UK expands heart and vascular care to hospitals across the state

By Melissa Patrick
Kentucky Health News

One of the many ways that UK HealthCare strives to improve the heart health of Kentuckians is through its Gill Heart and Vascular Institute Affiliate Network, which includes a community of hospitals across the state working to ensure patients receive high-quality cardiac care close to home. 

The program serves a great need, since heart disease is the leading cause of death in Kentucky and the state has one of the country’s highest rates of heart disease. 

Dr. Navin Rajagopalan

Dr. Navin Rajagopalan, director of the affiliate network, said it is made up of over 20 hospitals throughout the state.  

"Our key mantra is always . . . one of collaboration," he said. "The University of Kentucky is a big hospital, we have lots of services here. But we never want to be seen as competing with local, community hospitals for their patients. So we want patients to stay local for as long as possible to receive optimal cardiovascular care." 

He added that while it's important for UK's program to remain strong for patients who may need higher levels of care, the goal of the network is to "provide resources, education, and training, where appropriate, to the hospitals in our network." 

New to the network is Owensboro Health Muhlenberg Community Hospital in the Muhlenberg County seat of Greenville, featured recently in a UK news release. CEO Ed Heath said being in the network "furthers our mission to heal the sick and to improve the health of the communities we serve." 

“We look forward to utilizing the expertise of UK HealthCare and the perks of this affiliation to better serve our patients," he added.

Rajagopalan stressed that the program isn't about UK taking over a hospital's cardiovascular program, but is designed to foster collaboration and expertise-sharing among the member hospitals. Members of the network have access to educational resources, quality-improvement initiatives and specialized training, and Rajagopalan said the network can provide outreach clinics or assist with cardiovascular imaging. "The idea . . . is that patients can receive specialized care close to home," he said.

When Dr. Michael Karpf was running UK HealthCare in 2013, he said it needed to expand its geographical reach to maintain its newly raised national status and to ensure access to quality care for Kentuckians. "We want the hospital to be the first choice when it comes to complex care,” he said, identifying several regional competitors. First on his list was Vanderbilt University in Nashville, which is 80 miles closer to the Greenville hospital than UK and gets many patients from Western and Southern Kentucky. It has locations in Hopkinsville and Franklin.

Asked if UK's program is driven by competition in any way, Rajagopalan said, "No, we make it very clear that this is not based on referrals." 

Hospitals in UK's Gill Heart and Vascular Institute Affiliate Network (UK HealthCare map)

Rajagopalan said UK is not actively recruiting new hospitals into the network and already had some relationship with many of them. More often, he said, hospitals will call UK with a question about something and that's how they learn about the program. He added that UK HealthCare also offers the Markey Cancer Center Affiliate Network and a Stroke Care Network. 

As for money, he said fees collected within the affiliate network are put back into the program in some way: "We don't make any money off the network." 

According to the news release, the affiliate network includes 24 hospitals, more than 15 outreach locations and more than 12 sites where Gill provides cardiac image interpretation services across cardiovascular imaging modalities.

Rajagopalan told Kentucky Health News that the work they are doing at the Gill Heart and Vascular Institute Affiliate Network is "relatively unique." 

"We're kind of hoping to have more success stories and kind of share what we're doing to  other academic centers," he said. "Because I think the way that we, as an academic institution, interact with the community hospitals in our region is rather unique in terms of the spirit of collaboration and in trying to support all the hospitals  in the community."

Learning CPR for children and infants could help save a little life

(Photo from Prostock-Studio, via iStock/Getty Images Plus)

By Dr. Callie L. Rzasa

University of Kentucky

More than 23,000 children in the United States suffer an out-of-hospital cardiac arrest annually. Although the reported number of infant out-of-hospital cardiac arrests varies widely, only 6.5% for children less than 1 year old who experience an out-of-hospital cardiac arrest survive to hospital discharge.

According to the National Center for Injury Prevention and Control, unintentional choking and suffocation are a leading cause of all injury deaths for infants less than a year old. Nearly 3,500 infants die each year in the U.S. from sleep-related infant deaths such as suffocation, entrapment, strangulation and sudden infant death syndrome.

Make safety a habit at home by implementing safe sleep practices, such as making sure babies sleep in their own crib or bassinet on a firm, flat surface without potential suffocation hazards such as blankets, stuffed animals or crib bumpers.

New parents, grandparents, babysitters and caregivers should take the time to learn infant- and child-specific CPR (cardiopulmonary resuscitation). It’s important to remember if the child is unresponsive, not breathing or only gasping, call 911 and start CPR immediately.

For a child 1 or older:

• Push on the middle of the chest 30 times at a depth of 2 inches with one or two hands at a rate of 100 to 120 compressions per minute.
• Provide 30 compressions and then give two rescue breaths.
• Repeat cycles.

For an infant younger than 1:

• Push on the middle of the chest 30 times at a depth of 1½ inches with two fingers at a rate of 100 to 120 compressions per minute.
• Provide 30 compressions and then give two rescue breaths.
• Repeat cycles.

If you have access to an automated external defibrillator, use it as soon as possible. Most AEDs are equipped with child- and infant-sized pads. They can help guide CPR and provide treatment for certain heart arrhythmias. Continue compressions until emergency services arrives.

For more information about CPR for adults, children and infants, find a class or training center near you.

Callie L. Rzasa, M.D., is medical director of Kentucky Children's Hospital Congenital Heart Clinic and American Heart Association board president in Central and Eastern Kentucky.

MedCenter Health, chain based at Bowling Green hospital, to expand medical specialty offices at new building in Glasgow

The ceremonial groundbreaking
(Photo by Michael Crimmins, Glasgow News 1)

Kentucky Health News

The small hospital chain based in Bowling Green, MedCenter Health, is expanding its medical-specialty offerings in its largest close neighbor, Glasgow.

MCH has had a presence in Glasgow for “a number of years,” but will now have a building of its own and start providing specialty medical care, Wade Stone, executive vice president of MCH, said Thursday at the groundbreaking for the facility on South L. Rogers Wells Boulevard.

Stone said the facility will allow MCH to continue combating the nationwide physician shortage, especially with regard to specialty services, spurred by the chain's partnership with the University of Kentucky College of Medicine, reports Jack Dobbs of the Bowling Green Daily News.

“As Med Center Health has evolved into an academic teaching institution we’ve been able to successfully recruit many of those specialties and grow those programs,” Stone said. “We can deploy those specialists to other rural communities.”

MCH Glasgow, which is expected to open in about a year, will also "allow patients to complete pre-op and post-op procedures locally, instead of having to commute to Bowling Green," Dobbs notes.

