Pictured from left to right: Maryjane Wurth, Kimberly Wilson, John Haupert and Anton Gunn.
This week, as part of the South by Southwest (SXSW) festival’s Interactive Health and MedTech track, the American Hospital Association and hospital leaders have been sharing how hospitals and health systems are transforming to advance health in their communities.
AHA partnered with Energizing Health to create opportunities for health organizations, community advocates, entrepreneurs, and philanthropical organizations to innovate and collaborate on initiatives aimed at addressing health equity by eliminating systemic barriers, reducing inequities and building healthier communities. In addition to AHA, participating organizations include the Aetna Foundation, the Robert Wood Johnson Foundation, the Cambia Health Foundation, the St. David’s Foundation, the American Heart Association and the American Cancer Society, as well as civic, hospital and community leaders from across the country.
Read on for highlights of some of the sessions and watch for full coverage all week in AHA Today, as well as key takeaways from the festival in the March 19 issue of AHA Market Scan. You can follow along with AHA on social media or using #SXSW.
Access to Care: All Health is Not Created Equally – AHA Executive Vice President and Chief Operating Officer Maryjane Wurth moderated a thoughtful discussion on how hospitals and health systems, clinicians and community partners are working to improve access to care in a more equitable and inclusive manner.
“We know access to the system is not the same as access to providers who understand your issues,” Wurth said in introducing the panel.
John Haupert, president and CEO of Grady Health System, described how his system, located in Atlanta, is addressing not just the community’s acute-care needs but the social determinants.
“At Grady, we have understood for decades that we have to provide more equitable, person-centered care,” said Haupert, explaining how the system works to also identify and address the social determinants of health for patients. He described how Grady is working as a convener with community groups to address the social determinants and is opening a healthy food center later this year in one community with food deserts.
“We know all of these issues are zipcode-based,” said Anton Gunn of Health Equity Cypher, which works to bring health care and community leaders together to identify opportunities and create culturally competent solutions for the particular community, particularly African-American communities. “Insurance is part of the solution … but we have to keep the conversation going with the people of the community.” He called the Affordable Care Act’s community health needs assessment process a great step forward in identifying a community’s needs and involving the community in that discussion.
Kimberly Wilson, founder, HUED, explained how psychological barriers can prevent people of color from accessing care when they can’t find providers who look like them or have the cultural competency. She described how she had to travel from New York to Baltimore to find an African-American physician to treat her for a medical condition. This led her to create HUED, a technology-based platform that allows the user to search for medical professionals of color that can understand and meet their needs. Wilson noted how this is easier in large urban communities, but more difficult in smaller or rural communities. They are also investigating telehealth options to help meet these needs.
Gunn also advocated for broadening how we gather community feedback by going to where community members gather, such as the barber shop for African-American men.
“These are new ways to think about how we treat people to be healthy,” said Gunn. “We need more people at the front end thinking about how we transform how the system operates.”
Haupert described how Grady is implementing a congregational health program by sending nurses to African-American churches to provide health information and help parishioners access care.
The panel also discussed the need for more clinicians of color, who may better understand their patients’ experiences and needs. Haupert shared how Grady has worked with the Emory University and Morehouse School of Medicine to help facilitate placing Morehouse residents in positions at Emory in some subspecialties where diversity lags, such as orthopedics.
Delivering Care Anywhere: Beyond the Office Visit – Care is increasingly moving beyond the four walls of a hospital or doctor’s office and into the community, and even patients’ homes. With advancements in telehealth and in-home care, doctors have the ability to eliminate transportation barriers and reach more patients.
In this session, AHA Chief Medical Officer and Senior Vice President Jay Bhatt, D.O.; William Buster, executive vice president for community investments, St. David’s Foundation; Bonnie Clipper, vice president of practice & innovation for the American Nurses Association; and Daniel Weberg, senior director of innovation and leadership liaison, Kaiser Permanente, explored the impact of telehealth and in-home care on the trajectory of a person’s health journey and solutions for combating the digital divide inhibiting marginalized communities from taking advantage of these technological advancements in health care.
Weberg shared how Kaiser Permanente has “made video visits the norm” for many types of services. “We have more virtual visits for many things than we do in-person visits,” he said. But systems that do not have risk-based contracts struggle to do them because they cannot get reimbursed.
Cellphones may offer one way to make virtual visits or advice-seeking a reality for many. But while cellphones may be nearly ubiquitous, not everyone has access to smartphones or the data plans needed for some tech-heavy interventions. However, text messaging is one tool that can be used nearly universally, and providers could focus there to better ensure access, noted Buster.
There are other opportunities to bring health care to the home, the panel agreed. “You have to “break yourselves out of the traditional ways you see care,” said Buster, noting how organizations like Meals on Wheels have enhanced their visits to ensure homes and patients are healthy.
Bhatt shared how many hospitals and health systems are bringing “hospital at home” programs to communities around the country.
“What we’re learning is, [improving health] is a team sport,” said Bhatt. “You have got to have thought around who are the right members of that team, and how do they need to be engaged and what’s the training for that workforce that needs to be developed, particularly around the issue of equity and the cultural sensitivities … We’re a visitor as a team in the patient’s home.”
But delivery care at home can be challenging for those facing housing insecurity or without access to broadband internet. Weberg described Kaiser Permanente’s latest efforts to support housing security in California. In January, the organization announced several major initiatives that will improve health outcomes by creating stable housing for vulnerable populations. They include seeding a real estate investment in Oakland, anchoring a $100 million national loan fund for affordable housing and kicking off a plan to end homelessness for more than 500 Oakland-area residents.
Other places in the community offer providers new ways to engage with patients. “You have to meet individuals where they are,” said Bhatt, citing community meeting places such as barber shops, churches and markets, where people gather and could access services.
Buster agreed that “you have to support those every day organizations that people have connection with and comfort in.” He also advocated for more holistic city planning that takes health into account when making design decisions rather than thinking about systems independently.
Bhatt said technology can be a great enabler, but cautioned that it is not the only solution.
“Tech is a double-edged sword,” Bhatt noted. “On the one end, it can be an extraordinary enabler of health for accelerating the kind of change we want to see. But it can also in some instances perpetuate bias, whether through algorithms or the pathway of decision-making. How do we help bring in the voices of those who are experiencing the technology and then help build it and share it?”
The panel also discussed the workforce challenges related to ensuring we can continue to provide the kind of care we need in the future. Weberg noted how nursing schools are not preparing nurses for telehealth. “I think we’re a long, long way off,” he said. “… I don’t think the education side is ready to meet our needs.” He shared that Kaiser Permanente’s new medical school is also facing how to overcome similar challenges.