When people hear about a healthcare accelerator, they usually think of an incubator program in which digital health companies receive investment to strengthen their technology.this is not the case Boston Medical Centerof Health Equity Accelerator.
After being overwhelmed with data on racial health disparities that continue to disproportionately affect black and brown patients in the U.S., BMC roll out Accelerator in November. The accelerator’s co-executive director, Elena Mendez-Escobar, said its goal is to speed up the timeline between identifying inequalities and implementing action plans to address them.
“BMC has been a safety net hospital for 150 years, so it has always been focused on health equity,” she said. “Many agencies have long been committed to health equity, but they don’t have a clear and intentional focus on race and ethnicity that we think is lacking.”
According to Mendez-Escobar, 70 percent of people with BMC identify themselves as black or Latino. Because of this, hospitals are not only responsible for closing the racial health equity gap, but they also have a wealth of data to dig into to understand which disparities affect people of color the most.
Accelerator researchers analyzed BMC data to identify the following five clinical areas with the most pressing racial health inequities: Maternal and Child Health, infectious diseases, behavioral health, chronic disease, oncology, and end-stage renal disease. To address health inequalities in these clinical areas, the Accelerator has assembled cross-functional teams of clinical experts, researchers, and healthcare professionals to speak with patients and determine what changes BMC should make to its care delivery model.
For example, after researchers at the accelerator found that black mothers in BMC were 1.7 times more likely to have serious complications at birth than white mothers, it assembled a multidisciplinary team. The team – made up of doulas, midwives, doctors, procedures specialists and researchers – investigated the question by completing literature reviews, analyzing EMR data and conducting focus group discussions with patients.
Within months, they found that the leading cause of more complications in black patients with BMC was related to preeclampsia, a serious pregnancy complication characterized by high blood pressure. The only treatment for preeclampsia is childbirth, so a patient’s care team must make a quick decision to induce labor or to have a C-section. The longer it takes to make these decisions, the higher the patient’s risk of bleeding. The accelerator study found that nursing teams took longer to make these decisions for black patients, causing them to bleed more.
BMC quickly took a series of steps to address this finding, such as expanding its doula program and disseminating patient-facing videos about preeclampsia to increase patient representation. The hospital has also expanded its hypertension remote monitoring program to detect cases of preeclampsia earlier and update its clinical protocols, so there is less variability in the time it takes to make childbirth decisions during a preeclamptic episode. To measure the impact of these changes, BMC will look at metrics such as preeclampsia complications and black maternal mortality.
Establishing the Health Equity Accelerator enables BMC to rapidly implement these interventions. Mendez-Escobar noted that the accelerator was established to accelerate clinical change and outreach efforts, which are the results of health equity research.
Rather than focusing on troves of research articles and years-long trials, academic medical centers can often develop an action plan on health equity issues within three or four months, if they have a dedicated plan to do so, she said.
Photo: gmast3r, Getty Images
