Tag Archives: post-dispatch

ER scribes handle EMRs, free up doctors

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.

St. Louis Post-Dispatch reporter Michele Munz has found that some emergency rooms are easing the transition to electronic medical records by hiring “scribes” to enter information into the system, thus freeing up the doctor to focus on the actual patient.

emr-scribes

Photo by MC4 Army via Flickr

Munz reports that scribes are often young, well-trained, tech-savvy pre-med types who get $8 to $10 an hour and plenty of real-world clinical observation for their trouble. The use of one California-based company’s scribes has grown sevenfold in the past two years, expansion its CEO called “exponential.”

Munz’ story shows that the growth is driven by the desire to ameliorate productivity hits that many hospitals have faced in the wake of EMR adoption.

After the switch to computer records, emergency departments have reported a loss in productivity. At DePaul, patient wait times initially increased 28 percent and patient satisfaction declined 40 percent despite additional staffing, said Dr. Stephen Larson, director of the hospital’s emergency department. St. John’s Mercy also reported a peak in wait times.

While both hospitals have seen wait times drop as doctors get past the learning curve, the emergency physicians group at DePaul decided to begin the scribe program in December “to allow us to continue to add to our gains,” Larson said.

St. Louis reporters find felons practicing medicine

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.

The St. Louis Post-Dispatch‘s Blythe Bernhard and Jeremy Kohler tell the story of an ophthalmologist to show how a convicted felon can be allowed to return to medical practice, sometimes in the same state in which he or she was convicted. The ophthalmologist in question went to prison after lying to patients, defrauding Medicare and obstructing the resulting investigation, yet now works in an Illinois clinic and has permission to reapply for his Missouri license.

The investigation is strengthened by two sidebars, one listing examples of other felons/physicians and the other explaining how and why an ophthalmologist lied to patients and Medicare about what he was injecting into their eyes.

For the record, my favorite sentence in the entire piece is “Medical boards don’t release statistics on how many active licensees are convicted felons.” It certainly would make things easier.

Earlier stories from Bernhard and Kohler document similar problems with a lack of openness of records and how disciplined doctors can still keep their records clean:

AHCJ members can read about how the pair have done much of the reporting on this ongoing project.

Rise, fall of two St. Louis pharma companies

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.

Midwest Health Journalism Program fellow Jim Doyle, a reporter at the St. Louis Post-Dispatch, tells the story of Forest Pharmaceuticals (a subsidiary of Forest Laboratories), which has been accused by federal regulators of sketchy marketing practices, primarily involving its antidepressants Celexa and Lexapro and unapproved pediatric use. The company has pleaded guilty to federal criminal charges and agreed to pay $300 million in criminal and civil penalties, Doyle reports.

Armed with the breaking news, Dolye then goes deeper, finds the company’s local roots, charts its rise and tries to pinpoint where it went wrong. It’s the same formula he used for his story on another imploding local drug-maker, KV Pharmaceuticals, earlier this year.

Reporters encounter hospital’s lack of transparency

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.

Blythe Bernhard and Jeremy Kohler of the St. Louis Post-Dispatch investigated a string of serious mistakes at a local hospital and found the story of a 16-year-old girl who suffocated in a bean-bag chair after being sedated. It’s a remarkable and chilling story on its own and, as AHCJ Immediate Past President Trudy Lieberman points out, it’s made even more valuable for health journalists thanks to Kohler’s willingness to explain his investigative process.

Acting on multiple tips referring to a botched 2007 kidney removal, Kohler began the laborious process of triangulating the error. You should really take a minute to read his entire explanation, but if you really don’t have time, just take note that his path was something like this: Tips from sources -> Joint Commission -> Missouri Division of Insurance -> National Practitioner Data Bank -> Missouri Department of Health and Senior Services -> Missouri Board of Professional Registration for the Healing Arts -> The actual hospital.

And even then, he was unable to get clear confirmation that surgeons had removed the wrong kidney from a patient. Instead, the hospital cited privacy regulations.

Last week, officials with SSM Health Care, the St. Louis-based corporation that operates DePaul and several other hospitals, said they could not speak about specific patient cases because of federal privacy laws. “The desire to defend ourselves and paint an accurate and full picture does not outweigh our patients’ right to privacy,” they said in a statement.

Even a subject like this, which clearly involves what Kohler calls “information that patients in need of a surgeon would be interested in knowing,” the obstacles between readers and the truth about a “never event” appear insurmountable.

AHCJ members part of new St. Louis health section

In an encouraging move, the St. Louis Post-Dispatch will be placing greater emphasis on health coverage with the planned launch on March 25 of a new comprehensive health section. Called StL Health, the section will combine stories that, in the past, would have been scattered about the features, news and business sections.

The new, stand-alone section, which will appear every Thursday, will offer business health, consumer news, trends and features, and will have a staff of four full-time writers – a medical reporter, a business reporter and two feature writers – and one part-time writer. AHCJ members Blythe Bernhard and Harry Jackson Jr. will be among the staff.

“The idea is to provide news that matters to our readers,” says Jackie Hutcherson, who will edit the section.

“It made sense to do this, because it’s shifting pieces into one spot where we can make the most out of our health coverage and have it all in one place. It’s certainly a subject that affects everyone in one form or another – people with children, seniors, anyone who goes online for health info. It crosses a wide swath of readership.”

Another key focus of the coverage will be local hospitals, which Hutcherson points out are not only vital healthcare facilities, but also large employers in the greater St. Louis area.  “They’re such a vital part of the economy, and they’re in our backyard, which affects our readership.”

Related

Read more about what AHCJ members are doing.