AHCJ | Association of Health Care Journalists | Covering Health
The Association of Health Care Journalists is an independent, nonprofit organization dedicated to advancing public understanding of health care issues. Its mission is to improve the quality, accuracy, and visibility of health care reporting, writing, and editing.
They increasingly are turning to medical marijuana to manage a range of conditions, from cancer and Parkinson’s disease to chronic pain. A recent study published in The European Journal of Internal Medicine found that cannabis therapy is safe and effective for elderly patients who are seeking to address these and other medical issues.
Researchers surveyed 2,736 patients, 65 years and older, who received medical cannabis from January 2015 to October 2017 in a specialized medical cannabis clinic. More than 60 percent were prescribed medical cannabis because of pain, particularly that associated with cancer. After six months of treatment, more than 93 percent of 901 respondents reported their pain dropped from a median of eight to four on a 10-point scale. Close to 60 percent of the patients who originally reported “bad” or “very bad” quality of life had upgraded to “good” or “very good” after six months. More than 70 percent of patients surveyed reported moderate to significant improvement in their condition. After six months, 18.1 percent stopped using opioid analgesics or reduced their dose.
All patients first consulted with a doctor before receiving a prescription. More than 33 percent of patients used a cannabis-infused oil; approximately 24 percent inhaled their therapy by smoking, and about 6 percent used vaporization. While the researchers state their findings to date indicate cannabis may decrease dependence on prescription medicines, including opioids, they said more evidence-based data from the aging population is imperative.
However, as this Pain News Network article notes, a RAND Corporation extended analysis of opioid death rates found that after 2013, the association between medical marijuana and lower opioid death rates “completely disappeared.” Researchers surmised “as states have become more stringent in their regulation of dispensaries, the protective value generally has fallen.”
That same report, however, also found that marijuana may help protect the brain from stroke, relieve pain, and for adults with multiple sclerosis-related muscle spasms, found “substantial evidence” that short-term use of certain manufactured cannabinoid-based medications known as “oral cannabinoids” improved their reported symptoms. Researchers also found conclusive evidence that for adults with chemotherapy-induced nausea and vomiting, oral cannabinoids were effective in preventing and treating those ailments. NASEM recommends more investigation to close the gaps in knowledge and address the current barriers to advancing medical marijuana research.
A spate of recent stories highlighting the nation’s housing crunch has shined a spotlight on how homelessness or other poor housing situations impact health. So what’s being done about it?
At Health Journalism 2018, a panel of experts will weigh how challenges when it comes to where people live can also affect how they live, as well as consider how programs and other potential solutions and policies aim to improve wellness by tackling the housing conundrum through a more integrated approach.
Attendees will look at the issue through the lens of panelists from two Phoenix-based organizations that are making an effort to take on homelessness and health head-on, as well as a Washington, D.C.,-based policy expert.
Brandi Whisler serves as director of outpatient services at Circle the City, a nonprofit community health care organization founded by physician Sister Adele O’Sullivan that provides health care to homeless patients, including traditional outpatient care as well as respite care.
The group served as one of five demonstration sites for a U.S. Centers for Medicare and Medicaid-backed study of acute medical care for homeless persons who are not quite sick enough to be admitted to a hospital, the Phoenix Business Journal recently reported.
“In Arizona, the per-patient cost to CMS when comparing the 12 months before and after receiving medical respite care at Circle the City was reduced by an average of 58 percent. Going from $2,220 monthly down to a $900 monthly on average, that’s a potential savings of more than $4.7 million attributed to the 309 patients who participated in the study,” the Journal’s Angela Gonzales wrote in her piece.
Panelist Ginamarie Brockdorff, who manages supportive services for Lodestar Day Resource Center, will discuss daily challenges and issues facing clients and patients. Both Circle the City and Lodestar are part of as part of Phoenix’s Human Services Campus, a collaborative effort among a variety of local groups and authorities that also provides dental care, substance abuse and mental health services, a shelter, a music wellness program and other services in one central location.
Additionally, Stacey Millett, director of the Robert Wood Johnson Foundation and The Pew Charitable Trusts’ joint Health Impact Project, will lay out policy issues at the national, state and local level. The joint project examines how social issues such as housing, along with education and employment, can weigh on people’s health.
We’ll discuss a range of issues from financing and availability of housing as well as other barriers that keep vulnerable populations from finding – and keeping – adequate and affordable housing. We’ll also touch on related environmental factors such as air quality, lead paint and soil contamination. Issues specific to homelessness, such as access to care and communicable diseases such as the recent string of hepatitis A outbreaks, will also be on the agenda.
Reporters and editors covering housing issues in both urban and rural areas will leave with a deeper sense of the outside factors that can lead to homelessness as well as what health issues to pay closer attention to in their reporting. They’ll also gain a better understanding of how various groups, agencies and officials are trying to approach the issue amid a trend toward more holistic solutions.
