All posts by Irina Ivanova

Kiev-born, Brooklyn-based (with stops in Germany, Australia, Pennsylvania, Massachusetts, France). Editor, reporter and policy wonk. My sweet tooth is indomitable.

Ivanova/Willens: Medical Data Breaches

A proposed title or headline

Who’s losing your data?

A story slug — up to three words that capture the essence of your story

Data breaches

Key elements

– Since 2009, more than 2.5 million medical records have been lost or stolen in New York State. That means one in ten New Yorkers has had their data compromised.

– Institutions reporting breaches of medical data run the gamut from insurance providers to public hospitals to prestigious university-affiliated medical centers.

– The overwhelming majority of these breaches occur with electronic (not paper) records.

A news hook, or explanation of why this story matters now

In brief, medical data means big money–both for its legitimate users and to people selling it on the black market.

The New York State Department of Health is on the verge of rolling out the State Health Information Network of New York (SHIN-NY), a network that allows patients’ medical information to travel more easily between providers. While medical providers stand to gain “bonuses” in the form of federal money for converting to medical records, patient advocates have raised concerns with the project, including lack of transparency and patient consent.

We want to show the extent to which data breaches exist in the current system, and the overlap between institutions that can’t secure their data now with those who will be part of the SHIN-NY (spoiler: there’s a lot of them.)

Links to data

Data breaches in New York state since 2009: http://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/breachtool.html

A cleaned-up file is here (that we’re trying to geocode):

https://docs.google.com/a/journalism.cuny.edu/spreadsheet/ccc?key=0Alfw-9hKKmAHdHJMMVFUZWg3c2YyblQ3MjJoc3dRMFE&usp=drive_web#gid=0

We’re also thinking about ways to map overlaps in patients of the various entities on teh “breach list.” In other words, how likely is it that someone who’s a patient at Doctor X’s also has a health plan with carrier y? Possibility here for an intelligent guess about how many people have had their medical records compromised more than once.

Sources

Dr. Latanya Sweeney, Harvard/FTC — technologist & privacy expert. latanya@fas.harvard.edu

Dr. Deborah Peel, founder, Patients’ Privacy Rights. dpeelmd@patientprivacyrights.org

Corinne Carey, New York Civil Liberties Union; advisor to SHIN-NY. ccarey@nyclu.org.

Eric Fader, health care lawyer, Day Pitney.  efader@daypitney.com // (212) 297 2413

 

Trauma charges in Florida

This graphic from the Tampa Bay Times is the result of a yearlong investigation into  what different trauma centers (a type of hospital) in Florida charge.

http://www.tampabay.com/topics/specials/2014/trauma-fees.page

There are a few things I really like about this graphic. One, it’s relatively simple. It traces similar metrics (costs for x procedure) across the same institutions. It’s a nice simple color scheme. And it’s not too busy at the outset–but you can click on individual names to get more detailed information.

I think it’s a good example of using clear, straightforward graphics to make the point that some phenomenon has no clear justification. Health care costs are notorious for this–there is no rhyme or reason for them.

When you click through the years, some clear patterns are visible–in particular, that the cost keeps rising through the years.

One gripe I have is about the color-coding on the map. The middle range (which indicates for-profit centers that are not HCA) is indistinguishable on my computer from the nonprofit. They could easily have expanded the color range (or at least tested the graphic on a few different monitors).

Also, when you click through different procedures, the y-axis changes! This is fairly annoying and I think unnecessary–there isn’t a HUGE amount of variation in costs.

Not so charitable — Ivanova/Johnson pitch

From Irina Ivanova and Victoria Johnson

A proposed title or headline

Not so charitable

A story slug — up to three words that capture the essence of your story

Charity care

Key elements

From 2008 and from 2010–

Amount of money hospitals receive for charity care (the “indigent care pool”). The number of applications they approve. The hospitals’ size (calculated by number of beds).

A news hook, or explanation of why this story matters now

In New York, where more than a dozen hospitals have closed in the past decade and six more are in danger of closing, the issue of cost and access to health care is particularly dire. The governor lobbied for NY to get an infusion of federal funding in part to help restructure Brooklyn hospitals, which activists say are necessary to provide medical care to the poorest people.

There’s a program in place called the Indigent Care Fund, which gives money to hospital throughout the state that have a lot of poor or uninsured (read:unprofitable) patients. But just because hospitals get that money doesn’t mean they spend it. Data collected by the Community Service Society shows that some hospitals that get large amounts of funding for charity care offer none, or little.

When CSS released this report in 2012, it was a big deal–the Times and other major media picked it up. The report used data from 2008-2009, and since that time, hospitals’ charity care practices have come under scrutiny and are now audited by the state. We’d like to show whether, and how much, hospitals’ charity care policies have improved in the past few years.

A description of and link to the data

  • A 2012 report from the Community Service Society, a nonprofit, describes the 201 hospitals in New York that provide charity care and compares it to the number of applications they approved. Report uses 2008 data.

https://docs.google.com/spreadsheet/ccc?key=0AvuYANAX-U9QdHJGQ2JuX3UwbFR6bngxYTJFVHRNbnc&usp=sharing#gid=0

  • Data from Institutional Cost Reports from 2010 (the same reports from which CSS gathered their data, above), covering all hospitals in the state. (Note: we’re still figuring out how exactly to extract the data).

https://health.data.ny.gov/Health/Hospital-Cost-Report-Audited-Data-2010/j5hh-bsea

  • A list of hospitals open, closed, and close to closing in New York City as of 2014

https://docs.google.com/a/journalism.cuny.edu/spreadsheet/ccc?key=0AvuYANAX-U9QdDFrSFZXRWN6X2xBdlNyWk9OdzMtZ0E&usp=sharing#gid=0

  • Sources

  • Elisabeth Benjamin, Vice President, Health Initiatives/Community Service Society of NY. (212) 614-5461; ebenjamin@cssny.org

  • Robin Gelburd, president, FAIR Health. 212-370-0704

  • Keith Smith, surgeon who runs a cash-based, transparently priced practice in Tulsa, OK.  KSmith@surgerycenterok.com; 405-627-0274