that Medicare costs will outpace funds.

At the 2012 meeting of the Association of Health Care Journalists, panelists addressed the future of Medicare during the session “Will Medicare Survive the Decade?” moderated by Trudy Lieberman, a fellow at the Center for Advancing Health and a contributing editor at Columbia Journalism Review.

A reporter's guide to medical decision making     Posted: 05/09/12

Today, patients are often faced with life-altering medical decisions. A woman with early stage breast cancer may be asked by her doctor to decide whether she prefers a complete mastectomy or a breast-sparing lumpectomy followed by radiation treatment. A man with early prostate cancer might get a similar question: Would he rather have radiation therapy, surgery to remove the tumor, or do nothing but monitor the situation?

In medical situations like these where there is no single best treatment, making sure that patients are involved in decisions makes room for individual preferences and priorities, and puts treatment in line with the patient's values. But people faced with such decisions frequently lack the resources, support, and expert coaching that they need to make a truly informed choice, said the participants at Health Journalism 2012 panel, “A reporter's guide to medical decision making.”

Medicaid: Covering cost-cutting efforts and impact of health reform     Posted: 05/08/12

“Conflict makes a good story, and there’s nothing quite like Medicaid for conflict,” Matt Salo, executive director of the National Association of Medicaid Directors, told reporters at a panel discussion during AHCJ’s annual conference in Atlanta. Salo and other panelists pointed to several story ideas and resources for reporters to follow up on.

Debates over screening, comparative effectiveness research lead to compelling reporting     Posted: 05/02/12

Rochelle Sharpe
Rochelle Sharpe

This is one of the key questions reporters will try to answer as they cover the Obama administration’s efforts to promote comparative effectiveness research. Rochelle Sharpe, a Pulitzer Prize-winning freelance writer, has written about comparative effectiveness research that is designed to determine the most effective ways to treat disease and fill gaping holes in our medical knowledge. Here, she shares sources and questions that reporters should be asking about the topic.

Is earlier diagnosis of Alzheimer’s around the corner?     Posted: 05/01/12

The two most feared words in the English language arguably could be “Alzheimer’s disease.”

“People are still incredibly afraid of it,” said Dr. Allan Levey, chairman of the Department of Neurology at Emory University School of Medicine, during the Health Journalism 2012 session about potential ways to identify changes in the brain before symptoms of the dementia become obvious.

Right now, there is no cure and no long-term treatments that can arrest or reverse the decline. Still, the race to identify people at risk of Alzheimer’s or with the disease is because “we’re all very clearly aware that our chances of making an impact with treatment will depend on making a diagnosis as early as possible,” Levey said.

Who is caring for undocumented immigrants?     Posted: 04/30/12

The rules about when and where the undocumented can get care are a complex thicket. For that reason, plus misinformation, cultural and language barriers and fears of deportation, these immigrants tend to avoid getting care until they reach a crisis. It's also very hard to get good data on undocumented immigrants, as national surveys and health care providers generally don't ask about immigration status (exception: the Pew Hispanic Center has some data).

The speakers in this session at Health Journalism 2012 outlined the rules about care for the undocumented and offered up a wrenching case study of one adolescent girl.

Google tools for health reporters     Posted: 04/21/12

Katherine Leon has a problem with SCAD, the Savannah College of Art and Design. Leon has her own SCAD – spontaneous coronary artery dissection. Leon has been fighting to create more awareness about the disease but when someone looks up SCAD on Google, the first results are almost always that other SCAD.

So on Thursday, in a panel called “Google tools for health reporters" at the Health Journalism 2012 conference, she pleaded with Sandra Heikkinen of Google: Can’t you do something about that other SCAD. Heikkinen’s response? Put a minus sign before Savannah and it eliminates results with that word in it.

That search tip and others were part of the panel on Google as Heikkinen extolled different tools for health journalists to explore the world that is Google. She used the minus sign  herself recently when she was looking up cruise options for her mother.

Former president, first lady kick off conference with discussion of global health, mental health     Posted: 04/20/12

Jimmy and Rosalynn Carter discussed their work to improve mental health care and their global health efforts.
Jimmy and Rosalynn Carter discussed their work to improve mental health care and their global health efforts. (Photo: Len Bruzzese/AHCJ)

Former President Jimmy Carter and first lady Rosalynn Carter welcomed AHCJ back to Atlanta for the first time in 11 years during Thursday night’s kickoff session, “A Conversation with the Carters.”

The founders of the Carter Center sat down with independent journalist and former AHCJ president Andrew Holtz and more than 300 conference attendees for a candid discussion of mental health parity in the United States and disease eradication in developing nations.

Whistleblower suits form basis for reporting on for-profit hospices     Posted: 04/11/12

Jordan Rau
Jordan Rau

Jordan Rau of Kaiser Health News has turned a sharp eye on for-profit hospices during the past year, writing about allegedly abusive practices detailed in whistleblower lawsuits.

The whistleblowers – former company insiders – claim that some operators are enrolling patients in hospice care inappropriately in an attempt to maximize Medicare revenues. Lawsuits have been settled out of court, and companies haven’t admitted any wrongdoing.

Here, Rau explains how he came upon the trail of his New York Times story and pursued it, with a few twists and turns, over the course of several years.

Reporting on 1-800-GET-THIN clinic highlights regulatory issues     Posted: 03/15/12

Michael Hiltzik, a business columnist at the Los Angeles Times, has spent more than two years writing about the company behind 1-800-GET-THIN, advertising Lap-Band surgery in Southern California. His work has triggered a warning from the FDA, investigation from insurance regulators and, finally, action from Allergan, the maker of Lap-Bands. In this article, he discusses his work and the pushback and lawsuits he faced as a result of his reporting.

Reform will require nonprofit hospitals to assess charity care; reporters can evaluate it now     Posted: 02/20/12

Tony Leys
Tony Leys

One little-known element of the health care reform law sets new rules for nonprofits. They are required to assess community needs, and inform patients of charity policies. Some legislators want tougher rules and oversight to make sure they are providing enough service to the community to justify the tax break.

Reporter Tony Leys, of the Des Moines Register, describes how he examined how much charity care is provided by hospitals in Iowa in return for the substantial tax breaks they get for operating as nonprofit organizations. Leys, a 2011-12 Regional Health Journalism Fellow, was able to compare local hospitals, using new IRS reporting requirements for nonprofit hospitals, and estimated how local property tax revenue was affected by the tax-exempt hospital properties in those areas.

Parting thoughts: Berwick shares views on media coverage of health care and reform     Posted: 02/09/12

In a Newsmaker Briefing at Health Journalism 2011, CMS Administrator Don Berwick unveiled a website on health data.
Berwick appeared at a Newsmaker Briefing at Health Journalism 2011.
(Photo: Len Bruzzese)

He has worked with reporters as part of his jobs at the Institute for Healthcare Improvement and, most recently, at the Centers for Medicare and Medicaid Services.

Having left CMS in December, Berwick agreed to share his thoughts with AHCJ President Charles Ornstein about media coverage of CMS, health reform and his tenure.

Controversy over breast implants spreads across Europe     Posted: 02/07/12

Europe focus

British clinics delivering cosmetic surgery were thrown into crisis by the decision last month of the French government to fund the removal of thousands of breast implants manufactured by the now-closed French company Poly Implant Prostheses (PIP). The implants were found to have used industrial grade silicone made for use in mattresses.

In the story, John Lister explores the controversy of these breast implants in Europe, including the lack of data on how many women in the United Kingdom received the implants, how the UK's National Health Service has been drawn into the business of removing the implants and the regulatory system that allowed the implants in the first place.

Investigating patient safety at a Dallas institution     Posted: 01/27/12

Ryan McNeill
Ryan McNeill

For two years, a team of reporters at The Dallas Morning News has written stories of breakdowns in patient care at one of Texas’ most important medical institutions, Parkland Memorial Hospital.

In story after story, News reporters showed how systemic breakdowns in care left patients maimed or dead. Officials from Parkland and its academic partner, the University of Texas Southwestern Medical Center, were highly critical of the News’ coverage. Here, reporter Ryan McNeill reveals some of the reporting that went into the effort to investigate patient safety in Dallas hospitals.

Tip points reporter to troubled assisted-living facility     Posted: 01/08/12

Mary Kate Malone
Mary Kate Malone

The South Bend Tribune recently broke the news that state officials were considering yanking a license from an assisted-living center where troubling care deficiencies had been documented.

This topic – problematic conditions in assisted living facilities – is receiving a considerable amount of attention across the country and may well be one that health reporters are asked to look into.

We asked Mary Kate Malone, author of the South Bend piece and a staff writer at the newspaper, how she came upon the story and fleshed out details. We also asked her to tell us a little bit about herself.

Boomerangst: Series helps explain what the aging of the boomers means     Posted: 01/08/12

Cover of the Bommerangst projectReporters in Canada have done some pretty spectacular reporting on aging issues.

The largest effort, Boomerangst, came from The Province in Vancouver, British Columbia. The Province has a weekday circulation of about 157,000 and Sunday circulation of 171,000. The weekly readership in print and online is 957,500.

The first piece in the newspaper’s 14-part series ran in mid-October; follow-up stories are ongoing.

Ros Guggi, deputy editor at the paper, describes how this exceptional effort came together and the community’s strong response.

Investigation: Falsified charts in nursing homes linked to patient care     Posted: 12/08/11

Marjie Lundstrom
Marjie Lundstrom

Sacramento Bee reporter Marjie Lundstrom recently wrote a two-part series on the falsification of patient records in nursing homes. Her investigation turned up a narrow aspect of nursing home care that has gotten little public attention.

She used public records, court records and patients' stories to document false record-keeping and blatant cover-ups that went right to the heart of patient care. She found cases of altered records to minimize blame and legal liability; filling out charts en masse, out of laziness or necessity because of under-staffing; improperly dispensing medications and therapists that continued to bill Medicare for high-priced therapy for patients too ill to participate.

Finding the patterns linked the falsification issue directly to patient care. In some instances, vulnerable nursing home residents died because their medical charts failed to reflect their true conditions.

Group effort documents effects of cutting services to seniors     Posted: 11/30/11

Services that mean a world of difference to needy seniors – everything from meals on wheels to specially equipped vans that take older people to doctors’ appointments – are threatened as financially-strapped states take a knife to over-extended budgets.

The California HealthCare Foundation Center for Health Reporting has undertaken one of the most extensive explorations of this trend in a series called Home Alone, a look at the impact of planned cuts to a program that funds California adult day care centers. The project was executed with nine other partners, some of which publish in languages other than English.

Richard Kipling, managing editor of the Center, describes how this project came together and what was involved in making it work.

Reporter investigates high rates of elective procedures     Posted: 11/03/11

Emily Bazar
Emily Bazar

One of the goals of the health reform law is to change the payment incentives to get rid of some of the unnecessary or overly aggressive care This is not rationing, proponents point out, but it is getting patients the care they need without getting them the care they don't need, whichoften carries risks, side effects and big medical bills. That's been part of the message from the Dartmouth Atlas.

Reporter Emily Bazar, of the California Health Care Foundation Center for Health Reporting, found some extemely high rates of elective heart surgery in one California community. She took data availability in California, some of the Dartmouth framework, and her own reporting and endeavored to reveal the meaning behind some surprising statistics: Citizens in one Central Valley town were five times to six times more likely to undergo elective heart surgery than other Californians.

Bazar analyzed the study to determine if external factors influenced the data, or if Clearlake residents were really receiving unnecessary (and expensive) operations.

We asked Bazar to share her experiences reporting on this data and to shed light on how journalists can transform statistics into a compelling story. While Bazar’s investigation is based on California data, all or nearly all states collect similar data that can be analyzed. Here is what Bazar learned from reporting this story.

How young reporters put together a comprehensive look at aging     Posted: 10/25/11

Brave Old World is a fascinating multimedia look at aging produced by News21 fellows from Columbia University’s Graduate School of Journalism.

The site debuted in September after a team of 13 young reporters spent 10 weeks interviewing older adults, their families and a wide variety of experts. On-the-ground research took the group to eight states.

The resulting stories, told through text, audio, photographs, interactive graphics and video, provide a nuanced look at aging trends unfolding across the country. Parts of the project appeared in The Washington Post, on The New York Times website, on forbes.com and in Kaiser Health News.

Paula Span, the project leader, and some of her students discuss their contributions to Brave Old World and what they learned from this endeavor.

Access Denied: Looking at a lack of health care availability     Posted: 10/20/11

Shannon Muchmore
Shannon Muchmore

The 2010 health reform law is supposed to dramatically expand coverage of the uninsured. In the meantime, there are still some 50 million uninsured people. And questions remain about how underserved areas are going to absorb millions more people when they get covered.  The  Tulsa World Reporter Shannon Muchmore recently completed a three-part series about access to health care in Oklahoma, finding a shortage of physicians, particularly specialists, contributes to an underserved population.

"Access Denied" looks at how it affects all Oklahomans and what can be done to improve access to care. Here, she provides some tips (including some tools that can walk you through some simple data analysis) for journalists interested in pursuing similar reporting in their areas, accompanied by a number of resources about rural health care, disparities in access to care and workforce issues.

Investigating North Carolina's system of housing people with mental disabilities     Posted: 10/06/11

Rosemary Hoban
Rosemary Hoban

Rosemary Hoban, a reporter with North Carolina Public Radio/WUNC, compared North Carolina's system for treating the mentally ill with those in place in other states and how cuts have affected the systems of care.