One of the specialists will be Paul Moore, who has been cardiothoracic surgeon in Bowling Green for 30 years, Dobbs reports: "He said he has been treating patients in Barren and surrounding counties for the past six or seven years, but described MCH Glasgow as a central location."

Dobbs told Glasgow News 1, “We have a number of patients that come from here, not just from Barren County but Adair County, Clinton County, Monroe County; this seems to be a central location they can all get to easily. I’m at the point now where I want to get out and see the patients who really need access and the care I can give that’s not given locally and that’s really important.”

Other specialties listed in a press release were Vascular Surgery, ear/nose/throat, hematology/oncology, neurosurgery, urology and orthopaedics/sports medicine. Stone said three or four full-time primary-care physicians will also practice at MCH Glasgow, which will have 22,000 square fete of floor space,

Glasgow's hospital is the locally owned T.J. Samson Community Hospital, which has a branch in Columbia. MedCenter Health, which grew out of the publicly owned Bowling Green-Warren County Hospital, has hospitals in Albany, Franklin, Horse Cave and Scottsville.

It's Heart Month, which confronts the leading killer in the U.S.; here are five ways to keep your heart healthy or make it healthier.

University of Florida illustration

Kentucky Health News

February is American Heart Month, which focuses on the fact that heart disease is the leading cause of death in the U.S., and ways to lower your risk for heart disease. Here are five ways to boost your heart health, from the Centers for Disease Control and Prevention:

Exercise regularly. Maintaining a healthy weight is an important part of heart disease prevention, and regular exercise is one way to achieve this. The surgeon general recommends that adults get two and a half hours of moderate physical activity like walking or biking weekly. Children and adolescents should aim for an hour of physical activity every day.

Eat healthy. Establishing healthy eating habits is another way to maintain a healthy weight. Avoid foods that are high in saturated fat and trans fat. Opt for foods that are high in fiber and low in saturated fat, trans fat and cholesterol to help prevent high cholesterol. Foods with lower sodium can help lower your blood pressure, and consuming foods with less sugar can help keep your blood sugar under control.

Set limits. Limiting your alcohol intake and avoiding smoking can also help you prevent heart disease. Knowing your limits and setting boundaries can help you stay disciplined, which is another vital part of lowering your risk for heart disease.

Monitor health conditions. If you struggle with high blood pressure or high cholesterol or have diabetes, managing these conditions is a key part of preventing and lowering your risk for heart disease. Consult with doctors and other members of your health team to see what their recommendations are for managing existing medical conditions. They may prescribe medicines to help manage your blood pressure, cholesterol or blood sugar, along with lifestyle changes to help.

Work with a team. It's important to work with your health care team if any of your conditions change, if your family has a history of any of these medical conditions or if you suspect you might be at risk for them. Consult your doctor if you’ve already had a heart attack or if you struggle with mental-health issues. Create a treatment plan that works for you and discuss it regularly, making adjustments when necessary. Don’t stop taking any prescribed medicines before talking to your doctor.

Prioritizing heart health is critical for preventing and lowering your risk for heart disease. For more tips to boost heart health, visit cdc.gov/heartdisease/prevention.htm.

Cold weather poses increased risks for heart attacks and strokes

Centers for Disease Control illustration

By CHI Saint Joseph Health

As the temperatures drop and winter weather approaches, CHI Saint Joseph Health urges Kentuckians to be proactive in knowing the adverse effects winter weather can have on their heart health.

“Regardless of background, age or gender, it is important to be aware of the cold and how it could impact your heart health,” said Dr. Sharat Koul, an interventional cardiologist with CHI Saint Joseph Medical Group. “Cold temperatures put extra stress on your heart by pushing your blood pressure up, which can precipitate a range of cardiovascular events.”

When your body is experiencing extreme cold temperatures, it can add a burden to your cardiovascular system. The cold causes your heart to work overtime to keep you warm and constricts your arteries, limiting the blood flow to your heart. This heightened workload can elevate heart rate and blood pressure, potentially leading to a heart attack or stroke.

While maintaining regular physical activity is critical for heart health, exercise caution when engaging in outdoor activities during the winter. 

Whether you’re shoveling snow in the driveway or running through the neighborhood, be mindful that physical exertion in colder temperatures can cause additional strain on your heart. 

Particularly with activities like snow removal, it is important to steer clear of overexertion and refrain from pushing yourself beyond your limits. Snow removal is a very strenuous activity, and your heart is already working overtime to combat the cold.

People with heart conditions such as arrhythmia or high blood pressure, or those with risk factors such as being overweight, smoking or having diabetes, should be particularly vigilant during winter as they are at a greater risk of heart issues during colder temperatures.

To protect your heart during the winter months, CHI health-care providers advise dressing in layers when venturing outdoors, limiting exposure to the cold weather, staying informed of the extreme temperature forecasts, and remaining dry during freezing rain and snow. 

Additionally, keep up with your heart health year-round by staying hydrated, eating a balanced diet, getting plenty of sleep, and exercising at least 150 minutes weekly. These proactive measures can collectively help safeguard your heart during winter months.

Recognizing the warning signs of a heart attack is also crucial for timely intervention.

Symptoms include chest pain or discomfort; pain in the jaw, neck or back; shortness of breath; dizziness; and nausea or vomiting. Women may also experience upper abdomen pain, indigestion and faintness. 

If you suspect someone is having a heart attack, dial 911 immediately and, if able to, administer hands-only CPR. If you are not already CPR-certified, acquire the necessary skills at https://cpr.heart.org/en/.

Identifying a stroke is equally critical, and the acronym FAST helps:

• F: face drooping
• A: arm weakness
• S: speech difficulty
• T: time to call 911

Every minute counts when someone is experiencing a stroke, so it is paramount to act fast.

Heart expert: Ibogaine to treat opioid addiction is safe only in hospitals; others say risk can be mitigated; 'rough' plan outlined

By Melissa Patrick
Kentucky Health News

In a session focused on challenges of getting the psychedelic drug ibogaine approved by the Food and Drug Administration for treating addiction with help of the state's opioid settlement funds, a cardiologist said it couldn't be done in a reasonable time and the drug is unsafe.

"My opinion is that ibogaine is not safe, the efficacy is unproven, it's unlikely to be approved by the FDA in a reasonable time period, and the cost to Kentucky would be unsupportable," said Dr. Mark Haigney, a board-certified cardiologist and electrophysiologist, and an attending physician at the Walter Reed National Military Medical Center.

Haigney was invited to a special Kentucky Opioid Abatement Advisory Commission meeting on Oct. 17 by commission member Patricia Freeman, a pharmacy professor at the University of Kentucky. The meeting also saw the head of the commission discuss a "rough" plan for funding ibogaine research.

