Pulse on Health by Jeff Hansel

Sneeking peeks at private patient information

Here's a question for Minnesota health providers:  Have you ever snuck a peek at a neighbor's medical records, just out of a sense of curiosity?  Or maybe took a look at the records of a famous person after he or she was a patient on your unit?  If so, your days of employment might be numbered.

More than a dozen Kaiser Permanente employees have lost their jobs after taking a look at the medical records of Nadya Suleman, the woman who gave birth to octuplets earlier this year, according to CNN.com.  Twenty-three employees were either fired (15) or disciplined (8), the article says.

So be forewarned.  It's illegal, it's creepy and you'll probably get caught if you sneak a peek at, say, the records of your neighbor, your new daughter-in-law, former Pres. George H.W. Bush, Minnesota Sen. Amy Klobuchar or Sen. Patrick Kennedy. 

And if you get caught, don't be surprised if you get plenty of time off to reflect.

Pulse on Health

By Jeff Hansel, member Association of Health Care Journalists

Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904

 

Flex spending and paperwork as a cost of health care

My company, like many, offers a flex spending option for health coverage.

When I pay for something health-related that's not covered under my health-insurance policy, I get reimbursed for the money I spend.  

In reality, the money is mine to begin with.  It's withdrawn from my paycheck bit by bit, then paid to me when I turn in a receipt showing I spent money on, say, vitamins, the patient balance for a blood test or an "approved" health-related item.

I recently stopped in to pay my bill at a local medical facility and needed a receipt showing:

• date of service

• list of services provided

But those items aren't automatically listed on the receipt for services that might have occurred several weeks ago.  Thus, each time I make a payment — in order to get my flex spending money back — I must make a special request that the billing office produce a special printout describing what services I'm paying for.

It strikes me that this is but one example of unfortunate and seemingly unnecessary costs of health care.  It usually takes the time of two to three employees to complete the task.  Imagine if businesses, health providers, insurers and patients all worked with the same standardized process.  Or, imagine if everyone could connect electronically.  For example, imagine if I could send an e-mail to the business office and it would get forwarded, with receipt attached, to my company.

The country's complex and varied billing systems, treatment definitions and requirements adds mountains of cumbersome, costly and, in many cases, repetitive paperwork that serves no real purpose other than to clog our lives.  When, for example, was the last time you actually made use of an EOB (explanation of benefits)?

Pulse on Health

By Jeff Hansel, member Association of Health Care Journalists

Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904

 

Your slice of $1 billion

Get your slice of the $1 billion Elk Run biotechnology project pie by attending the 5th Annual Regional Bioscience Conference in Worthington Thursday and Friday.  Specifically, it's your chance to hear directly from G. Steven Burrill, CEO of San Francisco-based venture capital group Burrill & Company.  

He's scheduled as the keynote speaker at 8 a.m. Friday.  If I'm able, I'll head over to Worthington and cover his presentation on your behalf.  But there's a lot more going on at the conference than Burrill's keynote address, from bio-fuels to animal health and renewable energy.

Still, it'll be our first chance to see Burrill up close and personal.

"G. Steven Burrill has been involved in the growth and prosperity of the biotechnology industry for over 40 years," says the conference agenda.  "Mr. Burrill is one of the original architects of the industry and one of its most avid and sustained developers."

The conference agenda notes that Burrill serves on the boards of:

• Pharmasset

• BioImagene

He's a member of the Boards of Directors of:

• Catalyst Biosciences

• DepoMed

• Ikano Therapeutics (formerly Intranasal)

• Phytomedics

• ProteoGenix

• Proventys

• Targacept

• XDx

The conference agenda further notes that Burrill previously served 28 years with Ernst & Young "directing services to clients in the biotechnology/life sciences/high technology/manufacturing industries worldwide."

The diversity of companies he's involved with give us a better idea of his background in dealing with Elk Run.  We'll be following up.

Pulse on Health

By Jeff Hansel, member Association of Health Care Journalists

Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904

 

Celebrate your doctor

It's national doctors day today (March 30, 2009).  The Southern Medical Association says a red carnation is the way to show your appreciation. 

