Tag Archives: errors

Why we should use caution when reporting on AI in medicine

Rebecca Vesely

About Rebecca Vesely

Rebecca Vesely is AHCJ's topic leader on health information technology and a freelance writer. She has written about health, science and medicine for AFP, the Bay Area News Group, Modern Healthcare, Wired, Scientific American online and many other news outlets.

Photo: Roger Mommaerts via Flickr

Hospitals and health systems are jumping into artificial intelligence (AI) in an effort to help physicians better analyze images and other clinical data. But reporters should be careful about overstating the value that these new tools can bring to clinical decision-making.

Radiology is the medical specialty probably most associated with AI today because of the tantalizing possibility that computers could help radiologists read images more quickly, enabling earlier diagnoses and treatment.

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Journalists learn about efforts to improve diagnostic process

Carla K. Johnson

About Carla K. Johnson

Carla K. Johnson (@CarlaKJohnson) is a medical writer at The Associated Press and has covered health and medicine since 2001. A former member of AHCJ's board of directors, she leads the Chicago AHCJ chapter.

Photo: Carla K. Johnson(from left) Paul Epner of the Society to Improve Diagnosis in Medicine, Dr. Karen Cosby of Rush University Medical School, and Dr. David Liebovitz of Northwestern Memorial Healthcare. spoke to Chicago's AHCJ chapter.

Photo: Carla K. Johnson(from left) Paul Epner of the Society to Improve Diagnosis in Medicine, Dr. Karen Cosby of Rush University Medical School, and Dr. David Liebovitz of Northwestern Memorial Healthcare. spoke to Chicago’s AHCJ chapter.

If you’ve read Dr. Lisa Sanders’ “Diagnosis” column in The New York Times Magazine, you know the process of identifying a patient’s problem can be fraught with opportunities for error. You also know diagnosis is rich territory for dramatic storytelling.

For health care journalists, it’s a great time to write about the topic. Errors in diagnosis are receiving new attention because of the recently released Institute of Medicine report “Improving Diagnosis in Health Care.” It’s part of the landmark “Quality Chasm Series” that produced the “To Err is Human” report in 2000 and the “Crossing the Quality Chasm” report in 2001. Continue reading

Exploring ‘preventable harm’ and making it accessible to readers

Joanne Kenen

About Joanne Kenen

Joanne Kenen, (@JoanneKenen) the health editor at Politico, is AHCJ’s topic leader on health reform and curates related material at healthjournalism.org. She welcomes questions and suggestions on health reform resources and tip sheets at joanne@healthjournalism.org. Follow her on Facebook.

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.

OIG: While adverse events are common, records of them aren’t

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

To draw attention to its ongoing monitoring of the incidence of adverse events in US hospitals and the accurate reporting thereof, the HHS Office of Inspector General is highlighting a roundup of reports on the subject.

If you get a chance to read it, you’ll probably see why I decided to distill it to a bulleted list of somewhat remarkable numbers.

Here goes:

  • In a one-month period, 27 percent of Medicare recipients experienced “care-related harm.”
  • In that month, these events cost Medicare an estimated $324 million.
  • Half of them were adverse events, half were “temporary” events such as allergic reactions.
  • 44 percent of the adverse events were deemed “preventable.”
  • “Hospital staff did not report 86 percent of events to incident reporting systems.”
  • That is partly because only 12 percent of incidents of care-related harm met requirements for being reported in the state in which they occurred.
  • “Many of the events not reported as required involved serious harm, including six patient deaths.”

For those looking to dig deeper and better understand the adverse events and how they’re reported, the OIG refers to a number of relevant reports. Journalists will be particularly interested in reports explaining how reporting requirements have failed, as it helps explain the limitations of currently available data sets.

Formula 1 pit crews inspire physicians

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

In American Medical News, Kevin O’Reilly examines a study of the lessons physicians have learned from the high-speed ballet of precision-drilled Formula 1 pit crews. After all, those tire-changing automatons have perfected the sort of routine that medicine’s checklist advocates have been preaching for some time. Because their actions are so specific, the F1 crews provide a seductive example of the efficiency that can be gained through practice, databases and, of course, checklists.

f1
Photo by usag.yongsan via Flickr

“At the moment, we kind of say, ‘Well, we do it this way.’ Everybody thinks they know really what happens, but not everyone does,” (lead author Ken Catchpole, PhD) said. “There is lots of individual variation that creeps into these things. Sometimes that’s good, and it’s responsive to individual patients. But often that creates these uncertainties that increase the opportunities for errors to happen.”

Catchpole has helped physicians at London’s Great Ormond Street Hospital for Children use F1 techniques to improve their handoff of pediatric heart surgery patients to intensive care, with results first published in the May 2007 issue of Pediatric Anesthesia. New protocols developed in response to video examination of pit stops and visits with F1 racing crews helped cut the duration of patient handoffs and reduced omissions of critical information and technical errors by 67%, the study showed.

For more, see Fierce Healthcare’s Dan Bowman to brief exploration of medicine’s fascination with Formula 1.

Canadians fight for disclosure of medical treatment

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

It took eight years, a whistleblower and intervention from a state commissioner to uncover a fatal medical error in a Newfoundland hospital, one committed by a doctor with an (undisclosed) record of such actions. As Canadian broadcaster CTV reports, Canada’s free access to health care doesn’t translate to free access to information.

Here’s my summary of the story’s key events, as I understand them:

  1. A woman in Newfoundland dies soon after her ER doctor misdiagnosed a blood clot in her lung and gave her treatment that a colleague said would have been equivalent to a “lethal injection.”
  2. The victim’s family doesn’t know that anything was out of the ordinary until six years later, when the colleague contacted the family directly to explain what he believed to be a mistake.
  3. The family approaches the hospital for information, and gets a few treatment records, but is denied access to records from an internal investigation of the incident.
  4. Using the province’s FOI laws, the family again pushes for the investigation information. Their request is denied.
  5. Finally, “the family appealed to the province’s Information Commissioner, who ordered Eastern Health to hand over the records.”
  6. A year later, the records were disclosed – but key EKG information was not. Thus, the family’s fight for disclosure continues unabated.