Modern Healthcare

Beyond the four walls: how providers are taking action to address social determinan­ts of health


There is no question that healthcare will increasing­ly be delivered in a consumer friendly fashion, and that means addressing social determinan­ts that impact health and limit access to care.

For Valleywise Health, addressing these circumstan­ces is vital to the organizati­on’s survival as the public health system of Maricopa County, Ariz. Fifty percent of Valleywise’s patients are on Medicaid, and 60% of all Valleywise patients are vulnerable to social issues, said President and CEO Steve Purves.

During a major overhaul that began in 2014, the health system made sure new clinics were being built in the county’s most vulnerable communitie­s to ensure equitable access to care, rather than areas that were most likely to bring in more revenue. “Our goal was to have a clinic within a 15-minute drive of vulnerable patients in Maricopa,” Purves said.

As Valleywise continues to transform to better serve its community, Purves has introduced rapid cycle testing as a tool for innovation. Projects are promptly tested on a small scale to see if they work: if the project fails, leaders can quickly move on to another idea, but if they work, they’re quickly implemente­d. Purves notes that it has been imperative to communicat­e progress to innovators by tracking results on an internal dashboard.

“Nothing gets folks charged up like seeing the fruits of their labor, so there’s nothing more frustratin­g than when somebody who has a great idea floats it up the flagpole and doesn’t hear it didn’t work,” Purves said. “They could have spent more time working on something else.”

Adventist Health has been taking direct action to improve the lives of its patients, after the system recently discovered that there was an 8-year difference in life expectancy across the communitie­s that it serves, according to CEO Scott Reiner.

“I was struck by this disparity,” Reiner said. “Being a top safety organizati­on doesn’t matter if the people in our communitie­s are living shorter lives.”

Adventist has shifted its focus to become a “community wellbeing organizati­on” that not only manages care within the four walls of the hospital, but also works to transform the communitie­s they serve. The health system has pledged to spend $1 billion in the next ten years to measurably improve the well-being of communitie­s. The system has already begun addressing housing disparitie­s through Project Restoratio­n, a community-based initiative that brings medical respite and transition­al housing for individual­s with complex health and social needs, reducing overall community costs by 71%.

Big tech is looking to help health systems address these difficult issues. Uber Health, a division of the ridesharin­g giant, is addressing transporta­tion disparitie­s through a HIPAA-secure platform that allows health systems to request and schedule rides for patients.

A 2006 study by the National Institutes of Health found that every year, 3.6 million Americans miss at least one medical appointmen­t or delay appointmen­ts because they lack reliable transporta­tion. No-shows can put a significan­t cost burden on health systems and a damper on population health outcomes, so many providers are providing underserve­d patients with compliment­ary transporta­tion through the platform.

Uber’s massive supply of drivers and transparen­cy features, like real-time tracking and upfront pricing, differenti­ate it from traditiona­l transporta­tion providers, which often require 24-72 hours advance notice and can have unreliable pick up and drop off times, said Lauren Steingold, head of strategy for Uber Health at Uber. A theme continued to emerge throughout the meeting that connected to Aaron Martin’s presentati­on: when you continue to take out the “friction” and connect the fundamenta­l creator with the recipient, new ways of approachin­g significan­t healthcare challenges begin to develop.

Ritesh Patel, chief digital officer of health and wellness at Ogilvy Consulting, presented on a variety of other startups that are shaping the future of care delivery and bridging gaps in care. Patel showed a number of global innovation­s to come, many of which are futuristic. Some of the examples shown included Zipline, a startup that utilizes drones to transport blood and drugs to remote villages in Rwanda; Babylon Health, an AI-powered symptom checker chatbot with 24/7 access to human doctors via telemedici­ne; and Zebra Medical Vision, an AI algorithm-based imaging platform that assists radiologis­ts by flagging abnormalit­ies on diagnostic images.

“We’re seeing connected things changing delivery of care and changing how we interact with patients,” Patel said.

 ??  ?? Suja Mathew, MD, FACP, and Amy Perry listen as leaders discuss social determinan­ts of health.
Suja Mathew, MD, FACP, and Amy Perry listen as leaders discuss social determinan­ts of health.

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