UK, Central Baptist get millions in federal incentives to use electronic health records

University of Kentucky HealthCare and Central Baptist Hospital in Lexington are the first hospital systems in the United States to receive funds from the Centers for Medicare and Medicaid Services' electronic health records incentive program.

UK received $2.8 million, Central Baptist $1.3 million, according to a press release from the state Cabinet for Health and Family Services. Kentucky is one of only four states to begin receiving the federal dollars, which are meant to encourage hospitals and physicians to transition to computerized patient records. The funds are part of the 2009 economic-stimulus legislation.

Another 25 Kentucky providers have started the application process. In the next four years, Kentucky hospitals should receive more than $100 million in incentive funds, the release states. "Electronic records can do so much to improve efficiency, reduce medical error and, ultimately, change the face of the American health care system," Gov. Steve Beshear said.

Kentucky is among the first to receive the funding because its providers were "farthest along in the process in moving down the path to adopting these types of systems," said Beth Fisher, spokeswoman for the Cabinet for Health and Family Services. "This means we're pretty far ahead than a lot of other states." (Read more from Business First; for the original press release, go here.)

Statewide smoking ban proposed in legislature

State Rep. Susan Westrom of Lexington, left, announced her intent to file a bill today that calls for a statewide smoking ban, which would prohibit cigarette use in workplaces, restaurants, bars and private clubs.

The Courier-Journal's Laura Ungar reports the bill is supported by the Smoke Free Kentucky coalition. "We feel like the time has come to make sure everyone across the state is protected," said Amy Barkley, a director for the Campaign for Tobacco-Free Kids. "There's absolutely no reason for anyone to be exposed to secondhand smoke."

Tobacco-Free Kids advocates released numbers from a poll Wednesday showing 59 percent of Kentucky voters support would support a comprehensive smoking ban, which prohibits cigarette use from the workplace, restaurants and bars. Of those, 44 percent strongly favor the law, a press release reads. The survey also found 76 percent of Kentucky voters believe exposure to secondhand smoke is harmful.

Dr. Terry Pechacek, associate director for science with the Centers for Disease Control's Office on Smoking and Health, said that is definitely the case, saying there is "no safe level of exposure" to cigarette smoke. He supports any move that would ban the substance. "This is not anti-smoker," he said. "This is protecting those people through no fault of their own who are being exposed to a deadly set of toxic compounds that come from the end of a cigarette."

"If (smoking) was not a personal behavior, it would have been something that would have been addressed long ago," he added, likening the harmful effects of smoke to "lead in gasoline." "As soon as we recognized the lead was getting into the environment and harming children, it was rapidly removed."

Statewide, 28 communities have passed smoking ban ordinances, 26 of which have already taken effect, Ungar reports. Lexington implemented its ban in 2004. In 2007, Louisville enacted a ban prohibiting smoking in public buildings. Nationwide, 29 states and Washington, D.C. have passed comprehensive smoking bans. Four other states have smoke-free laws that include restaurants but allow tobacco use in bars.

In Kentucky, CDC numbers show 25.6 percent of adults smoke. It ties with West Virginia for having the country's highest percentage of adult smokers.

Dr. Ellen Hahn, who directs the Tobacco Policy Research Program and has been instrumental in getting smoking bans passed in Kentucky communities, said she does not believe the statewide ban will pass this year "because such proposals typically don't," she told Ungar. State Rep. Tom Burch of Louisville, who chairs the House Committee on Health and Welfare, said he plans to sign on as a sponsor of the legislation. He told Kentucky Health News the issue will be given a "favorable hearing" in his committee. (Read more)

For useful information, including maps, regarding smoking ban legislation nationwide, go here.

Bill would require background checks for all nursing home staff

A bill filed Tuesday would require that all nursing home staff, not just employees in direct contact with residents, be subject to background checks.

State Sen. Tom Buford, R-Nicholasville, right, sponsored the legislation, saying the move would not cost the state any money, the Lexington Herald-Leader's Valarie Honeycutt Spears reports.

The bill would affect staff such as custodians, maintenance employees and food- service workers. Workers who has been convicted of a misdemeanor, if it is not related to abuse, neglect or exploitation of an adult, would still be eligible for hire. (Read more)

Kentucky is one of 11 states with federal incentives for using electronic records in Medicaid

Medicare is now offering incentives to hospitals and eligible health-care professionals for the use of electronic health records, but Medicaid is doing so in only 11 states. Kentucky is one of them.

Dr. Donald Berwick, administrator of the Centers for Medicare and Medicaid Services, said the change from paper records will be challenging, but CMS and the Office of the National Coordinator for Health Information Technology "have taken steps to ease the transition."  

