where I have relocated to with my
husband about three years ago at the
time we had about two and a half
children and as a general irresponsible
mildly pregnant individual my first
inclination was to contact the local
medical practice in order to find a
family doctor and pediatrician at our
new county of residence much to my
surprise every doctor was not accepting
new patients and that happened to be the
common response until I was finally able
to find an appointment months away this
is the family my husband our two lovely
daughters and baby Michael much like any
other family in Fulton County
the fact is residents in rural areas
have a decreased access to care
resulting in poor health outcomes
what is our area all about statistically
we have over 1,200 businesses one
Airport our population vacillates at
around 55,000 with half residing in
rural and the rest in cities in town
15.9%
are 65 and over with 21.2%
being 17 and younger poverty rates and
level of educational attainment strongly
influence community health our County is
disproportionately affected by poverty
16.2% reside under the federal poverty
level as compared to 11.8% in upstate
New York and 15.6 percent New York
statewide 18.6% live in single-parent
households as compared to 16.6% in
upstate New York and 19.8% New York
statewide 21.9% received Medicaid and
forty seven point six percent of
children were eligible for free or
reduced lunch
our health care landscape we have one
hospital one urgent care center
13 primary care clinics 92 primary care
physicians 19th registered physician
assistants and 20 nurse practitioners
there are 155 registered physicians in
Fulton County as compared to 215 in the
rest of that are under Perl Health
Network and 285 New York statewide
health outcomes and these are out of 62
counties in New York State overall
health
47 length of life 48 quality of life 49
health factors 56 health behaviors 50
clinical care 53 social-economic 58 and
physical environment 32 we do enjoy our
great outdoors and the many lakes that
we have here in many respects were much
like any other rural county in the
country working for the local public
health department we thought what can we
do telehealth initiatives may provide a
viable solution to the increased need
for remote access to care telehealth
being the overall concept of
telemedicine and telemetry components
encompassing remote consultations with
doctors as well as vital statistic
equipment the benefit of telehealth
includes evidence-based costs and time
effectiveness and may have a major
impact on overall health outcomes
believe it or not today we are on the
cusp of healthcare innovation the
location of this talk to Fulton
Montgomery Community College happens to
be the epicenter of our pilot telehealth
initiative in collaboration with our
community stakeholders and with the
approval of our County Board of
Supervisors we have received funding
from the Medicaid restructuring
initiative in order to set up telehealth
stations at the Fulton Montgomery
Community College Office for the aging
in News and the local Fulton County
Public Health Department as a matter of
fact our first health station is right
across this wall here
basically we’re taking over closets all
across the county because there are no
windows and privacy is a major
consideration and incurred that
hipaa-compliant platform will be
utilized to connect our county residents
in real time not as store-and-forward
technology to a doctor at that Nathan
what our and st. Mary’s hospitals or any
other provider of their choice the
server will be housed with the Fulton
County IT department for neutrality
getting back to what the statistics
dictate the leading causes of death in
Fulton County are heart disease cancer
chronic lower respiratory disease stroke
and unintentional injury often alcohol
and substance abuse related premature
deaths are due to cancer heart disease
chronic lower respiratory disease
unintentional injury and stroke in that
order obesity and smoking rates in
Fulton County are high contributing to
increased incidence of hypertension
cardiovascular disease cancer and Stroke
30 point nine percent of adults in
Fulton County are obese as compared to
27 percent in upstate New York as well
as nineteen point five percent of public
school children as compared to 16 point
seven percent of their upstate New York
counterparts the smoking rate of Fulton
County adults has continued to rise from
25 percent in 2013 to the 29 percent of
adults that you see depicted here as
compared to seventeen point three
percent in the rest of upstate New York
resulting in increased hospitalizations
edie visits due to asthma COPD and other
respiratory conditions cancer continues
to be a local public health priority
with ovarian colorectal and prostate
topping the charts according to the US
Department of Health and Human Services
Fulton County’s considered to be a
health professional shortage area for
primary care mental health and dental
care
there is hope according to a recent
survey approximately 70 to 75 percent of
residents of Fulton County have a
smartphone a larger percentage use other
technology such as a laptop tablet or
personal computer let us pause here and
think about that for a moment that
statistic is astonishing think of its
implications this common thread that
unites many indicators and most
demographics may potentially have a
positive impact on our health outcomes
for the remaining residents that are now
unable to do so in lieu of socio
economic educational connectivity or
other barriers we are hoping to set up
health stations across the county to
improve remote access to care for all
residents what we are hoping to achieve
here in Fulton County New York falls
under the spectrum of true prevention
health education and improved access
that may positively impact our health
outcomes this is quintessential
population health this initiative has
the potential to impact all residents of
Fulton County New York and is at the
forefront of health care innovation here
you may say well telehealth initiatives
are not new there are plenty of
evidence-based publications with regard
to their utility and efficacy all over
so what is the innovation to that I
would respond this is a viable
sustainable initiative that has the
potential to improve remote access to
care and have a profound impact on
health outcomes while reducing the
burden of chronic disease that within
the confines of our given infrastructure
our local Public Health Department may
leverage existing resources and act as a
lynchpin to facilitate the connections
between stakeholders culminating in
improved care ideally Fulton County
residents will utilize their own
smartphones or other technology devices
in their homes and throughout the
community health stations will be
available as a supplement
alternate means of access are not
available connecting to a local health
care provider ensures continuity of care
from remote access to in-person visits
while optimizing the local provider
panel and reducing burden on physicians
the budget for this project is minimal
as compared to other health initiatives
while the correlating impact is vast the
funding is provided by the regional and
medicaid restructuring plans as well as
other grant monies geared towards
towards health improvement and
population health Fulton County New York
is the fifth most populous region in the
Adirondack oral health network as you
now know it is a rural area with
restricted access to care due to a
limited provider panel remote location
and over overall low population density
the future according to Clem bezel chair
and futurist of the institute for
alternative futures in his brilliant
vision for public health 2030 for a nice
h/o scenario for community driven health
and equity that includes a positive
public health movement communities
promoting population health widespread
health consciousness and a value shift
to equity
he’s even included telemedicine my
personal favorite he highlights the
necessity for political leaders to
include public health on their agenda
the population health initiative
discussed today is viable capable of
being sustained long-term and provides a
positive health impact in this region
healthy people 2020 is committed to the
vision of a society in which all people
live long healthy lives and the outlined
initiative may take us one step closer
to making this a reality I will leave
you with one final thought prevention
education and access equals population
health thank you [Applause]