Denman: S.C. patients have a medical home base

January 24, 2015 In The Press0

By JERRY DENMAN – Guest Columnist

I’ve got a riddle for you. What wears a white coat and is always on call but never returns your phone call? If you guessed a doctor, some might say you were right. With administrative headaches taking up to 30 percent of doctors’ time, it’s no surprise when they don’t get back to you personally. Fact is, the current system is leaving doctors very little time to focus on patient wellness. This has dramatically altered patient-doctor relationships over the past 20 years, but in South Carolina things are changing.

South Carolina is at the forefront of a powerful new concept in patient care: the patient-centered medical home. This model centers on a patient’s total care, starting with wellness, the prevention of illness and enhanced access to care through extended office hours and telephone and e-mail communication, by a primary-care provider and a team of caregivers such as nurses, dieticians and pharmacists.

This system allows primary-care doctors to better manage all their patient’s health needs and coordinate care with other health professionals using a team approach. Research clearly shows that a patient-centered home approach is good for people’s health and for their pocketbooks.

Positive results have been realized in preventing disease, in assisting patients to better navigate a complex health system and in helping patients manage their chronic conditions. For example, a yearlong patient-centered medical home pilot project between BlueCross BlueShield of South Carolina, BlueChoice HealthPlan of South Carolina and Charleston’s Palmetto Primary Care Physicians showed 10.4 percent fewer in-patient hospital days and 12.4 percent fewer emergency room visits compared to the previous year among 809 participants with diabetes in Charleston, Dorchester and Berkeley counties.

South Carolina is fortunate to have the Palmetto Health Family Medicine Center at the University of South Carolina School of Medicine focused on the patient-centered medical home issue. This was the first primary-care practice in South Carolina to be recognized as a Level-III Patient-Centered Medical Home — the highest possible designation.

Our state isn’t alone in seeing results from this approach. In communities across the nation, employers, health insurance companies and primary-care doctors are coming together to improve how care is delivered. A Washington state pilot saw a 20 percent drop in emergency room visits. A North Carolina project experienced a 40 percent drop in hospitalizations for asthma and a 16 percent drop in emergency room visits. A Pennsylvania health care system reported $3.7 million in net savings in its pilot.

This model helps doctors catch symptoms earlier, before they become an emergency situation. The long-term impact could be patients who are focused on healthier living. This special patient-doctor relationship is particularly effective when dealing with patients with chronic illness such as diabetes, heart problems and depression, which account for some 80 percent of our nation’s health-care expenditures. Studies show that when people have a primary-care doctor as their usual source of care, their health care costs a third less and they have a 19 percent lower mortality rate.

As patient-centered medical homes increase, we will move to a common model for the coordination of care, advancements in the use of electronic medical records and a standard measure for success based on keeping patients healthier. Primary-care providers need to take the time to learn about this new approach taking hold throughout the state, and patients need to make their voices heard. Let your primary caregiver know that this is the kind of care you would like for yourself and your family.

Along with providing incentives for employees to work with their primary-care providers to stay well, employers should let their health plans know they are interested in this approach as well. IBM was one of the pioneers in the area of patient-centered medical homes because this is the kind of care we want for our employees. As one of the nation’s largest purchasers of health insurance, we have a vested interest in finding ways to improve care and keep our employees healthier. When one of our employees has a primary-care provider as the usual source of care, it costs IBM a third less money and the employee is 12 percent less likely to be obese and 7 percent less likely to smoke.

What all these results show is that there is something really powerful about the healing relationship between a patient and a doctor that is foundational to keeping people well. When there is a real relationship and trust between the doctor and patient, it amplifies how important health and wellness are in life. Creating a smarter, more connected health-care system that puts the patient at the center of care is an important goal for all of us both physically and financially.

Mr. Denman is IBM’s senior state executive for South Carolina.