The federal programs encourage physicians and hospitals to transition to computerized patient records, because they are believed to improve the quality of health care and patient outcomes. Through Medicare, Mosquera reports physicians can get up to $44,000 over five years by participating. For Medicaid, eligible professionals can receive as much as $63,750 over six years. Under both programs, participating hospitals may profit by millions of dollars, Government Health IT's Mary Mosquera reports.

As renowned minister fights two tough diseases, journalist chronicles his journey

A well-known Kentucky pastor is nearing the end of his battle with Alzheimer's and Parkinson's. Laura Ungar, health writer for The Courier-Journal, has been chronicling Charles Music's fight since 2005.

In her latest installment, Ungar speaks to Music's wife of 51 years, Jane, who remains his loving caregiver at his Texas nursing home. Jane recently returned from a trip to Central Asia to visit her daughter, "a part of a life course that Jane, 73, must now chart for herself ... She's focusing on her roles as mother, grandmother and friend so she doesn't lose herself as she loses Charles," Ungar writes.

During his lifetime, Music pastored at Methodist churches in many rural Kentucky towns before settling in Louisville. Ungar's piece provides a good example of how to write sensitively and informatively about life-ending conditions. (Read more)

Republican lawmaker, a nurse and former hospital boss, offers bills to help children's health, gets criticism from tea-party types

By Tara Kaprowy
Kentucky Health News

A Republican legislator from Northern Kentucky is proposing several bills that she says would improve children's health, defending herself from criticism by conservative bloggers who say she would extend government's boundaries too far, and picking up support from a conservative newspaper columnist.

Rep. Addia Wuchner of Florence, left, a registered nurse and former hospital administrator, wants to require 30 minutes of exercise a day in elementary schools by 2013 and have entrance forms for kindergarten and sixth-grade students include the students' body mass index, roughly a measurement of weight-to-height ratio.

Other proposals in what Wuchner calls her Kentucky Kids First package would form a childhood obesity task force and require the Cabinet for Health and Family Services to create nutritional and physical activity guidelines for licensed child care centers.

Wuchner has caught flak from some Republicans, including lawyer-blogger Marcus Carey, who asked on his blog, The Bluegrass Bulletin: “Does Rep. Wuchner realize that she is violating about 15 fundamental Republican precepts against helping public schools or children in poverty, citing scientific facts, interfering with parental rights and promoting socialistic notions of healthy behavior?”

Tom Wurtz was likewise critical in a post on the Northern Kentucky Tea Party website, titled “Rep. Wuchner: Leave Our Kids’ Big Macs Alone!”

In an interview with Kentucky Health News, Wuchner said her critics are off base. “I don’t believe in a nanny state or a fat police and that’s not what this bill is about,” she said. Wuchner said the school forms already list height and weight, and the BMIs would provide data that could easily be compared over time and among schools. “They could pull it by district or by county and know statistically are we improving or are we getting worse,” she said. That would allow creation of a map of child obesity like the one below for adult obesity, from http://www.kyhealthfacts.org/. (Click on image for larger version)

Wuchner's proposals are actually conservative, Louisville lawyer and Mitch McConnell biographer John David Dyche wrote in his column in The Courier-Journal on Jan. 4, the day the legislative session began.

“These measures would save the state money in the long run,” he wrote. “Yet some Northern Kentuckians who should be Wuchner’s allies are reacting with short-sighted ideological horror. . . . These critics evidently prefer that Kentucky continue suffering childhood obesity’s enormous economic and human consequences, rather than having state government take sensible action on an issue so squarely within its 10th Amendment sphere.” (Read more)

Here are Wuchner's bills, as links:
BR 159, to enact 30 minutes of physical education for school children a day
BR 160, to enact inclusion of body mass indices on school physical examination forms
BR 197, relating to early education assessment and intervention
BR 310, to establish a Legislative Task Force on Childhood Obesity
BR 312, to educate parents and caregivers about pediatric abusive head trauma

Doctors wary of using social media for patient communication

Doctors are reluctant to communicate with patients via social networking sites like Facebook and Twitter, according to a story in The Cincinnati Enquirer. "You have to be very cautious, because once something's out there in the ether, it could go all sorts of places," Dr. Margaret LeMasters told the newspaper's Cliff Peale. "There's probably a way to do it, but you just have to be careful."

The health-care industry in general has been wary of using electronic communication between companies and consumers, Peale reports. Doctors, especially, prefer communication with patients either by phone call or face to face. The American Medical Association has released a new set of guidelines on use of social networks, most of which encourage caution. (Read more)

Health officials to immunize child-care workers for whooping cough, which is making a comeback

Amid a rash of whooping-cough cases, Northern Kentucky health officials will immunize child-care workers against the disease. The effort is to help stop the infection, also known as pertussis, from spreading, Peggy O'Farrell of The Kentucky Enquirer reports.