The panel will be held Friday, April 13, at 9:20 a.m. and will use the hashtag #AHCJ18housing.
Waldman told other reporters how she did it earlier this month at the National Institute for Computer-Assisted Reporting conference.
Today, AHCJ and ProPublica are co-publishing a tip sheet based on Waldman’s presentation at the conference. It describes the federal laws protecting the privacy of patients and students, and the strategies journalists can employ to obtain useful data without violating anyone’s privacy.
Additionally, today we are sharing a second tip sheet, also emerging from a NICAR presentation by a ProPublica journalist, about data on opioids. Charles Ornstein, a member of AHCJ’s Right to Know Committee and AHCJ’s former president, wrote an eight-page guide packed with advices and links to resources. The Right to Know Committee will archive this tip sheet along with other useful items on our HIPAA and Public Records pages.
Lamar Alexander and Patty Murray are circulating a new “ACA stabilization” plan that in some ways is more ambitious than past efforts and takes into account the repeal of the individual mandate penalty. The senators are trying to get it into the omnibus spending bill Congress wants to pass by March 23.
But success is not very likely at this point. It’s not impossible given all the horse-trading that has to happen to get a huge omnibus spending bill passed, and Alexander, in particular, is persisting. But it definitely is a long shot. Republicans want to add abortion restrictions that are not acceptable to Democrats. Also, a cluster of conservatives – a handful in the Senate and more in the House – are opposed to spending any money fixing the Affordable Care Act or, as they call it, “bailing out” insurers.
One reason the effort is not totally dead: the plan would bring down premiums next year, and that’s an attractive thing for politicians to go home and talk about before facing voters in November. A preliminary Congressional Budget Office analysis estimates that premiums (which are expected to rise because of the mandate repeal and the introduction of non-ACA compliant health plans) would be 10 percent lower in 2019 on average if this legislation were enacted, and by 20 percent on average in the following two years (with some variability among states). Some private analysts estimate higher. Major elements of the Alexander-Murray proposal include:
In honor of Sunshine Week, AHCJ invited organizations devoted to government transparency to write about how their work can help health care reporters. Here is the last of four.
MuckRock, a nonprofit that assists journalists, newsrooms, and others requesting public information, has helped thousands of reporters file public records requests all across America, digging out information from federal agencies and local inspection boards alike.
Time and again, public records break essential stories and shine light on dangerous lapses — but only if someone knows to ask.
Here are some tips on using freedom of information laws to get great stories while juggling everything else you need to get done.
The best requests are the ones you don’t have to file. Before you ask, search. Increasingly, agencies are proactively posting information in online “reading rooms.” DocumentCloud provides a wonderful resource to search through as well; everything is from vetted newsrooms, and you can usually easily find more context about documents you find there. You can also search and filter through tens of thousands of public records requests on MuckRock. Finally, see if agencies might have any good documents hiding on their website using a this quick Google trick: Restrict your search to the agency’s domain and various filetypes like PDF, XLS, and PPT. Example query on Google: “keyword site:agency.gov filetype:pdf” It can be amazing what you’ll find.
Great requesters steal — with credit. If the above research steps didn’t get you the document you’re looking for, you’ll have to file a request — but hopefully now you have a better sense of what documents exist and you can write a much more targeted request based on what you’ve learned.
Review documents an agency has previously released, trying to look through the agency’s eyes. Do they file a certain kind of incident report after an accident? You can ask for all of those forms filed with the agency within certain dates you’re interested in. Or, if you’re looking at a broader story, think about what documents would be related to documents you’ve already come across. For example, maybe all those accident forms are then entered into a spreadsheet. It’s worth asking the agency for copies of any databases or spreadsheets that log or summarize those accident reports, in this example.
Anytime you can use the form names or language an agency refers to for a given document it will make it easier for them to search for what you’re requesting.
Finally, go through records-based stories of yesterday. Issues that were big problems 10 or 20 years ago are often big problems today, so it’s always a good idea to occasionally request updated versions of the documents that drove those stories. If you found something interesting on MuckRock, you can log in and ‘clone’ a request with just one click. If your request was inspired by prior work, make sure to cite it.
Knowing is half the battle. The more specific and detailed you can be in describing the record you want, the harder it is for the agency claim that it does not exist or they can’t find it. Avoid asking for “any and all,” and provide any clues you can so the agency can search internally for it. Did the mayor mention a study at a press conference? Was there a citation in a footnote somewhere? Include that detail in your request. Also, study up on your state’s laws — you’ll be better prepared to haggle over exemptions. We have guides to each states’ records laws, as does the Reporters Committee for the Freedom of the Press.
