Food safety is of paramount importance for all industries. Ensuring the preparation, handling, and storage of food meets certain health and safety standards is critical for businesses involved in the production of food, its distribution and service, not only to uphold their reputation but also to safeguard the public from the spread of foodborne diseases.

The healthcare industry must also adhere to strict standards in the area of food safety. This is particularly important to protect vulnerable individuals who are more susceptible to the detrimental consequences of contracting food-borne illnesses as well as the staff members who care for them.

According to figures from the CDC, each year 48 million people get sick from a foodborne illness, resulting in 128,000 hospitalizations and 3,000 deaths. This highlights the added risk of contamination within healthcare facilities and the spread of foodborne illnesses posing risks to patients and the public.

In this article, we will explore some of the measures healthcare facilities can implement to mitigate the risk of foodborne illnesses arising and spreading, ensuring the safety of their patients and staff members.

Implement Food Screening

By implementing food screening measures, healthcare facilities can ensure a first line of defense against any unsafe food products from entering their premises or being provided to their patients.

This includes checking the packaging of food to ensure it is intact and has not been compromised or contaminated in any way. Perishable food items should be visually inspected to ensure their quality and freshness and should be stored at appropriate temperatures and settings.

Healthcare facilities can also take advantage of technologies like food X-ray inspection systems which can screen incoming food items for potential contaminants such as stones, metal fragments, glass particles and plastics which may not be visible to the naked eye. By doing so, these facilities can significantly reduce the risk of foreign objects and contaminants that can contribute to the spread of foodborne illnesses.  Learn more about how x-ray inspection systems work here.

Monitor Temperatures

Appropriate food temperatures are critical for maintaining food safety and avoiding the growth and spread of harmful pathogens and bacteria. To reduce the risk of any foodborne illness outbreaks, staff should regularly check refrigerator and freezer temperatures to ensure they are within safe ranges as well as those where food is stored and transported. 

In addition, cooking temperatures should also be adhered to according to the type of food being prepared, and food temperatures should also be monitored before serving. By conducting such checks, staff can ensure the safety of food throughout its supply chain, up to the point of consumption.

Training and Certification

Healthcare practices should ensure relevant staff members receive the training and education they need to safely handle, prepare and serve food to patients, visitors and staff members.

This may include Hazard Analysis Critical Control Points (HACCP) certification, which can help individuals in healthcare identify potential risks and hazards in the food handling process and take steps to correct these. Regular training on the latest food safety protocols can also ensure staff members introduce measures to minimize the risk and spread of foodborne illness.

By implementing these measures, healthcare facilities can ensure food safety, safeguarding the well-being of their patients, staff, and the public.

Health equity helps ensure all individuals have equal access to healthcare. According to the Centers for Disease Control and Prevention, health equity means everyone has a fair and just opportunity to attain their highest level of health.

To address the benefit needs of underrepresented population groups, payers can develop “more equitable approaches to healthcare benefits design that recognize and meaningfully address access and affordability concerns,” according to a 2022 article in the American Journal of Health Promotion.

With their focus on paying above-average salaries and having rich benefit options, many employers feel this is not a concern in their population. However, they may still find that employees and their families live in areas of concern, such as areas of greater poverty.

Recognizing the health needs of all employees can advance engagement, productivity, and ultimately improved performance. Here are three strategies for healthcare payers to consider when developing benefits plans for equitable coverage for their populations.

1. Begin with leadership buy-in

As payers start thinking about advancing health equity, they must build the business case first. The organization’s leadership must support this approach and prioritize health equity in the corporate health and well-being strategy.

As treatment costs change year-over-year, a percentage known as the medical cost trend, we can expect a 7% medical cost trend in 2024. This is an increase in 2024 for healthcare costs covered by individual and group health plan markets, compared to 6.0% in 2023 and 5.5% in 2022, according to data from PWC.

However, these costs impact different populations differently, which is a foundational point to understand and present when talking with leadership. Even how people allocate their money for health care concerns will vary by population.

2. Understand your data and data sources

Payers can track and measure multiple health and socioeconomic data sources to help ensure their health equity goals and strategies are sound. This includes supplementing their existing data with new and external data resources, such as publicly available data.

For example, the United States Department of Agriculture tracks supermarket accessibility at a Census Tract Level. Food insecurity is an important socioeconomic factor, so merging this data source with existing population health data makes it possible for payers to understand how access to quality food can impact their population’s health outcomes.

Other potential data sources include:

·         The CDC/ASTDR Social Vulnerability Index uses U.S. Census data to determine the social vulnerability of every census tract ranked on 16 social factors, including poverty, lack of vehicle access, and crowded housing. It groups them into four related themes: socioeconomics, household characteristics, racial and ethnic minority, and housing type and transportation.

·         Health survey data, such as the American Community Survey, can provide insights into the attitudes and behaviors of good nutrition and healthy lifestyles.

·         The HUD’s Location Affordability Index can help health plans and employers understand the cost of housing and transportation for their members and employees. These are two of the most significant budget items for most families and can dramatically impact the overall health equity of members. This data can also direct decisions about where to invest in communities.

And the list goes on. Race and ethnicity data emerged as the country moved out of the COVID-19 pandemic. Gender at birth or gender identity data can also be collected. Providers may also capture data about sleep, stress, burnout, tobacco use, and financial concerns during their face-to-face visits with patients. All these factors can play a role in health, and the volume and quality of this data will only grow as providers become more comfortable and effective in capturing it.

Payers can draw insights from healthcare and socioeconomic data to better understand their population by focusing on the right healthcare analytics, visualization, and reporting to these robust data sets. They can also better understand if the third-party vendors they have contracted with to engage their population – for example, a grocery delivery service or wellbeing provider – are helping people who are most in need.

3. Develop a relevant, data-driven engagement strategy

Once the data has revealed which populations need to be engaged, payers must consider how they engage those target populations. The more personalized the communication, the more effective it will drive positive outcomes.

Data can help here, too, so it is valuable to supplement population health data with community information via census tract data. By understanding the community members live in, payers can consider specific barriers when crafting an outreach and engagement strategy.

Here is an example. Aggregated population health data from employers and health plans can identify significant trends. This data shows a significantly higher number of emergency room visits in higher-poverty neighborhoods than in lower-poverty communities. 

It is easy to understand why – higher poverty areas may have less access to primary care physicians and reliable transportation, meaning the only choice for care for people living there may be an expensive ER visit with ambulance transport.

By understanding these barriers, employers and health plans can consider how to adapt their communications and engagement strategies appropriately. Engaging with community and neighborhood partners to ensure every member can access quality care regardless of socioeconomic barriers makes sense.

Payers can impact their populations with health equity strategies

So many factors affect health equity, such as affordability of and access to care, ethnicity, geographic location, and socioeconomic status. With an ongoing understanding of the data, payers and employers are equipped to engage those patients who need to be involved to ensure health equity. 

About Brandi Hodor

Brandi Hodor is a senior analytic advisor with Merative. She oversees a cross-functional team that can deliver analytics with a commitment to innovative solutions in traditional and value-based care arrangements.

The United States Census Bureau released its most recent statistical findings in 2020, revealing a notable increase in the diversity of the nation’s population. In 2010, the likelihood of randomly selecting two ethnically or racially diverse individuals was 54.9%. By 2020, this had risen to 61.1%. Given these figures, it is unsurprising that healthcare providers are actively seeking solutions, particularly through existing and emerging technologies, to overcome their most significant cultural challenges in patient treatment. 

Have there always been cultural challenges in healthcare? Undoubtedly. Yet, as the country becomes more diverse, healthcare providers encounter an increasing number of obstacles. Some are more apparent than others, such as those related to communication and language barriers. For example, a patient with a basic understanding of English might struggle to accurately describe symptoms, ask complex medical questions, express concerns, or fully comprehend a provider’s responses. 

