Device lets diabetics get blood-sugar levels using Web, iPhone

Starting next week, diabetics will be able to test their blood-sugar levels using a device that instantly sends their readings to an online database that can be accessed by the patient, doctor or caregiver. “This system charts the results to highlight trends and spot problems, and can be accessed via a Web browser or an iPhone app,” writes Walt Mossberg in a column in The Wall Street Journal.

With 366,000 adults in Kentucky already diagnosed with diabetes, the technology could signal a big change in diabetic care and could be a boon for diabetics living in rural areas.

Mossberg, a Type 2 diabetic, used the new device, made by Maryland-based Telcare, and assessed it uses. Looking like a “thick, old cellphone,” it works like a traditional meter, requiring the user to prick their finger to get a drop of blood and touch a test strip to it. That information is then sent to an online database. “Because it automatically logs results and allows real-time sharing, I believe diabetics who use this new system will be less likely to skip readings, or to fudge the numbers, especially if they allow doctors and other caregivers to see the results instantly. And that could mean an improvement in their health,” he writes.

Hospital employees report only 1 of 7 medical errors, study finds

In keeping with other studies on the subject, a new report shows hospital employees only report and recognize one out of every seven medical errors, accidents or other events that harm Medicare patients. "Yet even after hospitals investigate preventable injuries and infections that have been reported, they rarely change their practices to prevent repetition of the 'adverse events'," reports Robert Pear of The New York Times.

While hospitals serving Medicare patients are supposed to track and analyze the cause of medical errors and most hospitals do have a system in place to inform administrators about adverse events, "Hospital staff did not report most events that harmed Medicare beneficiaries," said Daniel R. Levinson, inspector general of the Department of Health and Human Services and author of the report.

Levinson said more than 130,000 beneficiaries were subject to one or more adverse events in hospitals in one month. An adverse event includes medical errors, severe bedsores, hospital-acquired infections, delirium as a result from too many painkillers, or excessive bleeding because blood thinners were used improperly.

The study involved the input of independent doctors, who reviewed 293 cases in which patients had been harmed. Forty of the cases were reported to hospital managers and 28 were investigated by hospitals, "but only five led to changes in policies or practices," Pear reports.

One of the major issues is that hospital employees don't recognize when a patient is harmed, Levinson said. In some incidents, "employees assumed someone else would report the episode, or they thought it was so common that it did not need to be reported," Pear reports. In other cases, employees thought an event was so unusual it wouldn't be likely to recur.

In answer, Medicare officials said they will come up with a list of "reportable events" for hospitals and employees to use. Hospitals, in turn, should give detailed instructions to employees about what kinds of events should be reported. (Read more)

Some employers stop hiring smokers in effort to 'walk the walk'

As smoking bans become more common nationwide, employers are taking it one step further and refusing to hire people who smoke. Primarily in hospitals, employers "won't hire applicants whose urine tests positive for nicotine use, whether cigarettes, smokeless tobacco or even patches," reports Wendy Koch of USA Today.

"We have to walk the walk if we talk the talk," said David Fotsch of Idaho's Central District Health Department, whose board agreed to stop hiring smokers last month.

"We're trying to promote a complete culture of wellness," said Mary Marshall of the Geisinger Health System in Danville, Pa., which likewise stopped hiring smokers. "We're not denying smokers their right to tobacco products. We're just choosing not to hire them."

As for how many U.S. businesses are opting not to hire smokers, there is no data but "the trend appears strongest with hospitals," Koch reports.

Critics say the practice is the equivalent of employment discrimination. "It's a very dangerous precedent," said Michael Siegel, a professor at Boston University's School of Public Health.

"What's next? Are you not going to hire overly-caffeinated people," said Nate Shelman, Boise's KBOI radio talk show host. "I'm tired of people seeing smokers as an easy piñata."

But federal laws do not view the move as discrimination because smokers are not recognized as a protected class. Still, 29 states, including Kentucky, as well as the District of Columbia, have passed smoker-protection laws.

Paul Billings of the American Lung Association said he is not convinced that refusing to hire people who smoke will help them quit — smoking cessation programs probably are more effective, he thinks — but the ALA nevertheless opts not to hire them. "We're non-smoking exemplars," he said. (Read more)

Beshear talks to University Hospital officials about future

Gov. Steve Beshear met with officials with University Hospital officials yesterday to discuss ways the facility can take part in a merger. Last week, Beshear rejected a much-publicized proposal that would have unified University Hospital with Jewish Hospital & St. Mary's HealthCare and Saint Joseph Health System, which is owned by Catholic Health Initiatives.

Beshear called the meeting "productive" and said he would get back to officials next week, reports Patrick Howington of The Courier-Journal.  "We remain committed to supporting University Hospital in reaching our common goals of care for our most vulnerable citizens while maintaining sound financial footing for the institution," Beshear said. James Taylor, CEO of University Hospital, declined to go into detail about the one-hour meeting.