After her series ran, the U.S. Department of Justice concluded that the state was in violation ofthe Americans with Disabilities Act in in its housing of people discharged from state psychiatric hospitals, and also violated the Supreme Court's Olmstead decision, which says states need to house people with mental health disabilities in the most integrated community setting possible.

In this article for AHCJ, she explains what she found was wrong with the system and outlines many of the useful resources she used in her reporting.

Reporting on why some patients are stuck in hospitals     Posted: 09/29/11

Yanick Rice Lamb
Yanick Rice Lamb

Patients typically complain about being released from the hospital sooner than they would like. So Yanick Rice Lamb became intrigued when when she heard about patients languishing in hospitals weeks and even months after being medically ready for discharge. This can happen to uninsured and underinsured patients who need long-term care.

Given the recent downturn in the economy, this could potentially happen to anyone who loses a job and the health coverage that came along with it. When she learned about AHCJ's Media Fellowships on Health Performance, she found that delayed discharge was an ideal topic: It was an underreported topic and information was fragmented and spotty, at best.

Find out what she learned from her 10-month look at this narrow slice of the population – the sickest, poorest and most invisible patients. She includes an extensive list of story ideas and angles for other reporters to look into.

Public reporting of patient harm is a potent force     Posted: 09/22/11

Marshall Allen
Marshall Allen

The Las Vegas Sun series "Do No Harm: Hospital Care in Las Vegas" identified cases of preventable harm that occurred in each of the city's 13 hospitals.

The series was rooted in the belief that people have a right to know about the quality of care provided by their local hospitals. That seems like common sense, but it's considered revolutionary in American health care. Hospitals, nursing homes and doctors are accustomed to operating with little outside accountability for their performance. In most states, you can't find out an individual hospital's rate of deadly infections or injuries to patients. Or, what you can find out is carefully controlled by hospital lobbyists.

In this article for AHCJ, reporter Marshall Allen, now with ProPublica, explains how transparency may have the power to transform health care systems. He examines the myths surrounding transparency and looks at the outcomes of programs that have been instituted. 

Focus on freelancing: Tips for buying liability insurance     Posted: 08/30/11

Liability insurance folderSome publishers and media outlets don't provide liability coverage for freelance writers' articles, and freelancers may blog or publish their own material, leaving many troubled by their exposure to possible legal problems – and the resulting financial impact.

Separate media liability coverage is available for writers, with policies covering libel, trademark/copyright infringement, defamation, invasion of privacy, and errors and omissions. But most writers don't buy it because coverage can be expensive, ranging from $500 a year to more than $1,500.

Independent journalist Andy Miller has some tips to consider if you are looking into your insurance options.

Reporter Q&A: Duluth News Tribune exposes malpractice allegations     Posted: 08/25/11

Brandon Stahl
Brandon Stahl

In May, Duluth (Minn.) News Tribune investigations editor Brandon Stahl and courts reporter Mark Stodghill published a major story about how a local neurosurgeon, Stefan Konasiewicz, had amassed a record of malpractice allegations despite praise and high pay from his hospital.

Stahl followed up with additional pieces this month about the money the hospital reaped from Konasiewicz's surgical department and the growing list of patients complaining that they were harmed by the doctor.

In an e-mail conversation with AHCJ board president Charles Ornstein about how the story came together, he reveals how he got local doctors to publicly discuss their complaints about Konasiewicz and the resources he found most helpful.

Updated hospital data allows reporters to identify ongoing problems     Posted: 08/16/11

Open quote mark for pull quote After several years, a surprising number of hospitals can't seem to improve – and an elite group has been able to maintain its excellence.Close quote mark for pull quote

The release this month of federal data on hospital quality is a good reminder for reporters to give their local hospitals a checkup.

The Centers for Medicare and Medicaid Services has been reporting patient survival rates for hospitals across the United States for four years now and hospital readmission rates for three. While some journalists may have a been-there-done-that reaction to yet another round of data, the latest release has important information for your readers, viewers and listeners. After several years, a surprising number of hospitals can't seem to improve – and an elite group has been able to maintain its excellence.

Reporter offers advice on avoiding embarrassing incident     Posted: 08/03/11

A call from the medical examiner to my editor the morning of Friday, July 22, started the worst day of my 22-year journalism career.

A patient featured in my front-page story about a new treatment for brain aneurysms, whose photo appeared above a quote saying she felt "fantastic" after having the procedure at a local hospital, died six days before the article was published.

How did this happen? I hope my explanation allows this unfortunate episode to yield lessons for other journalists who cover health care.

Follow the numbers to report on hospital executives' compensation packages     Posted: 07/28/11

IRS Form 990 from Emory Healthcare showing compensation.The tax-exempt status of not-for-profit hospitals has received heightened scrutiny over the past few years as policy makers across the country and at every level of government try to ensure their communities receive tangible benefits in exchange for the millions of dollars in lost tax revenue.

One factor encouraging policy makers and the public to treat tax exempt hospitals less like charities and more like for-profit businesses is the compensation packages of hospital executives.

M.B. Pell, of The Atlanta Journal-Constitution, recently wrote about compensation packages, including perks such as country club memberships, first-class air travel and free housing, that hospital executives in the Atlanta area receive. In this article, he explains how he got the information – which is public information – and how reporters everywhere can look into executive compensation.

Reporters find heart devices skipped FDA's more rigorous approval process     Posted: 06/30/11

Tricuspid valve in a model heartDeborah L. Shelton and Jason Grotto of the Chicago Tribune couldn't help but wonder: How does a medical device get implanted into patients without first getting FDA approval?

That question led to their two-day series in late May that reported for the first time that certain heart valve repair devices had been "down-classed" from class III to class II, a regulatory category that required that they undergo less scrutiny, even though the devices are permanently implanted and life-sustaining.

One of the annuloplasty rings had been stitched into the hearts of at least 700 patients in Chicago and elsewhere without going through proper channels. In fact, even though the company could have submitted both rings for clearance through a less rigorous regulatory pathway, it didn't even do that. In these two cases, the process was skipped in its entirety.

Beat reporter uncovers FDA's failure to take action about contaminated products     Posted: 06/22/11

Shanoop and Sandra Kothari of Houston, claim the wipes led to the death of their son, Harrison Kothari, 2.
Shanoop and Sandra Kothari of Houston claim tainted alcohol prep wipes led to the death of their son, Harrison Kothari, 2. (Photo courtesy of MSNBC.com)

What happens when health care products that are supposed to protect against infection and illness turn out to be contaminated with potentially deadly bacteria?

Even worse, what happens when the federal agency that's supposed to oversee the safety of the products concludes that shoddy sterilization and known contamination don't pose "an imminent health hazard?"

JoNel Aleccia, an MSNBC.com health reporter, unraveled the dual threads of human harm and regulatory mistakes.

In this article, she shares with AHCJ members how she covered each step of the story as it unfolded, including what documents were useful and how she got them.

Jewish health issues, community are focus of new initiative     Posted: 06/20/11

A new public health initiative in Northeast Ohio, the Jewish Community Health Initiative, hopes to take advantage of a cultural or religious community – in this case, Cleveland's 80,000 Jews – to disseminate public health messages and encouraging healthier behavior.

Jewish health care is not only about diseases that specifically attack Jews, such as Tay-Sachs, Gaucher and Niemann-Pick, Singer noted. The health problems that affect the highest numbers of Jews are the same ones that predominate among non-Jews in America: heart disease, diabetes, obesity and cancer. Thus, the Initiative focuses on reducing health problems common in the population at large.

Health Journalism 2011: From pee wee to pro: Head injuries in sports     Posted: 04/27/11

Matt Grady, M.D., a pediatric sports medicine specialist at Children's Hospital in Philadelphia, Jack Jallo, M.D., Ph.D., director of the Division of Neurotrauma and Critical Care at Thomas Jefferson University Hospitals, and Margot Putukian, M.D., team physician and director of athletic medicine at Princeton University, explained the symptoms, diagnosis and recovery from concussion.

Concussions are a concern for all age groups, the experts said. But children, either at play or in organized sports, are at high risk. Grady said that emergency room data showed that 65 percent of concussions occurred in people younger than 18, and most happened in the 11- to 14-year-old age group.  

Considering the data, it seemed surprising to many in the audience that concussions have not been extensively studied among pediatric patients.

Health Journalism 2011: Panelists share stories from the frontlines of military trauma care     Posted: 04/27/11

If the audience wasn't fully awake yet for the morning session entitled "Lessons of war: Advances in medical science and technique," the pictures of soldiers' blast injuries – one of them extending from the back to the front of a leg-should have captured their attention.

 

Michael S. Weingarten, M.D., M.B.A., F.A.C.S., professor of surgery and chief of vascular surgery at Drexel University College of Medicine in Philadelphia, was explaining how the military transports critically injured patients across continents while, at home, he worries about moving a patient downstairs a few flights.

There is a lesson in all of this for trauma care in the U.S. Only about 10 percent of Americans in rural areas live within 45 minutes of a trauma center. And nationwide, hospitals are dealing with surgeon shortages. "The problem will be exacerbated," Weingarten said. By 2015, it is estimated that there will be only 21.6 surgeons per 100,000 people by 2015.

Health Journalism 2011: Can the FDA ensure food safety?     Posted: 04/27/11

Food safety experts discussed the impact of the Food Safety Modernization Act, signed into law on Jan. 4, and the Food and Drug Administration's potential to prevent  future contamination  and related disease outbreaks.

Michael Taylor, J.D., deputy commissioner for food at the FDA, emphasized that the law will move his agency's focus from reaction to prevention and  partnership with industry, consumers, and agencies ranging from the Centers for Disease Control and Prevention to state and foreign governments.

There are still questions about how the increased vigilance will be funded and how to improve the safety of meat and poultry, which are not under the purview of the FDA.

Health Journalism 2011: Future of nursing: Blueprint for health care reform     Posted: 04/27/11

Using registered nurses to their fullest educational potential to provide primary care for communities is working in one new open-access clinic run by a variety of health care providers.

Panel members agreed that nurse-led models of health care will help solve the primary care shortage many communities face. But at the other end of the perfect plan is a shortage of nursing professors which could put that in jeopardy.

Health Journalism 2011: Experts dubious about an HIV vaccine     Posted: 04/27/11

The public will not see any HIV vaccine or its human trial in the near future. This is the disappointing message that a panel of experts concluded at Health Journalism 2011 on April 16.

In the 1990s, when HIV was discovered, scientists were optimistic that a preventive vaccine would be developed soon to end the HIV pandemic, just like it was for polio. However, 30 years later, with the failure of the Thai trial and more understanding of the characteristic of the virus, doctors have realized that they are nowhere near that elusive goal.

Health Journalism 2011: End-of-life planning a 'fertile area' for storytellers     Posted: 04/26/11

People are eager to have honest discussions about end-of-life alternatives.

But in many ways, such conversations have been "engineered" out of today's health care system, said speakers at Health Journalism 2011 in Philadelphia, meaning that patients and families need to engage in such discussions before an acute illness occurs.

Speakers pointed out that journalists and health professionals can assist by informing people about the burden of suffering that comes with some treatments and helping them understand the alternatives.

Health Journalism 2011: Experts weigh in on ethics in clinical trials     Posted: 04/26/11

An eclectic expert panel considered "Clinical Trials: Intersection of ethical, practical and financial"  - a topic rife with undisclosed financial perks, conflicts of interest and potential benefits for participants, academic researchers, drug companies and patients.

The speakers included academic physicians Carl Elliott, M.D., Ph.D., and Jason Karlawish, M.D.; Robert (Bob) Helm, a former professional research subject; and John Fauber of the Milwaukee Journal Sentinel. Fauber, who has reported on problematic aspects of medical device research and FDA approval, organized and moderated the at-times intense discussion.

Health Journalism 2011: Debate over health reform continues     Posted: 04/26/11

The Affordable Care Act, which recently celebrated its first birthday, is now the law, and parts of it are slowly being implemented. But the debate is as strong as ever.

Congress and the White House are putting on "a show," said Noam Levey, a health policy reporter for the  Los Angeles Times. On one side, President Barack Obama and the Democrats want the law pretty much as is, while the other side has the Republican-controlled House of Representatives and its Senate GOP counterparts, who want either to change or repeal it, he added.

Panelists emphasized that the real issue for journalists to cover is the implementation of the law and how states are reacting to the law.

Health Journalism 2011: Is enough being done about health care-associated infections?     Posted: 04/22/11

William Marella, P.J. Brennan, Kerry O'Connell and Marshall Allen discuss health care-associated infections.Dr. Patrick J. Brennan didn't waste time answering the main question of a panel assembled to discuss health care-acquired infections: Is enough being done?

"We should just stipulate that not enough is being done," Brennan said.

About 1.7 million Americans get health care-acquired infections each year and at least 99,000 die. That is the equivalent of everyone in the city of Philadelphia being infected, and those who die could pack the Phillies' stadium two times, said William Marella, director of the Pennsylvania Patient Safety Authority's statewide safety reporting program.

Health Journalism 2011: Going mobile: The new telemedicine     Posted: 04/22/11

The practice of medicine is evolving in ways that make use of smart phones and mobile devices, and even though your doctor's office doesn't yet have the patch or the pill or the Kinect, a new breed of doctor/geek is busy crafting the technology. And regulators in the United States are scrambling to keep up.

Reporting finds 'alarm fatigue' to blame in patient deaths     Posted: 04/21/11

Life support monitor
A life-support monitor. (Photo: RambergMediaImages via Flickr)

In January, a patient at one of the country's best hospitals suffered a fatal heart attack while 10 nurses on duty did not respond to repeated alarms from his cardiac monitor. They told investigators that they did not recall hearing the beeps warning of the patient's falling heart rate.