Patricia Freeman
(Photos by Melissa Patrick)

After two hearings that focused on ibogaine development and personal testimonies favoring the drug, she asked to invite experts in regulatory drug development to testify about the challenges of navigating ibogaine through the FDA process, given its potential for damage to the heart and its current classification as a Schedule I drug with no medical use.

Freeman said she had concerns that people at one hearing thought there would be quick access to ibogaine with the $42 million investment and felt compelled to ensure they understand that this would be a multi-year endeavor with no guarantee of success. 

"I felt this was important as it would help make sure that at large, our commission would be as fully informed as possible prior to making a decision on proposed ibogaine funding," Freeman said. 

The proposal comes from Bryan Hubbard, chair and executive director of the commission, which operates in the office of Attorney General Daniel Cameron, the Republican nominee for governor. Ibogaine is illegal everywhere but Mexico and New Zealand, but has been anecdotally reported to stop drug-withdrawal symptoms. 

Haigney, who described himself as an "expert in drug-induced sudden death and drug-induced loss of consciousness," said that while he recognized the attractiveness of a single-dose drug like ibogaine to treat opioid-use disorder, such a drug must be "safe in the immediate term, effective in the long term, FDA-approved, and affordable for the huge number of Kentuckians with opioid-use disorder." 

He said ibogaine isn't safe because it is known to cause cardiac arrhythmias and sudden death. In detail, he explained that this happens because ibogaine causes a "prolonged QT interval," which is one of the measurements taken by a standard electrocardiogram. 

A prolonged QT interval occurs when the heart muscle takes longer to contract and relax than usual, which can affect heart rhythms and lead to sudden cardiac arrest. 

Haigney said the FDA requires all drugs to undergo cardiac testing and that "the finding of QT interval prolongation is the most common reason for removal of a drug from further development." 

He added that a prolonged QT interval can happen when a drug blocks the cardiac potassium channels to the heart and that ibogaine is a "potent blocker" of this channel, even with normal therapeutic doses. 

"So this means that most if not all subjects would experience some significant degree of blocking the channel," he said. "And this is a very poor prognostic finding for a drug."

Haigney pointed to a study of 14 hospitalized patients who received a "relatively low dose" of ibogaine. The average increase in QT interval was 95 milliseconds. He said the FDA's published guidelines say it is concerned when a drug prolongs the QT interval by 5 milliseconds or more. 

"I've never seen a drug prolong the QT interval so profoundly," he said, adding later, "This degree of QT prolongation would be expected, associated with increased risk of fatal events."

He then asked rhetorically, "Can this drug be given safely?" His answer, "Yes, in the hospital. We do a lot of dangerous things in the hospital with a lot of technology," adding that this would be "an incredibly resource-demanding" drug to administer. 

"The likelihood that this drug with this safety profile will be approved by the FDA in less than 10 years, in my opinion, is remote and the effort will require at least a billion dollars," Haigney said. "The administration of ibogaine would strain hospital resources at a time when bed shortages are severe. This is a treatment for wealthy individuals who can pay for hospitalization with intensive monitoring," so it would not help most Kentuckians "who struggle with opioid dependence." 

Freeman also invited Robert Walsh, recently retired from working in the National Institute on Drug Abuse for 36 years, where he headed NIDA's Regulatory Affairs Branch. 

Walsh spoke to the regulatory challenges of ibogaine development, including cardiac safety, ensuring enough supply of a plant-based drug from another country, creating a plant-based drug with the same dose in each pill, and the challenges of working with a Schedule I drug in laboratories and clinical settings.

Dr. Sidney Peykar, a cardiac electrophysiologist and medical director at the Cardiac Arrhythmia Institute, said the drug could be given safely in a hospital setting and said he has expanded the protocol for how to administer ibogaine safely at the Beyond Ibogaine Treatment Center in Cancun, Mexico.

"Most if not all of these deaths could be mitigated or completely prevented through safety protocols," he said.

Dr. Javier Muniz, the FDA's supervisory general-health scientist for controlled-substances initiatives, was asked if FDA would definitely not approve ibogaine. He said that without all of the information in front of him, "I have no idea." 

Asked by Freeman if a 95-millisecond QT prolongation would disqualify ibogaine from being approved, he said it's important to remember that when the FDA is considering the approval of a drug, the agency looks at a drug holistically and considers both risks and benefits. 

Bryan Hubbard, right, and
Carlos Cameron, commission
member. 

Hubbard was asked after the meeting if any speaker had caused him to change his mind about his ibogaine plan. He said, "Dr. Haigney was brought in here to oppose this initiative and he articulated all of the talking points that the opponents of this initiative have already parlayed at public remarks. So there was nothing that was either surprising, nor persuasive about his remarks, and insofar as what he has articulated, are already widely publicly disseminated talking points of opposition."

He said Haigney was "thoroughly debunked [by] individuals who serve, respectively, on an FDA advisory board for psychopharmacology, as well as the science journal for the FDA's research arm related to controlled substances."

At the end of the meeting, Hubbard gave the commission a "very rough draft" of a plan with a list of requirements that would have to be met before the commission would commit $42 million to the project. He did not release the plan, but told Kentucky Health News after the meeting that it contains these points:

• "Viable research proposals from qualified research entities" that will match the state's $42 million
• The state would have ownership of any patentable intellectual property that is generated
• Clinical trials would be held in the West End of Louisville and in Wast Kentucky, "in a way that ensures social, racial, and economic equity of access to the treatment,"
• An approved drug-investigation application from the FDA "with secured clinical-trial sites and a diverse group of qualified clinical-trial participants before the first dollar is ever matched by the commission," 

"This will have to be a viable, go project before any commission resources are put on the table," Hubbard said,. Nothing like this has ever been done. So all of this is breaking ground." He cited "the competing interests, the areas of concern, the nature of this money, the necessity of protecting it, the necessity of making sure that the Commonwealth of Kentucky has a leadership position that is protected and recognized, and consideration of risk that we are taking by making this bet."

When it comes time for the commission to vote, he said, "Theoretically, the vote will be to legally authorize a $42 million match from the commission for our clinical research team that is ready to conduct clinical trials with ibogaine in Kentucky."

Hubbard said it is imperative that no vote be taken until Dr. Nolan Williams' peer-reviewed research of veterans who have suffered from traumatic brain injury and received ibogaine is published and they hear from him about his findings. Williams is an associate professor at Stanford University.

At the commission's first public hearing, Williams said he had let other professionals look at the data from his study and they said "the findings are shocking and that they've never seen a drug do this before." 

