St. Joseph Health System announces merger with Jewish Hospital & St. Mary's HealthCare

Rebuffed in its bid to take over Louisville's University Hospital, Catholic Health Initatives announced today that its St. Joseph Health System had merged with Jewish Hospital & St. Mary’s HealthCare, effective retroactively to Jan. 1. Gov. Steve Beshear rejected the original merger plan because of University Hospital's public status and the proposed control of CHI, which follows Catholic health directives.

The new organization is called KentuckyOne Health and is headed by Ruth W. Brinkley, as president and chief executive officer. She is a former executive at CHI and Ascension Health. The organization "includes hospitals, clinics, specialty institutes, home health agencies, satellite primary care centers, and physician groups with more than 80 locations, 2,500 staff physicians and more than 13,000 employees across the state of Kentucky and southern Indiana," CHI said in a press release. It said it will invest $320 million into the merger.

"As part of KentuckyOne Health, historically Jewish facilities will remain Jewish," the release said. "Historically Catholic facilities will remain Catholic." Dr. Gerald Temes, chair of Jewish Hospital HealthCare Services, said in the release, “We have had a mutually beneficial relationship with Catholic Health Initiatives for the last six years. We’re confident this is the right direction for the Jewish Hospital organization.” (Read more)

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)