Monthly Archives: August 2015

A guide to understanding why science is messy, hard and wonderful

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Photo: Gareth Jones via Flickr

Photo: Gareth Jones via Flickr

An utterly fantastic long read by Christie Aschwanden at FiveThirtyEight.com, cuts to the chase very early: “Science is hard – really f***ing hard.”

Christie Aschwanden

Christie Aschwanden

Aschwanden’s piece – which ought to be required reading for every health journalist (and probably every news consumer, too) – aims to convey just how challenging it is to get reliable findings through scientific research and all the ways that science, despite our best efforts, is ultimately a human enterprise subject to human failings.

“If we’re going to rely on science as a means for reaching the truth – and it’s still the best tool we have – it’s important that we understand and respect just how difficult it is to get a rigorous result,” she writes. And of course, this reality is part of what makes responsible and thorough reporting on medical research such a challenge at times. Continue reading →

Tara Haelle (@TaraHaelle) is AHCJ's medical studies core topic leader, guiding journalists through the jargon-filled shorthand of science and research and enabling them to translate the evidence into accurate information.

AHCJ webcast will address how payers, providers are implementing bundled payment

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bundled-payment-webcastLate last month we wrote about criticism leveled at the federal government’s latest bundled payment proposal.

Since then, other experts have come forward to criticize not only the Comprehensive Care for Joint Replacement (CCJR) proposal announced last month, but also the Bundled Payments for Care Initiative (BPCI) program that began in April 2013. Both programs come from the federal Centers for Medicare & Medicaid Services.

You can find detailed criticism of CCJR from Harold Miller, president of the Center for Healthcare Quality and Payment Reform, on the CHQPR’s blog, and from Suzanne Delbanco, executive director of Catalyst for Payment Reform, and Francois de Brantes, executive director of the Health Care Incentives Improvement Institute (HCI3), on the Health Affairs blog. For an explanation of how CMS can improve the BPCI program, see this HCI3 blog post from de Brantes. Continue reading →

Joseph Burns (@jburns18), an independent journalist who resides in Brewster, Massachusetts, is AHCJ’s topic leader on health reform. He welcomes questions and suggestions and tip sheets at joseph@healthjournalism.org.

Exploring ‘preventable harm’ and making it accessible to readers

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Sarah Kliff

Sarah Kliff

Vox’s Sarah Kliff, who has an AHCJ Reporting Fellowship on Health Care Performance, is writing a series about fatal, preventable medical errors.

Not the inevitable tragic things that can happen to a patient – but the ones that we know how to avoid, the lives that should not be at risk.  Kliff spent several months on one story – actually a story and accompanying video and graphics – that combined insights about how hospitals think central line infections and a gripping narrative about the death of a 3-year-old girl.  You can find the story here.

Kliff wrote a “How I did It” essay for AHCJ that addresses a lot of the nuts and bolts of a vast project like this. She outlines how she reached out to patients/families, how she organized the voluminous – initially not searchable – medical records, how she found researchers who could elucidate things she did not fully understand in those records.

And she talks about the power of a good analogy to both organize a 5000-word narrative and give readers an accessible entry point to her work. Read about how she did it.

Contributing editor to Politico Magazine and former health care editor-at-large, Politico, Commonwealth Fund journalist in residence and assistant lecturer at Johns Hopkins Bloomberg School of Public Health.

Does hospice use alone reflect quality end-of-life care?

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Image by Steve Harwood via flickr.

Hospice use is a common indicator of quality end-of-life care. The timing of hospice enrollment is an important component of that care, and a recent study finds wide variations among states.

Researchers from Yale University compared 2011 hospice use data on a state-by-state basis of 660,000 Medicare patients during the last six months of their lives. They identified several key trends among states in the rates of very short or very long hospice stays (reflecting late or early enrollment) and of patients leaving hospice before their deaths. Continue reading →

Liz Seegert is an independent health journalist and AHCJ’s topic leader on aging. She covers older adults, baby boomers, health policy, and social determinants of health, as well as many other health issues. Her bylines include stories for PBS/NextAvenue.org. the American Journal of Nursing, TIME Health, Medscape, Consumer Reports, and Medical Economics, as well as dozens of other trade and mainstream media. Her articles have been syndicated in Forbes.com, the Los Angeles Times, the Hartford Courant, the Saturday Evening Post and other major outlets.

Look at how health quality measures have become a jungle

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"Pieter Bruegel the Elder - The Tower of Babel (Vienna) - Google Art Project - edited" by Pieter Brueghel the Elder (1526/1530–1569) - Levels adjusted from File:Pieter_Bruegel_the_Elder_-_The_Tower_of_Babel_(Vienna)_-_Google_Art_Project.jpg, originally from Google Art Project.. Licensed under Public Domain via Commons.Some experts view the burgeoning number of quality measures as health care's Tower of Babel.

“Pieter Bruegel the Elder – The Tower of Babel (Vienna) – Google Art Project – edited.” Licensed under Public Domain.Some experts view the burgeoning number of quality measures as health care’s Tower of Babel.

Quality measures are good, right? We all want our doctors and hospitals to follow best practices and be held to them.

It’s not so simple.

Put aside for the moment whether the measure is accurate – we don’t always know or agree on what the best thing is in health care (Exhibit A: mammograms).

There’s another quality problem.

There too many quality measures. Oodles and oodles of quality measures. Continue reading →

Contributing editor to Politico Magazine and former health care editor-at-large, Politico, Commonwealth Fund journalist in residence and assistant lecturer at Johns Hopkins Bloomberg School of Public Health.