Technology could be game changer for health care

dworthington@heraldonline.comNovember 6, 2013 

When compared to national health care results, York County’s numbers are no different than most.

Cancer and heart disease are the top two causes of death. The percentage of people with hypertension and diabetes is about at the state average. There are about 1 percent more people with heart disease locally than the in South Carolina as a whole.

But hen it comes to health factors and lifestyle choices, York County fares less well in comparison with U.S. data. Twenty percent of adults in York County smoke cigarettes compared with 13 percent in the United States. The percentages of smokers in Lancaster and Chester counties are 21 and 26 percent, respectively.

Twenty-six percent of York County residents live what is classified as a “sedentary lifestyle” compared with 21 percent in the United States. In Lancaster County, it’s 32 percent, and 34 percent in Chester County.

When it comes to environmental factors affecting health, York County again doesn’t compare well.

Fifty-six percent of the restaurants in York County are classified as “fast food” compared with 27 percent nationally. At 56 percent, York County has the 14th-highest concentration of fast food restaurants of the state’s 46 counties. Allendale County tops the list at 100 percent. One out of every two restaurants in Chester County is classified as fast food, and in Lancaster County the rate is 51 percent.

Six percent of the population in York County has “limited” access to healthy foods, while the national average is just 1 percent. In Lancaster County, it’s also 6 percent, while it’s 9 percent in Chester.

Overall, South Carolina ranks 39th for affordable and accessible health care. In York County, 19 percent – or 38,000 people – do not have health care compared with 20 percent for the state. That 20 percent figure includes Lancaster and Chester counties. For the country, the rate is 11 percent.

Even with what seems to be a long list of discouraging numbers, York County ranks second best in the state for health care, according to data from the County Health Rankings & Roadmaps program, a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. Lancaster County ranks 22nd in the state, and Chester County 39th.

But health care is more than numbers. Dr. David Garr and Deborah Williams of the Medical University of South Carolina forecast better health outcomes for state residents through technology. The duo spoke at Wednesday’s luncheon to celebrate the fifth anniversary of the York County Free Clinic.

Technology will be the change agent, moving health care from a system based on volume to one that is based on value, Garr said.

One of the key technological components is electronic medical records, Garr and Williams said.

Electronic records allow everyone to access the same data. Patients can take ownership of their own health care, the pair said.

Electronic medical records also will facilitate collection of medical data, particularly patient outcomes. Physicians or hospitals that exceed projected health outcomes should receive higher reimbursements for their results, Garr said.

Basing reimbursements on outcomes will lead physicians and their teams to stress preventive medicine, Garr and Williams said. To get outcomes, Garr said, physicians will start reaching out to patients, reminding them to come for visits much like dentists and veterinarians do now. Physicians and their teams will spend more time looking at social factors such as employment, diet and home environment that affect people’s health.

Technology already has affected some health care delivery. South Carolina has a tele-medicine network that allows patients to stay home and access specialists via the Internet.

And technology may be just a phone call away. With the percent of adults with smart phones expected to hit 80 percent in the next five years, patients may soon use their smart phones to send all sorts of medical information directly to doctors without going to an office.

Garr and Williamson said making these fundamental changes will take time. Education starts with the patient taking ownership of his or her health. Health care, they said, needs to be driven from the patient up, not pushed from the top down.

It also means educating health care professionals. And it means creating incentives – mostly financial – to get desired outcomes.

The result, they said, would reach what Donald Berwick, former director of the Centers for Medicare and Medicaid Services, described as the “three aims.”

Changes in health care, Berwick said, should increase patient satisfaction, improve their health and decrease costs.

Don Worthington •  803-329-4066

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