Maybe I'm out of the loop, but I frankly never heard of this holiday — until today.  I'm not surprised there is such a holiday (recognized by Congress, according to holidayinsights.com.  There of course is a holiday for everything (which helps support the greeting card industry, flower shops and chocolate makers).  Your doctor will probably forgive you if you give him or her a box of chocolates — chocolate contains flavonoids, you know.  That means (especially) dark chocolates also contain antioxidants, which can reduce high blood pressure (according to NaturalNews.com).

Of course, everything in moderation.  I bet a thank you note would be just as appreciated.

Pulse on Health

By Jeff Hansel, member Association of Health Care Journalists

Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904

 

Tobacco tax increases

The federal tobacco tax goes up 62 cents per pack on cigarettes Wednesday (April 1, 2009).  This is a real tax increase, no an April fools joke.  That's a hefty increase, reportedly the largest ever in federal cigarette taxes.  

Over the years, I've spoken with many smokers and non-smokers about the issue of tobacco taxes.  Even smokers will often say they support increased taxes — if it'll help them quit smoking.  Studies show that indeed happens.  As prices increase, so does the motivation to quit.  But tobacco is a tough habit to turn away from, even if you want to.

[Cigarette smoker — is the glove he's wearing prophetic?  Click to enlarge. Copyright.]

At the convenience store the other day, a woman ahead of me in line made a purchase.  Her total came to $97.  I thought, wow, that's a lot of money, but she's probably also paying for gas.

As I mulled the price, I realized, nope — she's paying for two cartons of cigarettes.  97 bucks!  Ouch. 

The debate about the risks of tobacco has long since passed.  Smoking kills, and the evidence is clear, as the photo below points out (my friend, who served in Afghanistan, says such warnings are military requirements).

[Copyrighted photo.]

Tobacco's addictive grip is strong.  But $97 for a bulk purchase would provide pretty strong motivation, for me, to quit — if I smoked.  And that's the price she paid before the tax increase.  Tack on another $14 or $15 to that price tag and you see where I'm going.  If you're a two-pack-a-day smoker, figure on spending another $500 this year.

In 10 years, you'll spend enough on cigarettes to pay off a $34,000 student loan, buy a pretty nice car or put a big down payment on a house.  But, to do that, you've got to break the habit first — and I'm aware not everyone wants to.  

Pulse on Health

By Jeff Hansel, member Association of Health Care Journalists

Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904

 

Stop cancer from spreading?

Researchers at Mayo Clinic in Jacksonville, Fla. say they've found a way to stop cancer from spreading.

In the March 29 online issue of Nature Cell Biology, they report that "a molecule known as protein kinase D1 (PKD1) is key to the ability of a tumor cell to remodel its structure, enabling it to migrate and invade. The researchers found that if PKD1 is active, tumor cells cannot move, a finding they say explains why PKD1 is silenced in some invasive cancers," an announcement from the clinic says.

"It appears that PKD1 must be turned off if cancer cells are to migrate" and spread around the body, the researchers report in the statement.

It continues, saying, "now that we have identified PKD1 as key regulator in processes regulating actin-based directed tumor cell movement, we can begin to think about designing treatments to stop invasive cancer cells from metastasizing."

Mayo cancer biologist Peter Storz led the team, along with Tim Eiseler, Heike Döppler and Irene Yan of the Mayo Department of Cancer Biology; and Kanae kitatani and Kensaku Mizuno of the Graduate School of Life Sciences at Tohoku University in Japan.

Pulse on Health

By Jeff Hansel, member Association of Health Care Journalists

Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904

 

The slow death of embargoed news

I have begun to realize that "embargoes" (a method used to give journalists advance notice about breaking news) are slowly dying.

The modern age of technology is beginning to make them pointless.  When news is pending, some organizations, such as Mayo Clinic, will offer an embargoed announcement.  

That means the journalist consents not to publish a story until the agreed-upon time.  It's an extremely useful method of helping reporters fully interpret news before publishing.

But, these days, announcements of this type are routinely posted on Internet-based news links for journalists. Those news links are accessible to the general public via the Web.

