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  1. Carlson, Elizabeth Ann

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A bestseller involving healthcare, deception, lies, and vast sums of money is reviewed and highly recommended. In contrast, a website known for its unbiased reporting is highly recommended for all to bookmark and visit regularly.


Bad Blood: Secrets and Lies in a Silicon Valley Startup by John Carreyrou, 2018. New York, NY: Random House. 320 pages and costs $27.95. This book has a prologue, epilogue, acknowledgments, notes to chapters, and an index. It is a New York Times bestseller and named one of the best books of the 2019 by National Public Radio (NPR), The New York Times Book Review, Time, The Wall Street Journal, and The Washington Post. It was also named the McKinsey Business Book of the Year.


The book is about Elizabeth Holmes and the company she started, Theranos. These names may be familiar as they were in the news regularly in 2015 and 2016 as the falsehoods and shady practices were revealed in The Wall Street Journal and subsequently in other news and media outlets. The author is a reporter for The Wall Street Journal, and this book is based upon the investigations and interviews he did beginning in 2015 when he received tips on irregularities in February 2015 from a blogger who wrote about pathology. The blogger read a featured article in The New Yorker about Elizabeth Holmes and Theranos in which the blogger found things that made him suspect. Carreyrou had read the same article and remembered similar thoughts that made him question the content; specifically, the description of how the blood-testing devices made by Theranos worked. The story he uncovered is fascinating and details how the company was built upon lies, deception, and secrecy.


This book reads like a thriller as the actions taken to deceive investors and companies that purchased the product are lied to repeatedly about the existence of a small device. This device allowed patients to test their blood at home using only the small amount of blood from a finger stick. The problem was that the claims made by Holmes and Theranos were not true. Holmes used these claims to raise large sums of money from investors and then used the fact that persons and groups had invested in Theranos to secure more investors and more money. The investors named in the book are a list of prominent and well-known people. The lack of skepticism on the part of investors and companies was hard to believe as I read this book, as was the willingness to let Holmes tell them what they wanted to hear without independent corroboration.


Theranos employees, who questioned Holmes and her partner Ramesh "Sunny" Balwani, who was also her boyfriend, were dealt with quickly and severely. Complete loyalty without question was expected from all employees. The book details person after person who were fired because they did not blindly agree with what was occurring. Since Theranos employees signed nondisclosure agreements, once they were ex-employees, many were harassed and intimidated as Theranos tried to keep any negative information from being shared.


The reason this book is included in this column is because case after case are presented where treatment plans for patients either did or did not begin based on faulty results that the company provided knowing that the results were not correct. When physicians questioned the results, they were also harassed. Of equal concern is the fact that Theranos lied to users and investors that they adhered to regulatory rules and set up elaborate deceptions when regulators came to inspect the laboratory and processes. At no time in the history of Theranos did it appear that the touted device actually exists, nor did it ever work. Theranos constantly implied that the blood results came from the device on-site. While in reality, elaborate ruses and work-arounds were used; blood samples were shipped to the company and completed in a standard laboratory and then passed off as having come from the device.


This book recounts such egregious actions on the part of Theranos as a company and those outside companies such as PR firms and lawyers they hired that it seems like a story, not something that happened and is still unfolding. Not too long ago, I read in the newspaper that Theranos and Elizabeth Holmes are under investigation. While reading this book, I was astonished that Holmes was able to carry on as she did for so long and bamboozle so many investors and companies into giving her millions and millions of dollars.


I highly recommend this book because it serves as a cautionary tale that when providing patient care at any level, proof positive is needed before actions are taken on the basis of hype. It is a fairly quick and easy read and would be a good book for a discussion group.


I reviewed the Kaiser Family Foundation (KFF) website at http://www.kff.org. I am grateful to my friend and colleague (M.Z.) who pointed me to this site. Another of my colleagues calls this site the "CDC of policy sites" due to its unbiased reporting. As I searched for this site, the Media Bias/Fact Check site (http://www.mediabiasfactcheck.com) was flagged. It rated the Kaiser Family Foundation site as "least biased" and stated, "Overall, we rate Kaiser Family Foundation Least Biased based on pro-science reporting and High for factual reporting due to the use of strong credible sourcing. (February 2, 2017) Updated (D. Van Zandt, September 19, 2018)." The other sentence that jumped out at me was "A factual search reveals they have never failed a fact check" (http://www.Mediabiasfactchekc.com/Kaiser-family-foundation). This is high praise in my mind and certainly warrants being on a nurse's radar.


The KFF states that it is "Filling the needs for trusted information on national health issues." On the home page of the KFF site, there is "Trending on KFF," which the day I was on the site included information about HIV, Health Reform, Medicaid, Women's Health Policy, Global Health Policy, Uninsured, some polling, Chart of the Week, and columns on healthcare by Drew Altman. Selecting any of these, the reader is lead to more detailed information on the topic.


I selected Health Reform and found a poll on support for policy changes to lower drug costs. The next clicks led me to a detailed explanation of how the poll was done and the findings. The findings were in-depth and were clearly written and easily understood. I was surprised by the depth and comprehensiveness of the information available.


On the left side of the site is the navigation panel. The reader will find topics such as Disparities Policy or Private Insurance, Polling, Perspectives, State Health Facts, specifically State Health Facts and Custom State Reports, Graphics & Interactives, Charts & Slides, Kaiser Health News, Media Campaigns, Peterson-Kaiser Health System Tracker, Newsroom, and About Us. Under the Peterson-Kaiser Health System Tracker, there is a Household Health Spending Calculator for families and individuals and a National Health Spending Explorer. A few clicks on the National Health Spending Explorer brought me to the Health System Dashboard. This dashboard provides current data on items such as total U.S. spending on healthcare or total costs of healthcare based upon type of insurance, income, and family size. These data can be customized to address questions you may have.


I found myself "surfing" the State Health Facts for quite a while. I was fascinated by the amount of data available for use by anyone. One set of facts I found interesting was the number of MDs, advanced practice registered nurses (APRNs), and physician assistants per state. As you would expect, the number of each type of provider varied by state but the number of APRNs, for example, varied greatly by state more so than I would have guessed.


I browsed the "Health System Dashboard" that, as the website states, "compiles data on the U.S. health systems" performance in four categories: Access and Affordability; Health & Well-Being; Health Spending; and Quality of Care. Under Quality of Care, I learned that there has been a 13% reduction in hospital-acquired conditions between 2014 and 2017. The data available are seemingly unlimited, and I could and did "surf" for quite a while reading about a wide range of topics.


The topics mentioned are only a slice of the data available on this website. I highly recommend this website to everyone, nurse, healthcare provider, or someone who has nothing to do with healthcare unless it is to see his or her primary care provider for wellness checks. It is a wonderful source for up-to-date statistics and the effect of current policies. I know that I will suggest this website to one of my friends who cannot get enough "hard data" on healthcare topics.


I highly recommend both media reviewed. The book Bad Blood by John Carreyrou that details the rise and fall of Theranos and Elizabeth Holmes is engaging, written like a suspense thriller and well-referenced. It is a cautionary tale on what to believe without solid evidence. On the contrary, the KFF website is all about data and unbiased information on the healthcare system, policies, and outcomes. It should be bookmarked on everyone's computer, thus giving access to current, unbiased data.