Before the eight guests spoke, Hubbard took about five minutes to address how he and the commission came to explore ibogaine and its potential therapeutic uses. He said as far back as 2018, he became aware of emerging science on therapeutic psychedelics and an author who at the time wrote about the topic and led him to other sources of information. Her newsletter The Journey is published on Substack. She wrote under the pen name of Julia Blum now uses the name Julia Christina.

Hubbard was responding to an Oct. 9 Daily Beast story, excerpted in Kentucky Health News, which reported that about the time Cameron implicitly endorsed his plan at a public event, a major national political contributor increased its investment in ibogaine research and later gave Cameron's campaign a political boost. He is running against Democratic Gov. Andy Beshear, who has objected to Hubbard's ibogaine plan.

Hubbard said, "It's important to set the record straight in full public view, lest the fictitious narrative of a smoke-and-mirror smear job generated by a third-rate, agenda-driven political tabloid prevail in the public arena against the integrity and sincerity of all who have offered their time, expertise and visceral lived experiences for all the world to see on behalf of all Kentuckians."

The commission's next regular business meeting is scheduled for 1 p.m. Nov. 14 at 1024 Capital Center Dr., Suite 200, Frankfort.

The heat is on; here's how to keep your heart healthy in summer

By Dr. Vincent Sorrell

Chief of cardiology, UK HealthCare

Memorial Day marks the unofficial start to summer. From outdoor barbecues to lounging by the pool, summertime means more time spent outdoors with friends and family. But fun in the sun comes with risks.

Humans regulate heat through blood flow. A healthy heart dissipates heat by pushing blood toward the skin. We also shed heat through sweat. People with pre-existing heart conditions are especially at risk, as heat can put extra stress on the heart. According to the Centers for Disease Control and Prevention, more than 600 people die every year from preventable, heat-related illnesses. More than 65,000 are treated in the emergency room for heat stroke, heat exhaustion and dehydration.

It’s important to recognize the signs of heat exhaustion and heat stroke and what to do is someone is in danger. With heat exhaustion, look for signs such as heavy sweating, paleness, muscle cramps, fatigue, and dizziness or fainting. It can be treated by moving the person indoors and cooling them off with a cool cloth. If they don’t improve in an hour, seek medical help.

Heat stroke is more severe. Symptoms include high body temperature (above 103º F), skin that’s red and hot but not sweaty, rapid pulse, throbbing headache, and dizziness and confusion. Heat stroke is a medical emergency — call 911 right away if you see someone in distress.

Dehydration can begin within just a few hours of the onset of extreme heat. Signs of dehydration include fatigue, headache, muscle cramps, dizziness and dry mouth. Dehydration causes the heart to pump harder, which can put heart patients at further risk. Elderly patients in particular need to drink up, as they may not feel thirsty until they are dehydrated. Some patients may still not feel thirsty even after they become dehydrated.

Here are some ways you can stay safe in the sun:

Drink lots of water. Hydration helps the heart pump more easily and helps the muscles work more efficiently. The more you sweat, the more you need to replenish fluids. Skip the alcohol, coffee and tea as it can further dehydrate you. It’s important to keep drinking, even if you don’t feel thirsty.

Keep your cool. In excessively hot temperatures, stay indoors. If you must be outside, find a shady spot and use a fan or a damp towel to stay cool. At the peak of heat in the early afternoon, avoid being outside for prolonged periods of time. Wear loose, light-colored clothing as well as a hat.

Monitor medications. Due to the extra strain of heat, heart patients need to be diligent in keeping up their prescription regime.

Be smart when it comes to exercise. Exercise is important for long-term heart health. If you don’t have the option to take your work out indoors, stick to the early hours of the day. Take it easy — avoid excessive or intense effort in extreme heat.

UofL Health-Jewish Hospital team is second in U.S. to implant a new type of artificial heart; Indiana man 'doing well' after 5 days

The University of Louisville announced Wednesday that UofL Health-Jewish Hospital had implanted a new type of artificial heart in a Southern Indiana man, making it the second U.S. hospital to implant the French-made device.

Mark Slaughter, M.D. (University of Louisville photo)

The heart was implanted Aug. 20 by a surgical team led by Dr. Mark Slaughter, the lead cardiothoracic surgeon at the hospital and chair of cardiovascular and thoracic surgery in the U of L School of Medicine. "The recipient, whose identity is being withheld upon request . . . is doing well," a U of L news release said.

The Aeson heart "serves as a bridge to transplant for patients with end-stage biventricular heart failure – heart disease affecting both left and right sides of the heart – allowing more time for the patient to receive a permanent heart organ transplant," the release said. "The new device is designed to solve the limitations of left-ventricular assist devices, which pump blood in just one chamber, by pumping blood in both heart chambers."

It also has sensors that detect blood pressure and position and adapt blood output accordingly, and has an external power supply, the release said: "The device is medically approved in Europe, where approximately 20 devices have been implanted. The first Aeson artificial heart in North America was implanted in July at Duke University," in a 39-year-old man from North Carolina.

The release noted past pioneering cardiac efforts at U of L and Jewish, which the university took over in 2019 "to preserve its storied organ-transplant program," notes Deborah Yetter of the Courier Journal. "On July 2, 2001, U of L cardiothoracic surgeon Laman Gray led the surgical team that implanted the first self-contained artificial heart in the United States at Jewish Hospital," the release said. "The AbioCor artificial heart was implanted into Robert Tools, who lived five months on the device. The UofL surgical team also performed the first heart transplant in Kentucky at Jewish Hospital in 1984."

UK, Ashland hospital celebrate partnership that's been in effect since April 1; joint venture now holds hospital's assets

King's Daughters Medical Center in Ashland has 465 beds. (2011 photo)

The University of Kentucky's health-care system and King’s Daughters Health System in Ashland are now partners, they announced Wednesday in Ashland, with Gov. Andy Beshear and his top health official on hand.

The partnership, which was announced as a "joint venture" in January, "went live April 1," UK HealthCare said in a press release. "Together we created a joint venture, which holds the assets, and we have a management agreement in place for UKHC to operate the KDHS health system," said Allison Perry, the university's deputy public-relations director.

Kristie Whitlatch, president and chief executive officer of King’s Daughters, said in January that her hospital would have a new governing body, with its current chairman but equal representation for UK, and that she would be on the management team at UK HealthCare. That is now in effect, Perry said.

The press release said the joint venture "creates new opportunities for both organizations to better serve patients throughout Kentucky, southern Ohio and West Virginia by expanding the delivery of specialty health care services throughout the region."

