Covering the healthcare beat
For great, helpful tips, story ideas and what to do with the data you've acquired, turn to this storypack for all things healthcare. We are including the latest tipsheets and stories from some of the best investigative journalists, as well as several databases you can turn to.
Tips for Following Health Reform Where You Live
Fairhall provides information on tracking and reporting on changes in the insurance marketplace in the face of health care reform. Included is a list of helpful websites covering health reform and insurance issues.
One big-ass(arse) database – and other medical issues
"Health databases can unlock important clues about matters of life and death in your community. From identifying unsafe hospitals to detecting questionable treatments used by doctors and their escalating costs, you can write important stories that have an immediate impact and lead to lasting change."
Finding and using health care data
"This tip sheet will direct you to several trustworthy databases about the quality of health care delivered by hospitals, transplant centers and nursing homes."
How Well Does Your State Oversee Nurses (and pharmacists, dentists, psychologists...)?
Government oversight can be tricky when it comes to our caregivers. Find out who is overseeing your nurse, and whether or not they are qualified to be evaluating such performances.
Health Care on the Beat: Investigating Doctors and Drugs
Wilson's tipsheet covers the health care beat - from doctors to drugs. The tipsheet contains information on the approach to your coverage and many useful links.
Health Care Survival Guide: Investigating America's Hospitals
Berens tipsheet addresses how to cover the health & science beat. He begins by stressing the 3 F's: "follow the paper; find the expert; and ferret out the research." Berens gives a list of basic public records pertinent to the beat; available databases; and "real world advice" based on his own experience covering health and science.
Brain Wars: How the Military is Failing Its Wounded
NPR and ProPublica investigated to see whether the government had kept its promise to improve health care for soldiers with brain injuries. The stories reveal that the military was not diagnosing most of the brain injuries and those that were diagnosed were not being recorded in the soldier's medical records.
Dialysis: High Costs and Hidden Perils
The series examines the country's poor system of dialysis care that supports almost 400,000 Americans. One in four patients will die within 12 months of starting dialysis treatment in the U.S. The reporter shows how patients are often treated in unsafe and unsanitary conditions, exposing them to hepatitis and other diseases.
Do No Harm
For the first time, reporters published an analysis of Nevada's state hospital records and revealed nearly 1000 cases of preventable harm to patients over the past decade. There are also reports of widespread hospital-acquired infections and countless cases of accidental surgical injuries. The reporters show that hospitals have tried to keep this information hidden from the public.
First, Do No Harm
This investigation focused on lax supervision of doctors-in-training, patient harm and alleged billing fraud at Dallas' premier medical school complex and its primary teaching hospital, which are financed largely by taxpayers. It also examined more broadly questions about medical training, patient care and healthcare fraud at teaching hospitals around the United States.
"Medicare and Home Health Care"
The Wall Street Journal investigated the home health care industry, which has seen increased growth during the last few years. After studying the data found in "millions of Medicare files," reporters found evidence of fraudulent behavior. Several home health companies including one of the largest - Amedisys Inc. - are "taking advantage of the Medicare reimbursement system" by finding ways to pay themselves more.
Why Health Insurers Are Winning
Even though the health reform promises to be of value to everyone, one group would benefit the most. This group is the insurance companies. The interests of the insurance companies have been shaping the health care reform and ensure their own enrichment. This has been done by lobbying, which has influenced the conservative Democrats.
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. The reporters documented numerous recent cases in which elderly and disabled residents were assaulted, raped and even murdered in the facilities.
The FDA relies on the Adverse Event Reporting system to flag safety issues and identify pharmaceuticals or therapeutic biological products (such as blood products), for further epidemiological study. It may ultimately prompt regulatory responses such as drug labeling changes, letters to health care professionals, or market withdrawals.
