Online training could help rural doctors offer better mental health care

More than half of all U.S. mental health care takes place at the primary-care level, and that percentage is even higher in rural areas, where mental-health doctors are often hundreds of miles away, reports Newswise, a research-reporting service. A new online training program could help rural primary-care doctors better treat patients with mental health issues, and that could be important in Kentucky.

The Behavioral Health Education Center of Nebraska, a part of the University of Nebraska Medical Center, designed the program. Educational Director Howard Liu said primary care doctors are overwhelmed by the amount of mental health care they must provide. Newswise reports "the goal is to help primary care providers get more comfortable as they prescribe medications and refer patients to psychiatrists and therapists." The adolescent version of the program was released last fall and is being used by doctors worldwide. The adult and geriatric version will be released this spring.

Primary care doctor Angie Brennan estimates 35 percent of all visits to her practice have been mental health related. She said there are specific rural challenges to treatment, including "reluctance to see a counselor and a lack of mental health insurance coverage – combined with an intensified fear that someone in the community will find out a patient has mental health issues." (Read more)

Doctors use telemedicine to help patients with dementia, Alzheimer's

Following a nationwide trend, Kentucky doctors are turning to telemedicine to help patients with memory problems such as those associated with Alzheimer's disease and dementia, reports Allison Elliott with the University of Kentucky.

"State-of-the-art memory evaluations should not be limited to persons that are able tom ake the often long and arduous trip to Lexington," said Dr. Greg Jicha, neurologist at UK's Sanders-Brown Center on Aging. "Taking advantage of Internet technologists to bring expert care into even the smallest of rural communities is a blessing for many families across Kentucky that simply cannot bring a loved one with dementia to Lexington.

Several times a month, physicians with the Sanders-Brown Center will connect to patients in clinics throughout the state. Participating clinics include Harlan Appalachian Regional Health; the Hazard Center for Rural Health; T.J. Sampson Hospital in Glasgow; Trover Clinic in Madisonville; Western Baptist Hospital in Paducah; Owensboro Medical Center; and St. Claire Regional Medical Center in Morehead. (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)