Northern Kentucky had 127 recorded cases of pertussis in 2010, way up from 38 in 2009, said Joyce Rice, an epidemiologist with the Northern Kentucky Health Department. Statewide in 2007, there were 47 cases; last year, there were 250.

About three-fourths of children nationwide are immunized against the disease, which requires receiving four shots between the ages of 8 weeks and 15 to 18 months. Kentucky does not require a whooping cough booster, but it does require one against tetanus and diphtheria for 11- and 12-year-olds. Health-care providers often use a vaccine that includes whooping cough. Though pertussis is often associated with children, health officials say adults likely need a whooping-cough booster as well.

Pertussis is characterized by violent, distinctive coughing that can lead to vomiting or a short loss of consciousness. (Read more)

Legislator wants ban on caffeinated energy drinks

Kentucky teenagers will have to be 18 in order to buy high-caffeine energy drinks if state Rep. Danny Ford, R-Mount Vernon, has his way.

The lawmaker, left, told The Associated Press he plans to have the General Assembly consider banning the sales of the drinks to anyone under 18 when it convenes today, Jan 4.

Ford's move comes after the U.S. Food and Drug Administration deemed alcoholic energy drinks an "unsafe food additive." The worry is the caffeine diminishes feelings of intoxication, increasing risks of alcohol poisoning. Ford said he feels nonalcoholic energy drinks can also be potentially risky to children's health.

Kentucky legislators have considered, but have not passed, a ban on caffeinated energy drinks. "I think if we had some of the information then that we have now that it would have passed," Ford said. The ban targets carbonated drinks with 71 milligrams of caffeine per 12-ounce serving containing taurine and glucuronolactone. (Read more)

Your blogger believes health coverage can change lives

Tara Kaprowy, the chief blogger for Kentucky Health News, is a freelance journalist living in Somerset. At the end of 2010, she left her post at The Sentinel-Echo in London, where, for five years, she was a general-assignment reporter covering health, schools, downtown revitalization and crime. She continues to write her weekly column, "A Canuck in Kantuck," for the thrice-weekly newspaper.

Kaprowy moved to Kentucky in 2004 from her native Winnipeg, Manitoba, where she worked as an assistant editor in food, travel and tourism magazines. She completed her master's degree in literature from American University in Washington, D.C., in 2001, before which she earned her bachelor's degree in English from the University of Winnipeg.

In 2010, she was one of 11 reporters nationwide who participated in the Bluecross/Blueshield Health Coverage Fellowship in Boston, with support from the Foundation for a Healthy Kentucky. Since, she has been deeply invested in health coverage and believes the news media have powerful roles to play in improving the health of Kentuckians.

Musical reminder fights bed sores in nursing homes

Ten Kentucky nursing homes are using music to cue health care workers when patients with bed sores need to be moved.

Laura Ungar of The Courier-Journal reports that a burst of music comes through the facilities' loudspeakers every two hours, prompting health workers to stop what they're doing and move patients unable to move themselves. Ambulatory patients also use the music as a reminder to change their positions.

The 10 participating nursing homes are owned by Signature HealthCare and are in Augusta, Bedford, Beattyville, Lexington, Louisville and Prestonsburg.

"Repositioning people is not something new; what's new is the prompt," said Pam Larimore-Skinner, director of nursing at Signature HealthCare of Trimble County. "I think it makes people more conscious of the two hours because time can get away from you."

The experiment is funded by a $300,000 grant given to the University of Cincinnati College of Nursing from the Robert Wood Johnson Foundation. The study is to analyze if the audio reminders can reduce the number of bed sores, which damage skin and can lead to serious infection. So far, nursing home employees have noted improvement. (Read more)

Conflicting health stories can cause confusion

Conflicting headlines involving the dos and don'ts for how to stay healthy were discussed by a panel in Louisville late last month, The Courier-Journal's Darla Carter reports.

"In January, I heard that if I eat fish, it's good for my heart because fish fat helps protect my heart," Dr. Alan Altman, right, a Colorado-based consultative gynecologist, said. "Oh my god, now it's November, and they tell me I'm going to get mercury poisoning if I eat a lot of fish."

Altman also discussed the differing views regarding drinking coffee; the conflicting opinions concerning hormone therapy for menopausal women; and the changing screening guidelines for prostate and breast cancers.

Experts said the public should read the latest health news with a degree of skepticism. "It's important not to get too upset or necessarily get swayed by individual reports," said Dr. Donald Miller, director of the University of Louisville's James Graham Brown Cancer Center.

Many health stories are based on studies published in scientific journals. But these studies can be biased or otherwise problematic, experts cautioned. Moreover, health stories in the news media don't always include enough information or can be prematurely conclusive. "The media, God bless them, treat each study as a completed puzzle, and that's where the confusion comes in," Altman said. (Read more)