The agency requires product manufacturers and distributors to report adverse events regularly in accordance with 21 CFR 310.305 and 314.80. Mandatory reports for drugs in clinical trials and newly marketed drugs are submitted in various forms: 15-day alerts, quarterly or annual updates. The MedWatch program also collects voluntary reports from health care professionals and consumers. Adverse drug experiences include any serious and unexpected consequences of human drug use in a medical practice - such as failure of "expected pharmacological action," as well as accidental or intentional overdoses or abuse.
AERS replaced the Spontaneous Reporting System in October 1997. The FDA estimates that 118 reports for 1997-98 are included in the old SRS data. The AERS collection begins with the fourth quarter of 1997 and is complete through December 2006. Emphasis on reporting and efficiency of collecting reports have fluctuated, as seen by the relatively small number of records for the earlier years in this dataset and the incomplete entries throughout.
The AERS format attempts to improve and standardize the same basic information fields collected in SRS. The most notable difference between the two sets is a Comments table containing detailed memo fields; it only exists for SRS data 1993-1998.
The MAUDE dataset includes information about problems that occurred with medical devices, including injuries, deaths and/or product malfunctions.
The data comes from two forms: Medwatch 3500 and 3500A. Health officials use form 3500 to voluntarily report adverse events. User facilities (hospitals, clinics etc.,) as well as product distributors and manufacturers are required to report problems, and they use Medwatch 3500A.
Patient-specific data is also removed for privacy reasons.
The database was known as Medical Device Reports (MDR)prior to 1992, when it was switched to MAUDE to reflect new reporting requirements. MDR had mandatory reports from manufacturers and voluntary reports from others.
Given the overlapping years between MDR and MAUDE, you should acquire both data sets if you want to have a full picture of the device malfunction reports from those years. The overlapping periods are 1991-August 1996.
The Mortality Multiple Cause-of-Death database contains detailed information found in standard death certificate records from the United States and its territories.
The data includes information on causes of death as well as detailed information about the deceased. Some of these details include the decedent's age, race, sex, marital status at the time of death and much more. Due to privacy reasons, names and dates of birth are not included.
Specific information about the circumstances of each death is included, such as whether it was a natural death, an accident, occurred in the workplace, or was a suicide. This data traces locations by offering such details as the deceased's state of birth, state of residence as well as the state where the death occurred. Geographic information is complete for areas with population of 100,000 or more, and includes counties, cities and MSAs.
This file is an August, 2011, download from the National Practitioner Data Bank Public Use File. On Sept. 1 the federal government removed the data, which had been publicly available since 1990.
Investigative Reporters and Editors, along with the Association of Health Care Journalists and Society of Professional Journalists, is protesting this removal of public information. IRE has also filed a FOIA request to receive the most recent version of this data set.
IRE/NICAR processed this data set from August and is making it publicly available online to anyone. FTP is the best and easiest way to download the raw NPDB data. State slices are available on the FTP site.
To start, open ftp://email@example.com within Windows Explorer (not Internet Explorer) or open ftp.nicar.org with better FTP software like FileZilla or Cyberduck. The user is "npdb" and the password is currently "freedata".
Please read all files pertaining to the data set before using it. In particular the Readme1101-DAT.pdf provides information for this data set in terms of record layout and definitions of terms.
The National Practitioner Data Bank Public Use Files contains information about doctors and other health care practitioners who have had medical malpractice suits filed or adverse action taken against them. The information has been redacted or altered to remove details that could identify a particular practitioner.
This database includes information on malpractice payment and adverse licensure, clinical privileges, professional society membership and adverse actions concerning physicians, dentists and other licensed health care professionals. Authorized health care organizations, insurance companies and government authorities can access the full version of the National Practitioners Databank for background checks or to enter new reports.
Although names are not included in the public version, some news organizations have been able to use this database with other public data, including court records, to determine the identity of individual practitioners in the past. Since that time, however, the public use file has been changed to obscure potentially identifying details. For example, the field indicating year of medical school graduation has been changed to a decade, i.e. 1980s or 1990s, and malpractice award totals are given in ranges, not exact figures.