State and federal health investigators, in part, blamed a phenomenon that is little known outside hospitals: alarm fatigue. The hospital workers were desensitized to alarms after hearing them constantly throughout the workday.

Boston Globe reporter Lizbeth Kowalczyk decided to look at how often alarm fatigue is a factor in patient deaths, on a national level and in Massachusetts. The sources and techniques she used to report the stories, which she shares in this article for AHCJ members, could be used by other reporters to write about alarm fatigue in their states, but also may be applicable to other topics.

Health Journalism 2011: What editors wish writers knew     Posted: 04/21/11

Amanda Moon, Scientific American Books, (right) discusses how she works with writers as MSNBC.com's Linda Dahlstrom looks on.We love writers, declared all three panelists at "What Editors Wish Writers Knew," a well-attended freelancers' session at Health Journalism 2011. They shared some harsher facts, too. "I feel like what I do for a living is keep writers waiting," confided Sarah Austin, Self's news and health features director.

The panelists also explained some of the realities of the organizational structure of magazines, how to get their attention when you pitch a story and the need for writers to do some research about a publication's audience.

Health Journalism 2011: The intersection of highway safety and health     Posted: 04/20/11

If a disease killed nearly 33,000 Americans each year and was the No. 1 killer of Americans younger than 35, it would surely be a topic covered by most health reporters.

 

Substitute "fatal traffic wrecks" for the word "disease" and reporters have "all the elements of a great public health story" that's not being reported as much as it needs to be, said Jacob Nelson, director of traffic safety policy and research for the American Automobile Association.

 

Nelson and his fellow panelists, journalists Robin Schwartz and Andy Miller, urged journalists who attended the "The intersection of highway safety and health" panel at Health Journalism 2011 to examine whether public health leaders, traffic safety officials and lawmakers were doing enough combat traffic deaths.

Health Journalism 2011: Panelists suggest stories about health reform implementation     Posted: 04/20/11

There are three key aspects for journalists to watch as the Affordable Care Act moves into its second year: Congress, the courts and the states, according to panelists speaking about "Health Reform: Repeal, replace of implement?"

Noam Levey, health policy reporter for the Los Angeles Times, suggested that reporters be aware of several Republican proposals, including those concerning medical malpractice, high risk pools, interstate sale of insurance, association health plans, variable health premiums and individual/employer mandates. 

Other reporters noted court cases that could affect implementation of the new health care law, as well as state actions and regulations that should be closely monitored.

Health Journalism 2011: Neurosurgeon reflects on time in the media spotlight     Posted: 04/20/11

Lemole spoke to health journalists at AHCJ's annual conference.For G. Michael Lemole Jr., M.D., it's simply his job to save the lives of patients who have suffered from life-threatening traumatic injuries.

Lemole, chief of neurosurgery at the University of Arizona Department of Surgery and University Medical Center, found himself in the national spotlight after he performed brain surgery on U.S. Rep. Gabrielle Giffords after she sustained a gunshot wound to the head in Tucson on Jan. 8.

As the keynote speaker at Health Journalism 2011, he retraced the treatment of the congresswoman earlier this year and his experience working with the media.

Health Journalism 2011: Collins focuses on molecular basis for diseases to develop therapeutics     Posted: 04/20/11

NIH Director Francis Collins spoke at a Newsmaker Briefing at Health Journalism 2011.At the start of his Newsmaker Briefing at Health Journalism 2011, Francis Collins, M.D., Ph.D., director of the National Institutes of Health, told a tale of discovery. The tale began with an observation made in one HIV-positive person who was cured of the virus following a bone marrow transplant for leukemia. The tale continued with the discovery that a rare gene variant may protect people from AIDS and ended with a small trial of HIV-infected people in Philadelphia using discoveries stemming from that research.

The story underscored Collins's desire for research efforts that bring together an assortment of approaches to help understand health and disease. Knowing the molecular basis for disease offers the greatest potential for therapeutics, he said.

Health Journalism 2011: Reporting on effectiveness of autism treatments     Posted: 04/20/11

The mother of a child with autism, along with medical experts, helped unravel the complicated information about treating the condition during a panel at Health Journalism 2011 in Philadelphia. They discussed complementary and alternative treatments, the unusually high placebo effect found in autism treatments and some therapies that have less evidence to prove their effectiveness.

The panelists also offered a useful list of suggestions for reporters who are covering autism and the treatments available.

Health Journalism 2011: Localizing national health care investigations     Posted: 04/19/11

Maurice Tamman of The Wall Street Journal talks about quest to get the Medicare claims database.Not every journalist or media organization has a budget to back up long-term and expensive investigations into health care or other issues. Not anymore. Yet all can take information found in national stories and create a story relevant for local audiences, according to panelists at Health Journalism 2011.

And doing so will help make positive change for a health-care system that is "very fundamentally broken," noted Charles Ornstein, senior reporter at New York-based ProPublica, board president of Association of Health Care Journalists and moderator for Friday's session of "Localizing national health investigations."

Health Journalism 2011: What you need to know about accountable care organizations     Posted: 04/19/11

Accountable care organizations, a key component of federal health reform, may be unsustainable and not financially viable, but some examples show the method has the potential for success.

Regardless, ACOs are a complicated, important topic that health care journalists should take time to explain and investigate, according reporters and health professionals said in a panel titled "What you need to know about accountable care organizations" at Health Journalism 2011.

Health Journalism 2011: Best practices in blogging and social media     Posted: 04/19/11

Though blogging and social media have been around for some time now, some people still argue that blogging, social media and journalism should be independent of one another. Scott Hensley of NPR's Shots blog contends that couldn't be further from the truth. 

During a panel about "Best practices in blogging and social media" at Health Journalism 2011, Hensley said bloggers and journalists are perfect matches for each other.

Health Journalism 2011: Officials, reporters offer conflicting advice on getting public documents     Posted: 04/16/11

The fight by journalists to obtain public documents isn't likely to get any easier, according to the four speakers on the standing-room-only panel Right to know: Getting information from government agencies as part of Health Journalism 2011.

While one government official suggested reporters should "be friendly" in their requests, a reporter on the panel said a reporter's personality shouldn't matter. She also said she's never made an FOI request, despite having done an award-winning investigation into nursing homes. 

Health Journalism 2011: Berwick debuts website featuring health data     Posted: 04/15/11

Journalists have a key role to play making health care safer and informing the public, Medicare chief Donald Berwick told reporters attending the annual conference of the Association of Health Care Journalists in Philadelphia on Thursday.

To help them do their job, Berwick unveiled a government website, the "Health Indicators Warehouse," and offered a live demonstration. He said the site offers "a treasure trove of data," including information never released before in an easily accessible form, including patient safety data, preventive health care indicators, Medicare payment claims and hospital performance at the state and hospital referral region level. Information is searchable by topic, location, health outcomes among other factors.

Team investigates region's high infant mortality rate     Posted: 03/18/11

Milwaukee has one of the highest infant mortality rates in the nation and a persistent, troubling gap in birth outcomes for African Americans when compared to whites.

Milwaukee has one of the highest infant mortality rates in the nation and a persistent, troubling gap in birth outcomes for African Americans when compared to whites.

In late 2010, the Milwaukee Journal Sentinel decided to do something about it by launching "Empty Cradles," a yearlong effort by a team of journalists. The reporting effort, which began with a package of stories in January, is being done by a team of reporters who cover children's issues, health, economics and more, as well as a database reporter, a photographer, a graphic artist and a multimedia producer.

The project's editor, Greg Borowski, explains their approach to the project, how they have worked on it and what they hope to accomplish.

Officials, health system administrator discuss challenges, implementation of the Affordable Care Act     Posted: 03/03/11

Bruce Japsen, moderator, and panelists Chiquita Brooks-LaSure of the Office of Health Reform at U.S. Health and Humans Services and Illinois Department of Insurance Director Michael McRaith discussed the Affordable Care Act.Support for health reform has been complicated by political rhetoric and the general public's lack of knowledge about the Affordable Care Act, according to officials who spoke at last week's AHCJ Chicago chapter meeting. Twenty-five journalists and students gathered at Columbia College Chicago for the discussion of the health care overhaul as the law nears its first anniversary. Bruce Japsen, a Chicago Tribune health care reporter, moderated the panel.

AudioAudio of this panel is available for AHCJ members.

A new government in Ireland might bring health care change     Posted: 02/18/11

Dr. Muiris Houston

Ireland's latest election might lead to the adoption of a universal health care model that prioritises medical care by need rather than by ability to pay.

"If the health manifestos of Fine Gael and Labour, the two political parties most likely to form the next government are serious, then the time has come to adopt a universal health care model, "Dr. Murius Houston says.

Reporter runs into wall requesting FDA's public records of financial disclosures     Posted: 02/16/11

AHCJ and its Right to Know Committee have been advocating for better and faster access to information and experts in the federal government. One agency – the FDA – has repeatedly been a focus of our efforts. Journalists have been concerned over the agency's embargo policy, constraints on newsgathering and refusals to answer queries from reporters.

Here, John Fauber of the Milwaukee Journal Sentinel describes another disturbing incident: his months of fruitless efforts to obtain public records from the FDA.

Medical-legal partnerships: Tackling the social causes of health disparities     Posted: 02/09/11

Medical-legal partnerships are increasingly being used to help aging patients.Since the first formal medical-legal partnership was set up in 1993 by Barry Zuckerman, M.D. and lawyer Ellen M. Lawton, physicians and lawyers have been working together to help patients combat non-medical issues that exacerbate minor health issues such as living conditions that are below health codes and navigating the health care system.

Although such partnerships started in pediatrics, the number of MLPs focused on the elderly is growing, a phenomenon explained by the growing number of elderly citizens and increased life expectancy.

DocumentCloud opens a window into inspection reports for readers     Posted: 02/03/11

Readers can see source documents and reporters' notes in DocumentCloud.While doing a comprehensive investigation of the quality of care in hospitals for the Las Vegas Sun, Marshall Allen wanted to show the breadth of inspectors' findings, including those that may not grab headlines but are just as important to the public.

To do that, Allen used DocumentCloud to share the inspection reports with the public, including notes about specific violations. In this article for AHCJ members, he explains the advantages of using DocumentCloud and how journalists can use it to help readers understand the news.

VA's new position on Agent Orange an opportunity for more coverage of veterans' health issues     Posted: 02/02/11

Vietnam veterans can now seek health care benefits for illnesses related to exposure to Agent Orange as the result of a recent court decision. Veterans are seeking the benefits from the U.S. Department of Veterans Affairs in increasing numbers. One expert says the VA is reviewing about 17,000 claims. For health care journalists, that means more coverage of veterans' health issues and challenges may be on the horizon.

Behavior modification for 'White Coat Myopia'     Posted: 01/06/11

Overcoming Find powerful, relevant stories that don't begin and end with doctors

Every year end brings a flood of stories about the "Top Medical Breakthroughs." Over the rest of the year there is no shortage of front page headlines announcing new drugs, devices and clinical trial results. But independent journalist Andrew Holtz thinks the intensive cultivation of medical news reports leaves fertile acreage of health stories untilled. In this article he suggests fresh stories and approaches to health coverage for the new year.

NICE official: Rumours of demise greatly exaggerated     Posted: 01/05/11

Kalipso Chalkidou
Kalipso Chalkidou

Andrew Lansley, the United Kingdom's health secretary, recently announced plans to reorganize the National Institute for Health and Clinical Excellence (NICE), which was established to vet the cost-effectiveness of new drugs and treatments and give national guidance on whether they should be prescribed by doctors within Britain's National Health Service.

The announcement set off concerns among some about the potential for unequal access to drugs from one district to another. The British press warned of cases in which patients denied a drug by a doctor will shop around until they find a physician who will give them what they want.  

John Lister recently sat down with Kalipso Chalkidou, the international director of NICE, to find out what the changes really mean for the agency.

NICE loses power to control availability of drugs     Posted: 11/29/10

U.K. Health Secretary Andrew Lansley has announced plans to strip the key powers from The National Institute for Health and Clinical Excellence or NICE.

The institute was set up under Tony Blair's government to vet the cost-effectiveness of new drugs and treatments, and give national guidance on whether they should be prescribed by doctors within Britain's National Health Service.

Top reporters share their tips on health care investigations     Posted: 11/11/10

Associated Press reporter Stephanie Nano helped host the chapter event, which featured New York Times reporter Duff Wilson.
AP reporter Stephanie Nano and New York Times reporter Duff Wilson.

Two award-winning health care reporters offered tips and story ideas to help other journalists dig into financial reports, legal documents, and databases that the average consumer can't navigate and present the information in a useful way.

Charles Ornstein, a senior reporter at ProPublica and AHCJ president, and Duff Wilson, New York Times reporter, discussed their work and offered tips on mining hospital data, spotting conflicts of interest, understanding publicly available financial reports, and persuading patients and families to share their stories.

Audio

Listen to what they had to say, what sources they suggest, see their presentations and tip sheets and start finding the hidden stories in your community.

Turkey opts for costly hospital finance scheme     Posted: 11/10/10

The Turkish government has begun to select bids for the first of a "large number" of major hospital projects, estimated at $5 billion over the next five years. But the Turkish government has opted for a system of financing based on a model that is causing major problems for hospitals in the United Kingdom.

London-based journalist John Lister writes that the British experience with hospitals funded through Private Finance Initiatives or  Public-Private Partnerships presents a cautionary tale for the Turkish government and others considering this model.

