Kentucky and Ohio are now exchanging prescription data, but system needs more use by health-care providers and police

Kentucky and Ohio are now automatically exchanging data on prescription drugs, with a new electronic network called the Prescription Monitoring Information Exchange. PMIX links the Kentucky All- Schedule Prescription Electronic Reporting (KASPER) system and the Ohio Automated Rx Reporting System (OARRS). Now perhaps all we need is a Big Old Automatic Terminal (BOAT) so Kasper can row it with the Ohio oars.

Kidding aside, "The announcement marks a highly anticipated milestone for prescription drug monitoring programs and ongoing work to fulfill a need to share data across state lines," Gov. Steve Beshear's office said in a press release. "Kentucky’s Cabinet for Health and Family Services oversees KASPER, which is considered a national model for prescription drug monitoring." The Ohio-Kentucky linkup is federally funded.

Authorized users in the two states can securely access prescription monitoring data from both systems. "A physician in Kentucky will be able to request a KASPER patient report and stipulate that they need Ohio data included on the report," the release says. "Doctor shoppers often seek controlled substances from multiple providers and cover increasingly large territories to obtain the drugs."

Kentucky and several other states allow a prescriber, dispenser, or law-enforcement officer from another state to register and get their prescription data, but "Due to the effort required to establish and maintain separate accounts with each state and review multiple reports and formats, only a limited number of practitioners and law enforcement officers have done so," the release says, then quotes KASPER coordinator Dave Hopkins: “We think the PMIX pilot will facilitate efforts to share prescription drug monitoring program data among all states.”

Louisville vascular surgeon provides 'hands on' support for troops

Dr. Andrea Yancey, a vascular surgeon from Louisville, has completed two weeks of volunteer service treating wounded American soldiers transported from Afghanistan and Iraq to the U.S. Army’s Landstuhl Regional Medical Center in Germany.

“I now have a better understanding and enhanced respect and appreciation for our military,” Yancey said in a press release from the Society for Vascular Surgery, which has provided continuous two-week rotations of vascular surgeons at LRMC for the past four years, the release said.

“The soldiers were young, polite, and grateful,” Yancey said. “Their mental and physical toughness and capacity for resilience were hard to comprehend. In spite of their injuries, they never complained or asked for pain medicine. They did not want to inconvenience anyone.”

Yancey is an assistant professor of surgery at the University of Louisville and a surgeon at the Robley Rex Veterans Affairs Medical Center in Louisville.

Kentuckians gather to support breastfeeding; part of world event

Kentuckians gathered in several places Saturday to show their support of breast feeding. Events were held in Ashland, Edgewood, Lexington, Louisville, Nicholasville, Owensboro and Paducah as a part of the Big Latch On, “a one-minute synchronized nursing event in multiple locations” sponsored by the La Leche League USA, Valarie Honeycutt Spears of the Lexington Herald-Leader reports. (H-L photo)

Shayna Chasteen of London told Spears she attended the Lexington event “to help make other mothers aware of the benefits of breast-feeding and to promote ‘normalizing breast-feeding in public.” Brion Barnhill, the only father who attended the Lexington event, told Spears, “Luckily my wife cares more about my baby’s health than what somebody else thinks.”

Kentucky law supports breast feeding, allowing mothers to breast-feed or express milk in any public or private location without it being considered public indecency or indecent exposure, Spears reports. “We stress breast-feeding as the gold standard in infant feeding, because of the nutritional and health advantages it provides,” Cabinet for Health and Family Services Secretary Janie Miller said in a statement. “Women have more success with breast-feeding when they receive consistent and accurate information and are supported by their health care providers, family and community.” (Read more)

The Big Latch On was part of the World Breastfeeding Week, Aug. 1-7. To learn more about the event or locate a La Leche League in your area, click here.

Parents should talk to kids about dangers of tanning beds

With teens expected to turn to tanning beds in the fall to keep their bronzy summer glow, parents are encouraged to talk about the dangers of "fake baking."

"Using tanning beds before age 30 increases a person's risk of melanoma, the deadliest form of skin cancer, by 75 percent, research shows," said Dennis Hughes, assistant professor of pediatrics at M.D. Anderson Children's Cancer Hospital in Houston. "So, it's important to talk to your kids about tanning beds just like you'd discuss smoking, sex, drugs and alcohol."

Research-reporting service Newswise says 35 percent of 17-year-old girls have used tanning beds. One study showed tanning beds are addictive, with 80 percent of college kids who habitually tan saying they could not stop. Access to the facilities is easy, with an analysis of 116 American cities showing that tanning salons outnumber Starbucks or McDonald's.

