Lives in the balance: The pursuit of health equity

May 12, 2022 |  EHR, Population Health, Social Determinants, Care Coordination


Genetics presents each of us with a personal health potential and unique set of predispositions, however, the likelihood of falling victim to predispositions or reaching optimal health potential has less to do with genetics and more to do with health equity. Health equity describes the opportunity for all people to reach and maintain their optimal health potential, without any disadvantages that can be ascribed to social, political, and economic circumstances. The social, political, and economic conditions that influence the ability of people to achieve optimal health are collectively termed the Social Determinants of Health (SDOH)

Researchers and policymakers have long been aware of the discrepant health and quality-of-life tied to social determinants, as patients who are subject to poverty, racism, discrimination, and other systemic issues perpetually demonstrate worse health outcomes. Recently, the topic has garnered increasing attention as the disparate impact of the COVID-19 pandemic brought health inequality to the mainstream. The conjunction of social media and social justice shone a bright light on the privilege of health. 

Though only about 20% of health outcomes are attributable to actual medical care, the ability to access appropriate care and the conditions that exacerbate need continue to drive health inequity. Providers equipped with industry-leading EHR solutions like MEDITECH Expanse cannot provide equitable care if patients forego treatment based upon cost. 

Care in the ambulatory setting can only be successful if the patient is able to follow the recommended guidance outside of visits, as the bulk of health behavior occurs outside of medical settings.

Healthcare systems in the U.S. and globally are challenged with meeting the needs of patients whose life experiences undermine their ability to reach full-health potential. Uncontrolled chronic conditions drive care to higher acuity settings, escalating costs, and jeopardizing outcomes.

In the U.S., as reimbursement models move away from volume-based to value-based, the economic health of provider groups and healthcare organizations is tied to providing cost-effective quality care with an emphasis on prevention. Minimizing the cost burden of chronic illness and multi-morbidities is no less important for countries with national health systems such as Canada and the UK.

If the ability to afford care rather than the affordability of care is a differentiator of outcomes, health inequity will persist.

Ultimately, the best medical care in the world cannot overcome the barriers that social determinants present, and therefore, organizations have to think outside of the box (like Ozarks Healthcare), and outside of the practice. Efforts must focus on building cooperation between healthcare organizations, community-based organizations, and public policy-makers to introduce programs and initiatives that provide necessary support to populations with increased risk due to SDOH. 

For its part, the Centers for Medicare and Medicaid Services (CMS) recently unveiled their strategic pillars, the first of which is Advance Equity. The intent of this pillar is to address health disparities that derive from systemic issues in the U.S. health care systems. Initiatives to provide greater equity include adoption of quality measures that promote equity and the expansion of benefits covered under the Affordable Care Act (ACA).

Health equity and outcomes improve when patients are supported in the ways they need. Getting to the root of those needs requires a strong patient-provider relationship built upon trust. Through Expanse Care Compass, practices can manage the care of their patients with an understanding of what makes that patient unique and what challenges they may be facing. 

Effective care management is the consistent thread that pulls the patient, care team, and diverse care settings together to ensure everyone, especially the patient, has what they need to pursue the goal of optimal health. Health equity exists when the potential to reach full personal health is available to everyone.

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Written by Kate Jenkins-Brown, EdD, Product Manager, Population Health Management, MEDITECH

Kate is responsible for overseeing the strategic incorporation of AI into our Expanse solutions and the development of MEDITECH's population health platform including our ambulatory care management solution, Expanse Care Compass. As part of her role, Kate stays engaged in the latest industry topics on AI innovation and governance to guide MEDITECH’s direction with new technology. On behalf of MEDITECH, Kate serves as the co-Chair for the EHRA SDOH Taskforce and participates in the Gravity Project community meetings which are designed to identify terminology and interoperability standards that allow for actionable communication of the social determinants that affect health outcomes.
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