Federal stimulus money invigorates medical research     Posted: 11/04/10

Are you looking for a surprising source of economic power to report about in your community? How about a story with a health care hook to the federal stimulus spending and jobs creation?

Attendees at a recent AHCJ chapter event in San Francisco learned that academic medical centers – especially ones that have a track record of funding from the National Institutes of Health – are a good place to look for such stories.

Irish protests continue over hospital cuts     Posted: 10/01/10

Protests over the €1.23 billion spending cuts for health and children’s services imposed last year to combat a massive government deficit are growing in Ireland and even causing some ministers to rethink their positions.

Two Teachta Dálas, members of the lower house of the Irish Parliament, angered by health cuts are threatening to withdraw their support for the ruling coalition government. Mattie McGrath, a maverick TD for Tipperary, said his future support for the Fianna Fáil/Green/Progressive Democrat coalition for which he was elected would depend upon the future of South Tipperary General Hospital in Clonmel.

McGrath’s political break followed a similar announcement from the west coast, with Galway West Independent TD Noel Grealish announcing at a protest in Galway attended by some 350 people that he was withdrawing his support for the coalition.

Medical errors and the movement toward transparency     Posted: 09/23/10

The Chicago chapter of AHCJ recently hosted David Mayer, M.D., co-producer of the award-winning film, "The Faces of Medical Error ... From Tears to Transparency: The Story of Lewis Blackman," and a leader on transparency in health care. Mayer is associate dean for the University of Illinois at Chicago College of Medicine, co-executive director for UIC's Institute for Patient Safety Excellence and a practicing anesthesiologist.

Mayer described changing the culture of "deny and defend" in hospitals to a culture free of "shame and blame," in which health care providers acknowledge mistakes that are made. In such efforts, providers are encouraged to learn from mistakes and they explain the errors that do harm to patients and their families.

Reporters urged to insist on response from government agencies     Posted: 09/16/10

FDA headquarters in White Oak, Md. (Photo by thisisbossi via Flickr)
FDA headquarters (Photo by thisisbossi via Flickr)

When the FDA would offer only "no comment" on a notorious incident last summer, Felice J. Freyer, a medical writer at The Providence (R.I.) Journal, was disappointed but not surprised. She published her story about an FDA matter (the use of unapproved IUDs) without the agency's input.

But Freyer became concerned when, four days after her story came out, the FDA posted on its website a "consumer update" that answered some, but not all, of the questions she had posed to the agency.The web-only consumer advisory left questions unanswered and probably reached few consumers.

Freyer, who is an AHCJ board member and chair of AHCJ's Right to Know Committee, complained about the incident, pursuing the matter up the chain of command. She eventually received an apology, but little by way of explanation. She is sharing her experience and her advice in the hope of encouraging other reporters to persist in seeking information from the federal government.

The real challenge for Italian health care     Posted: 09/13/10

Changes are on tap for the Italian health care system. Standard health care costs will be defined, which means determining the amount necessary to keep Italians healthy, starting with what "virtuous regions" spend, (meaning those regions with their balance sheets in order: Emilia-Romagna, Lombardy, Tuscany and Veneto). A saving on standard costs of at least 4 billion euro is expected.

However, AHCJ member Gianluca Bruttomesso raises some questions about why the system should be subjected to limits and  deceleration in development.

Public handicapped by lack of information on medical errors     Posted: 09/09/10

CMS Statement of Deficiencies

Who protects the patients?

That’s what reporters at  the St. Louis Post-Dispatch wanted to know – and it’s the title of an occasional series on health care. Jeremy Kohler and Blythe Bernhard found a paucity of information available to patients to help them choose hospitals and doctors. What they discovered was that "When 'never events' occur, the public has virtually no way to find out about them, at least in Missouri and many other states without reporting laws." Here, Kohler tells AHCJ members what they did find and how they found it.

Experts discuss benefits, dangers of telemedicine     Posted: 08/12/10

AudioAudio of this session is available.   

Telemedicine, telehealth and teleradiology are bringing patients and physicians together, but problems can arise when there are opportunities to cash on the services that make these broadband connections possible.

At a meeting of AHCJ's San Francisco Bay Area chapter last month, three experts on the highly subsidized practice of telemedicine and telehealth painted a much different picture about the sustainability of programs directed mainly at poor and underserved patients than did a fourth expert, who described the Wild West vision of teleradiology.

'Landmark:' Behind the scenes of covering health care reform     Posted: 07/22/10

 Landmark book coverAfter passage of health reform, a Washington Post team wrote "Landmark: The Inside Story of America's New Health-Care Law and What It Means for Us All."

In this piece for AHCJ, member Joanne Kenen interviewed two of the authors, Ceci Connolly and Alec MacGillis, who offer some of the high and low points of the passage of health care reform, as well as stories reporters should cover in the coming days.

Medicaid data yields details on prescribing habits     Posted: 07/01/10

Prescription medicationsOne psychiatrist in Chicago was prescribing a risky psychiatric medication to more patients than all the doctors in Texas, based on Medicaid prescribing data.

That sentence is simple and evocative. Reporter Christina Jewett says she never could have written it if she hadn't navigated the world of Medicaid data. Doctors who bill the health insurer to the needy leave a mighty paper trial, and states vary in their ability and willingness to reporters follow it. For the valiant, though, the rewards are great. You can learn about prescribing, services rendered to patients and payments denied to doctors. Jewett shares some of what she learned with AHCJ members.

No More McAllens     Posted: 06/01/10

A handful of the nation's brainiest healthcare economists and policy analysts looked beyond obvious geographic variations in Medicare spending to explore why the federal health program for seniors pays considerably more to treat beneficiaries in some healthcare markets than others.

What the VA faces with Iraqi Freedom/Enduring Freedom Vets     Posted: 05/13/10

A group of AHCJ members were treated to a tour of the Jesse Brown VA Medical Center and presentations about the center's care on April 22, 2010, as part of Health Journalism 2010. Attendees learned about the changing demographics of VA patients, the effect a struggling economy has on veterans, the system's electronic medical records and developments in prosthetic limbs.

Can reporters raise health literacy in the community?     Posted: 05/05/10

In a panel about health literacy at Health Journalism 2010, panelists looked at how journalists might communicate about health and medicine better. One speaker said that making complex scientific information understandable takes work, but studies show that even highly educated people prefer simple and "clean" language. Another suggested that journalists use summaries in articles, "what you need to do" points, and direct patients to useful web resources. A third expert said that full financial disclosure by researchers and limiting reporting to prospective, double-blind studies would be steps toward improving the quality of medical reporting.

Hands-on experiences highlight AHCJ field trip     Posted: 05/05/10

Her eyes blink, her pupils dilate and, yes, doctors, she has a pulse. She also can have a seizure and complications giving birth - on command. Her name is NOELLE® and she's one very busy childbirth simulator at Northwestern University's Feinberg School of Medicine. Under the direction of John Vozenilek, M.D., director of Simulation Technology and Immersive Learning, an eager group of field trip attendees in mini-med school at Health Journalism 2010 helped deliver her "baby," aided by silent commands from a nearby wireless PC. 

Journalists not only got to walk through emergency scenarios with NOELLE and infant, but their calm and cool were further tested in a high-fidelity simulation that involved rescuing a patient from a near-fatal asthma attack. Next, they cautiously replaced a ventral venous catheter under ultrasound guidance and revived a patient from cardiac arrest while demonstrating aptitude in CPR and automatic defibrillation.

Contaminated foods pose threat to public     Posted: 04/28/10

Contaminated foods sicken and kill Americans every year. Though the stories receive wide coverage in the U.S. media, the danger hasn't lessened. That's because of weaknesses in the regulation and inspection of foods, panelists said during a discussion about the safety of the food supply.

Speaking at Health Journalism 2010, Michael P. Doyle, a microbiologist who directs the Center for Food Safety at the University of Georgia, said there are two major – and increasing – threats to the U.S. food supply: imports and animal manure.

Experts acknowledge difficulty of writing about preventive health guidelines     Posted: 04/28/10

When it comes to clinical practice guidelines, Americans have, no pun intended, developed a healthy skepticism.

"It's as complicated as you think it is," panelist Len Lichtenfield, M.D., deputy chief medical officer of the American Cancer Society, told the roomful of journalists attending the panel discussion, "Guidelines for Writing about Preventive Health Guidelines" at Health Journalism 2010 in Chicago.

"You have a difficult job," Lichtenfield said. "You're trying to take something that's complicated, that's mired in science and trying to make sense of that. If you think it's difficult, you're right. In a soundbite environment, these are complicated issues."

TBI, PTSD among war-related illnesses veterans face     Posted: 04/28/10

More than 2 million service men and women have served overseas in support of the wars in Iraq and Afghanistan. Some 15 percent of those have deployed three or more times since 2001. The Department of Veterans Affairs notes significantly increased incidence of psychological and physical problems in these multiple-tour vets.

Medical personnel outlined key issues facing the nation's newest veterans during a "Mounting physical and mental health needs of returning vets" panel at the annual Association of Health Care Journalists conference in Chicago.

Untold stories remain in nursing homes     Posted: 04/27/10

Many reporters reject doing nursing home investigations because they assume all the best stories have already been done.

But serious problems remain and many untold stories exist in institutions that serve some of the most vulnerable members of our society, said speakers at Health Journalism 2010 in Chicago.

Women's health an important topic for the next decade     Posted: 04/27/10

"Women became a topic in the nineties, and all we could hear about was pregnancy. Women's health was considered to be about our reproductive system, but we it's more. We are not an organ, we should be seen by a whole and we need to cover the biological needs and reactions by sex and gender," said Janine Clayton, M.D., deputy director from the Office of Research on Women's Health, during a panel about women's health research at Health Journalism 2010.

The panelists agreed there is a need to make distinctions between sex and gender and that both should be considered while covering and studying women's health issues and emphasized the importance of gender roles in treatment.

Addressing racial and ethnic disparities     Posted: 04/27/10

Despite spending more money on health care each year than any other country, the United States' quality of available care and measured health outcomes remain low when compared with other high-income nations worldwide, said Christopher Murray, M.D., D. Phil, director of the Institute for Health Metrics and Evaluation. The disparities in care provided by our nation's health care system and the overall health of our citizens also continue to widen, he said.

Several speakers, during an hour-long discussion at the Health Journalism 2010 conference in Chicago, explained how journalists could use available statistics on racial and ethnic health disparities to raise awareness of underserved and unhealthy populations. The panelists emphasized that journalists should give attention to these disparities because health reform alone will not fix the gaps in local health care.

What can we learn from superagers?     Posted: 04/27/10

There's more than one recipe for becoming a superager, including well-known ingredients such as environmental and behavioral aspects, as well as research into the genetics and brain anatomy that enhances healthy aging.  One researcher has found that superagers, individuals 85 and older, have a passion they pursue with an outlook that is empowering.

High hopes, limited regulation a dangerous formula for 'functional foods'     Posted: 04/27/10

Journalists covering nutritional supplements and so-called functional foods should compare the marketing messages of manufacturers to the science behind those claims, said panelists at a Health Journalism 2010 session on the topic.

Consumers spend billions of dollars annually on supplements and functional foods, said Marilyn Marchione, medical writer for the Associated Press. Although such products face lower regulation than pharmaceuticals, many consumers seek "drug-level effects," she said.

Looking for docs in all the wrong places?     Posted: 04/27/10

In the wake of health care reform ,more patients will go in search of medical care. The question is, will there be enough doctors to handle the need? By the year 2016 the number of retiring physicians is expected to exceed the number of students graduating from medical schools.

Catastrophe or opportunity? Perhaps it's not so much a numbers issue as it is a distribution one.

Caring for aging population will require health care transformation     Posted: 04/27/10

In the sea of America's diverse population, the rising tidewaters of baby boomers are creating a tsunami of health-care needs. The reverberations are already noticeable from too few specialty-trained physicians for diagnosing and treating complex problems of the elderly and growing shortages in the nurse workforce.

For every 10,000 people age 75 and older, just four geriatricians are available today, Herbert Sier, M.D., told attendees at the annual Association of Health Care Journalists' conference in Chicago. Sier is associate chief of geriatric medicine at Northwestern Memorial Hospital, part of the Feinberg School of Medicine at Chicago's Northwestern University.

Journalists encounter obstacles in identifying conflicts of interest in medical research     Posted: 04/24/10

Journalists have new tools to decipher conflicts of interest in medical research, but there are still many obstacles to obtaining information, according to panelists at the Health Journalism 2010 conference in Chicago.

Steps have been taken on many fronts, from greater transparency on the part of researchers to stricter standards by editors of several major medical journals, but speakers at the April 23 panel, "Spotting conflicts of interest in medical research," agreed that journalists still face challenges in identifying bias.

What did the U.S. learn from the H1N1 pandemic?     Posted: 04/24/10

Getting consistent health messages out in the world of the 24-hour news cycle was one of the leading challenges facing public health officials as the H1N1 flu pandemic news unfolded in the past year, a panel of experts said at Health Journalism 2010 conference.

Experts: Where you live affects your health     Posted: 04/24/10

Can your zip code really affect your lifespan? Location has a lot more to do with your health than you think, experts said Friday at Health Journalism 2010 in Chicago.

Where you live is linked to projected life expectancy, disease and overall level of health, said the three-person panel composed of public health and food experts.

Sebelius predicts ‘hand-to-hand combat’ on health law     Posted: 04/24/10

Speaking at the annual Association of Health Care Journalists conference in Chicago, Kathleen Sebelius, secretary of the Department of Health and Human Services, predicted an "ongoing hand-to-hand combat" with health insurers over elements of the new sweeping health care legislation.