Secretary Eric Friedlander (Photo
by Matt Jones, Daily Independent)

The hospital already had a partnership with UK's Markey Cancer Center. After Our Lady of Bellefonte Hospital in nearby Russell closed in April 2020, Eric Friedlander, secretary of the state Cabinet for Health and Family Services, told Beshear's senior adviser, Rocky Adkins, that there was an opportunity to create a partnership, Adkins recalled at Wednesday's announcement, Aaron Snyder reports for the Ashland Daily Independent: "Adkins pointed out Friedlander in the crowd, who gave him a rousing applause."

Whitlatch said Wednesday, “This partnership is an excellent example of how health care providers can successfully collaborate to share resources to facilitate patient care, physician recruitment and improve essential services. We are already seeing benefits of the collaboration as we are able to invest in our team members and our facilities.”

The UK release said, "The partnership will allow for expanded offerings in other needed health-care services for the area, including pediatric cardiology. Last week, the two organizations collaborated on their first pediatric echocardiogram read, and in the near future the Kentucky Children’s Hospital team will be providing onsite pediatric cardiology services at King’s Daughters."

King’s Daughters has 465 beds at its hospital in Ashland and 10 at King’s Daughters Medical Center Ohio, in Portsmouth. The system also includes a long-term care facility, seven urgent-care centers, and 30 primary-care and 36 specialty-physician practices.

Saint Joseph Hospital listed as one of America's 250 best

Saint Joseph Hospital of Lexington announced Feb. 13 that it was the only facility in Kentucky to be included in the lost of "America’s 250 Best Hospitals" list by Healthgrades 2020 for the second consecutive year. "The distinction places Saint Joseph Hospital in the top 5 percent of nearly 4,500 hospitals assessed nationwide for its superior clinical performance as measured by Healthgrades, the leading resource that connects consumers, physicians and health systems," the hospital said in a news release.

“This is an honor for our highly experienced and dedicated physicians and employees, who make awards like this possible,” hospital President Bruce Tassin said. “We are committed to providing our patients with quality care and services, and to be recognized among top 5 percent of hospitals in the country to receive this award is exciting for us all. We cannot thank our team enough for their hard work and dedication. As Lexington’s first hospital since 1877, we are honored to continue serving this community more than a century later.”

From 2016 through 2018, Medicare patients in hospitals receiving the 250 Best Hospitals award averaged a 26.6 percent lower risk of dying than if they were treated in hospitals that did not receive the award, as measured across 19 conditions and procedures for which death is the outcome.

In addition to being named one of America’s 250 Best Hospitals, Saint Joseph also was ranked in the best 100 hospitals, the top 2 percent, for pulmonary and cardiac care. Its sister hospital, Saint Joseph East in Lexington, won a pulmonary care award for the last two years.

Baby born fine after mother monitors fetal heartbeat for doctors, to make sure he doesn't develop deadly disease in the womb

Tim and Greta Wright and family (UK photo by Hilary Brown)

By Hilary Brown
University of Kentucky

In 2018, Greta Wright and her husband Tim, of Lexington, received two surprises. The first surprise was finding out she was pregnant with their second child. The second, less joyous surprise was that Greta had a rare auto-immune disease called Sjorgren's Syndrome, and it could be fatal to her unborn son.

"Needless to say, we were frightened and felt completely defenseless," she said.

Sjorgren's Syndrome is an autoimmune disease that attacks the glands that make tears and saliva. It's a rare disease, affecting somewhere between five and 40 people out of 100,000. During pregnancy, certain proteins in the mother's blood can cross the placenta and damage certain organs in the fetus, and the heart is especially susceptible. In a condition known as fetal heart block, the baby's heartbeat can slow to a dangerously low rate or even stop completely.

"The fetal heart is at risk to be affected, especially the nerve wiring system, which might lead to fetal heart block," said Dr. Majd Makhoul, pediatric cardiologist in the Kentucky Children's Hospital Congenital Heart Clinic. "If this happens, the heart top and lower chambers don’t communicate with each other and that leads to decreased cardiac function and heart failure. This can lead to serious fetal complications and sometimes fetal death."

"One to three percent of women with Sjorgren's will have babies affected with this electrical condition," said Dr. Wendy Hansen, an obstetrician in UK HealthCare's Department of Maternal-Fetal Medicine and chair of the Department of Obstetrics and Gynecology. "Although Sjorgren’s was a new diagnosis, she could have had when she was pregnant with her first child, and she simply didn’t know."

In order to ensure a safe pregnancy, the UK fetal-cardiology team applied for a grant from the National Institutes of Health to participate in a large-scale national study of fetal heart block. The study seeks better understanding of its risks and causes, and to find medical interventions that can reverse fetal heart block if caught early enough.

Traditionally, pregnant women with Sjorgren's have weekly appointments with fetal cardiologists to assess for fetal heart block during the critical period of pregnancy. However, a complete fetal heart block can develop in as little as 24 hours, and there is no effective treatment for it. Some medications can reverse it, but only in the early stages.

So, Hansen had Greta use a listening device two to three times a day to monitor the fetal heartbeat. Using sound clips of both normal and abnormal heartbeat as reference, she sent recordings to both Makhoul and Hansen if she had questions about the heartbeat's regularity. Once, an irregular heartbeat concerned Makhoul enough that he had Greta to come to the hospital, where she was proactively treated as if the fetus was being affected by the syndrome. Less than 12 hours later, the heartbeat stabilized and stayed normal throughout the rest of the pregnancy.

"Greta would come into each visit with a list of questions and articles she had read, makes me smile when I think about it," said Hansen. "Her and Tim's openness, sense of humor, positivity and great communication were their defining qualities."

In April, Greta and Tim's son Asa was born healthy with no complications. Makhoul attributes Asa's strong start to his dedicated and conscientious parents.

"Greta and Tim made our job easy by asking the right questions from early on and being deeply engaged at every step of the process," said Makhoul. "They were appropriately concerned and anxious at times but approached the situation with the right attitude and maximized their chance of having a healthy baby by adhering to our recommendations to the letter."

"Doctors Makhoul and Hansen made what could have been a horrible experience a great one," said Greta. "We felt like we were part of the UK family. We also knew that we didn’t have to worry about two separate teams of doctors – the Maternal-Fetal Medicine and the Pediatric Congenital Heart Clinic­­ – communicating with each other as we saw it happening proactively every day."

Painkillers appear to increase risk of deaths other than overdoses, according to new study of Medicaid patients in Tennessee

"Accidental overdoses aren't the only deadly risk from using powerful prescription painkillers," The Associated Press reports. "The drugs may also contribute to heart-related deaths and other fatalities, new research suggests."

