Shared wisdom

Sometimes all we need is a quick suggestion from our peers to zero in on a good story. Here we turn to front-line journalists for advice, some simple insight to add to our repository of “shared wisdom.”

What are some of the untold stories or story angles in femtech?

I’m not seeing covered that women should still be really focused on common social applications like Google, Facebook, etc. That’s the main source [of information] where law enforcement is going to go first [when looking to find women seeking illegal abortions, etc.]. I’ve seen a lot of discussions about deleting period-tracking apps. There’s a lot of hype about that, but that’s not really where the main focus should be just given how much of a remote step that is. The main focus should be on warning and educating consumers about how their health care data and how their conversations could be accessed from these much more mainstream areas.

The other one that I’m not seeing talked about nearly as much is security. There’s been a ton of discussion on privacy, but privacy and security are actually separate topics. There hasn’t been as much emphasis on what are [vendors] going to do to make sure their platform is secure from third-party bad actors who may want access to this data. Health care data on the black market has a huge value; it’s about $250 per health record. Add the fact that reproductive health data in a lot of states could now lead to potential civil or criminal consequences, and that to me suggests that hackers now have an increased incentive to go after these types of sources like femtech apps. They can potentially use it to not only get a large sum of money from the company, but [potentially] identify the individuals whose health data they have, and go after them and try to extort or blackmail them directly.

Bethany Corbin, femtech practice lead and senior counsel, Nixon Gwilt Law

Tips for covering investigative tech stories

  • LinkedIn can be incredibly useful for tracking down sources with ex-employees usually being more likely to speak than current staff. LinkedIn offers free Premium access for journalists — join one of the quarterly seminars to qualify: https://news.linkedin.com/media-resources/linkedin-for-journalists.

  • Other social networks are also useful. Patient or user groups on Facebook and Reddit can connect you to human sources while Twitter and Google News alerts allow you tap into conversations and other stories.

  • Every interaction a company has with a public agency is a potential route to information. Search their databases first, then get going on public records requests. Federal FOIA requests are useful but can be very slow — make these your first port of call at the very start of an investigation if you hope to use them in your reporting. State and local agencies are often much more responsive.

  • Pick up the phone. Digital communications are so easy, it's tempting to try to do everything over email and direct messages (DMs), but phone conversations, although time-consuming to organize and transcribe, will give you better quotes, more detail and deeper insight into the people you're dealing with. Always ask sources who else you should be speaking with — a personal connection vastly improves the chance of a response.

Mark Harris, freelance investigative technology reporter

How do you sort out the hype when covering new technology?

A good element of health tech stories is being as specific as possible about key indicators of success. Sometimes that means asking the people that are putting forth technologies and pitching exciting new tools, How are you measuring success? And with what populations? Who are you speaking to? How did this get developed? And what are your long-term sustainability plans, because we do a lot of reporting on exciting funding rounds and then a year later, they don’t go anywhere. There are a lot of exciting new products and new technologies on the market that are really revolutionizing some aspects of health care. Balancing that excitement with a healthy skepticism, I think, is pretty necessary in health tech stories.

Kat Jercich, Senior Editor, Healthcare IT News

Seeing the big picture in tech stories

Something that I try to do when writing about psychedelics in mental health is think back to larger contextual issues. For example, I wrote about psychedelics being used as telemedicine and the drugs being sent to people’s homes. The reason the company could do this is because of a legislative loophole. The Drug Enforcement Agency previously put a stop to sending controlled substances to people via telemedicine due to one adverse event where a patient died.

When you have companies rushing to join the psychedelic Renaissance, it's really not hard to imagine how one bad circumstance could lead to it changing the way that psychedelic medicine is unrolled in the future. One of the bigger points of that story is that we should go slow because maybe there is a place in the future for telemedicine to have a real benefit but if we rushed into it, and then something bad happened, it could get shut down. With all tech and telemedicine stories, there's always like a bigger issue at play on individual companies that are in action right now.