Thomas Frieden, M.D., M.P.H., director of the Centers for Disease Control and Prevention, also addressed conference attendees, presenting a newly issued report outlining the states' progress in fighting smoking. The report, subtitled "The Good, the Bad and the Improving," said national smoking rates had leveled off after years of declines.

Session focuses on tracking health care costs using Dartmouth Atlas     Posted: 04/24/10

Sifting through Medicare data is no easy task for even the most statistics-savvy health reporters. But new tools from Dartmouth Atlas, a Medicare data analysis organization run by the Dartmouth Institute for Health Policy and Clinical Practice help streamline the process.

Kristin Bronner, Dartmouth Atlas' managing editor, presented the Web site's updated capabilities at the Health Journalism 2010 conference in Chicago on April 23, 2010. The Atlas' new site design launched the day before.

News from Health Journalism 2010     Posted: 04/23/10

A set of newsmaker briefings as well as a stellar line-up of panels resulted in dozens of stories about the conference, infection prevention, patient safety, health reform, smoking, FDA activity and more.

Uncovering conflicts of interest in medicine, research     Posted: 03/18/10

Conflicts of interest in medical researchJohn Fauber of the Milwaukee Journal Sentinel has been covering conflicts of interest in medicine for about two years, during which he has reported on the large sums of money that the University of Wisconsin medical school and dozens of doctors were getting from drug companies. He has uncovered links between the university and the marketing of hormones, written about a journal editor who earns royalties from medical devices that appear in his publication and found physicians who don't adequately disclose their conflicts of interest in journal articles.

In this article for AHCJ, Fauber details what he has learned and how he went about investigating the pervasive influence of drug company money on the University of Wisconsin School of Medicine and Public Health and its doctors.

Shortened Lives: How location, lifestyle affect health     Posted: 02/04/10

John Fitzpatrick, 10, receives treatment at home in Oakland, Calif., to combat his asthma. In their series "Shortened Lives," Suzanne Bohan and Sandy Kleffman profiled people from different (though nearby) ZIP codes, noting the life expectancy for each. They found wide disparities in their expected life spans, based on where they live, their social status and the toll of chronic stress. The series explains the effect these disparities have on health care costs, as well as how they are caused and how they might be addressed.

Bohan and Kleffman wrote about the project in a piece for AHCJ members and we have included additional resources for those interested in exploring disparities in health care in their own communities.

Covering a complex story for the long haul     Posted: 01/28/10

Memorial Medical Center in New OrleansLast August, Sheri Fink's article, "The Deadly Choices at Memorial," a collaboration between ProPublica and The New York Times, described what happened at one isolated New Orleans hospital in the chaotic days after Hurricane Katrina.

She found, after more than two years of research, that more medical professionals were involved in the decision to inject patients with drugs to hasten their deaths – and far more patients were injected – than had been previously understood. While those arrested said their goal had been to relieve pain, two physicians told her on the record that they intentionally hastened deaths, and they explained why. She used toxicology reports and autopsies, along with recollections and documentation from the days after Katrina to report the story.

The reporting and writing process for this 13,000-word article may offer insights for AHCJ members undertaking long-form, investigative reporting.

Addressing the growing demand for kidneys     Posted: 01/20/10

kidneyJosephine Marcotty of the Minneapolis Star Tribune recently wrote a series addressing the increasing demand for kidneys, a need spurred by an aging population, increases in diabetes, obesity and high-blood pressure. She found that it is a public health crisis that costs the nation $33.6 billion a year, and there is no end in sight.

Marcotty covered one woman's search for a kidney, the ethics of paired donations and how the medical center decided who would get organs.

In this article for AHCJ, she shares what she learned about kidney donation and how she reported the story.

Compromised care: What Chicago Tribune reporters learned about felons in nursing homes     Posted: 01/08/10

Compromised care
Photo via Flickr by ulrichkarljoho.

Chicago Tribune reporters David Jackson and Gary Marx, in a three-month investigation into the policies and practices of Illinois nursing homes, found that Illinois is an outlier among states in its reliance on nursing homes to house younger adults with mental illness, including thousands of felons whose disabilities qualify them for Medicaid-funded nursing care.

Jackson and Marx documented numerous recent cases in which violent psychiatric patients who were not receiving proper treatment assaulted, raped and even murdered their elderly and disabled housemates. The stories also showed how the chaotic and harmful behavior can spill outside the nursing home walls when patients are not properly supervised.

In this piece for AHCJ members, Jackson and Marx describe some of the techniques they used in the investigation.

Experts say tuberculosis poses a nearly silent threat     Posted: 01/07/10

Panelists discuss tuberculosis.Hear "tuberculosis" and think Brontë sisters? Consumption? The developing world? Think again: According to a panel of experts at a recent AHCJ New York City Metro chapter event, tuberculosis is alive and well and living in major cities and rural areas in the United States and all over the developed world.Audio

Read more about the disease, the threat posed by multi-drug resistant and extensively drug resistant  tuberculosis and prevention and treatment efforts. Audio files of the panel and the speakers presentations will help you learn more from the experts and journalists on the panel.

Childhood obesity: Experts discuss strategies, solutions journalists should cover     Posted: 11/17/09

Changing behavior and educating people about food is key to helping children become fit and avoid obesity, according to the San Francisco pediatrician who spoke at a Nov. 12 panel organized by the Bay Area chapter of AHCJ. The panel featured a doctor and a journalist who are examining and trying to find solutions to the epidemic of childhood obesity. Journalist Elaine Herscher, an author and senior managing editor at Consumer Health Interactive, offered a number of story ideas for reporters.

Audio availableAudio of this panel is available.

 

SF chapter presents workshop on FOI, public records     Posted: 10/23/09

More than 40 people attended a panel that offered an overview and updates about the Freedom of Information Act and the California Records Act, strategies for obtaining records, and how to use the information effectively. Lee Tien of the  Electronic Frontier Foundation explained the basics of FOIA and gave examples of government responses to FOIA requests under the Bush and Obama administrations. Michael Risher, a staff attorney at the American Civil Liberties Union, offered advice about using the California Public Records Act. Phillip Reese, a reporter at The Sacramento Bee, shared ways to use the data you get to create ways of making information digestible and comprehensible to readers.

Audio availableAudio of this panel is available.

Reporter discovers data missing from federal Nursing Home Compare     Posted: 09/24/09

Duane SchragDuane Schrag of the Salina (Kan.) Journal recently discovered critical data was missing from the federal Nursing Home Compare data online.

The federal government encourages consumers to use Nursing Home Compare to help them choose long-term care facilities. It takes into account variables such as health inspection results, nursing home staff data, quality measures and fire safety inspections. Additionally, reporters have used the data to investigate nursing homes.

In this article, Schrag shares how he discovered the holes in the data and what he learned about Nursing Home Compare.

Paper's investigation reveals contaminated drinking water     Posted: 06/25/09

Oil barrelIn July 2007, the Fayetteville, N.C., City Council learned about a neighborhood's 20-year fight over gasoline contamination in private drinking wells. The revelation led The Fayetteville (N.C.) Observer to ask: What else lies beneath?

In an award-winning investigation, the newspaper found dozens of areas with groundwater contamination, including entire neighborhoods. Although public health officials had known about the contamination for years, little had ever been done. Here, one of the reporters details how they uncovered the story and what they learned about contaminated water wells.

Complementary and alternative medicine: What's working and what's ahead     Posted: 05/06/09

Naturopathic and Western medical doctors met journalistic skeptics and true believers to discuss the science and scams that mix in the growing alternative medicine market, at the Health Journalism 2009 panel "Complementary and Alternative Medicine: What's working and what's ahead."

Online tools for creating multimedia: easy, accessible, and inexpensive     Posted: 04/29/09

There are many ways for journalists to enhance storytelling with the use of online multimedia tools without having to learn a lot of new skills. That was the message of Seattle-based independent journalist Daniel Lathrop’s presentation at the Association of Health Care Journalists' annual conference in Seattle.  Lathrop presented a range of online tools helpful when incorporating photography, video and sound into storytelling. He also talked about networking sites that enable journalists to increase the size of their audience.

Journalists learn to market, brand themselves     Posted: 04/28/09

Barbara Feder Ostrov didn't come to the freelance life by choice. She was four months pregnant when laid off from the San Jose Mercury News and was thrown into freelance writing reluctantly.

What she found out is that even reluctant freelancers can make a living, but it takes preparation and marketing to make it work.

Feder Ostrov was one of a three-member panel moderated by New York freelance writer Irene Wielawski who gave tips to fellow journalists on how to build a brand and market themselves as freelancers at the AHCJ conference.

Improving reporting on medical studies     Posted: 04/21/09

"It is possible for good health journalists to provide spectacular stories on health," said David Henry, CEO of the Institute for Clinical Evaluative Sciences. 

During the afternoon panel on "Statistics, Conclusions, Limitations: Reporting on Medical Studies" at the annual Association of Health Care Journalists meeting in Seattle both Henry and moderator Gary Schwitzer, concurred that most health and medical reporting is inaccurate, imbalanced and incomplete. "After three years and 750 stories reviewed there is still a ‘kid-in-the-candy-store projection of health' in most health news,"Schwitzer said shortly before he launched into a dissection of several news stories.  

Do audiences understand health stories?     Posted: 04/21/09

Health journalists understand some of the key elements audiences need to better understand health stories, but they also misunderstand the impact statistical information has on audience comprehension, according to a University of Missouri researcher.

Speaking at the Association of Health Care Journalists' annual conference, assistant professor Amanda Hinnant, Ph.D., said the results of a survey she and colleagues conducted showed that health journalists realize audiences will be more likely to understand health stories that include a human element, use graphics to illustrate important information and employ a conversational tone.

Genetic, environmental factors at work in aging process     Posted: 04/21/09

Aging is a biological, psychological and social process, as four researchers explained at Health Journalism 2009. Aging research is important to learn how to slow down the process. At age 50, humans have about 62 years left of their lives, according to Matt Kaeberlein, Ph.D., assistant professor, Department of Pathology, University of Washington (or we might if we learned how to slow down the aging process).

One of the biggest factor of aging is smoking, which affects reproduction, cardiovascular, pulmonary, skin, bone and neoplasia. Genes actually play the biggest role in lifespan. Kaeberlein noted that there is no reason that the human body has to wear out with time, and aging must be "programmed."

Hospital patient safety initiatives borrow from transportation industry     Posted: 04/20/09

Patient safety improvement and medical error prevention programs in U.S. hospitals often take their inspiration from the aviation industry's long-standing efforts to prevent errors and from Toyota Motor Corporation's "lean" production system, with its celebrated "stopping the line" policy, in which anyone working on the auto production line can stop it until an identified quality problem can be fixed. Two explicit examples from Seattle's Virginia Mason Medical Center and Seattle Children's were described during a panel at the Association of Health Care Journalists annual meeting in Seattle on April 17.

Reporters' preparation would decrease chaos in covering disasters     Posted: 04/20/09

Disasters are a time of chaos and uncertainty. To perhaps lessen this chaos for reporters, a panel of experts at Health Journalism 2009 in Seattle discussed how journalists might cover and survive disasters as well as understand the medical systems in place to handle them. The panelists offered insight into the many wheels set in motion when a disaster strikes and how journalists can prepare for and understand what might happen should one hit their community.

Animal-to-human contact key to emerging diseases     Posted: 04/18/09

A visit to the local health clinic might be beneficial for health reporters investigating animal-borne diseases, according to one panelist at the Association of Health Care Journalists conference in Seattle.

Health officials might not have a clue about how they would react to the outbreak of any number of diseases that are harmful to farm animals or humans, said William Davenhall, a global marketing manager with the computer mapping company ESRI.

"That would be an interesting story," he said during the April 18 panel on "Tracking animal-borne diseases." He noted: "Being prepared does not does not mean you are ready."

Obama order expected to increase speed, efficiency of stem cell research     Posted: 04/18/09

On the same day that Health Journalism 2009 featured a panel on "Second wind for stem cell research," The National Institutes of Health issued draft guidelines to allow government funding for stem cell research.

Lawrence Goldstein, Ph.D., a stem cell researcher with the University of California San Diego and a member of the board of the International Society for Stem Cell Research, and Chuck Murry, M.D., Ph.D., co-director of the University of Washington's Institute for Stem Cell and Regenerative Medicine, commented on the executive order, as well as on the chilling effects of President Bush's order that limited stem cell research.

Gaps in evidence drive movement toward shared decision-making     Posted: 04/18/09

Shared decision making is of public interest - at least to anyone who thinks they might one day go to the doctor.

"This must be gratifying to Jack Wennberg," panel moderator Gary Schwitzer, publisher of HealthNewsReview.org, mused at the end of the question and answer session following the panelists' presentations.

"He couldn't get his work published for 30 years. He was laughed at, considered a pariah. Finally, he had to publish in Science, which is not exactly a standard journal for variations in health care." Using Medicare data, his Dartmouth Atlas of Health Care demonstrated striking variations in the kind of care patients receive - and the resulting costs - depending simply on where they live.

As it has been applied, Wennberg's pioneering research revealed a large number of medical procedures where there is no clinical consensus as to the course of treatment. In response, there is movement to educate - and mandate - physicians to include their patients in the decision-making process.

Mental health: Reporting beyond the labels     Posted: 04/18/09

If you live with mental illness, tell the truth about it.  If you report on mental illness, watch what you say about it.