Additionally, varying health practices across cultures, communities, and religions significantly influence how providers interact with patients from different backgrounds or countries. Some patients, for instance, may prefer Eastern or alternative medicine. Others might have specific expectations regarding modesty or privacy during examinations or while discussing personal information. A lack of cultural awareness in providers can lead to unintentional missteps, potentially causing patients and their families to feel discriminated against or overlooked. 

Another cultural challenge in healthcare is the general feeling of distrust held by patients from certain cultures and backgrounds. This distrust may stem from lower health literacy, but it is often due to previous negative or questionable experiences with healthcare workers. According to a recent Deloitte survey of Black, Hispanic, Asian, and Native American people, 55% say a negative experience caused them to lose trust in a healthcare provider, and 36% have skipped or avoided care because they did not like the way their provider was treating them.

Given that individuals from specific races and backgrounds have historically faced mistreatment in the medical community, it is crucial to understand different cultural barriers and work to overcome them. This approach is necessary to deliver high-quality care to everyone. Despite the significant challenges that barriers to cultural competence in healthcare pose, they can be overcome. As discussed earlier, a range of digital and technological advancements can equip healthcare providers with the tools to effectively address the various challenges of treating a diverse patient population. 

How to Provide Culturally Competent Care: Health Equity and Technology 

By learning about and willingly adopting technological solutions, providers can quickly, confidently, and efficiently bridge the cultural gaps they face with patients and their families. For example, translation software products, apps, and tools are becoming increasingly prevalent in healthcare settings. According to Global Market Insights, the machine translation market size was valued at 982.2 million in 2022 and is expected to reach a compound annual growth rate of 22.8% between 2023 and 2032. The healthcare segment accounted for 20% of that market share in 2022. This illustrates the growing need for translation services in healthcare. 

Telehealth is another technology gaining popularity, particularly among providers seeking to enhance their cultural competency. This approach involves offering virtual appointments, which can be supplemented with translation tools when necessary. Telehealth allows providers to accommodate patients who might be unable to visit a hospital, clinic, or office for various reasons. Although telehealth is unsuitable for all situations or treatments, it can be instrumental in building trust with hesitant patients. It is especially beneficial for low-income individuals or those in rural areas.

Additionally, technology is being used to foster “softer” skills among providers, such as the ability to practice more inclusive medicine. A 2016 academic study of several hundred U.S.-based providers found that nearly two-thirds had received cultural competency training. Now, access to such training is more straightforward than ever, with tools like Zoom and Microsoft Teams enabling workshops and remote conferences. 

However, today’s innovations are not the limit. On the horizon, other disruptive technologies are emerging, poised to facilitate even more culturally appropriate care than is currently available. 

Future-Forward Healthcare Technologies Powering More Inclusive Medicine 

What are some other emerging technologies transforming healthcare? One example is virtual reality. Specifically, VR devices, such as wearable headsets, are being tested in various medical capacities, including chronic and acute pain treatment. Research suggests that using VR goggles can help patients reduce the intensity of pain sensations, potentially decreasing or eliminating the need for medications. As some cultures are hesitant to use conventional pharmaceuticals, VR technology could offer a viable alternative for patients experiencing physical distress. 

A second technology gaining attention is wearable devices. Wearable devices worn by patients transmit accurate health data to healthcare providers in real time. A study on wearable medical devices indicates that these devices assist providers in delivering more personalized care. Moreover, they offer a cultural advantage by enabling patients to feel more in control of their health and privacy. Provided patients have access to the necessary wearables, these devices can minimize in-person visits to healthcare providers while supporting a preventive health regimen.

Technological Solutions: Improving Healthcare for All 

Every person, regardless of background, deserves healthcare treatment. However, treatment has often been delivered through a unicultural, one-size-fits-all approach. 

Technology is now demonstrating how healthcare can be individualized and customized. Tech innovations have the potential to benefit all patients, particularly those who have felt overlooked or underserved by traditional healthcare approaches. 

About Unmesh Srivastava

Unmesh Srivastava is the chief digital and technology officer at Clever Care Health Plan. He has over 14 years of experience in healthcare technology and innovation, digital health, and value-based care technology.

What You Should Know:

– The Centers for Medicare & Medicaid Services (CMS) has taken a bold step towards improving care for individuals with both mental health conditions and substance use disorders (SUD), announcing the “Innovation in Behavioral Health (IBH)” Model.

– This IBH model holds immense promise for transforming how we address the complex healthcare needs of individuals struggling with both mental and physical health challenges. By focusing on integrated care, addressing social determinants, and promoting health equity, the IBH Model has the potential to significantly improve the lives of millions of Americans.

Bridging the Gap: Addressing Dual Needs for Better Health Outcomes

Medicaid and Medicare populations experience disproportionately higher rates of mental health conditions and/or SUD, often leading to poor health outcomes and premature death. This can be attributed to fragmented healthcare systems, limited access to care, and underlying social issues.

The IBH Model aims to bridge the gap between behavioral and physical health by:

• Empowering community-based behavioral health practices: These practices, including mental health centers, opioid treatment programs, and safety net providers, will become the central point of care, offering integrated services for both mental and physical health needs.
• Building interprofessional care teams: Behavioral health providers will lead teams encompassing primary care physicians, specialists, and community resources, ensuring coordinated care across the spectrum.
• Addressing health-related social needs (HRSNs): Screenings and referrals will connect patients with vital resources like housing, food, and transportation, addressing underlying social determinants that impact health.
• Value-based care: Practices will be compensated based on the quality of care and improved patient outcomes, incentivizing a focus on comprehensive, holistic well-being.

A State-Led Approach with Eight-Year Vision

The model will be implemented in eight states selected through a competitive application process. Participating states will partner with their mental health and/or SUD agencies and Medicaid Managed Care Organizations (MCOs) to develop and implement the IBH framework.

The eight-year journey will be divided into two phases:

• Pre-implementation (model years 1-3): This phase focuses on building capacity, recruiting practices, and establishing infrastructure. States and practices will receive funding for necessary upgrades in technology, staff training, and practice transformation activities.
• Implementation (model years 4-8): States will implement a Medicaid payment model that rewards practices for delivering integrated care, while selected practices can also participate in an additional Medicare payment model. Performance-based incentives will further encourage quality improvement throughout the implementation period.

Health Equity at the Core: Addressing Disparities

The IBH Model recognizes the disparities in health outcomes experienced by marginalized communities. To address this, it mandates:

• Health Equity Plans: Each participating practice must develop a plan outlining how they will address the specific needs of their diverse patient population and address any existing disparities in care.
• Screening and Monitoring for HRSNs: Regular screenings and referrals will ensure that patients receive the support they need to address social determinants affecting their health.
• Annual Assessments: Continuous monitoring of the model’s impact on health equity will be conducted to ensure its effectiveness in addressing disparities.

The Future of Integrated Care: Preparing for Advanced Models

The IBH Model is designed not only to improve care for individuals with dual mental and physical health needs but also to prepare practices for future advanced payment models and accountable care arrangements. This forward-thinking approach paves the way for a more integrated and equitable healthcare system, ultimately leading to better health outcomes for all.

“The Biden-Harris Administration believes that treating mental health and substance use disorder requires a “no wrong door” approach. This new model ensures that anyone can get access to the services they need, regardless of how they enter care,” said HHS Deputy Secretary Andrea Palm. “We will continue to test approaches that close the gaps between how behavioral and physical health are treated. Our goal is always to improve the overall quality of care and outcomes for patients and this model brings us one step closer.”

The model will launch in Fall 2024 and is anticipated to operate for eight years in up to eight states. CMS will release a Notice of Funding Opportunity for the model in Spring 2024. 