Shayla Love, senior staff writer at Motherboard (tech arm of Vice.com)

How do you whittle down health IT research into a workable story?

Instead of trying to shove everything into one story, decide what is interesting or what is a side thing related to the main story that you can put in a box for another day. Finding the beginning, middle and end and what things you can branch out of this is helpful to think about, so you don’t get overwhelmed with the information.

Georgina Gonzalez is a news reporter for Becker’s Hospital Review. 

Who are key sources or people to cultivate when covering health IT?

Public relations people are really important. Journalism and PR often are portrayed in a way that they are at each other’s throats. In reality, I think there are really positive relationships that can be built there. However, PR people and companies have a specific narrative they want to tell and it’s your job as a journalist to figure out what’s actually going on by reaching out to other people.

It’s also really important to talk to patient advocates and patients themselves. It’s very easy to forget to do that in this job because you have so many other people at high levels wanting to talk to you and to get airtime. If you reach out to a patient and ask how [a technology] affects them, they might tell you it saved their life, or they might say it was implicated in the sickness or death of a family member, and you gain this perspective that your story just absolutely couldn’t have existed without it. Keep in mind who these stories are ultimately for, which is usually the patient-consumer.

Other good sources are heads of health systems, especially in digital health. Tons of universities have digital centers of excellence, and it’s important to find the chief digital officers and heads of digital patient care programs, the movers and shakers in those spaces. Familiarize yourself with them, and make sure they’re familiar with you, even if it’s just an intro virtual coffee. Get to know them and what’s important to them, so if there are new developments they’re seeing, that they’ll tell you about them.

Erin Brodwin, health tech reporter, STAT

Health IT isn't a topic that gets a lot of coverage in the mainstream media. What tips do you have for reporters who want to pitch a health IT story to their editor?

Health IT plays an important factor in physician burnout.

There's all this aspiration to introduce new technology that can do all these wonderful things in health care – like machine learning and data analytics – but the whole system rests on clinicians. They are the interface with the machines and with the patient.

It's important as journalists to pay attention when the people using this technology are complaining about it.

Arthur Allen, a health care editor at Politico Pro, has covered health IT extensively and was a founding member of the eHealth reporting team formed at Politico in 2014.

How can journalists tell these stories [about technology in health care] better?

Be really skeptical of hype. Now that there’s a lot of money in this you’re seeing the entry of traditional digital companies and a lot of startups. They’ll sell you a bill of goods and they’ll sell others a bill of goods and they may be well meaning; they’ve got to try and create a business or those initiatives will flame out. The questions aren’t so much about whether the technology is working but what are the deeper implications of this? What’s the workflow?  What happens when the patient gets really anxious about this? Who does the information go to?

It’s technical vs. adaptive change. It’s easy to cover the technical change – here’s the new bell and whistle – and does it do the thing they say it’s going to do accurately. It’s a little harder to cover adaptive change, which is how does this actually fit into the lives of patients and the health systems and health organizations and doctors and nurses? I think those are going to be the more interesting stories.

Robert Wachter, M.D., chair of the Department of Medicine at the University of California, San Francisco, is considered the “father” of the hospitalist field and a leader in the patient safety field. He’s written six books, including “The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age,” which took a detailed look at the role of technology in health care. Wachter is married to journalist Katie Hafner.

What should reporters be asking about the legal sales of patient data?

Adam TannerDo patients, doctors, nurses, pharmacists and others in their community know about the trade in patient data and how do they feel about it? How are local research institutions using anonymized patient data, and what are the results? Are local companies selling in the big health data bazaar?

Reporters should also seek to document cases in which employers or marketers are using such information to discriminate against individuals.

Adam Tanner (@DataCurtain) is the author of the new book “Our Bodies, Our Data: How Companies Make Billions Selling Our Medical Records” as well as “What Stays in Vegas: The World of Personal Data – Lifeblood of Big Business – and the End of Privacy as We Know It” (2014). See his tip sheet on the patient data market.