This was the core advice from panelists on "Mental health:  Reporting beyond the labels" on April 17 at the AHCJ conference in Seattle.

"People with mental illness are more likely to be victims than perpetrators," said Jennifer Stuber, assistant professor of social welfare at the University of Washington.  But despite the research, many media depictions of these people continue to promote stereotypes of their being dangerous to themselves and others.

Changes to 990 forms make hospital finance investigations necessary     Posted: 04/18/09

If ever there was a time to dig into your local hospital's finances, this is it, Karl Stark told journalists Friday morning. The Internal Revenue Service has made the first significant change to its 990 form in 30 years, providing more details about charity care and community benefits.

"And there are all these financial pressures coming down on hospitals this year," said Karl Stark, health and science editor of The Philadelphia Inquirer. That may result in a new wave of closures and mergers.

AHCJ member reports from Malawi, Zambia     Posted: 04/17/09

Rose HobanAbortions in Zambia, AIDS orphans in Malawi and medical education in Africa. WUNC reporter and AHCJ member Rose Hoban dove headfirst into all of these issues and more on a recent grant-funded reporting trip to Africa.

In addition to nine radio stories, Hoban blogged extensively about her experiences and produced several videos and multimedia slide shows.

Sunshine Week: Some hospital quality measures online but more could be done     Posted: 03/15/09

Sunshine WeekThe Internet offers vast new opportunities to answer every patient’s most pressing question: Am I entrusting my health to people who will take good care of me?

In recent years, state and federal agencies have begun yanking data out of filing cabinets and opening their folders to the daylight of cyberspace. In addition to informing consumers, such Web sites prod everyone in health care to do a better job.

But much more can and should be done to give the public easier access to what the regulators know.

Survey shows 'battered' health journalists press on     Posted: 03/11/09

Health care journalists cited newsroom cutbacks, lack of time for research and travel and fewer opportunities for training at their news organization as factors making their jobs more challenging than ever, according to a survey released today by AHCJ and the Kaiser Family Foundation.

 

The digital revolution in health reporting     Posted: 03/03/09

More than 40 members of the San Francisco Bay Area chapter of AHCJ met to discuss the potential benefits of online social networking  for health reporters via blogs, Twitter and Facebook on Feb. 23. The event, "Tech Tools for Health Reporters," began with a look at the blogosphere.

President's corner: Look for opportunities to localize the debate on national health reform     Posted: 02/26/09

Trudy LiebermanTrudy Lieberman, president of AHCJ's board of directors, offers some ideas about how to cover health care reform, including tips on localizing the story, what to watch out for in the rhetoric, how to include the consumer context in stories, identifying who is representing the grassroots and who is representing the special interests.As Lieberman says, "Health reform gives our profession a chance to show what good journalism is all about. Good reporting is also a lot of fun."

Researchers study health bloggers, form online community     Posted: 02/12/09

Last fall, a trio of researchers published a paper examining that peculiar class of people who may be loosely described as health bloggers.The results, published in the Journal of Medical Internet Research, found that “Medical blogs are frequently picked up by mainstream media; thus, blogs are an important vehicle to influence medical and health policy.”

Two of the researchers also formed the Health Blogs Observatory, which they call an online community, and published a directory. We reached out to Ivor Kovic, an emergency physician, about the survey and their hopes for their observatory.

Making sense of hospital quality reports     Posted: 02/03/09

Michael RothbergThis spring marks 20 years since the Pennsylvania Health Care Cost Containment Council became the first in the nation to report hospital mortality data that was intended for release to consumers. Back then hospitals said the data would be misleading and only confuse consumers. Today, many states – along with the federal government and numerous private organizations – regularly publish or put online report cards on hospitals. But journalists are often unclear about the potential biases and limitations the reports present.

A report in the December issue of Health Affairs found serious flaws in the public reporting of hospital quality data. In this Q&A, one of the authors, Michael Rothberg, M.D., M.P.H., a researcher at Tufts University in Boston, discusses the findings. AHCJ also offers a number of resources for reporters who are looking at hospital quality.

Md. hospitals sue patients despite state subsidies     Posted: 01/29/09

Gavel in courtroomReporters Fred Schulte and James Drew looked into how low-income people afford care and how the hospitals collects payments. They found that court dockets brimmed with collection lawsuits filed by hospitals and many were filed against people living "in the margins." Some hospitals were trying to collect charges that HMOs or other health insurers had declined to pay and some were assessing massive interest rates. Maryland is the only state that sets the rates hospitals charge, rates that include millions of dollars in subsidies for charity care and bad debt losses.

President's Corner: Journalists must do better to inform, educate public     Posted: 01/07/09

Trudy Lieberman
Trudy Lieberman

A few weeks ago a former reporter who had won a Pulitzer told me how Barack Obama could move closer to universal coverage: He could let younger people buy into Medicare and the rest could get coverage through the Federal Employees Health Benefit Program that the reporter said was government insurance like Medicare. Shortly after that, a Fulbright scholar who had just spent a year in the United States told me that Obama planned to give everyone free insurance.

If two, smart, savvy people interested in the topic got the wrong message about health reform, what about all the ordinary people we are supposed to be informing?

For the past year I have reported on media coverage of health reform for cjr.org and can safely say that the coverage has been punctuated largely by several themes that have contributed to erroneous assumptions on the part of our audiences.

Study raises concerns over disclosure in health stories     Posted: 12/15/08

Health journalists used to covering studies in the Journal of the American Medical Association recently found themselves on the receiving end of a scientific inquiry in the peer-reviewed publication.

And the results were not pretty.

The news media often fail to report when drug company funding is used for studies of medications, according to a study, published in the Oct. 1 issue , by doctors at the Cambridge Health Alliance in Cambridge, Mass., a hospital system affiliated with Harvard and Tufts universities' medical schools.

Project launches test of a new model for health journalism     Posted: 12/10/08

“Sowing Hope,” a series in the Merced Sun-Star exploring the quest for a University of California medical school in Merced, a town in California’s San Joaquin Valley, is the first venture from the Center for California Health Care Journalism, a new organization blending nonprofit and traditional media support for health care stories.

Kaiser starting health news service     Posted: 12/09/08

Looking to fill what it feels are gaps in health coverage left by newsrooms slashing reporting staffs, the Kaiser Family Foundation will launch its promised news service in the first half of 2009. Kaiser Health News is expected to employ five to seven reporters, as well as freelance writers. The news service is the latest effort by a private foundation to step into the news hole left by the downsizing news organizations. It joins ProPublica, Florida Health News, Kansas Health Institute's News Service and the Center for California Health Care Journalism.

Reporter finds efforts to monitor groundwater contamination leave much to be desired     Posted: 11/18/08

Groundwater contaminationLeah Beth Ward of the Yakima Herald-Republic in Washington decided to investigate after well water at a school was found to have unsafe levels of nitrates. What she found was a failure of government regulatory practices, heavy influence on the state legislature by the dairy industry and an impasse among state agencies responsible for clean water – both drinking and groundwater. Ward writes about how she reported on the contaminated wells, the source of the contamination and the systemic problems that threaten our water supply.

Atlanta reporter checks up on school vaccination compliance     Posted: 11/13/08

Young boy receives his vaccinations in this photo from the CDC.The Atlanta Journal-Constitution found Georgia school and health officials routinely ignore a law requiring that children receive certain vaccinations before they are allowed to enroll in school and take no actions against violators. As a result, thousands of metro Atlanta children were allowed to enroll and remain in school last year without proof of required shots, records show. Reporter Alison Young writes about how she reported the story using state vaccination compliance audit information for 625 public and private schools in five Atlanta-area counties.

Number of factors affect people's access to health care     Posted: 10/31/08

Two doctors and a health business reporter discussed the roadblocks that prevent people from receiving health care during a panel at the Urban Health Journalism Workshop. Reed Abelson, of The New York Times, offers some thoughts about how to cover the "uninsured."

Shattering myths about emergency rooms: ‘Urgent emergents' and ‘frequent fliers'     Posted: 10/31/08

Despite the common belief that emergency rooms are inundated by uninsured patients, two emergency specialists told a panel at the Urban Health Journalism Workshop that's not necessarily the care. They did outline some of the problems ERs face and some recommendations about how to solve the problems.

Urban Health Journalism Workshop: The built environment's impact on public health     Posted: 10/30/08

The "built environment" encompasses all buildings, spaces, and products that are created or modified by people, including homes, schools, workplaces, parks/recreation areas, greenways, business areas, and transportation systems. It extends overhead, underground and across the country. It includes land-use planning and policies that impact our communities in urban, rural, and suburban areas. And every bit of it has an effect on our health. A panel at the Urban Health Journalism Workshop explored ways in which people's health is impacted by that environment.

Urban Health Journalism Workshop: Monitoring jail and prison health     Posted: 10/30/08

Reporters and an advocate from the Legal Aid Society discussed health care in prisons and jails at the Urban Health Journalism Workshop, including why adequate health care in jails and prisons ultimately effects society at large.

Visit to the Bronx provides insight into school-based health programs     Posted: 10/30/08

Children exercise in the classroom as part of a school-based health program in the Bronx, New York.Journalists learned about the scope and structure of some of New York's school-based health centers during a field trip to two Bronx schools on Oct. 17, preceding the 2008 Urban Health Journalism Workshop. Children receive basic health care, including things like immunizations and asthma treatments, through clinics in their schools. Officials say such programs improve the health care children receive, as well as easing the burden on their parents.

Urban Health Journalism Workshop: Asthma and children     Posted: 10/30/08

Asthma has everything to do with where someone lives. So, for this year's Urban Health Journalism Workshop concerning environmental issues and health, one panel honed in on children and asthma. Experts stressed the role that education about symptoms and management play in the wellness of children with asthma.

Health writer reflects on shaky times in newsroom     Posted: 10/27/08

Phil GalewitzPhil Galewitz is editor of AHCJ's newsletter, HealthBeat, an AHCJ board member and a health writer for The Palm Beach Post. The Post recently suffered massive layoffs, like so many newspapers in recent months. Galewitz discusses what it's like to be in a newsroom going through such changes.

President’s corner: Putting a human face on McCain, Obama health plans     Posted: 09/16/08

Election 2008: Health CareAHCJ President Trudy Lieberman urges reporters to write about how the presidential candidates' health care plans will affect ordinary people. She argues that, unless we tell audiences just what they can expect from either candidate, they might really become disengaged. The column's sidebar lists numerous sources and related information to help reporters get started on that task.

Journalists face 'health literacy' hurdles in reaching audience     Posted: 09/05/08

Study notes lack of specialized training
Health journalists could better inform the public if they realized how illiterate most Americans are when it comes to understanding medical concepts and issues, concludes a new study by two University of Missouri researchers.

Author Q&A: Julie Salamon on long-term reporting and urban hospitals     Posted: 08/20/08

Julie SalamonJulie Salamon has written for Vanity Fair and The New Yorker as well as the Wall Street Journal and the New York Times. Her latest project arose from time spent reporting at Maimonides Hospital in Brooklyn, N.Y., where she observed the comings and goings of the hospital. The result is her new book, "Hospital: Man, Woman, Birth, Death, Infinity Plus Red Tape, Bad Behavior, Money, God, and Diversity on Steroids." Salamon took time out from a stop in Maine to answer some questions for AHCJ.

Deciphering cost reports helps paint picture of hospital's financial health     Posted: 07/31/08

Fort Worth Star-Telegram reporters Darren Barbee, Yamil Berard and Anthony Spangler spent four months examining the JPS Health Network through public records and data, including financial and tax documents, reports to state and federal agencies, and correspondence.

Berard obtained cost reports for the hospital – and eight others – and analyzed them to determine whether there was evidence that the hospital had hiked prices to increase federal funding and whether price hikes affected some patients, such as the uninsured, more than others. Berard writes about how she went about obtaining cost reports, what kind of information can be found in them and how she did the analysis.

Building a database reveals deficient nursing homes     Posted: 07/17/08

Matt Canham of The Salt Lake Tribune scoured nursing home inspection reports – not available online in Utah – and found details of hundreds of deficiencies. He used those reports to build a database that's now available on the paper's Web site for the public to search. Through the data, Canham was able to identify problem homes. Most were “yo-yo” facilities, dipping in and out of compliance. The series also found that ownership is a top predictor of quality, though neither the state nor federal government has good information on who owns these facilities. This article is accompanied by a number of resources, including tip sheets, a video of story ideas, related articles and Web sites.

A glimpse at health journalism paychecks     Posted: 07/16/08

See the results of a snapshot salary survey taken by more than 100 journalists in March.

Elizabeth Edwards: How might she advise Obama?     Posted: 07/11/08

Elizabeth Edwards, health care reform advocate and wife of former presidential candidate John Edwards, is now advising Sen. Barack Obama's campaign on health care issues and is a senior fellow at the Center for American Progress where she works on health care issues.

In her keynote speech at Health Journalism 2008 in Washington, D.C., Edwards discussed differences between the plans offered by Sen. John McCain, Sen. Hillary Clinton and Sen. Barack Obama. Her talk outlines some important differences, as well as the questions that reporters should be asking the candidates about health care.

Newspaper risked credibility by making deal with hospital     Posted: 06/26/08

Anne Arundel Medical CenterThe Capital, a 47,000-circulation daily newspaper in Annapolis, Md., sold its weekly Health Page to Anne Arundel Medical Center, a local hospital, one day in March, putting it in charge of all content, including the stories and layout. The deal was ethically and journalistically wrong, unfair to the readers and a bad business decision, according to experts, and even the paper's publisher. But striking such deals with local hospitals or other medical providers is not uncommon, although they're more predominant among local television stations than newspapers, according to Bob Steele, the journalism values scholar at the Poynter Institute.