Parent should talk to their children before they start frequenting tanning facilities, Hughes said. Children should know tanning beds emit the same harmful ultraviolet light as the sun and, consequently, are not safe. Rather than making them look attractive, "explain that tanning will actually make them look worse" in the long run, Hughes advised. (Read more)

Public health champion bravely fights cancer, inspires many

Dr. Rice Leach, who has championed public health in Kentucky for decades, is inspiring many by the upbeat way he is battling cancer. "He has talked about it at Lexington-Fayette County Board of Health meetings and at Rotary Club meetings. His hat of choice, a gift his son John bought at Cracker Barrel, reads 'I'm having a no hair day,'" the Lexington Herald-Leader's Mary Meehan reports.

Leach was Kentucky's commissioner for public health from 1992 to 2004. He is now commissioner of Fayette County's health department, which has undergone a tumultuous transition after the very public replacement of Dr. Melinda Rowe. "I've really admired his dedication to the job," Geoff Reed, a senior adviser to Mayor Jim Gray, told Meehan. "He's just that kind of person who shows real passion in everything he does."

Leach, 71, has lymphoma, a cancer of the lymph nodes for which he is being treated with several rounds of chemotherapy and radiation. Meehan reports how Leach drew inspiration from the example set by his daughter, Mary Leach Whitcomb, who bravely fought breast cancer until her death in 2007. "If that 37-year-old can handle that big mess, you better believe I can handle this," he said. Meehan's piece provides a good example of how to write sensitively and informatively about a difficult subject. (Read more)

Health secretary tells legislators Medicaid budget has been balanced by moving all beneficiaries to managed care

The switch to managed care organizations has fixed Kentucky's Medicaid shortfall, with Janie Miller, secretary of health and family services, calling the budget "balanced." She said the projected savings from moving to managed care will take care of the $97 million funding gap caused by a lack of anticipated federal funding.

The Courier-Journal's Deborah Yetter notes that the shortfall was the most contentious issue for the legislature this year, with Gov. Steve Beshear wanting to plug the hole by moving to managed care and Senate Republicans wanting to make across-the-board budget cuts. After a special session, Beshear got his way and 560,000 Medicaid members are slated to move into managed-care organizations starting Oct. 1. Those in the Louisville region have been in one, Passport, for several years. Passport has a one-year contract with the state; Coventry Health Care Inc., Centene Corp. and WellCare Health Plans Inc. have three-year contracts. "They have every incentive to be successful," Miller said. "They are making a huge investment in this state."

Asked by skeptical legislators how the savings can be assured, Miller said they are guaranteed by the contracts. "To achieve savings, Medicaid will pay each company a fixed rate of about $345 per month per person. In turn, the company will be responsible for all costs of the person's health care," Yetter reports. "It's got a lot of potential," said state Rep. Jimmie Lee, D-Elizabethtown. "I have faith that if it's managed right, it could work." (Read more)

Rural folks have more chronic conditions and less access to health care, and Kentucky is one of the more rural states

Though rural Americans have more chronic health conditions than those who live in urban centers, they have poorer access to health care, a working paper released last month confirms. Health experts are pointing to technology, including telemedicine, to help bridge the gap.

The paper was compiled by the UnitedHealth Center for Health & Reform Modernization, an arm of the nation's largest health insurer. It found "there are only 65 primary care physicians per 100,000 rural Americans — 40 or so less than the 105 per 100,000 urban and suburban Americans," Molly O'Toole of Reuters reports. "Already five million rural residents live in 'shortage areas' defined by the government as counties with less than 33 primary care physicians per 100,000 residents." The problem intensifies when it comes to specialists, with rural areas having fewer than half the number of surgeons and other specialists per capita.

Kentucky is one of the more rural states, with the latest U.S. Census numbers showing that about 42 percent of its population lives in rural areas.

The study incorporated results of a survey of about 3,000 patients and primary-care physicians. It found drug abuse and teen pregnancy are bigger concerns in rural areas than in cities. Rural people tend to think their local health care is lower in quality than in urban centers. In many instances, they're right. "UnitedHealth confirmed this 'equality deficit' is supported by data showing that in 70 percent of markets, rural quality of care was measurably worse than in urban areas," O'Toole reports.

To remedy the situation, the report advises expanding the role for nurse practitioners and incorporating more mobile health clinics, technology such as telemedicine and preventive care into health care. (Read more)