What You Should Know:

– TruLite Health, a pioneer in health equity solutions, and Mayo Clinic, a global leader in medical care, today announced a groundbreaking collaboration to address disparities in medical outcomes and costs for diverse patient populations.

– This partnership marks a significant step forward in the fight against clinical bias, a pervasive issue that disproportionately impacts the health of Black, Latinx, and other minority communities.

Quantifying the Impact of Bias

Clinical bias has a staggering financial and human cost. A TruLite study revealed that individuals with one of seven chronic illnesses who are Black or Latinx incur approximately $5,300 more in annual healthcare expenses compared to their White counterparts. Truity™ aims to tackle this disparity head-on by ensuring all patients receive equitable care regardless of their background.

Truity™: AI Championing Fairness in Healthcare

TruLite’s revolutionary software, Truity™, identifies and mitigates clinical bias within electronic health records (EHRs). The platform analyzes patient data and suggests personalized interventions for clinicians, care teams, and patients themselves. These interventions address social and behavioral factors that often contribute to unequal healthcare outcomes, particularly for Black and Latinx populations.

Mayo Clinic: A Powerhouse Partner

Mayo Clinic brings its vast expertise and resources to the table. Their physicians will provide valuable feedback on Truity™, helping refine the user experience and workflow to maximize its effectiveness in clinical settings. Additionally, Mayo Clinic has a financial interest in the technology, demonstrating its commitment to advancing health equity solutions.

This partnership goes beyond software:

• Virtual health equity coaching: TruLite offers virtual coaching programs to empower patients and advocate for their healthcare needs.
• Partnership with Morehouse School of Medicine: TruLite collaborates with Morehouse to address the specific healthcare challenges faced by Black communities.

“This collaboration with Mayo Clinic represents a critical milestone in the fight for health equity,” says Dr. Alan Roga, Founder and CEO of TruLite. “Mayo Clinic’s expertise and commitment to patient care, combined with TruLite’s innovative technology, will allow us to reach a wider audience and make a real difference in people’s lives.”

Hospitals, health systems and group practices nationwide are finding value and effectiveness by partnering with an outsourced care guidance resource to extend clinical staff and strengthen care management support. The addition of a structured and highly scalable care guidance program that goes beyond mere navigation efforts provides a unique solution as a service proposition to comprehensively address many of the operational and financial challenges that directly affect the entire provider ecosystem. 

An Extension of the Clinical Team Beyond Mere Patient Navigation

Modern care guidance is an evolution of patient navigation that combines a systematized assessment to support disease-specific clinical conditions with a tech-enabled, human-led solution. Care guidance serves as an extension of a hospital’s clinical team to support a range of service lines and support activities. 

When properly designed and implemented, care guidance supports a myriad of clinical and non-clinical functions, including facilitating pre-and-post-discharge and continuation of care. While care coordination usually includes a limited set of commonly performed tasks like scheduling follow-up appointments, helping patients understand what the next step in their clinical journey should be, care guidance goes deeper into social determinants and the life factors that can impact a patient’s ability to stay on track. 

An effective care guidance program depends on specially selected care guides who work to establish a peer-to-patient connection with patients and their families. This human-led approach builds trust, enhances a patient’s ability to communicate and helps to uncover issues that pose barriers to care. The support of care guides then works to resolve these issues and assist patients in the ongoing process of their care. However, while the human touch is vital, care guides are unlikely to meet efficiency goals without a technology platform that goes beyond logging into structured workflows and barrier resolution pathways.

As healthcare organizations experience the profound financial impact of nurse shortages, care guidance is providing an innovative and efficient solution. It provides truly effective supplementary support services, functioning as a lower-cost extension of clinical teams and freeing up labor, time and resources so that nurses can focus on high-value clinical tasks.

A successful care guidance program delivers a strong return on investment (ROI) by improving efficiencies, reducing time and resource allocation, and helping overutilized clinical care teams focus on truly clinical items, all while improving patient satisfaction and retention Care guidance is of especially high value in alleviating non-clinical tasks and of its ability to help identify and solve barriers embedded in the social determinants of health that have an outsized impact on the patient care continuum. When a guidance program is properly deployed, it functions to promptly identify and resolve non-clinical issues patients experience before they become clinically problematic and costly. 

Value of a Technology-Enabled Care Guidance Resources 

A technology-enabled care guidance resource offers the most effective patient activation solution. It seamlessly integrates with a health system’s care management team to reduce clinical resource use, improve patient experience, advance health equity and enhance value-based care and reimbursement.

The right mix and integration of human and tech elements support personalized and meaningful peer-to-patient relationships and personalized communication, providing patients and their families with the connected support they need to stay on track and engage in the management of their condition throughout their care continuum. 

Integrating care guidance with information technology can significantly enhance the efficiency and effectiveness of healthcare services. By leveraging these technologies, care guidance programs become more agile, patient-centered and efficient. They facilitate quicker responses to patient needs, streamline administrative tasks and ultimately improve the overall patient experience within the healthcare system.

Collaborative Function of Care Guidance

Collaboration between provider teams supports a triad of care coordination and management. Hospitals and their clinical staff receive the extended support they need from a dedicated care guidance service.

• Reach and manage more patients, maintain their continuity of care.
• Remove non-clinical tasks from the workloads of nurses and clinical staff.
• Perform follow-ups and monitoring, conducting follow-up tasks and ensuring that potential issues and barriers are proactively identified and resolved.
• Schedule appointments, screenings, preventive care and annual wellness visits.
• Find financial resources, such as assistance programs, to alleviate medical costs.
• Arrange transportation and other logistics that enable a patient’s ability to receive care.
• Ensure compliance, adherence and medication management. 
• Reduce unnecessary service utilization and avoidable readmissions.

Addressing Social Determinants of Health and Resolving Barriers to Care

As healthcare organizations prioritize to deliver equitable, patient-centric care they must consider the full spectrum of a patient’s condition, including non-clinical factors and socioeconomic characteristics that influence their ability to access, receive and adhere to care.

Care guidance takes into account the role of social determinants of health (SDoH), with personalized services provided by skilled and trained care guides that recognize these non-clinical factors that influence an individual’s ability to access care and adhere to treatment. It’s this “human touch” that supports patients who are at-risk based upon SDoH characteristics.  These patients frequently require amplified levels of activation and monitoring that cannot be addressed within the typical hospital’s resource capacity and clinical scope limitations. 

SDoH are categorized by socioeconomic, education, cultural and environmental domains. Sub-standard conditions among these domains are shown to perpetuate patient health disparities, contribute to their unmet resources, services and transportation needs and widen health inequities, especially affecting those with chronic health conditions.

When non-clinical factors, which account for 80% of patient issues, are not promptly addressed and effectively resolved, they can lead to:

• Health deteriorations
• Excessive rates of clinical service utilization
• Extended hospitalizations and readmissions
• Higher total cost of care

Care guidance programs have proven to be effective in supporting disadvantaged and underserved patient populations who are at-risk for these complex health challenges. 

Data Captures Provide Strategic Insights

Optimally, care guides are equipped with scalable, technology platforms that provide structured workflows and use evidence-based disease and condition-specific protocols to proactively identify and resolve practical and non-clinical barriers experienced during the care journey. A patient activation platform that augments a hospital’s care management workflow and automates protocols helps uncover both non-clinical and clinical issues and barriers. With this technological support, care guides ensure that non-clinical issues get promptly resolved and clinical issues are immediately escalated to proper clinical care teams. 

An effective care guidance platform captures SDoH data and disparity-related barrier resolution, exceeding the capabilities of typical electronic health record (EHR) systems which are not specifically designed to facilitate the kind of resolution workflows that are needed to address health equity and SDoH issues. A specialized platform facilitates operational improvement by seamlessly exchanging relevant insights for each patient population. 