A study of of more than 45,000 Medicaid patients in Tennessee from 1999 to 2012 found that "those using opioid painkillers had a 64 percent higher risk of dying within six months of starting treatment compared to patients taking other prescription pain medicine," AP reports. "Unintentional overdoses accounted for about 18 percent of the deaths among opioid users, versus 8 percent of the other patients."

"As bad as people think the problem of opioid use is, it's probably worse," said Vanderbilt University professor Wayne Ray, the lead author of the study report. "They should be a last resort and particular care should be exercised for patients who are at cardiovascular risk."

The report in the Journal of the American Medical Association noted that opioids can slow breathing and worsen the disrupted breathing associated with sleep apnea, which could lead to irregular heartbeats, heart attacks or sudden death.

The patients in the study "were prescribed drugs for chronic pain not caused by cancer but from other ailments including persistent backaches and arthritis," AP reports. "Half received long-acting opioids including controlled-release oxycodone, methadone and fentanyl skin patches. . . . There were 185 deaths among opioid users, versus 87 among other patients. The researchers calculated that for every 145 patients on an opioid drug, there was one excess death versus deaths among those on other painkillers. The two groups were similar in age, medical conditions, risks for heart problems and other characteristics that could have contributed to the outcomes."

UK hospital, troubled by deaths in pediatric heart program, says it will partner with Cincinnati Children's Hospital

The University of Kentucky hospital, which suspended its pediatric heart program three years ago after five of its patients died, has signed a letter of intent to form a partnership with Cincinnati Children's Hospital Medical Center for heart surgery on children.

"The collaboration will enable more Kentucky children to receive care closer to home, a UK press release said. It called Cincinnati Children's "one of the top three children's hospitals in the country and a top 10 pediatric heart care program." The release said most parents of children at UK who need heart surgery are going to Cincinnati Children's.

Details are still being finalized, but the plan calls for a heart surgeon to be jointly recruited and have a primary appointment at Cincinnati Children's but be based at Kentucky Children’s Hospital, a UK unit. "A director of the pediatric heart program will be recruited immediately to oversee the program and drive its development," the release said. "The program director position also will be based in Lexington and serve as program liaison for both sites. The director will be employed by UK HealthCare."

Pediatric heart surgery would resume at UK by late 2016 or early 2017. "Initially, more complex cases will be sent to Cincinnati Children's," the release said. "Over time, as the Lexington site program matures, more complex cases may be performed at UK."

Dr. Michael Karpf, UK HealthCare chief
(Herald-Leader photo by Pablo Alcala)

Dr. Michael Karpf, UK's executive vice president for health, said in the release, "When we voluntarily suspended Kentucky Children's pediatric cardiothoracic program in October 2012, we said we would only re-open the program when we were ready to provide the best care for our patients and their families.  We are confident that this collaborative arrangement meets that mark with the highest quality surgical and clinical care, education and research in pediatric cardiovascular services for patients of Kentucky and their families."

"The move drew immediate praise," Linda Blackford reports for the Lexington Herald-Leader.

Somerset physician Kevin Kavanagh, founder and chair of Health Watch USA, a medical watchdog group, told Blackford UK couldn't have chosen a better partner: "I think this can be viewed as trying to shore up a deficit, and expand and better serve patients."

Tabitha Rainey, whose child had heart surgery at UK but went elsewhere after complications, said the move should have been made long ago: "They could have saved a lot of lives."

"Rainey and other parents were infuriated by UK's initial refusal to discuss why the program was suspended or to release mortality data for the heart program," Blackford notes. "UK said releasing the information could hurt patient confidentiality, but Attorney General Jack Conway said UK had violated the Open Records Act, a decision UK appealed in circuit court." After CNN did a report on the program, UK released the mortality rate: It  increased from 5.2 percent in 2010 to 7.1 percent in 2012. "National mortality rates average 4 percent to 5.3 percent, according to the National Institutes of Health."

Know the signs of a heart attack and don't ignore or dismiss them; quick action can be the difference between life and death

Many people who have a heart attack initially ignore the symptoms or dismiss them. For the best chance of survival and preserving heart function, you should not ignore these symptoms, and should get help quickly.

Heart disease is the leading cause of death in the U.S. and Kentucky. Nationwide, it causes about one in four deaths. The age-adjusted death rate from heart disease in Kentucky is 208.2 per 100,000 per year, according to the federal Centers for Disease Control and Prevention.

Below are some questions and answers about the symptoms and treatment of heart attacks and narrowed aortic valves, as reported by Gina Kolata for the New York Times.

How do you know if you are having a heart attack? Most people feel pain, pressure or squeezing in their chest and about one-third of people have symptoms in addition to or instead of chest pain that include abdominal pain, heavy sweating, back pain, neck and jaw pain, nausea and vomiting, Kolata reports. WebMD adds pain that radiates down one arm, indigestion or a choking feeling, extreme weakness, anxiety or shortness of breath, and rapid or irregular heartbeats to the list.

How can you decide if symptoms other than chest pain are actually from a heart attack? If your symptoms come on suddenly, or if they worsen over a period of hours or days, call 911 and get to an emergency room. "The best time to treat a heart attack is within one to two hours of the first onset of symptoms," says WebMD. "Waiting longer increases the damage to your heart and reduces your chances of survival."

Do women have different symptoms than men? "Probably not," Dr. Mary Norine Walsh, vice president of the American College of Cardiology, told Kolata. Walsh noted that women, however, are more likely to delay seeking treatment and doctors are more likely to dismiss their symptoms, especially if the woman is younger.

The American Heart Association says women often attribute signs of a heart attack to the flu, acid reflux or the normal aging process, even though it is the number one killer of women. It also noted that symptoms in women can be subtler, like shortness of breath, upper back pressure that feels like squeezing, lightheadedness or actually fainting.

What should you do if you are having heart attack symptoms? Call 911 for an ambulance to take you to the emergency room immediately. Do not drive yourself and do not have a friend or family member drive you unless you have no other choice. Kolata notes that paramedics are trained to treat heart attacks and are less likely to get stuck in traffic.

How can you find out if your local hospital is able to treat heart attacks quickly? Don't waste time fighting with your paramedic when you are having a heart attack, they will know the best place to take you, Kolata writes.

That being said, some hospitals are faster than others in treating heart attacks, but the time to research this information is before you are in the throws of a heart attack, Kolata writes. To find out this information, she suggest you ask each hospital what its "door to balloon time" is, which will tell you how long it takes the hospital to open a blocked coronary artery with a balloon after you arrive at the emergency room. If they don't have this information, ask if they take certain steps to speed up treatment. For example ask: Do paramedics transmit a patient's electrocardiogram to the hospital en route?; Does the ER doctor read the EKG and send out a single call to summon the cardiology team?; And are the team members on call required to be within 30 minutes of the hospital?

