Many of the sessions at this year’s HLTH Conference have been centered on health equity. There have been fantastic panels of experts discussing everything from: the lack of access to care, the inherent bias in AI, and digital disparity. It has been heartening to see this public discourse on a topic that has remained hidden in the shadows for decades.
Conquering the Digital Divide
Whenever Abner Mason, Founder and CEO of ConsejoSano is on stage, my ears perk up. If you’ve ever spoken or tweeted with Mason you’ll instantly see how passionate he is about health equity. He hosted a #HLTH2021 panel Conquering the Digital Divide that featured Lea Sims, Marketing Strategy Lead for Healthcare and Life Sciences at Verizon and Ed Deming, Healthcare Industry Strategist at VMWare.
Mason opened the session with a great quip that encapsulated the reality of our current healthcare system: “Our healthcare system today doesn’t do a good job at serving everyone. It does a better job at serving people who have money, but if you are in the low income bracket or have low health literacy our system doesn’t do a very good job serving you.”
From there, the panel discussed the potential opportunity offered by virtual care to address the inequities in the current system. The panelists generally agreed that virtual care could mitigate inequities in healthcare, but it wouldn’t happen unless we were thoughtful in how it was implemented.
Mason brought up the example of telehealth. Until COVID-19 hit, safety net hospitals did not offer any form of virtual care because they were only reimbursed for patients that walked in the door. When the pandemic hit, the government enacted emergency measures and suddenly telehealth and video visits could be offered.
The preference for many in this demographic was for telehealth (phone) vs video. Mason was quick to stress how important it will be to remember this fact as we exit the pandemic. “There is the potential that we will give a higher reimbursement for a video visit and a lower amount for a tele-visit,” said Mason. “If this happens, we will recreate an inequity as many organizations would opt to only offer the higher-reimbursed option which is not in fact the preferred option for many in this already underserved demographic.”
Strengthening Communities as an Inroad to Equity
Michael Petersen MD, Chief Clinical Innovation Officer at NTT DATA Services led a panel in a discussion about leveraging and involving local communities to help address health equity. I loved his opening statement: “Health equity cannot be solved from conference rooms in Silicon Valley and trust can’t be earned through apps and technology. What’s been missing is meaningful connections with communities.”
Kate Sommerfeld, President, Social Determinants of Health Institute at ProMedica shared how her organization (a payer+provider) opened a full-service grocery store in a food desert – a store that they still operate today. That store was considered an investment in the health of the local community. Since that time, they have worked with local community partners to open 5 additional stores in other underserved areas. For initiatives like this, Sommerfeld stressed the need to be patient for the ROI of this type of community investment. It could take years.
Toyin Ajayi MD, President and Co-Founder at Cityblock Health, an organization that provides care and other healthy services to local neighborhood, put forward a unique idea to infuse community impact into corporate America. She suggested setting community impact goals for executives – similar to financial performance metrics – and tie compensation/bonuses to it.
AI’s Role in Bias and Equity
This panel was captivating. Joseph Kvedar MD, Chair of the Board at The American Telemedicine Association was the host and he made a comment that got the wheels turning: “AI is not a black box like the way blockchain is.” Kvedar explained that unlike most other technologies AI needs more care and feeding.
Panelist Suchi Saria, CEO and Founder at Bayesian Health expanded on this thought by reminding the audience that AI in healthcare is likely trained on imperfect data. “Health data is messy,” she explained. “If you just grab data from a healthcare organization, you’ve inherited a bias dataset. That’s because data comes from processes and healthcare processes are far from perfect. There are many inherent biases.”
According to Suchi, minimizing the biases in AI is an ongoing process and requires the following key steps:
- Understanding the potential sources of bias
- Adequately measuring, monitoring, and testing for that bias
- Putting strategies in place to correct for it
- Continuously tuning as new sources of bias arise
The Future of Health is Equitable: Walmart on a Mission for Healthier Communities
This was one of the #HLTH2021 sessions that I was most looking forward to. With all the hype around Walmart’s push into healthcare, I was hoping for a behind-the-scenes look at their motivations and vision. I was not disappointed.
Cheryl Pegus MD MPH, Executive Vice President of Health & Wellness at Walmart, packed her 20min fireside chat with a ton of information about how Walmart approaches healthcare…and surprisingly they look INWARD for inspiration.
“We have over 1.2 Million associates that work at Walmart,” said Pegus. “Most live in the community that surrounds their store. 4,000 of our Walmart stores are located in Medically Underserved Areas (MUAs).”
MUAs are areas designated by the Health Resources & Services Administration as having too few primary care providers, high infant mortality, high poverty or high elderly population. When designing their approach to healthcare, Walmart asked their own staff how they would like to receive care.
“We should provide care the way people want to receive it,” continued Pegus. “If you are a mom with a family, working a regular job, healthcare means a Saturday afternoon, not 9-5 on a weekday. It means picking up glasses for your children at the same time you are picking up medication and groceries.”
Walmart’s greatest insight? Actively partnering with local community leaders. Pegus pointed to the company’s incredible success with COVID-19 vaccinations. Over 80% of the doses administered by Walmart have been in MUAs. This was only possible because they proactively sought out local community leaders and got them involved in vaccination education and drives.
Final Note
From the sessions I attended at #HLTH2021, it was clear equity was the central theme. I found it very exciting that the panelists spoke openly and honestly about the problems of equity in healthcare. There wasn’t a lot of sugar-coating. It was refreshing. Hopefully this will inspire people in the audience to do more to address this issue in their organization/company.
As a final note, I must acknowledge the HLTH event organizers. They took care of their remote participants. All the sessions were available digitally by the end of the day and many of the sessions in the main room are streamed live. Kudos.
We missed you, Colin, but it was great to catch up with John in Boston. Thanks for calling out some of these sessions that I missed – will tune in to the virtual replays!