How Information Technology is Utilized in Care Guidance:

• Resource Allocation: Data analytics help healthcare organizations allocate resources effectively based on patient needs, optimizing the patient navigation process.

• Machine Learning and AI: AI algorithms analyze patient data to offer personalized recommendations for treatments, lifestyle changes and support services.

• Interoperability: IT systems communicate across different platforms ensuring the smooth flow of patient information between healthcare providers and navigators, improving coordination of care.

• Data Analytics: By analyzing patient data, IT systems predict potential health issues, allowing providers to intervene early and prevent complications.

• Measuring Outcomes: Collect data to measure the effectiveness of their services, including patient satisfaction, adherence to treatment plans and health outcomes.

• Continuous Improvement: Based on collected data, patient navigation programs can be improved to better serve patients’ needs.

Data analytics within the platform provide insight into non-clinical issues, identify probable SDoH risks and facilitate personalized communication. AI and machine learning anticipate patient needs based upon condition-specific protocols that enable care guides to deliver an unprecedented level of vital, just-in-time communication. Led by this intelligence, care guides provide patients with the information they need to engage in the process of their care and empower each consumer to receive a better understanding of their treatment plan and options. 

Why More Health Systems Are Considering Care Guidance Programs 

Care guidance is now becoming a “must-have” addition to the service line portfolio of health systems, hospitals and provider organizations. It is at the nexus of managed care priorities where care guidance represents an innovative approach to connected care, advancing heath equity and delivering high-quality care.

A well-designed, scalable care guidance program offers a cost-effective, connected care solution, aligning with the “Triple Aim” goals of improving care, enhancing population health and reducing costs. Patients receive personalized, equitable care, clinical staff can focus on their core tasks and hospital administrators can improve financial and operational performance. This is where care guidance presents the most value and opportunity.

About Craig Parker, JD, CPA

Craig Parker, JD, CPA, CEO, Guideway Care, a company that partners with healthcare organizations to deliver on the promise of health equity through its unique combination of highly trained Care Guides and its patient activation platform. Craig Parker has a history of building innovative healthcare companies with business models that improve care delivery and provide better experiences for all involved. Before taking the helm at Guideway Care, Craig served as a senior leader in healthcare companies working in the patient experience and provider efficiency spaces. In his role as CEO, Craig serves as the company’s chief evangelist, spreading the message that Guideway Care’s services improve life for patients and providers alike.

What You Should Know: 

– NCQA announced that it has been awarded a $18M, maximum 5-year contract from the CMS Office of Minority Health to advance health equity and reduce health disparities.

The project, called the Health Equity Accelerator builds on NCQA’s strong foundation of work at the intersection of health equity, health care quality and health outcomes research, as well as NCQA’s longstanding relationship with CMS OMH. NCQA previously supported CMS OMH as the prime contractor for the Health Equity Innovation Incubator, which ran from 2016 to 2021. NCQA also partnered with RAND on that program.

Health Equity Accelerator Focus Areas

The contract’s major tasks and areas of focus are:

• Reducing Disparities and Improving Access and Quality, including the assessment of social drivers of health related to unplanned 30-day hospital readmissions, chronic kidney disease (CKD), end-stage renal disease (ESRD), chronic health conditions and preventive services, and chronic and potentially disabling conditions.
• Reducing Disparities in Mental and Behavioral Health, including analysis of mental and behavioral health disparities, as well as long-COVID’s impact on mental and behavioral health.
• Data-Driven Evidence to Support Policy and Operations, including the improvement and streamlining of health equity-related data elements, studying the impact of artificial intelligence (AI) and algorithms on health equity and supporting CMS’ Health Equity Data Workgroup (HEDWG).
• Health Equity Methodologies and Measures, including developing and evolving the Health Equity Summary Score and looking ahead on health equity measurement topics.

“CMS has articulated a clear vision to advance health equity and ensure our health care system helps everyone achieve their best possible health. The Health Equity Accelerator is designed to put that vision into practice,” said Rachel Harrington, NCQA Senior Research Scientist for Health Equity and Project Director. “Our team is deeply excited to begin putting our technical and subject matter expertise to work on these tasks.”

Massive disparities continue to plague healthcare in the United States. Many Americans do not have access to quality care, leading to higher rates of diseases like diabetes, hypertension, cancer, and obesity. Health equity means ensuring that health resources and services are accessible and affordable for everyone, regardless of gender, sexual orientation, race, geography, ethnicity, or financial circumstances. 

Health equity allows people to lead active and productive lives, reduces the healthcare burden on the government, and contributes to economic growth. By one estimate, healthcare improvements accounted for one-third of the economic growth of developed nations over the last century. Achieving health equity presents an urgent challenge that demands attention from all stakeholders.

However, actual medical care accounts for 20% or less of what affects population health. The remaining 80% comes from the social determinants of health, such as public safety, the availability of stable jobs, access to green spaces, cultural practices, and more. For example, people living near industrial zones tend to have lower life expectancies or are prone to certain diseases. Rural communities may lack easy access to preventive care and screenings. Language barriers may deter certain populations from finding accurate information. The costs are astronomical. Health inequity costs the nation $320 billion a year, a figure that could balloon to more than $1 trillion by 2040, according to Deloitte.

Several roadblocks hinder progress in achieving health equity, of which the perennial issues of funding and staffing are often in the spotlight. But there is another hurdle that is just as significant, and that is the lack of quality data on these social determinants. Data-driven insights are crucial in understanding health disparities. By comparing quality-of-care data with population, income, and ethnicity across the U.S., we can identify gaps and define appropriate next actions. 

Digital technology has transformed many industries in recent years. However, healthcare is often left behind, with many healthcare organizations still struggling to collect important data. The Institute for Healthcare Improvement found that while 59% of health systems named health equity as a top priority in 2021, 38% of those health systems pointed to inconsistent data collection as a top barrier to achieving that goal. And only 25% of U.S. hospitals screen patients for the social determinants of health and other markers.

Much in the same way “food deserts” limit people’s ability to choose healthy eating options, the healthcare industry faces a “data desert” that has real-world repercussions. There is no readily available database on the disease burden by population segment. Doctors have no access to data about the social determinants of health, hampering their ability to tailor care to patients. With incomplete data, certain populations are overlooked during the development of new drugs. It’s not a stretch to say that your phone knows more about many of these key factors than your doctor.

The industry will never topple barriers to health equity without changing the way providers and payers approach health data. For example, many companies are not aggregating the data they already have to generate insights. Additionally, sharing information between payers and providers is inefficient, leading to physician and patient fatigue. 

However, we can learn and build on efforts already underway to address this. Importantly, the Centers for Medicare & Medicaid Services (CMS), the largest payer in the country, whose services touch 170 million people, is rolling out a comprehensive 10-year initiative to understand the causes of disparities, improve accessibility to care, and better address the social determinants of health. The first priority is to expand the collection, reporting, and analysis of standardized data. 

It’s not just large-scale initiatives that will help. Payers and providers can implement small changes that can do a lot of good. Technology can play a crucial role in advancing health equity by bridging the data gap. Telemedicine connects underprivileged populations with remote, real-time care. Smart devices and mobile health apps empower individuals and make interactions more seamless – from viewing test results to reminders to get vaccinated to sending surveys on care quality. Responsible AI can remove biases, improve diagnostics, and enhance clinical decisions. Aggregation and integration of business and patient data can help create a deeper understanding of patients. Digital and process automation can alert providers to non-compliance. Data analytics can unearth patterns from real-world data to better understand the root causes of health inequities and provide targeted interventions.

Attaining health equity means we must work collectively to break down barriers and ensure that every individual has access to the care they need. By stepping up efforts to collect and share data on the social determinants of health and embracing technology to bridge the gaps, we can create a healthier future for all Americans. It’s time to join hands and take meaningful steps toward a more inclusive and equitable healthcare system.

