Doctor appointments only account for a small percentage of a patient’s time. However, medical outcomes are often linked to social determinants of health. But understanding a patient holistically can be difficult for clinicians facing time constraints and data gaps. Technology has surfaced as a potential way to help fill in the gaps.
Today at a HISS22 symposium on the patient experience, Dr. Baligh Yehia, SVP of Ascension and president of Ascension Medical Group, discussed how his organization has implemented new tools to help boost health equity.
“One is, I would say, this is that if you don’t ask, you don’t know. And we started about two years ago on a journey to collect social determinants of health information from our patients and our consumers. And it’s done mostly through technology,” Yehia said.
“Patients can do it as part of a pre-visit or they can do it while in the waiting room, or could be asked by someone in the clinic. That [gives us] the ability to collect information that is sensitive. We’re asking patients about their income, education and social connection, if they are lonely, personal violence at home …
“Answering those question in a clinic or when going and doing a checklist in front of you is not always the best … You can do it in the safety of your home or before you’re really into business. And that, I think, allows folks to be even more open, transparent and sharing those quicker needs.”
Historically there have also been gaps in how this health information was collected. Not all patients were necessarily asked the same questions.
“I think what we thought before we implemented this was that sometimes folks would frankly, stereotype and ask one patient a question and not someone else. The data shows that one in six of our patients have some sort of SDoH they are dealing with.”
While technology has the ability to improve care, it’s important to make sure digital health isn’t leaving some patients behind. Yehia said that at Ascension they look at multiple metrics to evaluate digital.
“We looked at the data through multiple different lenses. We looked at it through our payer information. We also used something called a social vulnerability index. We looked at race, ethnicity and age … What we saw is the uptake of virtual, for example, was sustained regardless of social ability index ranges and various metrics.”
Data can also tell a story about a patient, and a health system.
“Data is really important, because many times we need to step back up and to see who’s coming to care, who isn’t coming to care.
“When you think about using the example of HIV, we actually have a really good system in the States for that in terms of affordability. There’s all kinds of safety net programs that allow people to access care, to get medicines if they need it.
“But even though you have a pretty good system, there are still a lot of folks that we’re not getting into care. So you need to think deeper about what is preventing them? That’s where data is powerful. You really need to understand the nuances of a community.”
As for the future, Yehia called on the industry to evaluate their culture and look for partnerships. “So that’s how you create the culture of equity. And then, how do you set up the right system of care? So that has to do a lot for you, make it a priority for us as a system. …
“A lot of these issues are so big and require partnerships, partnerships from state, local government, partnerships from other nonprofits, all kinds of unique partnerships that sometimes we don’t think about.”
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