A story scheduled for release on Sunday (March 29, 2009) has already become public knowledge — if you know where to look (or stumble upon it) today (March 28, 2009).

If someone coincidentally searches Google for the "Mayo Clinic Department of Cancer Biology" and for researcher "Peter Storz" today (Saturday, March 28, 2009), the second link that comes up is the embargoed press release for Sunday's (March 29, 2009) embargoed announcement.

Sure, in this case it would be quite a coincidence for someone to happen to be searching for Storz (and to know that he works with Mayo's Department of Cancer Biology, which doesn't seem to have much of an online presence).  

But it points out something I've noticed a lot lately.  "Embargoed" press releases often appear on Google, GoodSearch and other search engines days before the embargo lifts.  I happened to do this search while seeking a link to post about Storz.  It was striking to me how easy it was to find the embargoed story, which is, in reality, already public because of its online presence.

If millions of Web users already have access to embargoed announcements, should journalists continue to honor embargoes?  

Today's search might be a little obscure.  But with more-common topics, it's highly likely Web searchers will often find "embargoed" announcements — before the embargo has been lifted.

An embargo helps journalists find time to read and understand background material, arrange and complete interviews and then publish news stories that gives a thorough analysis for readers.

Embargoes play a valuable role in accurate and thorough reporting.

But readers should realize that embargoes also play a role in control of the media — and the message.  Reporters know that every news outlet is going to report the story once the embargo lifts.  That results in a powerful, multi-media frenzy in which you receive the same message over and over again.  Studies have shown that, to get a message across, it's important to repeat, repeat, repeat. 

That means scientific journals that want to get their message out have a captive audience on the day the embargo lifts.  The story, if it has enough news value, will be carried on the Web, in newspapers, on TV and on the radio.  

If an enterprising journalist instead somehow stumbles across the story a week before the embargoed press release is sent, the medical journal, health system or university loses control of the message.  

It seems to me that's what's happening with embargoes.  Perhaps individual embargoes, where a journalist requests specific information on an embargoed basis, will continue to serve the public. But I think technology is slowly causing embargoes to lose their effectiveness.

Pulse on Health

By Jeff Hansel, member Association of Health Care Journalists

Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904

 

A different twist on rationing of health care

The folks in Fargo, North Dakota are facing a severe spring flood (March 27,  2009).  Watching from afar, this is a good time to look at your own local health-care system and consider whether it could do what the health providers in Fargo-Moorhead are doing.

Officials at MeritCare Health System and Innovis Health are cooperating and have a five-day plan for what to do in the event that city services such as sewer, water, trash removal and power get interrupted.

The medical centers are cooperating to make sure acutely ill walk-in patients, and those needing emergency services, have places to go despite multiple closures of services.  

Innovis, for example, has closed several of its clinics, but has kept one open, along with ER services.  

"A Nurse will be in each specialty clinic for triage," the Innovis Web site says.

MeritCare evacuated hospital patients, in large part, to free up staff so they can concentrate on patients with acute needs.

"The Emergency Center at MeritCare's downtown location will remain open. We will be stabilizing patients and transporting them to other hospitals," says MeritCare's Web site.  MeritCare will also keep two of its clinics open for primary-care walk-ins.

Public health Fargo began taking all tetanus vaccinations earlier this week, freeing up health providers for urgent treatment.  It's a realignment of medical services, making sure patients in need of immediate treatment will get it, moving hospital patients in the midst of lengthy care to other hospitals outside of Fargo to free up staff for urgent needs and using public-health nurses to lighten the load.

Again, this might be a good time to check your local providers' preparedness in the event a similar event were to take place in your own community.

Pulse on Health

By Jeff Hansel, member Association of Health Care Journalists

Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904

 

Trastek withdrawing as potential Cortese CEO successor at Mayo Clinic???

We received an unconfirmed tip saying that Dr. Victor Trastek, CEO of Mayo Clinic in Arizona, has removed his name from consideration as a potential successor to Dr. Denis Cortese, Mayo's national CEO who serves at the clinic's Rochester, Minnesota home base.