Because Saint Joseph would have had majority control in the initial deal, the other facilities would have had to adhere to Catholic health directives, which affect procedures such as elective abortions, sterilizations, artificial insemination and euthanasia. Those limitations raised concerns, and Beshear said his major reservation was that the move would mean "the loss of a control of a public asset," meaning University Hospital.

Hospital officials said earlier this week they will continue to work together to put together a proposal that Beshear "would feel compelled to approve,'" reports Laura Ungar of The Courier-Journal. "The jockeys are not changing right now," University Hospital spokesman David McArthur told her. CHI spokeswoman Mary Elise Beigert said her company "is evaluating potential options." Jewish & St. Mary's officials had no comment. (Read more)

In an editorial, The Courier-Journal applauded Beshear's decision to reject the merger. "Gov. Beshear and the Attorney General [Jack Conway] both hit the nail right on the head," the paper said. "It's time to drop this misbegotten merger effort, and seek other ways to strengthen the local hospitals." (Read more)

Expect action against pill mills, Beshear says in State of Commonwealth address; House GOP leader promises it

Gov. Steve Beshear received only two standing ovations during his State of the Commonwealth address last night, when he mentioned Kentucky soldiers and when he talked about fighting prescription drug abuse. (Photo by John Flavell, The Associated Press)

UPDATE, Jan. 6: House Republican Leader Jeff Hoover said at the state Chamber of Commerce dinner last night, "We will do something this session about this terrible plague," which is "crippling our society."

Beshear called the problem one "of the largest threats to productivity and health in our communities" and referred to the Kentucky Health Issues Poll, which showed 32 percent of Kentuckians have either a family member or friend who has battled prescription drug abuse. A report from the Kentucky Department of Public Health showed more Kentuckians die from prescription drug overdoses than from car accidents.

"Think about that: Our medicine cabinets are deadlier than our highways," Beshear said. As such, legislators should expect "to consider a wide-ranging package of legislation designed to strengthen KASPER, including making participation mandatory, and cracking down on pill pushers in white coats and on pill mills in Kentucky." Kentucky All-Schedule Prescription Electronic Reporting is the state's prescription drug monitoring system.

Sen. Jimmy Higdon, R-Lebanon, has pre-filed a bill that would require background checks for people planning to open pain clinics, prohibit convicted felons from running them, and required that a physician in such a clinic own part of it.

To view the entirety of Beshear's address, click here.

Several pieces of federal health reform law taking effect in 2012

At the beginning of the new year, family doctors started facing a 1 percent cut in Medicare reimbursement if they hadn't nixed their paper-based prescription pads in favor of an electronic version. The change is part of another piece of the federal health-care reform law taking effect, USA Today reports.

"There will be a significant number of folks that will incur the penalty," said Robert Tennant, senior policy adviser with the Medical Group Management Association.

E-prescribing, which allows physicians to generate, transmit and file patient prescriptions, is part of the federal government's effort to get doctors to use electronic health records. Last year, doctors received bonuses from Medicare and Medicaid to set up EHRs, but this year they will start being penalized if they haven't already done so — 1 percent this year, 1.5 percent in 2013 and 2 percent in 2014.

Another piece of the federal health care reform law that will begin falling into place in 2012 involves Medicare's Shared Savings Program, "under which groups that qualify as accountable care organizations will be eligible for shared savings in 2013," USA Today reports. "Under the program, savings from participants in an ACO — including hospitals and doctors working together to improve patient care and reduce costs — would be shared between Medicare and the providers."

One study showed Kentucky already has three ACOs established, though several Kentucky experts have said no ACOs have been formed in the state yet.

Jan. 1 also marked the beginning of consumers being eligible for rebates if their insurer spent less than it should have on medical care. As per the new law, insurers have to spend 85 percent for large group plans and 80 percent for small groups and individuals on medical care as opposed to administrative and other costs. Kentuckians will not be privy to these rebates this year, however. Kentucky got a one-year break from the rule after applying for an exemption. (Read more)

January is Glaucoma Awareness Month; disease is second leading cause of blindness

One million Americans will be diagnosed with glaucoma in the next 10 years, prompting Kentucky optometrists to raise awareness of the disease this month.

"People who do not visit their eye doctor on a regular basis are putting their vision and quality of life at risk," said Dr. Ben Gaddie, president of the Kentucky Optometric Association. "Glaucoma is often referred to as 'the sneak thief of sight' because it can strike without pain or other symptoms. Vision lost to glaucoma cannot be restored, so early detection and treatment are paramount."

Glaucoma is the second leading cause of blindness in the country. Data from the American Optometric Association show 50 percent of Americans incorrectly believe glaucoma is preventable and fewer than 20 percent of Americans are aware glaucoma causes deterioration of peripheral vision.

The Glaucoma Research Foundation has found African Americans ages 45 to 65 are 14 to 17 times more likely to go blind from the disease than Caucasians. People with a family history of glaucoma, those over the age of 60 or people who have experienced severe eye trauma are also more prone to the disease. (Read more)