Changing Our Approach Together: How Health Data Can Advance Health Equity

The following is a guest article by Tina Feldmann, VP of Corporate & Product Marketing at Kno2.

The content of this article is taken from a panel Kno2 hosted as part of the recent Civitas Networks for Health 2022 Annual Conference, in collaboration with DirectTrust™ within a track dedicated to the sharing of health data to advance health equity. Click here to access the full panel discussion.

“This health data session led by Kno2, a long-time member of DirectTrust and a new member of Civitas Networks for Health, gave a great overview of how the health IT industry can help facilitate the shift to informed, whole-person care,” said Scott Stuewe, DirectTrust President and CEO. “The variety of perspectives on this panel highlight and inspire the actions we can take to address health equity right now.”  With views from a physician, a nurse, and technologists, there were some beautiful patterns of alignment on key strategies to realize quick wins to level up care delivery and care outcomes, as well as shift provider and vendor mindsets in really powerful (and yet vulnerable) ways.

A Tone-Deaf Approach to Healthcare is Hurting the Most Vulnerable

The panel began with the salient statistic that while 10-20% of an individual’s health is informed by traditional care delivery, this approach serves as the entire basis for how we train and execute healthcare in the United States. We can see where the approach falls short, especially related to health equity, considering that 40-50% of an individual’s health is determined by social and economic factors. Our current methods of care and data exchange do not adequately account for these variables, and we can see how we are beyond the point of being able to ignore these “data points” because of how profoundly they can impact life…or death.

Therasa Bell painted a poignant picture when she said, “When assessing a person’s health, it’s more important we know their zip code than knowing their genetic code.” This has never been more apparent than in the wake of COVID and seeing how differently groups of patients fared based on where they lived, what kind of care and services they had access to, and what kind of practical needs were met (or not).

There is a prevailing notion (bias, really) that many patients who are faring poorly are simply making bad choices, choosing what Dr. Peter Schoch, SVP of Population Health for AdventHealth and President of the Florida Hospital Physician Network, calls “willful non-compliance.” But he remarked that that is actually incredibly rare. In his 20-years as an internist and working in population health, he reflected that, “The vast majority of non-compliance comes from the inability to comply because of one of these…social determinants or behavioral determinants of health…that we’ve not been able to address.”

Follow the Funds, Follow the Focus

Dr. Schoch later remarked that until we (as in the royal “we,” those of us in the healthcare industry) put together a business case for addressing and reimbursing for the attention to these needs/concerns did we really give meaningful consideration to their importance. He admits that’s not saying much for the industry, but the self-awareness of the panelists and call for honesty was highly refreshing and productive!

And as pointed out by Carrie O’Connell, RN and Senior Director of Clinical Strategy at WellSky, we’ve been sitting on these data points in charts for years and haven’t done anything with them. The task at hand is helping acute providers understand why they’re important (and have always been) and how they impact outcomes. Or more precisely, we’ve got to “get under that data…not just capture it, but respond to it,” asserts Kno2’s SVP of Strategy and Adoption, Travis White.

Caring for the Whole Person

The most powerful statement leading into the solutioning portion of the conversation came from Travis, remarking, “The power of capturing this data and acting on it is something that represents the patient’s authentic care journey…not the perceived one.” We simply cannot ignore things like language barriers, transportation issues, food insecurities, and lack of funds for medications, specialists, etc. It’s high time to alleviate patients from the burden of bias and inequity that come with averting our eyes from very real, practical needs that have everything to do with an individual’s ability to manage their diseases.

Dr. Schoch vulnerably acknowledged the unconscious bias present in not only healthcare delivery, but even in the traditional training leading up to practice. He asserts that we’ve got to focus on establishing a trusted relationship with patients and cultivating psychological safety for providers to acknowledge their bias and embrace training opportunities to better meet their communities where they are. Getting to the root of social and behavioral nuances of an individual requires a finesse and trust, not simply working through a checklist of highly-personal questions or assumptions based on appearance alone. We must see the person as a whole being, and, as Carrie O’Connell put it, “keep that mirror in front of us,” ever aware of our own assumptions limiting our care capacity.

Whole, person-centric care is truly the enlightened future…so how do we move the needle that direction with technology?

Post-Acute Providers for the Win!

Kno2’s passion to enable health information exchange for all includes connecting and representing the needs of historically overlooked healthcare segments including post-acute, therapies, EMS, vision, dental, behavioral health, specialty providers and others. It was therefore music to our ears when Dr. Peter Schoch pointed to the incredible opportunity that we have in the post-acute space, specifically Home Health, to develop these critical, trusted relationships with patients more quickly and deeply. So much can be observed within five minutes in someone’s living space to inform their care plan, an experience you simply can’t replicate in the in-office or acute setting. You see the person at home, with their hair down (so to speak), and can capitalize on needs right in front of you that have yet to be articulated or documented in the chart.

Kno2’s Travis White observed that where he has seen this kind of “intel” most impactful is when providers receive actionable communication about it, collaborating with all the relevant data (including spoiled food in the fridge and a busted A/C), and emphasizing that providers shouldn’t be hijacked out of their workflow to access it. It should be available when they need it, and where they need it. He remarked that providers actually have a great appetite for data! And as Dr. Schoch clarified, “I don’t need more data…I need the right data, in my workflow.”

It’s Time for “Common Sense Medicine”

We definitely can’t take credit for this phrase…that belongs to Carrie O’Connell. But we couldn’t agree more with her assertion that we need to not only empower clinicians to address disease, but to also step in and respond to obvious needs. She said providers shouldn’t just be asked to collect the data, but that, “[they] should be part of the solution in making that happen in the community for that person.” She gave the example of an air filter that needs to be cleaned, or a broken air conditioner. Clinicians don’t need to reach hard to determine that these practical needs will impact the patient’s health (pulmonary condition or not), and she’s absolutely right that we need to get reimbursement behind this empowerment to really see change happen.

Clinicians Should Be Able to Rely on Person-Centered Technology

We will never reach health equity across our diverse patient populations if we don’t create solutions that are equitable to all of healthcare. Perfecting the practice of person-centered care to drive health equity means extending that same hospitality to those in healthcare as much as those receiving healthcare – equitable technology solutions are person-centered.

And from a technology perspective, Travis White nailed it when he said, “we need to let the technology do more so the people can do more”. He cited HIPAA barriers, encouraging the industry to consider the true intent for exchange of data and how vital is the free-flow of information between providers – from acute to long-term post-acute – to drive these meaningful conversations and create full 360 awareness of the patient as a whole being. Because as Travis beautifully put it, “asking and answering a (socio-economic indicator) question is one thing…actually doing something with that answer is something else.”

About Kno2

The Kno2 network enables the secure, effortless, and maximized exchange of patient information across patients, providers, payers and IT vendors. From its inception, Kno2 has connected every meaningful network and endpoint involved in the exchange of patient information, and in turn, makes this broad connectivity available through a single Communication API to partners and providers. As the leading communication provider in healthcare, Kno2 recently announced their intent to apply for QHIN designation under the Trusted Exchange Framework and Common Agreement. To learn more, visit www.kno2.com/qhin.

Kno2 is a proud sponsor of Healthcare Scene.

   

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