About Alok Mandal

Alok, the head of healthcare consulting for Virtusa, specializes in healthcare-focused enterprise architecture, digital process automation (DPA), data engineering, robotics, artificial intelligence (AI), and cloud-first strategy.

Despite positive proof points, the expansion of virtual care and remote patient engagement strategies – including RPM –  continues to be hampered by misconceptions among potential users and misalignment of financial incentives among providers and payers.

It’s time to take a look at some of the myths holding back the adoption of virtual care and remote patient engagement tools and limiting progress toward achieving the interconnected goals of the Quintuple Aim.

If there’s a silver lining to the pandemic, it lies in our more nuanced understanding of how socioeconomic factors affect outcomes to produce an ecosystem in which better outcomes, lower costs, and better experiences for patients aren’t the only priorities anymore.

That’s why in the past few years, the Triple Aim morphed into the Quadruple Aim, adding an emphasis on clinician and staff experiences as burnout started to sweep the industry. And, after COVID-19 further exposed deeply rooted health disparities across communities, the Quintuple Aim. Achieving health equity is now a primary goal for providers, payers, regulators, and patient advocates seeking to ensure that healthcare is accessible and effective for all.

Virtual care, including telehealth, remote patient monitoring (RPM), and connected devices, are powerful and yet often underestimated factors in achieving health equity goals. These sophisticated technologies play a critical role in expanding access, building relationships between patients and providers, and keeping individuals on track with their care plans.  However, they are often misunderstood, leading to untapped potential and failed adoption. 

Here are some of the more common myths and the facts that debunk them. 

MYTH 1: Seniors don’t like or use virtual healthcare technology

REALITY: The US population is aging rapidly, putting pressure on the healthcare system to provide more and more services to an increasingly vulnerable population. Approximately one in three seniors are economically insecure and may struggle with paying for prescription drugs, getting transportation to medical appointments, or having access to a caregiver who can advocate for their needs.

Virtual care and RPM can bridge the gaps for seniors while controlling costs through more proactive, preventive care – but aren’t they too technologically averse to participate? According to the latest stats and surveys, the answer is ‘no.’

More than half of seniors over 65 already use some type of assistive health-related technology, including apps and wearable devices, according to a US News and World Report survey from March of 2023. Of the 47 percent who don’t use a digital tool, 70 percent just feel like they don’t need them yet.

Seniors who do participate feel more independent, safer, and healthier, and are eager to adopt tools that can help them age in place, says the survey.

With a large majority comfortable using the internet (75 percent) and smartphones (61 percent), the rising class of senior citizens doesn’t look anything like stereotypical technophobic elders of the past. Leveraging remote care to connect with this population can better support socioeconomically challenged seniors while increasing convenience and accessibility for all.

MYTH 2: Lack of broadband = totally inaccessible communities

REALITY: There’s no question that access to high-speed broadband internet is a social determinant of health. Broadband access is less frequent in geographical areas with higher burdens of chronic disease and reduced healthcare access. Households headed by older, disabled, or BIPOC (Black, Indigenous, People of Color) individuals are less likely than others to have a broadband internet subscription, perpetuating many health equity issues.

Broadband remains extremely important for supporting audio-visual telehealth interactions, access to personal health data, and many remote monitoring devices. However, an increasing number of devices and platforms are also available via smartphone, expanding accessibility to people who may have a mobile device but no home broadband account.

In 2021, 85 percent of people had a smartphone, according to the Pew Research Center, with similar levels of ownership among racial and ethnic groups. Rural residents and low-income individuals are somewhat less likely than others to have a smart device, but rates still exceed 80 percent in these categories.

And with more than $100 billion in federal funding being deployed to bring broadband to every American household, we are one step closer to closing the divide to ensure every American has the same quality internet access, resulting in virtual health for all.  

MYTH 3: Clinicians don’t think virtual care programs are worth the investment 

REALITY: The fourth component of the Quintuple Aim is improving clinical experiences – a necessary task in an era of widespread burnout and provider shortages. Virtual care and RPM platforms must be as easy to use for the provider as they are for the patient, especially when working with traditionally underserved populations that tend to have higher burdens of chronic conditions that require more intensive management.

Fortunately, healthcare providers understand the potential of virtual care and RPM to achieve clinical and financial goals without negatively impacting their workflows. A 2022 poll by the American Medical Association found that 92 percent of physicians see an advantage to digital tools, including 44 percent who are very enthusiastic about RPM and other strategies.  

In fact, physicians strongly believe that virtual care and RPM can help address every aspect of the Quintuple Aim. Seventy percent feel that virtual care and RPM support value-based care, while two-thirds of providers think they are crucial tools for promoting health equity. Physicians also noted that reducing burnout was an important driver for RPM adoption within their practice, and many are planning to adopt it in the near future to help them meet their clinical, financial, workflow experience, and health equity goals.

The COVID-19 pandemic exposed significant disparities within the U.S. healthcare system. While there is no ‘silver bullet’ solution to the problem, virtual care and RPM can go a long way to address the issue in a practical, sustainable way. Virtual care offers the opportunity to increase access to services, fill gaps in specialty care, and help address provider shortages. But outdated myths are stopping too many providers from taking that leap. Through education and awareness, we can promote understanding, break down barriers and encourage greater adoption. By prioritizing virtual care, we can build a future where health inequities are eradicated and all individuals, regardless of race, where they live, or how much they earn, have the support they need to live their healthiest lives. 

About Rich Steinle

Rich Steinle is the Chief Executive Officer at Carium, responsible for stewarding the company’s people, story and growth. His 30-year career spans enterprise, entrepreneurial health and human service ventures within managed care, software and technology, physician network development and consulting services. Rich previously served as President and CEO of Innovista Health Solutions, a managed services provider for physician organizations navigating transitions in delivery, payment and efficiency models. Prior to that, he served as CEO of multiple organizations focused on healthcare transformation, including primary care delivery, integrated physician networks, EHRs and collaborative medical real estate solutions.

What You Should Know: 

• SSM Health, a nonprofit health system and Siemens Healthineers have announced a new 10-year strategic partnership agreement focused on expanding access to high-quality care and training the next generation of health care workers. 
• The agreement with SSM Health creates the largest geographic Siemens Healthineers strategic partnership to date.  

Advancing Health Equity & Workforce Development

The strategic partnership will focus on advancing health equity and workforce develpment initiatives:

• Health Equity: The collaboration will further enhance quality, efficiency, and access to diagnostic and imaging services for communities across SSM Health’s four-state service area (Illinois, Missouri, Oklahoma, and Wisconsin). Additionally, the organizations will jointly invest in programs that expand early detection and management of chronic disease for underserved and vulnerable individuals in these communities. 
• Workforce Development: the organizations will work to address the critical shortage of radiologic technologists by implementing local imaging apprenticeship programs in collaboration with The Urban League of Metropolitan St. Louis. These programs will expand employment opportunities, provide training, and foster mentorship for local youth through the Urban League’s Save Our Sons & Save Our Sisters initiative. 

Partnership Expansion with Varian

SSM Health is also expanding its existing strong relationship with Varian, a Siemens Healthineers company, by implementing a tailored set of offerings from Varian’s Advanced Oncology Solutions (AOS) portfolio. These solutions are designed to enable SSM Health to integrate oncology services, further optimize the utilization of diagnostic imaging equipment and technology, improve clinical and operational effectiveness, and ultimately enhance patient outcomes.  

The organizations will work to address the critical shortage of radiologic technologists by implementing local imaging apprenticeship programs in collaboration with community partners, beginning with The Urban League of Metropolitan St. Louis. These programs will expand employment opportunities, provide training, and foster mentorship for local youth through the Urban League’s Save Our Sons & Save Our Sisters initiative. 