You took a fresh angle on the Flint lead crisis by showing how a physician mined EHRs of local children to uncover the unsafe levels of lead in the local water supply. How did you take what could have been a story about a specific technology company and provide balance?

David WahlbergInitially I was leery of doing a “free ad story” for Epic Systems, the largest private employer in the Madison, Wisconsin, (my local) metro area. 

But after talking with the Flint doctor and reading a paper she wrote about using the EHRs for this purpose, I decided it was a worthy local angle to a national story.

I broadened the piece to be about using EHRs in public health.

David Wahlberg is the health and medicine reporter for the Wisconsin State Journal. He has won multiple AHCJ Awards for Excellence in Health Reporting and was a 2015 AHCJ Reporting Fellow on Health Care Performance.

You did a long project including policy and narrative, and a patient’s family shared voluminous medical records. How did you organize those files? 

Sarah Kliff

DocumentCloud was  hugely helpful. The PDFs of the medical records weren’t searchable, but DocumentCloud let me search them, organize them and annotate them.

That helped me identify parts of record where I needed to find a medical expert or researcher to help me understand them – and it helped me stay organized when it came time to write.

Sarah Kliff is a senior editor at Vox, where she oversees policy coverage and writes about health care. She previously worked at The Washington Post and Politico, and is a recipient of AHCJ's 2015 Reporting Fellowship on Health Care Performance.

What do you do when you can’t get a hospital to talk to you? When they just don’t want to, or perhaps they can’t because of pending litigation?

I go to one of their competitors! They are often happy to talk about what they are doing – particularly if they have a success story to tell, or a new safety strategy or innovation to share.

Cheryl Clark is a contributing writer for MedPage Today and is helping launch a new investigative journalism organization called Hashtag30. As senior quality editor for HealthLeaders Media for more than six years, Clark wrote more than 1,300 stories about hospitals' efforts to improve quality and safety and related issues. 

How do you develop sources within a hospital – and not just the PR office?

Be human! I let them know I have a job to do, just like they do.

I may say to a nurse, “You need to understand things at your job, so you get them right. And I need to understand them, so I get them right."

Shannon Muchmore (@smuchmore) is the health reporter at the Tulsa World. She is @smuchmore on Twitter and can be reached atshannon.muchmore@tulsaworld.com. See her tip sheet on finding "real" people as sources.

What's a good starting point when you are looking for sources on a new topic or aspect of the beat?

The Alliance for Health Reform has a great resource called "Covering Health Issues: A Sourcebook for Journalists", which gives an overview of subjects ranging from health IT to dual eligibles; each chapter ends with a list of sources. The latest one is from Fall 2013 so some of the source information may be a little out of date, but it's a good place to start. 

Joyce Frieden is the News Editor for MedPage Today.

National medical groups often put out policy statements – but how does that filter down to their members at the community level?

David Pittman

Remember that rank-and-file doctors may not always agree with policy positions of their professional organizations (like the American Medical Association, American Academy of Family Physicians, etc.).

Talk to doctors beyond the leadership of these organizations for their perspective on important topics such as delivery system reform, scope-of-practice laws, and other topics.

David Pittman is a Washington correspondent for MedPage Today.

How do you find story ideas and how do you manage daily stories with longer-term reporting?

John Lundy

In the year that I've been on the health beat, I've become a regular scanner of nursing home reports. I've also learned how to "feed the beast" – do daily stories that can be done in the least amount of time but with integrity – and that allows more time to work on projects.

John Lundy is a health care reporter for the Duluth (Minn.) News Tribune. He was a 2011-12 AHCJ Regional Health Journalism Program fellow.

How do you find sources for stories?

Tony Leys

Don’t be afraid to ask people about their health conditions. They love to talk.

“Find out when “pie day” is at the senior center. You’ll find lots of people to interview!.”

Tony Leys is a reporter at the Des Moines Register and he was a 2011-12 Regional Health Journalism Fellow.