By Demi Radeva
Health equity took center stage at the HLTH Conference in Boston last year.
HLTH is an annual event that brings together thousands of leaders across the healthcare space– representing payers, providers, pharma, startups and more– to tackle the most pressing healthcare challenges and answer the question: “How do we create the future of health?”
The conference began on Sunday, October 17 with a full day of discussions on topics including: debiasing clinical guidelines; making complex care accessible to the homeless; improving interoperability between social and medical services; bridging the gap between patients and the facilities they need; and designing appropriate metrics to drive progress, among many others.
The discussions were vivid and left the audience with more questions than answers. Some of them include:
- How do we undesign these maps? Child Opportunity Index (COI)
- How many more clinical guidelines we use in medicine today are biased? Here is an example: Old formula prevents black patients from accessing kidney care.
- How can we make complex care work for someone who is homeless?
- Would we ever focus on primary prevention given our existing system constraints?
- How do we bridge the gap between the patient and the facility to which we are asking them to come into (which most of the time was built with us and not them in mind)?
- Have we failed as a society if we house those who are most likely to get hospitalized to prevent them from going into the ER and generate cost savings without asking how did they end up in this position in the first place and solving for that instead?
- What does a successful partnership framework look like between large for-profits and incumbents and small CBOs? For-profit business cycles and project requirements can be damaging to these organizations.
- How can we make interoperability a reality between social and medical services?
- What metrics should we use to drive progress?
Ideas on how to move forward included:
- Do better in the existing construct while working to change it. After all, our systems are designed to give us these outcomes that we are experiencing today.
- Improve structural competency, not just cultural competency.
- Regain and build the trust of those we serve.
- Recognize that qualitative data– people’s lived experience– is just as important as quantitative data.
- Link executive compensation to equity-focused objectives. Leaders should lead by example and commit to equity.
- Leverage political advocacy to drive policy change (i.e. in health screening, education, housing) and don’t rely too heavily on private business solutions driven by profit motive.
- Advocacy and social policies change (i.e. health screening, education, housing) versus private business solutions and profit making.
- Leadership and the leadership shadow. If the leaders are committed to equity that permeates through the whole organization.
- Executive compensation linked with equity-focused objectives.
- All three forms of prevention – not just tertiary (death prevention), but secondary (chronic prevention), and primary (disease prevention).
- Building and regaining the trust of those we serve.
- Qualitative data (lived experience). It is just as important, if not important than quantitative data (can be highly problematic).
- Being impatient. Not accepting the status quo any longer.
Also, I had the amazing opportunity to sit down with entrepreneurs who are leveraging digital health tech to build a more equitable future for all. Click on the links to access:
- Peter Hames, the founder and CEO of Big Health – Interview Link
- Dr. Lisa Fitzpatrick, the founder of Grapevine Health – Interview Link
- Keith Algozzine, the founder and CEO of UCM Health – Interview Link
- Ashley Tyrner, the founder and CEO of FarmboxRx – Interview Link
- Naweed Zemaryalai, CEO & Jessie Vera-Barrett, Advisor at TravaLab – Interview Link
However, I felt that HLTH lost the opportunity to give center stage to those who needed it most – the patients, the users, the members. We were in the heart of Boston where there are stark inequities just outside the doors of the beautiful convention center. It’s a place that houses some of the brightest minds in some of the most innovative hospitals in the country and the world, yet, poverty is right around the corner. And until innovators and executives get outside of their bubble and into the community and actually, listen, would we see real change?