What are the symptoms of a severely narrowed aortic valve? There are three classic symptoms of this disease of aging: shortness of breath, a feeling of heaviness and pain in the chest, and fainting, according to cardiologists. They also noted that these symptoms are often mistakenly attributed to the normal process of aging.

How can a doctor know if symptoms are caused by a narrowed aortic valve? The doctor will listen  for a heart murmur in the patient’s chest and can order an echocardiogram, which will reveal the narrowed artery and the extent of the damage.

Should everyone with a severely narrowed artery have it replaced? Not everyone should undergo treatment, Kolata reports, so ask your doctor if you are a good candidate. The latest treatment is a transcatheter aortic valve replacement, or TAVR, which allows doctors to replace valves without doing open-heart surgery. High risk patients who would have been considered at too great a risk of dying from open-heart surgery have a chance to have a valve replacement, but sometimes elderly patients whose health is compromised are not good candidates.

New cardiovascular inpatient unit opens at UK

UK HealthCare's new 64-bed Cardiovascular Inpatient Unit, one of the largest intensive-care units in the country, accepted its first patients Monday, says a University of Kentucky news release.

"This new unit doubles our capacity to treat Kentucky's sickest heart patients and brings the best technology medicine has to offer right to a Kentucky heart patient's backyard," UK President Eli Capilouto said in the release.

The new unit, located on the 8th floor of the Albert B. Chandler Hospital's new Pavilion A, has 32 intensive care beds and 32 progressive care beds.

Dr. Susan Smyth, medical director of the Gill Heart Institute, told UKNow that the unit "represents an unequaled opportunity to help staff provide patients with the highest standard of care in a technologically advanced healing environment."

One of the unique features of the CV Unit is that it has its own Central Monitoring Service station embedded on the floor, says the release.

"Even though the nursing staff is situated immediately outside a patient's room, they are often away from one patient while helping ambulate another," Smyth said in the release. "Having trained staff monitoring patients in such close proximity provides an extra layer of care."

The unit also has its own imaging suite for echocardiography. This not only minimizes patient transfers for testing, but will open up existing imaging areas for other inpatient and outpatient use, thereby reducing wait times. The Gill Heart Institute performs approximately 25,000 imaging studies each year, says the release.

Additionally, the floor is the first in Pavilion A to use new barcode technology for patient medication administration, which will minimize medication errors. It also offers interactive TVs in every room, with programming available specific to the patient and their heart health needs.

"Patients will be able to access videos describing their condition, their treatment, and education about self-care and healthy lifestyles," Dr. Michael Sekela, surgical director of the Gill Heart Institute, told UKNow. "Once they are home, they will be able to access the same information from their home computer, which should help minimize post-discharge confusion and the readmissions that often result from that."

The unit will continue its longtime policy to ambulate every cardiac patient at least once a day, regardless of their diagnosis or treatment, says the release. This is accomplished by a group of physical therapy students and volunteers caled CATWalkers.

"This new unit brings the highest level of cardiac care available anywhere on one floor, in an environment that's efficient for our staff and conducive to healing for our patients."Dr. Michael Karpf, UK executive vice president for health affairs, said in the release."Combined with the Gill Affiliate Network partnerships, this means patients get the level of care they need as close to home as possible."

St. Joseph Hospital in London will pay U.S. $16.5 million to settle malpractice suits involving unnecessary heart procedures

St. Joseph Hospital in London will pay $16.5 million to the federal government to settle charges that it got money from Medicare and the federal-state Medicaid program for unnecessary heart procedures, according to a document released Tuesday. The schemes and subsequent fines the hospital now faces may cause even more financial problems for KentuckyOne Health, Andrew Wolfson writes for The Courier-Journal.

Almost 400 former patients filed lawsuits, claiming cardiologists at the hospital performed "unnecessary, risky and often painful heart procedures to unjustly enrich themselves," Wolfson reports. According to the claims, two patients died and some will have to take blood-thinning medications for the rest of their lives, leaving them vulnerable to possibly fatal complications.

Several doctors at the hospital conducted unnecessary, invasive procedures such as heart stents and catheterizations on Medicare and Medicaid patients between 2008 and 2011, the government claimed; hospitals usually get $10,000 to $15,000 for each procedure, Wolfson notes.

"We all rely on health care providers to make treatment decisions based on clinical, not financial considerations," U.S. Attorney Kerry Harvey said in a news release. "The conduct alleged in this case violates that fundamental trust and squanders scarce public resources set aside for legitimate health care needs."

According to Harvey's office, the investigation continues because various doctors were involved, and their crimes are not absolved through the fine, Bill Estep reports for the Lexington Herald-Leader. For example, Dr. Sandesh R. Patil "pleaded guilty last year to lying about the severity of a patient's condition to make sure the government would pay for heart procedures," Estep reports. "Patil was sentenced to 30 months in prison."

Although St. Joseph London agreed to pay the $16.5 million, it did not admit violating the law, a common provison in such cases.. The hospital said it agreed to pay the penalty to avoid further expenses, "'uncertainty of prolonged litigation, and to allow the hospital to move forward.' It said the allegations arose in 'past relationships with some cardiologists who no longer practice at the hospital'," Wolfson reports.

St. Joseph President Greg Gerard said, "We are committed to providing the communities we serve with safe, high quality health care performed with the highest of integrity."

Three Central Baptist Hospital cardiologists in Lexington—Drs. Michael R. Jones, Paul W. Hollingsworth and Michael Rukavina—played a key role in discovering St. Joseph-London's malpractice, Estep reports. When they noticed that some patients they treated had been subjected to unnecessary procedures at London, they sued in 2011. "One patient who came to the Lexington practice had undergone 17 heart catheterizations—performed mostly by Patil—in London in four years, none of them necessary, according to the report," Estep writes. The three cardiologists will get $2,458,810 of the $16.5 million settlement, according to Harvey's office.

Although St. Joseph-London is finished with the civil portion of the case, the federal government will continue trying to get money from the doctors and clinics identified in the lawsuit, Harvey said. "This result would not be possible without the commitment of private citizens exposing this type of egregious fraud," said Perry K. Turner, special agent in charge of the FBI in Kentucky.

UK's Gill Heart Institute joins Appalachian Regional Healthcare to advance specialty heart care in Eastern Kentucky

Appalachian Regional Healthcare, the Appalachian Heart Center and UK HealthCare’s Gill Heart Institute announced a new collaboration to deliver cardiovascular care to Eastern Kentuckians, which will extend the UK's sub-specialty care footprint and increase access to cardiovascular expertise in the area.

