Journalists covering health care have an unprecedented volume of data at their fingertips these days. But turning that torrent of data into compelling stories that resonate with readers and foster urgently needed changes is the eternal challenge for ambitious reporters.
Few health care journalists have a more impressive track record of producing such stories than Charlie Ornstein, a senior reporter for ProPublica who recently spoke to fellows at the 2017 California Data Fellowship. From his Pulitzer-Prize winning reporting at the Los Angeles Times that helped bring about the closure of a problem-plagued South L.A. hospital to his pioneering work at ProPublica to free nationwide data on how much doctors receive from pharmaceutical and medical device companies, Ornstein has a gift for mining data to fuel high-impact stories.
In Ornstein’s view, we are currently in the midst of a paradigm shift in journalism. In the past, the story went something like this: A reporter tracks down data, analyzes it, finds the right people to humanize the numbers, and then “blesses the world” with the publication of the finished story. While that traditional model might be an effective way to spotlight a broad trend, it doesn’t do much to tell readers in, say, Tempe, Arizona how much money their doctor might have accepted from pharmaceutical companies or how their surgeon’s record on knee surgeries compares to her peers.
“I think one of the things that’s changing is the desire to let people see themselves in the data,” Ornstein said. Doing so requires journalists to think about a new set of questions: How do we then make the data available to others? Can reporters make the data easily accessible and searchable so online readers can essentially report their own story with data we’ve gathered? And relatedly, is this the kind of reporting project and dataset that can be updated over time so it remains relevant?
Not every reporting project will be a good fit for that kind of ongoing investment of newsroom energy, and smaller organizations can’t be expected to produce the kind of elegant searchable database Ornstein and his colleagues created for “Dollars for Docs.” But Ornstein’s point is that almost every newsroom can find some way to make the datasets their reporters have gathered more available to the public — even if it’s only an online link to the data itself.
“Your default should be, ‘How do I get this data out there so people can use it, and it’s not just for my story?’” he said.
Ornstein also urges reporters to not limit themselves to data that’s already publicly available. “Try to free new data,” he said, pointing to ProPublica’s successful effort to persuade CMS to release Medicare Part D data that revealed the prescribing habits of more than a million providers. “If you know someone is sitting on information, make it available,” Ornstein urged.
Once you do succeed in finding — or liberating — the right data source for the questions you’re trying to answer, Ornstein urges reporters to make themselves the expert about that dataset. “You know everything so you’re versed in that dataset,” he said. “You know it cold.”
During his tenure at the Los Angeles Times, Ornstein and his colleague Tracy Weber reported an explosive exposé on a failing kidney transplant program at Kaiser Permanente in San Francisco. They found the story by poring over data on transplant waiting lists at California hospitals, where they noticed Kaiser’s new program had a ballooning waitlist, with more people dying than receiving transplants. Kaiser’s program was shuttered shortly after the story ran.
“Understanding the organ transplant data led us in so many directions because we knew what to look for, and we knew what popped out at us,” Ornstein said. “We knew what it did tell you and what it didn’t tell you.”
But while developing that kind of deep understanding of a new dataset is essential for finding the stories hiding within, it’s entirely reasonable to ask for help in making sense of it. Ornstein encourages journalists to overcome feelings of intimidation in the face of massive, complex datasets by reaching out to other journalists (the IRE community is famously generous, for instance) or a professor or ace grad student at a local college.
“Ask people for help,” Ornstein said. “Oftentimes they’re willing to help you for nothing, or just for lunch. People are very interested in the way journalists operate and want to contribute to public understanding.”
But it’s also important to remember that the data, while it may point you to the story or provide essential context, is not the story itself.
Among his peers, Ornstein may be known as a kind of health data sherpa who climbs higher into the data alps than almost anyone else, setting the story lines for others. But his guiding philosophy of health care journalism is fundamentally a humanistic one.
“At their core, these healthcare stories are not about data or business or politics or policy or medicine. They’re about people,” he said. “Sometimes you get so focused by your data that you forget that the data is in service of the story, the story is not is service of data.”
[Photo by Medialab Katowice via Flickr.]