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Patient engagement redefined: Focus on health equity

By Signify Health Team on 10/15/20 3:02 PM

François de Brantes, Senior Vice President, Episodes of Care, was invited to participate in a panel discussion at this year’s HLTH VTRL, a trend-setting conference that brings together payers, providers, employers, investors, startups, pharma, policymakers, and the patient community to help solve some of the industry’s largest problems and to bring to life some of the most promising opportunities to improve health. 

In a panel session (summarized here) moderated by Elise Reuter of MedCity News, de Brantes joined Walmart’s Karissa Price and the University of Pennsylvania’s Shreya Kangovi to explore how the COVID-19 pandemic has exasperated systemic inequities in care access and outcomes and what can be done to address them. 

The COVID-19 pandemic is spotlighting many of the systemic issues that the healthcare delivery system faces and has identified significant portions of the American population who are disproportionately affected by them. It is in the hardest hit areas that provider groups are the least capitalized, are suffering from the results of the pandemic, and are not necessarily benefiting from the economic recovery efforts that larger healthcare systems are receiving. 

Healthcare providers and social workers in these areas are turning to (community health network) partnerships to find the resources and care to help the people they serve fill the clinical and social gaps impacting their health. These community health networks need to find solutions for individuals’ immediate needs while simultaneously building consensus on the more structural issues that must be addressed at the city, state and federal levels. 

For these community health networks to maximize their effectiveness, they need to be built following some fundamental guidelines:

  • Establishing trust within the local community. 
  • Having a real-world understanding of the resources and organizations available to help any individual in need.
  • Creating a collaborative community health network that is accountable for supporting clinical care while identifying and providing for gaps in a person’s social determinants of health.
  • Sharing data and information to provide clinicians and social workers with the information they need, when they need it, while protecting the privacy and dignity of the individual served. 

To effectively build trust, community health workers should come from the community they serve, listen to the people they’re trying to help -- learning their life stories and asking questions. They must understand the capabilities of community-based resources and which ones have outreach programs. It is no longer good enough to give a list of community services to a person in need and hope for the best. Community health workers need to help match people in need with the appropriate organizations and resources, and follow-through with them to ensure that needs are met.

While the community health worker is resolving a person’s immediate needs, the network should identify and catalog structural issues that will take more time to resolve and create a medium- and longer-term action plan to address those issues. 

Some members of the medical community have been focused on increasing the volume of services that they perform, irrespective of whether or not it is improving an outcome. Under the current payment structure, it’s not their job to worry about the other things in a patient's life that can impact outcomes.

This approach must be changed so that clinicians are motivated to increase their zone of accountability from purely clinical outcomes to including the adjacent outcomes that influence the clinical ones. This creates a direct role for  physicians to help address patients’ social determinants of health and to find ways for those patients to have their social needs met.

For this expanded role to be effective and sustainable, clinicians must have the ability to communicate and share patient information with community-based organizations and other social service providers in a safe and secure fashion. The good news is that there are successful models being deployed across the country that demonstrate the pathway for how clinical and social services (community health networks) can achieve measurable community health outcomes. 

Signify Health supports a number of (community health network) partnerships across the country among local and state governments, community social service organizations, insurance companies and healthcare providers where we have customized the data and information sharing to the specific needs of a community. Our proprietary technology platform allows the right information to be shared with the right individual, at the right time, while protecting a client’s privacy and dignity. 

The COVID-19 pandemic has highlighted many systemic issues within the healthcare delivery system, including being able to address both the clinical and social determinants of health challenges that many individuals face. As discussed in the HLTH VRTL session, there are clear opportunities to make an impact today as we continue to work on the more difficult systemic issues driving health inequities.

This session is available for viewing on-demand by registered attendees at HLTH VTRL 2020.