Records show 'dangerous doctors' rarely face discipline     Posted: 06/05/08

Dangerous DoctorsGina Barton of the Milwaukee Journal Sentinel describes how she used several sets of data and records, from both state and federal sources, to report the "Dangerous Doctors" series. The articles revealed that Wisconsin doctors are rarely disciplined by the state medical board, even when patients are harmed or die. She found the board is slow to look into complaints, is secretive about its investigations and rarely hands out serious punishment.

Bay Area panel on veterans' health highlights untold stories     Posted: 05/28/08

Returning veteransA panel of experts gave a compelling presentation about one of the nation's biggest health stories – the medical, mental and psychosocial challenges faced by returning war veterans and their families – at a May 21 meeting of AHCJ's San Francisco Bay Area chapter. An article about the panel, as well as audio of the event and handouts and presentations from the speakers offer numerous story ideas that haven't been covered yet.

W.Va. paper chronicles state's oral health problem     Posted: 05/22/08

Larry Coleman's old denture was stained by the tobacco he chews every day.

In a series of articles published last year, Charleston (W.Va.) Gazette reporter Eric Eyre chronicled the abysmal state of dental health in West Virginia. In clinics and private dentists' offices, Eyre found people suffering with painful toothaches, gaping cavities, abscesses, lip cancer, gum infections and molars cracked off because of an unsuccessful attempt at do-it-yourself dentistry. Eyre shares how he reported the story in this article, which is accompanied by a tip sheet, audio from Eyre and a West Virgina dentist and links to relevant Web sites and reports.

Outsourcing of pharmacies: Prescription for problems?     Posted: 05/15/08

Pharmacy outsourcingIn the March issue of Portfolio, Katherine Eban reported on the prescription error that killed a premature infant in a Nevada hospital which had outsourced its pharmacy operations. Eban says hospitals that turn over their pharmacies to management companies often cede nearly total control, a situation that can create a dangerous disconnect between the hospital’s medical staff and the pharmacy. Now Eban explains how she reported the story and offers ideas for reporters who should be looking into hospital pharmacies in their areas.

Focus on freelancing: Making sure you're covered for liability     Posted: 05/01/08

Liability insurance for freelancersWhile most staff writers take for granted that their publications' attorneys will defend them should the subjects of their stories ever get litigious, freelancers can't count on the same protection. Some agreements may make freelance journalists responsible for things such as libel, slander, invasion of privacy or copyright infringement – something that could be risky and costly for health writers doing investigative pieces about a drug, device, doctor or medical institution. Independent journalist Jane Allen writes about liability insurance for freelancers and offers some ways to protect yourself.

Health Journalism 2008: Ripping the cover off hospital finances     Posted: 04/14/08

Karl Stark, pharmaceuticals reporter for The Philadelphia Inquirer and Gita B. Budd, principal of ECG Management Consultants, provided attendees with a good mix of user-friendly information from about hospital finances from both sides of the writer's pen in "Ripping the Cover off Hospital Finances."

Health Journalism 2008: Under pressure - FDA oversight, funding, effectiveness     Posted: 04/07/08

This panel of current and former FDA officials and outside experts discusses how FDA resources, policies and legal authority shape agency actions and responses, with an emphasis on the agency's lack of responsiveness to FOIA requests and other media queries.

Health Journalism 2008: Violence and mental illness - How strong is the link?     Posted: 04/07/08

After the Virginia Tech shooting, journalists must keep a step ahead of the common wisdom when covering stories about mentally ill people and violence. Is violence inevitable or an aberration among the mentally disabled? Can we predict who will become violent? What can be done to treat or restrain mentally ill but potentially violent individuals? A psychiatrist, a medical sociologist, and an advocate for the mentally ill clarify the facts and explicate the controversies.

Health Journalism 2008: Pros and cons of genetic risk profiling     Posted: 04/07/08

This panel explored the ethical, medical and scientific dimensions of genetic testing. Experts in the field were joined by a 23-year-old woman who has tested positive for a gene linked to breast cancer, and her mother, a breast cancer survivor. They demonstrate that patients have access to more information than ever about their genes, but that knowledge brings an array of choices and consequences.

Health Journalism 2008: Lies, damned lies and medical statistics - how to interpret the evidence     Posted: 04/07/08

This panel offers examples of widely accepted medical practices and treatments that need a second look, including problems with screening for cancer, focusing on the controversy surrounding CT for lung cancer and PSA testing. Topics include the use of surrogate endpoints; how trial design can be manipulated to achieve the desired outcome; the meaning of such terms as underpowered, number needed to treat, sensitivity, specificity, all-cause mortality and relative risk reduction versus absolute risk reduction.

Health Journalism 2008: U.S. roles in global health - which direction?     Posted: 04/07/08

In today’s interconnected world, health is an increasingly global issue. The American role in confronting health issues in the world's poorest countries is evolving, with direct involvement from the U.S. government and increasingly-active foundations. Experts on global health delve into trends in addressing international health problems, both successes and failures, and look ahead to future challenges.


Health Journalism 2008: Medical tourism - trend or aberration?     Posted: 04/07/08

More Americans are going abroad for medical treatment – sometimes with the encouragement of their health insurers and employers. But while much of the medical care overseas is of high quality and far less costly, there are many things would-be “medical tourists” should do before they decide to go for such care. There also are important emerging standards for transport and interoperability of personal health data for medical tourism that could make this more feasible. Three experts in the field discuss pros and cons of medical tourism, and a journalist who has written about this extensively suggests how to cover medical tourism in ways that serve readers.

Health Journalism 2008: Community ... the health story     Posted: 04/07/08

Everyone knows "good" neighborhoods and "bad" ones. But there are gripping, untold stories to be found in the reasons people in some neighborhoods lead longer and healthier lives than those in others. It's more than a simple tale of wealth vs. poverty, health habits, or years of schooling. Even rich, well-educated people tend to die younger if they live in places strained by inequality and social disconnection. A health expert and a master storyteller discuss how to tell the stories from your community.

Health Journalism 2008: Edwards says McCain plan gives insurance companies a pass     Posted: 04/07/08

Elizabeth Edwards, wife of former presidential candidate John Edwards, was the keynote speaker at the Awards for Excellence in Health Care Journalism luncheon. Edwards discussed her view of John McCain's health care plan, revealed which candidate's plan she favored and she called upon journalists to make sure the candidates tell the truth about health care and their plans.

Health Journalism 2008: Life after cancer - Survivorship planning     Posted: 04/07/08

For many cancer survivors, beating the disease is only the first of many challenges. There's the threat of recurrence and psychological fallout that can take a toll on relationships. Young survivors face educational burdens and decisions that could affect their fertility. Older survivors struggle to hold onto jobs that provide health insurance, or pay the immense costs for treatment, while often dealing with co-morbid conditions. With two-thirds of survivors expected to live at least five years after diagnosis, these issues are very real and relevant to your readers. A cancer survivor and experts discuss the issues.

Health Journalism 2008: Finding success through the trades     Posted: 04/07/08

Regular gigs from medical and scientific trade magazines can bring a steady flow of income and provide freelancers with lots of ideas for the glossies or even books. Dozens of reputable medical and science trade publications cover the business, science, and technology of health care, crave good writers and top-notch reporting ... and will pay for it. How can you get started writing for trades? How can you find the best trades to fit your skills? What are the benefits? What are the downsides? Our panel of medical trade writers and editors explore this and more.

Health Journalism 2008: Clinical research into vaccines for cancer and other diseases     Posted: 04/07/08

In the 20th century, 22 vaccines were approved, including those for polio and influenza. So far this century, just one vaccine has made its debut. More nontraditional vaccines are in development for chronic diseases including Alzheimer's, hypertension and other cancers. Two vaccine pioneers, including the developer of the first cancer vaccine, and one of the top federal vaccine policy experts discuss the trend.

 

Health Journalism 2008: What health systems of other countries can teach us     Posted: 04/07/08

Experts discussed four countries with four very different health care systems: Canada, England, France, and the Netherlands. They'll describe what's good and bad in each nation – and offer some lessons for would-be reformers in the United States.

Health Journalism 2008: Economics of health 101     Posted: 04/07/08

We spend 16 percent of our economy on health care. A panel of experts explained the financial fundamentals of this huge and confusing system. How the money is spent, who pays the bills, who gets the revenues, the differences among public and private programs, and why health markets are local.

Health Journalism 2008: Which way health reform?     Posted: 04/07/08

Leading health policy experts from the left, middle and right debated the widely varying options facing lawmakers and voters.

Health Journalism 2008: Sociological aspects of breast cancer     Posted: 04/07/08

In the United States, African American and Latina women are diagnosed with breast cancer less frequently than white women. But once diagnosed, studies have shown that these women are far more likely to die of their disease. Vanessa Sheppard, a researcher at the Lombardi Comprehensive Cancer Center, discussed outreach initiatives for both groups and reducing health disparities.

Health Journalism 2008: How will retiring boomers affect the national health agenda?     Posted: 04/07/08

The first of the nation's Baby Boomers are just three years from retirement age. Experts predict escalating age-related chronic disease and disability, and a health care system ill-prepared to handle them. The nation faces a shortage of geriatricians, a lack of preventive care, a need to better integrate acute and long-term care, and bewildering array of financing options. Panelists discussed those problems and solutions developing at the federal and state level.

Health Journalism 2008: Current controversies in transplantation     Posted: 04/07/08

This panel at AHCJ's annual conference discussed organ transplantation, which involves genuine rationing, with not enough supply to meet demand. Panelists discussed a variety of tough questions: Should young people be given an advantage over older patients in distribution of donated kidneys? What should hospitals be required to do to protect the interests of living donors? Should the U.S. allow Americans to sell their kidneys?

Reporter offers testimony to FDA committee about agency's communication policies     Posted: 03/11/08

At the first meeting of the new advisory committee to the FDA on Risk Communications on March 6, 2008, AHCJ member and freelance reporter Kathryn Foxhall testified about the FDA's communications policies. The FDA is just one of many agencies and organizations that use tracking and monitoring by their public relations offices to stifle communication between its employees and the press.

Scribes and scrubs: A healthy mix     Posted: 03/04/08

While medical journalists, and students, have ready access to the successes of medicine through press conferences, hospital public information officers and journals, they have less opportunity to learn about the complexities and complications involved in patient care, especially in hospitals.

Mary Knudson, the science-medical writing adviser in the Master of Arts in Writing Program at Johns Hopkins University, wanted to offer her students a chance to learn about those challenges and problems that are not so readily discussed. Her solution, she explains, put the writing students inside a hospital, where doctors could drop in and talk to the students. It also included shadowing residents for a 15-hour shift, something that opened their eyes to the interactions between patients and doctors.

Author Q&A: Shannon Brownlee on overtreatment of patients     Posted: 02/28/08

Shannon BrownleeShannon Brownlee's book “Overtreated: Why Too Much Medicine is Making Us Sicker and Poorer” challenges one of the core beliefs of American health care: that more is better. “Overtreated” was named the No. 1 economics book of 2007 by The New York Times, over books by Alan Greenspan and Robert Reich. Brownlee talks to AHCJ about the book, how health care is playing into the presidential election, and what health reporters should be asking about and examining.

Courant reporters investigate nursing home chain     Posted: 02/27/08

Courant reporters investigate nursing home chainLisa Chedekel and Lynne Tuohy of The Hartford Courant used health inspection records, cost reports and court records to disclose that one of Connecticut's largest nursing home chains was repeatedly cited for serious patient-care deficiencies, was deep in debt and that there numerous allegations of wrongdoing in pending litigation. They write about how they went about researching and reporting the story.

President's corner: Candidates' health reform language needs closer scrutiny, definition     Posted: 02/26/08

Trudy LiebermanThe health care vocabulary of the presidential campaign includes terms such as "socialized medicine," "universal," "comprehensive," "guaranteed," "mandate," "coverage," "care" and "choice." Journalists pick up these terms, weave them in their stories, and telegraph a meaning that politicians want, although it may not be the same as the one in the dictionary. AHCJ President Trudy Lieberman calls on journalists to pin down the candidates and explain what the words mean before we let them get away with a smorgasbord of empty terms.

Foundations stepping into news game     Posted: 02/25/08

In Florida and Kansas, health foundations are funding news services to gather health policy news and disperse it on the Internet. The trend could take off this year as the Kaiser Family Foundation and the California HealthCare Foundation are considering launching their own types of health news services.

Bush signs compact with Tanzania, pledges nets to fight malaria     Posted: 02/20/08

President George W. Bush's Feb. 17 visit to the East African nation of Tanzania brought a major boost in the country's health care sector. Bush and Tanzania's President Jakaya Mrisho Kikwete signed the largest project in the Millennium Challenge Corporation's history – a $698 million (US) compact with Tanzania that will benefit 4.8 million Tanzanians. AHCJ member Emmanuel Rubagumya, managing editor of Health Focus Magazine in Dar es Salaam, Tanzania, reports on Bush's visit.

Powerful drugs being prescribed off-label to children     Posted: 02/06/08

Children and antipsychoticsThe St. Petersburg Times' Robert Farley spent six months investigating the skyrocketing amount of atypical antipsychotic drugs being prescribed to children. The drugs, developed to treat schizophrenia and bipolar disorder in adults, increasingly have been prescribed off-label to children with aggressive behavior or ADHD. During his investigation, Farley found that almost no research has been done on the long-term effects of these drugs on the developing brains of children. Here, he talks about how he developed two stories about the drugs and a third one that will be published soon.