Cortese is expected to retire in November.  Cortese told me in a telephone interview on his 65th birthday that he had long planned to retire when he turned 65.  But he was asked to stay around a while longer, and agreed to do so.  It was kind of Cortese to grant an interview on his birthday.  

I personally typically take my own birthday off as a personal "holiday."  But I suppose if you're the CEO of a $7 billion non-profit, you work most days — and nights.

By late spring (which is fast approaching), Mayo is expected to narrow its list of candidates for a successor to Cortese — so that he can work alongside that person for several months (a Mayo transition tradition).  

Our caller said Trastek wants to stay in Arizona.  We don't have independent confirmation (and it's too late at night to get it).  But it's rare for Mayo to name names until the process is complete (in other words confirmation one way or another might not happen until Mayo announces the successor's name).

Who else might be in line?  Mayo has not published its short list, of course.  But a few names come to mind.

Vice president and Mayo Rochester CEO Dr. Glenn Forbes

Of course, that would create more change in Rochester at a time when the clinic might be looking for local stability to back up the incoming national CEO.  Of course Mayo's national CEO Shirley Weis has been in position long enough to provide that.

Vice president and Mayo Jacksonville, Florida CEO Dr. William Rupp

He's new in his position, so it seems unlikely he would be elevated so quickly.

Vice president (and Mayo Rochester physician) Dr. Nina Schwenk

Here's an interesting choice.  The clinic, for the first time, chose a nurse — Shirley Weis — and,  for the first time, chose a woman (Weis) as chief administrative officer last year.  Perhaps the clinic will pick Schwenk to become the national physician leader.  

Of course, Weis, who came highly qualified to serve as CAO, was relatively unknown.  So perhaps Mayo will do the same with its physician leadership and pick a wild card.  

Taking on such a role puts a spotlight on a person's career and changes that physician's ability to spend time with patients.  So it's a huge commitment.  We'll let you know as soon as we get any additional tips.

Pulse on Health

By Jeff Hansel, member Association of Health Care Journalists

Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904

Reader claims poor reporting about fire

A reader anonymously mailed an envelope to me about the fire that destroyed a triplex on Friday (March 20, 2009).  I will transcribe below what the reader wrote on a photocopy of the article:

"There is no doubt a good reason Mr. Hansel had for letting everyone know that Ms. Wilson works for AllState and has renters insurance.  And then to include that Ms Wilson "believes" she is the only one that had insurance. 'It doesn't matter to me' and I doubt it matter(s) to anyone else.  Poor reporting."

Our newspaper each day includes the words "If it matters to you, it matters to us."

I and my editor felt this story mattered to the individuals affected, the neighbors and to the larger community.  Several individuals were displaced during a fire that caused a large plume of smoke that could be seen from a long distance away.  

I often include business names when interviewing a source.  If the person I interviewed had said she worked at a car repair shop, a hospital, a flower shop or a veterinary clinic, it's likely I would have mentioned where she worked.  

It's also important to note that many who read this article might think twice about their own insurance and its value.  We mentioned that "she works for Allstate Insurance" because we often mention the businesses where people work (mentioning the business name helps to differentiate between John Smith who hypothetically works at the police department, John Smith who hypothetically serves as a school maintenance worker and the John Smith who was hypothetically recently arrested).  

Mentioning where someone works makes it clear to someone's casual coworkers and acquaintances that yes, indeed, fire recently affected their life.  It gives people a chance to offer concern, if they wish.  

We generally mention whether someone affected by fire had insurance or not, to help readers know if the person might need financial assistance — or will be able to replace most belongings and recover without assistance.  In this case, at the time of the article, it appeared other renters were without insurance after a fire that left the building totally destroyed, according to the Rochester Fire Department's incident commander.  The word "believes" was used specifically because we did not have confirmation from other apartment dwellers.  The word alerts readers that it's possible other renters had insurance. 

I'm not sure if my response will be comforting to the reader who wrote to me.  But if someone took the energy to do so, I figure it's worth a try.

Pulse on Health

By Jeff Hansel, member Association of Health Care Journalists

Health Reporter for the Post-Bulletin newspaper, 18 1st Ave. S.E. in Rochester, Minnesota 55904