Share the FOIA love! Public records can seem like a lonely fight — until you find the amazing community of transparency lovers out there. Check in on the #FOIA hashtag, Instagram your most absurd redactions, post winning requests, and stop by MuckRock’s friendly FOIA Slack.
Photo: Ryan Basen Baltimore Health Commissioner Leana Wen, right, helps demonstrate how naloxone is administered.
Health journalists in Washington, D.C., participated in an all-day training session about reporting on the opioid crisis, hearing from treatment experts, medical providers and public health advocates.
The event took place Feb. 23 at the University of Maryland’s Philip Merrill College of Journalism, and was a partnership between the D.C. chapter of the Association of Health Care Journalists and the National Press Foundation.
Speakers included Dr. Caleb Alexander, epidemiology expert at the Johns Hopkins Bloomberg School of Public Health; John Auerbach, president and CEO for the nonprofit Trust for America’s Health; Dr. Jay Butler, chief medical officer at the Alaska Department of Health and Social Services; Benjamin F. Miller, chief policy officer for the Well Being Trust; Dr. Karen Remley, American Academy of Pediatrics CEO; and Dr. Leana Wen, Baltimore’s health commissioner.
Forty-three reporters attended the training, in which experts discussed drugs that are being used to treat addiction, how the epidemic is impacting children, and other areas of drug or alcohol addiction that have been affected. Officials detailed ways that they work to distribute naloxone to patients and how they connect them to treatment.
Experts said that doctors needed to be more judicious about prescribing opioids and that the stigma associated with addiction can be a barrier to patients’ seeking care.
They shared personal anecdotes of working in emergency departments and said a wide-ranging approach would be necessary to make a dent in addressing rates of deaths and addiction.
The opioid crisis has resulted in more than 42,000 deaths from overdoses on drugs such as heroin, fentanyl and prescription painkillers. Members of Congress are working on funding and legislation to address it, and the Trump administration has said that reversing the pattern of addiction and overdose is a top priority.
The following resources were provided by the speakers:
In honor of Sunshine Week, AHCJ invited organizations devoted to government transparency to write about how their work can help health care reporters. Here is the third of four.
Government websites are changing the information they supply related to topics such as sexual orientation and women’s health, and the Web Integrity Project (WIP) at The Sunlight Foundation, a national nonprofit organization based in Washington, D.C., has been on a mission to track those changes.
In our first-ever report published earlier this month, our nonpartisan team highlighted examples of statistical policy working papers and other resources that had either been relocated or entirely removed from federal statistical websites.
We alsp produce policy analyses to evaluate and recommend changes to Web governance practices and help ensure access to valuable Web resources.
Our monitoring work in the health care sector will focus on webpages that relate to politically sensitive topics, including maternal and child health, reproductive health, LGBTQ health, mental health, and the Affordable Care Act.
We’re already monitoring 10,000 webpages from various agencies and offices within the U.S. Department of Health and Human Services, including the Centers for Medicare and Medicaid Services, the Centers for Disease Control and Prevention, the Office of the Assistant Secretary of Health, the Substance Abuse and Mental Health Services Administration, and the Office of the Assistant Secretary for Planning and Evaluation.
Our websites will code the changes we report on, as well as those found by other civil society and media organizations, and we’ll compile them into a Website Change Tracker that will launch in the coming weeks.
With a decade of success achieving policy and legislative outcomes, our experts provide insight into the intersection of transparency, accountability, and technology, and suggest constructive ways to improve how governance works.
In the past, we’ve published databases that journalists found useful for digging into money in politics, influence, legislation, and regulators. Today, we publish analyses for improved transparency policy and maintain a list of President Trump’s conflicts of interest. Our reporting is used by policymakers and journalists around the world.
The Web Integrity Project plans to release new reports on changes we’ve found through our monitoring efforts. If you’re a journalist who would like to receive them, please let us know.
The Association of Health Care Journalists just updated its HospitalInspections.org website. The site now has 27,985 records of hospital inspection results, covering from January 2011 well into December 2017. Most of the records show details of each deficiency found in hospitals.
The website includes the results of government inspections of acute-care hospitals, critical-access (rural) hospitals and psychiatric hospitals resulting from complaints. It does not include reports of deficiencies found at long-term care hospitals, nor does it include the results of routine hospital inspections.
The file came from the Centers for Medicare and Medicaid Services, part of the U.S. Department of Health and Human Services. The database is searchable by keyword, city, state and hospital name. The website is open to the public. AHCJ members can also download the latest data for their own searches and analysis. They also have access to resources and tip sheets about how to best use the data in their reporting.
AHCJ launched the site in March 2013 following years of advocacy urging the government to release the deficiency reports in electronic format. Until then, reporters and the public had to file Freedom of Information Act (FOIA) requests with CMS to obtain the documents.
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