This seems to go against the trend, but the key to improving health equity may lie outside the clinical environment. Esther Farkas, chief strategy officer at the software company Unite Us, said that healthcare is not just a service provided in a clinic. Food and housing are also important health factors. She said that when these aspects of life are not safe, health will be affected.
Farkas spoke during a panel discussion “Improving health equity requires a collaborative approach” at the MedCity News INVEST Pop Health conference on Tuesday. Unite Us provides a software platform for the health system and pharmacies to coordinate care. As an example of how technology can bring healthcare beyond the clinical setting, Farkas cited her company’s involvement in California’s initiative to stop the spread of Covid-19. People who are vaccinated at the vaccination site also have the opportunity to obtain various health and social services through Unite Us. These services include food, housing and employment. Farkas said that providing such connections in this way reduces the burden on people trying to connect to services on their own.
Farkas said: “Not all care has to be transferred to the healthcare environment, which is more expensive and undesirable.”
In some cases, the improvement in health outcomes comes from medical equipment. iRhythm Technologies’ cardiac monitoring equipment is the key to improving cardiovascular outcomes in New Mexico. The company’s chief clinical officer and executive vice president of product Judith Lenane (Judith Lenane) said that the state has only 2.1 million people, but the population is spread over a wide area, making the state the fifth largest state in the United States. Because there are only 10 electrophysiologists in New Mexico, all of whom are in Albuquerque, patients in rural areas must drive up to 6 hours to receive cardiac care. As a result, Lenane said, the heart disease was not diagnosed and the patient did not receive timely care.
According to the partnership, the New Mexico Heart Institute and iRhythm identified patients in need, and then provided them with the company’s wearable heart monitoring equipment. Lenane said the monitoring technology collects cardiac data, improves patient compliance, and speeds up access to care. She said the institute is now able to provide care for up to five times as many patients without requiring additional staff. As for delivering equipment to patients, iRhythm is the old school. It uses the United States Postal Service.
“This seems low-tech, but when you think about solutions, you have to use low-tech,” Lenane said. “You have to meet people where they are.”
Darrell Langlois, senior vice president of strategy and business development for the insurance company, said that one of Blue Cross Blue Shield Louisiana’s outreach efforts involves working with the larger health system to improve maternal health. He pointed out that some of the challenges in providing maternity care stem from a lack of trust. For example, it is not uncommon for clinicians to ask new mothers about postpartum depression or anxiety. But Langlois pointed out that depending on the settings, the same problem may have different reception methods. Langlois said that wealthy mothers are more likely to provide honest answers to this question. He explained that a less affluent mother may be ashamed of expressing depression for fear that her child will be taken away.
Louisiana has been incorporating health equity into various mechanisms. Mia Alwhite, deputy director of the State Department of Health, Community Partnerships and Health Equity Bureau, said that various departments have been working with community organizations to communityize their health and equity work to the public. Equity has also been incorporated into policies and procedures. For example, the manual was revised to ensure that pronouns are inclusive for all. Alwhite said her bureau also worked with the state Department of Education to develop initiatives to help families participate in nursing services.
Coletta Barrett, vice president of missions at the Notre Dame Lake Regional Medical Center, said it is important to ensure that outreach connects with children. The medical center cooperates with children’s hospitals and schools to develop primary care and mental health programs. By reaching children who receive free and reduced-price lunches, these efforts can address a large proportion of children in need. Barrett said it’s important to bring this kind of outreach into school.
“If children are not healthy, they are not ready to learn,” she said.
Photo credit: Andrii Shyp, Getty Images