“At SSM Health, we are working to ensure all people have access to high-quality, compassionate, and affordable care, but we can’t do this alone,” said Jeremy Fotheringham, regional president, SSM Health. “Siemens Healthineers shares our deep-rooted commitment to innovation, quality, and value. We are thrilled to partner with them in our mission to transform health care delivery and address the health equity gap in our communities.” 

Trial sponsors have made efforts to address underrepresentation and promote Diversity, Equity and Inclusion (DEI) in clinical trials since the Federal and Drug Administration’s (FDA) 2016 guidance, but a new report released by the Government Accountability Office (GAO) still shows a continuous presence of major gaps in patient diversity. It begs the question: how do we ultimately achieve full representation and ensure accountability to uphold the promises we have made for patients?

As the industry transitions from receiving guidance to now having to abide by formal legislation requiring diversity action plans – moving from intention to action – sponsors will have to re-evaluate their processes and how to address this long, overdue industry challenge. If they don’t act now, it could cost them tens of millions of dollars to repeat trials to meet pre-agreed criteria and will also create delays in recruitment plans, getting new treatments to patients, and more. 

Let’s discuss how sponsors must take a multi-pronged approach to achieve representative diversity in clinical trials, as it will not be accomplished by pursuing any one tactic. It will also discuss what sponsors must do to strive beyond the legal minimum and truly move the needle for more representation, including utilizing decentralized clinical trial (DCT) models, increasing data centralization and management, partnering with communities, and understanding the power of empathy.

Prioritizing DCT Design and Data Infrastructure 

Leveraging modern, digital trial designs like DCTs is a key piece in this multi-pronged approach. DCT and hybrid trial designs incorporating flexible, local, and home-based data collection technologies and methods can eliminate geographical barriers for patients. Meeting patients where they are and building more flexibility can help to improve participation by lessening the time and opportunity costs it takes to be in a trial, reducing the overall patient burden.

However, DCTs significantly increase the amount of data sources in a given trial, making it critical for sponsors to first invest in building a stable, long-term data infrastructure to manage the new level of data flow. A Tufts study released in 2021 found phase III clinical trials generated an average of 3.6 million data points, a 300% increase from a decade prior. Given that DCT adoption has accelerated since the post-pandemic, we can expect that figure to rise as DCTs bring in continuous data streams from physiological monitoring, for example, glucose levels or heart rate, along with potential for RWD, EHR, eCOA/ePRO and other data from mobile trackers and devices. 

A centralized clinical data platform that can standardize and streamline clinical data into a single source of truth is a crucial piece of efficient infrastructure in this data-heavy environment. This foundation enables researchers to confidently use the data, react in real time, and prepare diverse clinical data sets for review, analysis and submission, while also measuring results against their diversity plans. 

By prioritizing infrastructure, it will also enable successful data orchestration and data fluency. Unlocking intelligence from combined information across different data sources such as electronic health records and labs necessitates an architecture equipped to merge disparate data sources and generate analytics. 

Pharma companies must leverage the right tools to extract actionable insights from the most pertinent data, not only to make trial pivots as needed but also to understand patients’ barriers to trial access and determine how to better engage them. From there, sponsors can better provide the appropriate support needed, whether that be transportation, expenses, or offering more remote options. 

Improved data centralization and orchestration will not only allow pharma companies to diversify outreach to different sub-populations but also fuel the industry to have better conversations – with each other and with patients. 

Driving Health Equity Through Community and Education

In addition to having the right tools, there are other ways sponsors can address underrepresentation in clinical trials. By partnering with local organizations within diverse communities, pharma companies can expand opportunities to reach patients interested in or needed for specific studies. These organizations can start conversations and dialogue within their communities, particularly those that have historically lacked knowledge about available clinical trials and/or have faced barriers to participation, to help drive diverse enrollment. In the December 2002 GAO report, the organization looked at common practices at centers showing positive diversity results.

Fifteen of the 17 cancer centers had facilitated enrollment with practices in at least three out of four key areas: organization, community, workforce and patients. The community category included ambassador programs and work with community advisors. In the report, The Yale Center for Clinical Investigation cited the success of their 2010-initiated ambassador program, reporting, “the proportion of patients in trials from a racial and ethnic group other than non-Hispanic White increased from 3 percent in 2010 to 32 percent in 2021.” In another example, a guidance document from MRCT outlined community engagement’s role in enhancing trial diversity, highlighting expected outcomes, strategy, and successful case studies. The case examples support the authors’ determination that community engagement aids in enhancing trust, awareness, and knowledge of trials within underrepresented populations.

Another important component is representation and education among sites. Recent research has found a correlation between the diversity of site personnel and diversity of enrolled patients and determined we have an opportunity to address diversity in trials by recruiting investigators reflective of their communities served. It is also critical to provide education for sites to understand the latest guidance from the FDA, as this will empower clinical research associates and the investigators to be knowledgeable of what to look for at the site level, giving every patient the opportunity to participate without encountering biases or barriers. Additionally, patients’ trust in pharma and clinical trials will be boosted by companies that visibly prioritize diversity in their own workforce and advertisements. A more diverse group of decision-makers will help foster diversified thinking for companies to overcome challenges in achieving equitable healthcare.

To truly reach patients, we must recognize the importance of empathy. Patient-centricity is no longer jargon used by the industry; it has now become the orientation of organizations and a part of the process each healthcare stakeholder is taking part in. Patients want to know and understand clinical trials, they want to feel confident and equipped to communicate, and most importantly, they want to know they are safe. Equity in research requires empathy for all patients, so we must seek to understand them first.

Going Beyond the Minimum and Striving for Equitable Health Long-Term

There is a long road ahead to not only tackle clinical trial recruitment issues but also retention and equitable research in healthcare. We will not create meaningful change if we view the FDA’s diversity action plan requirement as simply checking off a box and stopping there. We must think bigger picture, such as encouraging more diverse industry representation from the top down and working more intimately with communities to gain patient trust. 

Having brand awareness from B2C companies who are newer to the clinical space like Walgreens could also generate some of the industry momentum that we need on this issue.

As an industry, we have one common goal which is to improve patient outcomes. Competition should not stand in the way of this goal, and we must foster collaboration among industry stakeholders – pharmaceutical companies, CROs, clinical technology providers, etc. – to create long-term change. This will ultimately enable everyone to build and contribute to bettering industry imperatives in achieving diverse, equitable, and inclusive healthcare for all.

About Katrina Rice

Katrina Rice is the Chief Delivery Officer at Biometrics Services at eClinical Solutions. With a solid history of leading business transformations and managing global portfolios, she is as much at home scaling operations as she is in developing strategies that drive revenue growth. At eClinical Solutions, Katrina was recently promoted from Executive Vice President of Professional Services to Chief Delivery Officer. She has previously held various technical roles at Lockheed Martin Energy Group and Bayer. 

References

1. Collection of Race and Ethnicity Data in Clinical Trials. Available at: https://www.fda.gov/media/75453/download. Accessed April 2023.
2. Federal Actions and Selected Non-Federal Practices to Facilitate Diversity of Patients. Available at: https://www.gao.gov/assets/gao-23-105245.pdf. Accessed April 2023. 
3. Consolidated Appropriations Act, 2023. Available at: https://www.congress.gov/bill/117th-congress/house-bill/2617. Accessed April 2023. 
4. Rising Protocol Design Complexity Is Driving Rapid Growth in Clinical Trial Data Volume. Available at: https://www.globenewswire.com/news-release/2021/01/12/2157143/0/en/Rising-Protocol-Design-Complexity-Is-Driving-Rapid-Growth-in-Clinical-Trial-Data-Volume-According-to-Tufts-Center-for-the-Study-of-Drug-Development.html. Accessed April 2023.
5. Achieving Diversity, Inclusion, and Equity in Clinical Research. Available at: https://mrctcenter.org/diversity-in-clinical-research/wp-content/uploads/sites/11/2021/09/MRCT-Center-Diversity-Guidance-Document-Version-1.2.pdf. Accessed April 2023.
6. Getz, Kenneth, et al. Global Investigative Site Personnel Diversity and Its Relationship with Study Participant Diversity. Therapeutic Innovation & Regulatory Science. 2022; 56, 777-784. doi.org/10.1007/s43441-022-00418-9.

