With health inequities accounting for approximately $320 billion in annual healthcare spending and roughly $42 billion in lost productivity per year,1 it is unsurprising that healthcare organizations across the US focus on initiatives to improve health equity. High-quality data are needed to identify health disparities, find patterns or root causes, and implement targeted interventions.2 Health systems generate millions of data points each year, and the volume of data is projected to increase faster in healthcare over the next seven years than in any other field.2 Turning data volume into data insights and integrating them into meaningful clinical and operational processes requires hospitals and health systems to closely examine how they collect and use their data.
Here, we look at 3 health systems whose analytics-based approaches were awarded by the American Hospital Association (AMA).
1. Northwell Health3
Northwell Health is the fourteenth largest healthcare system in the US, serving 11 million patients. Over one-third of Northwell’s patients prefer languages other than English. To enhance communication and cultural competence, the system implemented AMA’s Communication Climate Assessment Tool. It emphasized collecting accurate race, ethnicity and language (REaL) data.
In particular, Northwell created a mandatory e-learning module for employees and partnered with the community relations department to educate patients about REaL data usage and storage. Efforts included creating a public service announcement video and offering interpretation services. The system also integrated accurate REaL data into the top banner of the electronic medical record (EMR), making it easily accessible for clinicians. These efforts and robust staff education led to a 465% increase in telephonic interpretation calls between 2009 and 2018 (from 51,207 to 289,615) and 1,500 onsite interpretation sessions.
Moreover, Northwell translated 119 vital documents into 22 languages, large print, and braille. A dashboard comparing internal registration data with local language demographics helps inform staffing needs. For example, if 40% of patients at a hospital speak Spanish compared with only 5% of the staff, Northwell can take the necessary steps to address this gap.
2. Atrium Health4
Atrium Health operates over 40 hospitals and 900 care locations. Atrium redesigned its EMR to improve the collection of patient demographic data, achieving a 97% collection rate for REaL data and sexual orientation and gender identity data.
In addition to improved data collection, Atrium developed a “demographic data wall,” an electronic scorecard tracking health metrics and experiences, thus allowing leaders to pinpoint and address outcome gaps. For example, the “For All” Health Equity Colorectal Cancer Screening Goal targeted disparities among Hispanic/Latino males, resulting in over 200 screenings through various campaigns and interventions over two years.
Atrium also expanded community outreach. The system offered increased COVID-19 education, testing and treatment, particularly for non-English speakers. It established fixed testing sites and a Multicultural Communications Taskforce to counter misinformation. To enhance transgender patient care, it created a new education program and Gender Identity Clinic at Levine Children’s Hospital.
3. Sutter Health5
Sutter Health serves over 3.5 million patients in 22 Northern California counties and has the region’s largest share of underinsured and uninsured patients. In 2003, 30% of its patients were people from racial and ethnic minority groups, a number that rose to 56% over 15 years. To address health inequities, Sutter developed a framework based on collecting REaL data, which it integrated into its EMR system. This data foundation led to the Health Equity Index (HEI), the first metric to use real-time health system data combined with external statistics to identify and address disparities in specific racial or ethnic groups.
Initially used to enhance language services, the HEI now helps Sutter analyze patient data clinically, develop equity programs and measure impact. For example, the HEI revealed higher asthma rates among African American patients, leading to a targeted asthma program in Berkeley and Oakland. For diabetes, the HEI highlighted increased emergency room visits among younger patients (20-44 years old), prompting targeted interventions. The HEI also identifies at-risk white patient subgroups, challenging the notion that only minority groups are at risk.
Moving forward, Sutter aims to expand the use of the HEI in other states to validate the potential usefulness of the tool on a national scale.
All three organizations show a remarkable and dedicated focus on data collection. Traditionally, leaders have relied on their experience and intuition, seeking data as a supporting factor. The trend is shifting toward a future where leaders allow data to guide their actions. Meaningful data is essential to moving the needle and eliminating health inequities. However, hospitals and health systems will drown in data, conflicting priorities and unfinished projects without a comprehensive data strategy. In the next decade, the ability to use data will divide systems of care. Those that are data-driven will see more success.
For organizations that need assistance identifying data-based strategies to advance their health equity goals, The Kinetix Group (TKG) can be your trusted partner by leveraging our insight-driven platform and advisory network. Contact us at inquiries@thekinetixgroup.com or here.
References
- Davis A, Batra N, Dhar A, et al. US health care can’t afford health inequities. Deloitte Insights. Published June 22, 2022. Accessed May 16, 2024. https://www2.deloitte.com/us/en/insights/industry/health-care/economic-cost-of-health-disparities.html
- American Hospital Association. Leveraging Data for Health Care Innovation. Accessed May 26, 2024. https://www.aha.org/system/files/media/file/2021/01/MI_Leveraging_Data_Report.pdf
- Institute for Diversity and Health Equity. Improving the Accuracy of Real Data: Northwell Health’s Center for Diversity, Inclusion, and Health Equity. Published July 2019. Accessed May 26, 2024. https://ifdhe.aha.org/system/files/media/file/2020/05/Northwell%20Health%20EOC%20Case%20Study.pdf
- Institute for Diversity and Health Equity. Atrium Health’s Proactive Approaches to Advancing Health Equity. Published December 2021. Accessed May 26, 2024. https://www.aha.org/2021-12-14-atrium-healths-proactive-approaches-advancinghealth-equity
- Institute for Diversity and Health Equity. An Analytic Approach to Advancing Health Equity. Published July 2019. Accessed May 26, 2024. https://ifdhe.aha.org/system/files/media/file/2020/05/Sutter Health EOC Case Study.pdf