Freelancers on the hunt for health insurance     Posted: 01/17/08

Health insurance for freelancersFreelance writers often have to shop around for health insurance that is both affordable and adequate. Freelance writer and AHCJ board member Sheree Crute looks at what's available and how to check up on the legitimacy of health insurance companies. We also invite our freelance members to offer their suggestions on the topic.

Women's magazines can miss wider views of health issues     Posted: 01/02/08

Intellectuals began accusing women's magazines of perpetuating feminine stereotypes decades ago. McCall's was the fastest growing of that genre in the 1960s when Betty Frieden wrote "A Feminine Mystique," criticizing stories published in McCall's and similar publications that included traditional, gender-solidifying topics. Forty years later, health is the hot topic for women's general interest magazines, which regularly promote wellness and medical features. These articles can provide valuable information overlooked by the mainstream press, according to researcher Barbara Barnett from the University of Kansas. But the coverage women receive from them often focus on superficial topics and reinforce women stereotypes as caregivers, she says.

Online jobs scarce for health reporters - but freelance opportunities abound     Posted: 01/02/08

With the explosion of health Internet sites such as Revolution Health, WebMD and Daily Strength, it isn't surprising that many health journalists, squeezed by mainstream media budget cutting, are contemplating moves to online jobs. The opportunities can be enticing for journalists at all stages of their careers, but caveat emptor: For every well-paying job with a well-established health site, there are dozens more offering skimpy compensation, unstable freelance gigs and sometimes questionable content.

Hospitals ask reporters to sign confidentiality agreements     Posted: 01/02/08

A growing number of hospitals across the country are asking reporters to sign confidentiality statements. The hospitals say they are following guidelines set up this year by The Joint Commission (formerly the Joint Commission on the Accreditation of Health Care Organizations). Hospitals and the press have always had a challenging relationship, and the privacy rules in HIPAA (the Health Insurance Portability and Accountability Act of 1996) further strained communications as hospitals have grown more fearful about the inadvertent release of patient information.

President's corner: If candidates won't focus on aging issues, journalists better     Posted: 01/02/08

AHCJ President Trudy Lieberman writes that the presidential candidates have been mostly silent about issues that affect the aging. Of the thousands or maybe millions of words that have been written so far about the candidates and their health care proposals, few have been about aging, the quality and financing of long-term care or, for that matter, the future of Medicare - all crucial issues facing this country. You almost might say the candidates are ignoring those topics, which is a shame given the realities of aging in America.

Reporter documents surgical errors through public records     Posted: 11/28/07

Surgical errorsWhen Boston Globe reporter Lizbeth Kowalczyk asked the health department to run a computer search of report and investigation summaries for 2005, 2006 and 2007-to-date, she discovered records of surgeries that involved the wrong site, wrong patient or wrong procedure, and instances of objects left inside patients. The reports showed that procedures to prevent such incidents were not implemented consistently and that some nurses and technicians didn't confront surgeons about lapses, even though they acknowledged later that they knew the what the surgeon was doing was wrong.

Online jobs scarce for health reporters     Posted: 10/31/07

Online jobs scarce for health reportersWith the explosion of health Internet sites such as Revolution Health, WebMD and Daily Strength, it isn't surprising that many health journalists, squeezed by mainstream media budget cutting, are contemplating moving to online publications. The opportunities can be enticing, but caveat emptor: For every well-paying job with a well-established health site, there are dozens more offering skimpy compensation, unstable freelance gigs and sometimes questionable content.

Death in Sin City: Analyzing the CDC's mortality database     Posted: 10/03/07

Death in Sin CityAlex Richards and Marshall Allen analyzed data from the CDC's mortality database to find out how the causes of death in Nevada and Clark County, home to Las Vegas, compared to the national average. They found that Nevada has the 12th highest death rate among people younger than 65, has a rate of deadly accidental poisoning and exposure to noxious substances that’s almost twice the national rate, has a rate from alcoholic liver disease 1.7 times the national rate and has the highest suicide rate in the nation and a suicide rate among the elderly that’s nearly three times the national rate.

An introduction to digital audio recording     Posted: 09/28/07

digital audio recordingOne of the most common queries on AHCJ's electronic mailing list is "How do I record telephone calls?" We've compiled some of the answers and added some background about digital recording. This guide will be expanded to include more about recording in the field, editing audio files and using them on the Web.

Specialty hospitals, surgery centers call 911 in emergencies     Posted: 09/20/07

Emergency roomMorgan Loew of KPHO-Phoenix analyzed records and found that at least 150 patients were transported to Phoenix-area emergency rooms over the past seven years after undergoing procedures at specialty hospitals and surgical centers. While patients may assume these places are equipped to handle emergencies, many are not. Loew offers tips on doing similar reporting and warns of some obstacles reporters might face and how to get around them.

SCHIP: Where does it stand and what do journalists need to know?     Posted: 08/30/07

SCHIP insures low-income children in the U.S.Congress and President Bush are at odds over legislation that would reauthorize the State Children's Health Insurance Program, which insures 6 million children whose families can't afford insurance but who do not qualify for Medicaid.

We interviewed Robin Rudowitz, principal policy analyst for the Kaiser Commission on Medicaid and the Uninsured, about the program and complications in reauthorizing the program.

Digging into DEA data exposes sharp increase in use of pain medications     Posted: 08/23/07

Pill bottlesIn this article written for AHCJ, Frank Bass of The Associated Press explains how he analyzed DEA records to find that sales of five leading painkillers nearly doubled from 1997 to 2005. He also offers some explanations about why the use of painkillers is on the rise and points out some traps that reporters should avoid when writing about the topic.

Point of View: One researchers take on rushed reporting     Posted: 08/15/07

Michael Bracken, professor of epidemiology at Yale University, shares his thoughts about health journalism. Bracken is co-author of a study published in the British Medical Journal that looks at the usefulness of animal studies.

Rats! Animal studies poor predictor of human effect     Posted: 08/15/07

Almost everyday, newspapers and television stations tout the result of animal studies published in major and minor medical and science journals or presented at medical meetings. But just how useful are animal studies to human health? Not very, according to two studies published late last year in the British Medical Journal and the Journal of the American Medical Association.

'Sick' mixes health policy history, short narratives for chilling picture     Posted: 08/15/07

Jonathan Cohn, author of "Sick: The Untold Story of America's Health Care Crisis - and the People Who Pay the Price," discusses the process, challenges and pleasures of writing his first book. In his book, Cohn weaves the history of the U.S. health care system with today's issues through stories about real people.

How we did it: Uncovering mystery deaths in state mental hospitals     Posted: 08/15/07

Alan Judd and Andy Miller of The Atlanta Journal-Constitution write about how they reported a series about deaths in Georgia's mental hospitals. They found that at least 115 patients had died under suspicious circumstances in Georgia's mental hospitals from 2002 to 2006, and that more than 190 patients over that time were victims of employee abuse.

Inspection reports reveal deficiencies in assisted-living care     Posted: 08/02/07

Assisted livingZiva Branstetter of The Tulsa World recently reported a series of articles about assisted-living centers. She found that the public is remarkably uninformed about major issues such as what services to expect in assisted living, when to choose a higher level of care and what a center's inspection records reveal. In addition, "assisted living" can mean different things to different people and in different states, and there are no specific federal regulations governing assisted-living centers; each state has its own standards.

Election 2008: Where do the candidates stand on health care?     Posted: 07/25/07

Election 2008: Health CareAs the 2008 presidential campaign intensifies, AHCJ will be tracking the candidates' positions on health care issues. Use our chart and more in-depth pages to see where the candidates stand on access to health care and which ones have released a plan for health care. We'll be updating the information and expanding to include positions on other important health issues, such as stem cell research, abortion and more.

Covering HIV/AIDS: 4th IAS Conference and more resources     Posted: 07/19/07

The 4th International AIDS Society's Conference on HIV Pathogenesis, Treatment and Prevention began July 22, 2007, in Sydney, Australia. AHCJ's Web site will be carrying live coverage of the event through kaisernetwork.org and offering additional resources for journalists covering HIV/AIDS.

Medical misconnections: Patient-safety problems     Posted: 07/11/07

Medical misconnectionsDavid Wahlberg of the Wisconsin State Journal reported on patient-safety problems, including tubing misconnections, incompatible defibrillator pads, nurse fatigue and more. In an article for AHCJ members, Wahlberg explains how he reported the series and offers tips for other reporters.

Covering stem cells: Background on science, politics and global competition     Posted: 06/14/07

Terri Somers of the San Diego Union-Tribune offers this backgrounder on covering stem cell research, including history, the importance of stem cells, politics affecting research decisions and the status of research around the world.

Evidence-based medical reporting: A brief primer     Posted: 06/07/07

This primer offers tips to help health care journalists find, read, and evaluate journal articles that report medical research. The main topics touched on include literature searching, study design, and biostatistical concepts. The primer also includes other tips and suggests additional readings.

Tips for interviewing service members returning from Iraq, the Middle East or Afghanistan     Posted: 05/28/07

Joe Hight, president of the Dart Center for Journalism & Trauma's Executive Committee and managing editor of The Oklahoman in Oklahoma City, has compiled some tips and advice on interviewing returning veterans.

Interviewing 'profoundly affected' soldiers     Posted: 05/28/07

Joe Hight, president of the Dart Center for Journalism & Trauma's Executive Committee and managing editor of The Oklahoman in Oklahoma City, gets tips from a wounded veteran, experts and journalists on how to interview soldiers returning from Iraq, the Middle East or Afghanistan.

Journal's new blog breaks stories, offers analysis     Posted: 05/15/07

Jacob GoldsteinIn March, The Wall Street Journal launched the Health Blog, an attempt to meld the Journal's standards for reporting and writing about health care with the immediacy and community that blogs make possible. Scott Hensley, news editor in The Wall Street Journal's Health and Science Bureau, explains the purpose of the blog and what the paper and Web site hope to accomplish.

N.J. pharmaceutical reporter becomes full-time blogger     Posted: 05/15/07

Ed SilvermanThe Star-Ledger's Ed Silverman is a new breed of big city health reporter. Since January, he's become a full-time Web blogger for the newspaper. The site is designed more for people working in the industry rather than consumers who are the end users. The Web site, which does not yet have any advertising, keeps a running stream of headlines to give users the news of the day. It also has a list of blog posts from Silverman and a place for readers to add their comments. Silverman makes as many as 10 posts a day to the site.

Passion for public service journalism leads to Web site     Posted: 05/14/07

Carol GentryCarol Gentry, a senior health reporter for the Tampa Tribune, has founded Florida Health News Inc. (FHN), a nonprofit online news service dedicated to informing citizens, policy makers and journalists about health policy and finance issues around the state. In its first phase, the site has posted health policy stories from news media throughout Florida, tracked legislative activities and highlighted Florida studies. The site is intended to be a one-stop resource for Florida journalists trying to navigate the complexity of important health policy developments. Reporters can request e-mail news alerts, giving them timely and easy access to vital background information.

How we did it: Diving into prescription privacy     Posted: 05/14/07

Bob Segall of WTHR-Indianapolis went dumpster diving at drug stores and found that personal prescription records were being thrown out and unsecured. Over two months, Segall and photojournalists found many dumpsters were sitting wide open in drug store parking lots and inside they found hundreds of patient records including names, addresses, phone numbers and birth dates, as well as the medications the patients were taking and the doctors who had prescribed them.

New CUNY program gives students tools to do more in-depth health reporting     Posted: 05/14/07

The City University of New York has started a concentration in health and medicine reporting. Students are learning how to detect spin, bias and conflicts of interest in health information; read and interpret scientific studies and translate data into understandable stories for the public.

Health journalism degree programs provide new pathway into field     Posted: 05/10/07

Medical and health information is complicated to understand, and even more so to report. With shrinking newsrooms and fewer specialized beats, the role of a health reporter becomes more critical. To address these changes, several colleges have begun offering medical journalism programs to improve the quality of health writing and reporting.

Webcast: The Future of the State Children's Health Insurance Plan (SCHIP)     Posted: 03/06/07

With the State Children's Health Insurance Plan (SCHIP) up for reauthorization, this roundtable - a partnership between the Association of Health Care Journalists and the Kaiser Family Foundation - focuses on what journalists need to know about covering SCHIP in their states.

Depth varies on newspapers' health Web sites     Posted: 03/01/07

The health pages on the Web sites of many newspapers vary a great deal when it comes to content, interactivity and many other things. We review some of what's out there and come to the conclusion that health reporters should be working closely with the Web staff.

Best of the AHCJ list: Evaluating newsworthiness of medical studies     Posted: 02/19/07

A recent query on the AHCJ electronic mailing list raised the issue of how to evaluate the significance and newsworthiness of a medical study. The question drew several useful responses from members and we thought it would be useful to share those tips and others here.

Fatal Food: A study of illness outbreaks     Posted: 02/19/07

Thomas Hargrove, a database analyst and national reporter at Scripps Howard News Service, used food-borne illness outbreak reports collected annually by the Centers for Disease Control and Prevention to find that 64 percent of all outbreaks of food sickness were officially listed as from "unknown" causes and that investigations of outbreaks varied widely among the states.

How we did it: Investigating organ transplant centers     Posted: 02/01/07

Charles Ornstein and Tracy Weber of the Los Angeles Times describe how they went about reporting on problems in organ transplant centers. They describe the data and federal standards they used to document problems, as well as the types of sources they used to report the ongoing story.

 

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