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How data helps physicians improve operations and achieve health equity goals


Federal agencies are taking steps to embed systemic health equity practices into their policies and operations to fortify the resilience of our nation's healthcare system and help all Americans reach optimal health outcomes.

Data can help bring about health equity: ©Dizain - stock.adobe.com

Data can help bring about health equity: ©Dizain - stock.adobe.com

According to a recent survey of U.S. health care executives, about 30% believe the case for improving health equity is entirely social, without business motivations. As a result, health equity initiatives often lack the same rigor and resources as other strategic efforts.

At its core, health equity is the state in which everyone has a fair and just opportunity to attain their highest level of health. When based on standardized, secure, and advanced data insights, equitable health care practices can significantly reduce strain on health care systems by driving preventative action rather than resorting to reactive procedures.

Federal agencies are taking steps to embed systemic health equity practices into their policies and operations to fortify the resilience of our nation's health care system and help all Americans reach optimal health outcomes.

The connection between health-related social needs and patient outcomes

As of Jan. 1, 2024, CMS implemented new policies for addressing health-related social needs (HRSN) to proactively treat and better understand the needs of our country's most underserved and chronically ill populations.

Coordinating care for patients with significant unmet HRSN can be a complex process for physicians that may require consultations with a multidisciplinary team of health care providers and community health workers. Further obstacles to comprehensively addressing HRSN include insufficient funding, staffing shortages, and inaccessible treatments.

To address these challenges, CMS’s new policies will support physicians that help patients identify and connect with the appropriate clinical and community resources to address unmet HRSN that may influence a patient's treatment.

Understanding and accounting for HRSN can help proactively address patient needs and mitigate the likelihood that a patient will require expensive health care services, such as an ambulance ride or an emergency room visit.

Modern IT solutions that provide data analysis, automation, and AI have a significant role to play as healthcare providers work to adequately understand these factors.

How advanced IT helps address health-related social needs

Data-driven insights and automation are transformational resources that alleviate tremendous strain on health care providers. Many primary care sites are already deploying these technologies for care coordination to increase provider access and reduce missed appointments. This technology can improve the operational efficiency of providers and streamline care coordination.

Patient data is also a fundamental factor in determining the optimal course of treatment and care coordination because it empowers providers to project patients’ health-related social needs. AI-powered data analysis based on HRSN can drive these projections and help providers account for external factors that they may not be able to ascertain otherwise. As a result, providers can simultaneously save time and costs while advancing health equity.

When leveraged responsibly, health care data management and analysis can illuminate critical information about a population’s health. For example, advanced data algorithms can expedite resource development and deployment for underserved and socially marginalized communities. Federal health agencies can use this information to monitor health trends over time and evaluate the effects of policy changes on health outcomes and disparities.

Organizing and analyzing patient data is essential to identifying and understanding the root causes of health disparities. With these insights, diagnoses and treatments can be more preventative than reactive, improving patient outcomes, reducing the burden on providers, and saving costs for the entire health care system. As holistic care becomes more prevalent throughout the health care system, providers will see significant returns on their health investments.

Critical considerations for optimal healthcare data management

Federal agencies and health care providers are working in collaboration to approach health in a holistic way. Standardized data collection and governance practices are needed to make patient health information transferable, interoperable, and actionable.

It’s imperative that health care providers can effectively collaborate amongst multidisciplinary teams and that all parties can access and analyze the necessary data to make informed decisions.

Additionally, it’s paramount that providers and beneficiaries are well-educated about HRSN. Providers should remain up to date on HRSN policies and regulations from federal health agencies and continually explore the latest IT tools and data management services. As providers improve HRSN data acquisition and accuracy, early interventions can be implemented, which will reduce the cost of care.

Providers should also inform their beneficiaries about changes in data usage, assure them that their data is being protected, and explain how these changes lead to improved care. Moreover, patients should feel empowered to take control of their health. By developing technology to promote health literacy and providing educational opportunities and resources to patients, disparities will be reduced.

To achieve a sustainable and equitable health care future, health care providers, agency leaders, industry experts, and leading academics must continue to engage in open discussions about harnessing HRSN data to improve patient outcomes while alleviating economic and labor strains on the healthcare system.

Kamala Green is the National Government Services’ Social Drivers of Health Program Manager and Dr. Greg McKinneyis the National Government Services’ Chief Medical Officer,

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