Technological Strategies to Improve Health Equity

This is the final post in a three-part series covering Modern Healthcare’s Social Determinants of Health Symposium, which was held virtually on August 11, 2022.  

An important component of the Association of Community Cancer Centers (ACCC) President Dr. David R. Penberthy’s 2022-2023 President’s Theme is the equitable leveraging of data and technological solutions to improve care delivery and reduce health disparities. “The science of oncology is exploding and keeping up with all the information is a daunting task,” he said. “We’ll identify opportunities to use AI [artificial intelligence] driven practice support tools and patient wearable devices, so we can focus on critical issues, such as shared medical decision-making, workforce shortages, improving care to underserved and marginalized patients, increasing clinical trial participation, and delivering person-centered care.”   

Benefits of the Cloud  

In Modern Healthcare’s symposium, speakers discussed health equity best practices and how data can mitigate social determinants of health (SDOH). During its session on SDOH in precision medicine, Daniel Low, MD, chief medical officer at AdaptX, explained that technological solutions offer insight and efficiency for healthcare professionals and organizations.   

AdaptX is a cloud-based platform that enables clinicians to use data to monitor, evaluate, and adapt care across patients and to improve the quality, equity, and efficiency of this care. Recently, the company helped one hospital’s Interventional Radiology Department that was struggling to meet patient demand and, as a result, saw an increase in service delays and  backlog. AdaptX allowed the team to assess its time distribution and performance, while facilitating the development of strategies to optimize patient flow. Within weeks, the technology platform helped the team decrease time spent on administrative tasks and increase revenue by six million dollars without increasing costs.    

Dr. Low explained that AdaptX was created to add an equity layer to healthcare by using artificial intelligence (AI) to scan an organization’s electronic health record (EHR) for racial, language, and gender disparities either throughout the care continuum or among patient outcomes. Crunching vast amounts of data, this system accomplishes in a few minutes a feat that would take a team of analysts years to do. Dr. Low shared two cases that demonstrate how this system tackles health equity.  

First, one children’s hospital that used AdaptX to analyze its EHR found that its 30-day re-operation rates for Black and Asian patients was between three to four times higher than their White counterparts. “That was unknown to the whole staff … [at] the hospital,” Dr. Low explained. “Most clinicians are too close to the work to see the forest from the trees.”    

Upon close examination of their data, the nurses realized that there was a problem with the post-operation educational session that patients were attending. “It turns out that the app[lication] for post op[eration] teaching was only available in English. The instructions were targeted toward non-Hispanic White, English speaking families,” Dr. Low said. “They would tell patients to drink a bottle of Gatorade to stay hydrated post-op[eration]. The Vietnamese patients did not know what Gatorade was.”   

This case demonstrates the importance of understanding the sociological factors that affect patients’ health outcomes. “If we ask more questions, we can help solve problems,” said Carlos Lejnieks, president and chief executive officer at Big Brothers Big Sisters of Essex, Hudson, & Union Counties, New Jersey. “It is easy to look at the flow of business as numbers on a spreadsheet, but behind each number is a human being. And behind each human being, there is a context.”   

Armed with this new information, the nurses at the children’s hospital changed their post-operation educational session to incorporate graphics and images that would be widely understood by all patients. “It came down to diagnosing the problem with their own data, and they were able to fix the problem,” Dr. Low said. “Modern technology allows you to quickly recognize if something you have done to fix a problem worked. Our ability to learn and adapt our systems is in an interesting place right now.” Michael Cui, MD, associate chief medical informatics officer at Rush University Medical Center, believes that we are now in an exciting time for addressing health equity because of modern-day access to analytics and precision medicine. “We have all the tools now,” he said.  

Each panelist on the day believed that the use of actionable data to effect change and advance health equity would be a staple of healthcare moving forward. “When we give someone a diploma, we are giving it to them with the expectation that what they learn today, they are going to be using [it] for the rest of their working life,” said Harold Paz, MD, executive vice president for health sciences at Stony Brook University and chief executive officer at Stony Brook University Medicine. “It is important that we do that based on what the systems of the future will evolve to, as opposed to the way that many of us practice medicine now.”    

Find more resources from ACCC on how to leverage technology to transform cancer care delivery and the patient experience online.