As the healthcare industry continues to evolve, there is a growing need for innovative solutions that not only improve the quality of care but also make care more accessible. Non-emergency medical transportation (NEMT) plays a crucial role in helping patients get to where care is delivered. As healthcare reform efforts continue to gain momentum, transportation benefits have become an increasingly critical component of providing equitable care to patients. NEMT helps close the health equity gap by ensuring all patients can access care, regardless of their location, medical needs or transportation options.

In recent years, technology has played a significant role in the advancement of the NEMT industry. Modern NEMT solutions streamline the ride booking and scheduling process, introduce new modalities, improve the overall experience for patients, and decrease fraud, waste and abuse (FWA). For decades, the industry lacked a patient-centric approach focused on efficiency, reliability, and accessibility for all populations, especially those enrolled in Medicare Advantage and Medicaid plans.

A reliable NEMT program can help health plans reduce administrative burden, lower the number of missed appointments, and ensure that patients receive the right level of care and support at the right time during their healthcare journey. Using integration services, health plans can integrate NEMT solutions and programs directly into existing platforms to better manage the member experience and provide an extra layer of connection for members when they utilize these benefits.  

By collaborating with innovative NEMT partners, health plans have made great strides to enhance the overall member experience. Historically, the member journey was largely overlooked, limiting members to two-day-plus advanced notice or long wait times for rides. With the introduction of on-demand ride-booking services through rideshare partners like Uber and Lyft, member needs are prioritized and personalized. Patients can book a ride when and where they need it; then, plans receive real-time updates and notifications during a member’s ride and can make any necessary adjustments as needed. Real-time ride monitoring helps reduce stress and anxiety for patients, prevents FWA, and ensures every ride has a digital record complete with geolocation at every step of the journey.  

While technology-first NEMT has advanced rapidly over the past few years, we’ve only begun to scratch the surface of how it can revolutionize care accessibility. As Medicare Advantage and Medicaid plans continue to grow, NEMT partners will play an increasingly important role in scaling transportation benefits. By working with healthcare providers and payers to integrate NEMT benefits into existing programs and systems, we can provide high-quality transportation services to our most vulnerable populations.

Given the proximity to high-acuity and underserved patients, who are commonly enrolled in Medicare Advantage and Medicaid plans, it’s important to determine whether a transportation provider has the capacity and expertise to meet the individual needs of each member. In a recent study, 21% of U.S. adults without access to a vehicle or public transportation skipped needed medical care last year. This experience is shown to vary depending on other factors such as race and ethnicity, household income, urban or rural location, disability status, and more. Expanding ride modalities with options like on-demand rides provides members the flexibility and comfort they’re looking for in an increasingly-consumer driven healthcare environment as well as plans with the tools they need to close these health equity gaps in accessing care for a diverse population. 

By offering members benefits that work for them and their unique needs, plans can focus on increasing benefit utilization and improving critical present and future Stars Ratings benchmarks like member experience and health equity. When measuring a program’s effectiveness, vendors and plans must work together to decide which data to capture, determine what’s working, and identify areas for improvement. Technology-first NEMT plays a critical role in capturing data and turning it into metrics that matter. 

Despite great strides made to help address the social determinants of health (SDoH), such as transportation access, government regulations continue to play a critical role in shaping the industry’s growth and impact. Various regulations, such as the Medicaid Non-Emergency Medical Transportation Benefit and the Americans with Disabilities Act, have positively impacted how patients access care and the quality of transportation services provided by NEMT vendors. These regulations are crucial for individuals who may not have reliable transportation options, especially those living in rural or low-income areas, and help ensure NEMT providers meet specific quality standards and are held accountable for providing safe and dependable transportation services. As the NEMT industry continues to evolve, it is important for providers to stay informed about the latest regulations and to work closely with government agencies to ensure they are providing the highest quality transportation services possible. By doing so, they can help close the healthcare equity gap and ensure all patients have access to the care they need.

While we can’t predict all the roadblocks the healthcare industry will face in the future, it’s clear that a more efficient, reliable and cost-effective NEMT solution will continue to drive better outcomes for health plans and patients. 

About Andy Auerbach

Andy Auerbach is the Chief Revenue Officer of SafeRide Health, the leading technology-first platform connecting patients to care one ride at a time.

What You Should Know:

– The National Committee for Quality Assurance (NCQA) today launched the Race and Ethnicity Stratification Learning Network, a free, interactive, online tool that offers data and best practices to help health plans improve how they collect race and ethnicity data on their enrollees. Improving data collection of race and ethnicity data is vital to improving health equity.

– The data available in this new resource summarize the care of 20 million people enrolled in 14 health plans that reported results on 5 HEDIS measures, stratified by race and ethnicity. Best practices on the site come from NCQA’s qualitative interviews of key staff at the 14 plans that compose the learning network.

About the Race and Ethnicity Stratification Learning Network

The Race and Ethnicity Stratification Learning Network was convened in late-2022 to develop a greater understanding and resources to support the stratification of quality performance data and use of stratified data to advance health equity.

Learning Network findings reflect 101 contracts across Commercial (27%), Medicaid (41%), Medicare (24%), and Exchange (9%) product lines, representing over 19 million covered lives. One participating organization could contribute multiple contracts. Each contract was assigned to a geographic region. Data submissions reflect a measurement period of January 1, 2021, through December 31, 2021.

Each participating organization was asked to identify key stakeholders to participate in the interview process. The final list of participants represented a range of roles, including data analytics, quality improvement, accreditation, quality management and improvement.

Over the last decade, the healthcare industry has experienced an explosion of digital innovation. Simultaneously, shifting consumer preferences around convenience and access to care has accelerated the pace of technology adoption at unprecedented speed, especially in the wake of the pandemic. 

The value of these digital tools is manifold: healthcare enterprises report increased operational efficiency, higher quality care delivery, cost savings, and the potential to deliver a more equitable patient experience by engaging all patients in their care. 

To most healthcare players, these advances would seem like a win-win. Yet, the industry’s expanding reliance on technology has fueled fresh concerns about disparities around how these digital health tools are accessed. When it comes to underserved populations, will they benefit? Or risk getting left behind?  

Health equity in patient portal use

The contributing factors leading to inequities in digital tool usage are complex, varied, and overlap with broader social drivers of health. The term “techquity,” or technology-related health equity, has been used more recently to draw attention to this persistent, and growing, challenge — and highlight the need to focus on equity in the design, development, and implementation of digital tools.  

The HLTH Foundation’s Techquity for Health Coalition report highlights the three core elements of techquity: access, initial uptake and use, and sustained engagement.

To narrow the digital divide in healthcare, we examined patient portals and their role in improving healthcare outcomes and patient experience. Patient portals empower patients to play more active roles in their care by providing access to their personal health information while increasing efficiency for providers and care organizations. Ideally, by streamlining patient communication and administrative tasks, providers should be able to minimize distractions and shift their focus to delivering high-quality care. 

If patients actually log in, that is. Today, 90% of hospitals and providers in the U.S. offer patient portals. Despite the high rates of adoption on the provider end, patient adoption is lagging; just 40% of patients accessed their online records at least once during 2020, though this number represents a 13 percentage point bump from 2014, according to the Office of the National Coordinator for Health IT (ONC). 

Research shows these adoption figures plunge across specific patient populations, revealing stark racial gaps in portal usage. A patient study conducted by the Ohio University School of Medicine found that Black patients were 40% less likely to use patient portals than white patients. 