Cardiologists Dr. Vidya Yalamanchi, Dr. Rao Podapati and Dr. Srini R. Appakondu from Hazard's Appalachian Heart Center will team up with UK to provide advanced treatment options not before available in the eastern part of the state.

“We look forward to the opportunity to work closely with the physicians and health care providers at Gill Heart Institute to enhance cardiology services to patients in Eastern Kentucky,” said Dr. Yalamanchi. “This partnership is an example of teamwork that emphasizes a commitment to providing exemplary patient care.”

In addition to the combined efforts in Hazard, UK and ARH have also agreed to jointly administer and manage cardiovascular services at ARH hospitals in Harlan, Whitesburg, McDowell, Hyden and Williamson, W.Va.

 “The goal of this collaboration is to expand the scope of cardiology services provided within our community,” said Joe Grossman, president of ARH. “By providing a range of comprehensive cardiology services, including inpatient and outpatient services to residents of Eastern Kentucky, we hope to improve lives in a region where patients suffer from some of the highest rates of mortality in the nation from heart disease and stroke.”

UK officials have said their hospital must expand its geographical reach to ensure access to quality care for Kentuckians. This collaboration represents a step towards achieving both this goal and the goal of being the hospital destination for sub-specialty care in the state and region.

“This alliance further expands the UK HealthCare mission to improve access to quality health care delivery for all Kentuckians in a cost effective and responsible manner,” Dr. Michael Karpf, UK executive vice president of health affairs, said in the release. “But the real benefit for many patients and their loved ones will be the ability to stay close to home for complex cardiology care.”

U.S. News gives Kosair Children's Hospital a national ranking; 11 other Kentucky hospitals make 'high-performing' list

Each year, U.S. News and World Report publishes its "Best Hospitals" guide for people seeking a high level of specialty care. The only Kentucky hospital to be nationally ranked in the report for 2014 is Kosair Children's Hospital in Louisville. It received national rank in these areas of specialty care: heart, lung, neurology, cancer, orthopedics and urology.

While no Kentucky hospitals were nationally ranked in adult specialty categories, 11 Kentucky hospitals made the cut for meeting standards of strong performance within the state:
     1. St. Elizabeth Edgewood - 11 high-performing specialties
     2. Baptist Health Louisville - 10 high-performing specialties
     2. University of Kentucky Albert B. Chandler Hospital - 10
         high-performing specialities
     4. Baptist Health Lexington - 9 high-performing specialties
     5. Jewish Hospital in Louisville - 7 high-performing specialties
     6. Norton Hospital in Louisville  - 5 high-performing specialties
     7. University of Louisville Hospital - 2 high-performing specialties
     8. King’s Daughters Medical Center in Ashland - 1 high-performing specialty
     8. St. Elizabeth Florence - 1 high-performing specialty
     8. St. Elizabeth Fort Thomas- 1 high- performing specialty
     8. St. Joseph East- 1 high-performing specialty

To read more about specialty rankings for each hospital, click here for an article in The Lane Report or here for the U.S. News report.

Chief of cardiothoracic surgery and pediatric heart program at UK, suspended from surgeries, takes job in Florida

Dr. Mark Plunkett, the chief University of Kentucky cardiothoracic surgeon whose surgery program was suspended last year for unspecified reasons, has accepted a new job a the University of Florida.

The internal review of UK HealthCare's pediatric cardiothoractic program is ongoing and should be completed in the next few weeks, Michael Karpf, UK's executive vice president for health affairs, told Linda Blackford of the Lexington Herald-Leader.

In December, Brenna Angel, reporter for university radio station WUKY, identified Plunkett as the surgeon at the center of the program review. At the time, Plunkett was on a leave of absence but remained on staff with a $700,000 salary, Angel reported. WUKY requested data under the Kentucky Open Records Act about Plunkett's most recent surgery and his patient mortality rate, but UK denied such requests. Attorney General Jack Conway ruled that UK must release the mortality rates and other data, but UK Has appealed to Fayette Circuit Court, citing privacy rules in the federal Health Insurance Portability and Accountability Act, even though Conway said HIPAA doesn't preempt the Open Records Act, as Angel reported. Angel has since left the station for Lexington city government but the station and the Herald-Leader are defending the appeal.

In addition to being chief of UK's Division of Cardiothoracic Surgery, Plunkett was director of its pediatric cardiac program and a co-director of UK's Gill Heart Institute, says his UK biography. He came to UK in 2007 from the UCLA medical center, where he worked with Karpf. His resignation is effective Aug. 14, UK officials told Blackford.

UK Board of Trustees OKs $31 million plan to outfit another floor of new hospital with eye toward federal certification for heart work

The University of Kentucky Board of Trustees has given UK HealthCare the green light for its $31 million plan to outfit the eighth floor of Pavilion A at UK Chandler Hospital over the next few months to make room for a growing cardiovascular program and to clear the way for a federal "Center of Excellence" certification.

After the project is complete, the floor will hold 64 beds, including 24 intensive-care beds for the cardiovascular program that offers heart transplantation, artificial hearts and ventricular devices, reflecting UK's focus on receiving the federal certification.

In the near future, such a designation will be necessary to get enough referrals from doctors and smaller hospitals to maintain important services, including cardiovascular services, and to guarantee that Kentuckians can get the care they need inside the state, Dr. Michael Karpf, executive vice president for health affairs, said in an interview with Kentucky Health News this spring.

Karpf and other UK HealthCare officials are also recommending a $30 million cost-reduction program for their system because Medicare and Medicaid reimbursements are expected to decline as competition stiffens over the next few years, reports Linda Blackford of the Lexington Herald-Leader.

In response to these forces, UK has a goal to secure half the available business from out-of-state competitive areas over the next 10 years to remain viable in a highly competitive market. And, focusing on complex care should drive revenue for the hospital because UK makes money on the complex stuff, Karpf told KHN.

Read more here: http://www.kentucky.com/2013/06/10/2673382/uk-healthcare-using-30-million.html#storylink=cpy

The $592 million, 12-floor patient tower has remained half-empty since 2010, and when the estimated $530 million project to fully occupy the tower is added to the initial cost of constructing Pavilion A, the total price tag will top $1 billion over 20 years, reports Blackford.

The overall construction and expansion is expected to support patient care for the next 100 years, says a recent UK press release. Once it's fully occupied, the the 1.2 million-square-foot facility will include 512 private patient rooms.

Read more here: http://www.kentucky.com/2013/06/10/2673382/uk-healthcare-using-30-million.html#storylink=cp