Additionally, national market research conducted by Upfront Healthcare and Ipsos found:

• Hispanic patients were less likely than white patients to use portals to check their lab results (35.1% vs 56.5%); 
• Black and Hispanic patients were less likely than white patients to use portals to access medical records (30.8% and 27.6% vs. 42.2%); and 
• Both minority groups were less likely than white patients to use portals to communicate with their care providers (26.8% and 21.2% vs. 36.8%).  

Barriers to patient portal access 

Because race and ethnicity are social constructs and so tightly coupled with systemic inequities in the United States, we must dive deeper into these initial warning signs. This will enable us to better understand barriers and root causes of systematic differences in digital tool usage — and develop strategies for potential solutions and interventions. 

Despite slight increases in patient portal usage, there are multiple potential barriers to equitable use, including: 

Broadband Internet Access: According to a Pew Research Center survey, Black and Hispanic adults are less likely than White adults to have access to broadband internet at home. Of note, while smartphone ownership doesn’t vary substantially by race, 25% of Hispanic and 17% of Black adults rely solely on mobile device data and do not have access to broadband at home compared to 12% of White adults.     

Digital Literacy: Many portals are not designed with usability and accessibility in mind, and patients underserved in healthcare often experience unnecessary technological setbacks. The burden is put on the patient to proactively log in and sort through a number of screens to access the information they need.    

Lack of Awareness: Studies have found that Black and Hispanic patients are offered patient portal access less often than their white counterparts. While 65% of white patients said their provider offered them access to the patient portal, only 54% of Black patients and 49% of Hispanic patients reported the same. 

Health Literacy and Language: Patient portals contain complex medical information, and some may only be available in English, making them difficult to navigate for patients with low health literacy and limited English-speaking skills.  

History of mistrust: Trust and privacy concerns may also play a role in Black patients’ wariness in using portals, as they may be influenced by the systemic racism Black Americans have historically encountered within the healthcare system. In one study, Black and Latino patients preferred to speak directly to providers and were more likely to cite privacy and security anxieties as reasons for portal nonuse. 

Lack of Personalization or Need: Uptake and sustained engagement may also be low because patients do not see a need for the patient portal. In a 2020 survey, 63% of patients said they did not access their portal because they didn’t have a need. 

More work is needed to address existing inequities

To address the existing inequities in patient portal use, healthcare providers and organizations must take steps to ensure that all patients have equal access to these platforms. 

It’s critical to ensure health systems are not throwing yet another piece of technology at patients without consideration of how it meets patient needs or fits into the existing patient experience. This includes a reexamination of the initial value of patient portals and whether current tools are meeting the mark. It’s now nearly 14 years following the passage of the 2009 HITECH Act, which provided incentives for health systems to adopt patient portals in the first place. 

If patient portals are being optimized to deliver a cohesive and better patient experience, providing digital literacy training and ensuring that patient portals are available in multiple languages is necessary. Health systems can promote portal usage in all communications, and help patients understand the value portals provide in meeting their healthcare needs — for example, scheduling a visit or refilling a medication.  

Providers should also work to build trust within Black and Hispanic communities and address cultural barriers to their portal use. Providers must recognize which patient populations are not likely to utilize the patient portal and encourage them to do so by directly addressing their specific concerns. 

One way to build trust is to personalize communications with patients. Healthcare is extremely personal, so patient communications and outreach should follow. Tailoring messages to the patient’s relevant needs and perceived fears makes them feel seen as an individual person, not just a number, and encourages engagement.  

Today, advanced technologies and patient engagement platforms, as a complement to the portal, are elevating personalization and ensuring that the experience is inclusive for all patients. These technology solutions can create more tailored content that addresses the barriers to portal usage and can help inspire patient confidence and trust within the healthcare system.  

About Lindsay Zimmerman, Ph.D., MPH VP, Bartosch Patient Activation Institute, Upfront Healthcare

Lindsay Zimmerman, PhD, MPH is a healthcare expert bringing together rigor and humanity to solve our most complex social and public health challenges. She believes in a true interdisciplinary approach to problem-solving, represented by her background in academic research, data-driven technologies, and patient-focused care models.

Prior to Upfront, Lindsay led large-scale projects at health systems, non-profits, and innovation centers focused on optimally leveraging social factors to proactively engage patients to become partners in their healthcare. Lindsay also co-founded Socium Health, an NSF-funded collaborative to research and prototype patient engagement and care coordination solutions. She has her Ph.D. in Health Informatics from Northwestern University and a Master of Science in Public Health from the University of Illinois Chicago in Epidemiology.

What You Should Know:

– Innovaccer is unveiling six new breakthrough solutions that help providers accelerate their success with population health, consumerism, and value-based care.

– Leading the lineup is Sara, the first conversational AI for healthcare analytics. Sara is a conversational AI assistant that literally puts the full breadth and depth of enterprise healthcare analytics into the hands of healthcare managers, physicians, and care teams. Anyone can ask Sara complex questions about their health system’s population and get immediate answers on clinical, financial, or operational metrics.

The other five new solutions include:

Innovaccer’s Health 1:1 is the first enterprise customer relationship management (CRM) solution built exclusively for healthcare. By integrating all clinical and consumer data for a patient into a longitudinal consumer/patient record, health systems can find new patients, guide their care, and retain them for life.The integrated data also helps to tie financial outcomes to patient acquisition and retention initiatives, documenting downstream ROI. As the industry’s only Enterprise CRM that’s populated with all of your relevant consumer and patient data from day one, there’s no faster or more effective way to accelerate your success with consumer and patient engagement.

Innovaccer’s Health Equity is a comprehensive solution that helps health systems improve service delivery to underserved communities. They can use Area Deprivation Index (ADI) and member-level Social Vulnerability Index (SVI) scores to estimate socioeconomic needs, build cohorts based on social risk, develop targeted interventions to close care gaps and tap the largest network of community resources for referrals. Social Determinants of Health (SDoH) insights integrated into clinical workflows help providers close care gaps at the point of care. Assessments and surveys capture a population’s complex and changing social needs, while automated workflows drive collaboration among patients, providers, and community resources with closed-loop confidential communications. And health leaders can track performance to measure and improve their health equity strategy using the solution’s customizable dashboard.

Innovaccer’s Network Optimizer is a one-stop solution for healthcare leaders to visualize market dynamics and use data to improve network design, optimize network performance, manage referral steerage, reduce network leakage, decrease care costs, and improve care quality. It uses multi-market, all-payer claims data to simulate network configurations and their influence on network performance with predictive analytics. Network Optimizer also helps predict and preempt the impact of inclusions/exclusions of any given provider group on the health system’s performance across network characteristics such as quality score, adequacy, utilization, and more.

Innovaccer’s Readmission Predict helps providers optimize discharge care planning and care management by using AI to predict the likelihood of readmissions at the time of discharge. Readmission Predict also analyzes Admission-Discharge Transfer (ADT) feeds, claims profiles, and SDoH data to suggest targeted interventions providers can act on. Care managers can then prioritize resources and devote additional appropriate attention to at-risk patients to improve care outcomes, helping avoid readmissions and associated costs.

Innovaccer’s Risk AI boosts coding accuracy by analyzing unstructured EHR and clinical data to help providers identify suspect codes and close coding gaps at the point of care. It uses AI, ML, and NLP to analyze years of unstructured documents—such as patient charts, progress notes, and discharge summaries—to flag potential conditions that might impact a person’s risk score. Suspect codes for these conditions are shown to physicians within their EHR clinical workflow, where they can easily view, accept, or reject them during the clinical encounter, closing appropriate coding gaps at the point of care. This cuts coding time, enhances coding accuracy, improves physician satisfaction and efficiency, and maximizes risk contract outcomes by significantly refining population stratification.