The Health Industry’s Progress Toward Equity and Eliminating Disparities: A Look at Medtech Innovators

July 10, 2023
4:51 pm

Previously on this site, we took a look at some of the initiatives Healthcare Leadership Council (HLC) members in the biopharmaceutical and care delivery sectors are taking to advance equity within our healthcare system and eliminate disparities.

This remains a strong priority for HLC and its membership from all sectors of American healthcare. Our members have formally and repeatedly made clear their commitment to ensuring that all citizens have access to high-quality healthcare and the opportunity to live longer, healthier lives. They are devoting significant resources and innovative spirit to achieving this goal.

Today in this space we’re going to examine what three of the nation’s leading medical technology companies are doing to advance health equity.  Again, it is important to note that we are only providing brief summaries, not the full extent of how these organizations have devoted themselves to this important cause.

Baxter has a long-term, multidimensional, initiative, ACT: Activating Change Today, to fight racial injustice globally and is taking action to achieve meaningful, sustainable change. There are several examples of recent progress, including:

  • Partnerships with several Historically Black Colleges and Universities to provide grants and scholarships to support Black students pursuing health and science degrees. Additionally, the Baxter International Foundation partnered with the Thurgood Marshall College Fund to establish the Baxter HBCU STEM Scholars Program, a three-year, $3.5 million initiative that funds scholarships and mentoring to support students at HBCUs pursuing careers in STEM and education.
  • Partnerships with the National Kidney Foundation of Illinois and The Links, Incorporated to expand the Black Kidney Awareness Resources and Education (K.A.R.E.) program which seeks to raise awareness of chronic kidney disease in Black communities across the U.S. and offers actionable tips and guidance for improving kidney health and managing kidney disease. It has reach more than three million community members.
  • The creation of a Critical Care Racial Disparities Advisory Board to understand why Black patients are disproportionately impacted by health disparities in critical care and identify what actions to take to address health disparities. Baxter also partners with the Congressional Black Caucus Foundation to help strengthen community initiatives that aim to address healthcare disparities affecting Black people, and with the National Minority Quality Forum to address its healthcare policy and equity objectives.

Johnson & Johnson partners with multiple community-based organizations to reach underserved populations and strengthen ties to the community. These include:

  • Working with the National Hispanic Medical Association to develop and strengthen resources and curricula for preparing and equipping physicians for cultural competence in the communities they serve, including a commitment to work with the Alliance of Multicultural Physicians to reach as many communities as possible with culturally relevant resources and materials that support culturally competent care.
  • Engagement with the National Minority Quality Forum to address health inequities through policy. As a founding partner of NMQF’s newly-formed Institute for Equity in Health Policy and Practice, J&J is working with the organization and other community partners to define the policy and structural alignment necessary to build on our system’s strengths for the 21st century and beyond.
  • The Healthy Lifestyle Hub: Bridge to a Whole, Healthy You (BTWHY) Food & Wellness Program is a patient-centric clinical and social care solution for disadvantaged populations. Through a coordinated effort of Johnson & Johnson, Mile Square Health Center, University of Illinois College of Applied Sciences, and Huron Consulting Group, the aim of this program is to improve clinical outcomes and reduce barriers to wellness for Mile Square patients who seek care at the Healthy Lifestyle Hub in Chicago’s Auburn-Gresham Community.
  • A close partnership with the National Urban League and many other community and multicultural organizations to address a number of health equity issues in communities across the country through the “My Health Can’t Wait” platform, through which healthcare professionals have a comprehensive hub of resources to help their patients understand the steps being taken for their safety.

J&J also has a well-established holistic approach to increasing diversity in clinical trials, investing at local and federal levels to improve policies, programs and practices that currently impede full representation and prevent tangible and equitable outcomes. The company has worked with hundreds of partners to enable change through policy. Additionally, its Research Includes Me platform serves to reach underrepresented communities by meeting them where they are on the ground through digital activities, partnering with trusted voices, and addressing barriers to participation in clinical trials.

Stryker is committed to driving evolution in clinical development to support health equity. The company recognizes that increased diversity in clinical trials leads to better patient outcomes. Efforts have begun within its clinical trials to address this need by tracking diversity and conducting outreach to underserved populations. For example, the COVID-19 pandemic led to increased use of pulse oximeters. But emerging evidence from real-world studies suggested that pulse oximeter performance could be impacted by skin tone, creating potential for treatment delay and poor outcomes. In response, Stryker’s Sustainability Solutions reprocessing business completed a clinical study that successfully enrolled a diverse patient population and demonstrated the accuracy of its reprocessed pulse oximeters in adult patients across all skin tones.

Additionally, Stryker considers disease prevalence in patient populations when determining enrollment in trials, and its R&D clinical teams emphasize the importance of diversity of perspective in clinical development. For example, scarcity of care and lack of infrastructure are barriers to stroke treatment in many parts of the world. In response, Stryker’s Neurovascular Division opened a state-of-the-art facility in India designed to accelerate stroke-related innovation in the Asia-Pacific region. Driven to improve patient outcomes, this facility offers a simulated neurovascular catheterization lab and opportunities for hands-on training and collaboration among customers, product development engineers, and other key stakeholders.

The Health Industry’s Progress Toward Equity and Eliminating Disparities: A Look at Healthcare Providers

June 02, 2023
12:33 pm

In an earlier post, we provided a snapshot of some of the actions Healthcare Leadership Council (HLC) members in the biopharmaceutical sector are taking to advance equity within our healthcare system and eliminate health disparities.

This is a priority for HLC and its membership from all sectors of American healthcare. Our members are each committed to ensuring that the healthcare system works for all citizens and they are devoting energies and resources to initiatives aimed at making this happen.

Today, we are going to use this space to examine what several of the nation’s leading healthcare providers are doing to advance health equity, and it’s worth noting that what is summarized in this post only scrapes the surface of the numerous programs these organizations are carrying out.

AdventHealth is working with community-based organizations to increase access to care for underserved communities. These collaborations include partnerships with federally-qualified health centers, houses of worship, and local nonprofit organizations. The health system is advocating for the development and adoption of national social determinants of health data standards. AdventHealth is also developing health equity plans to address potential disparities within its facilities and communities, working to create a diverse, equitable and inclusive environment for all team members, and advocating for policies that increase access to treatment and promote equitable care.

For Ascension, community impact work is focused on leveraging the power of data to understand the unique needs of different communities and inform funding strategies. By gathering social determinants of health data, Ascension can best determine how best to deploy resources and investments to improve access to care and help close the gap on life expectancy. Current priorities for the organization’s community impact work include maternal care, diabetes and behavioral health. Ascension has also established the Ascension Foundation, a national foundation focused on addressing root causes of health disparities in the United States, partnering with organizations that are already making measurable strides toward health equity.

Atrium Health is committed to cross-sector partnerships that are addressing social drivers of health and addressing health equity. These collaborations include a Community Resource Hub, an electronic platform that connects patients to free or reduced-cost services, including transportation, legal assistance, food and more; Feeding Charlotte, a local “food rescue operation that retrieves unused perishable food at several Atrium Health facilities and distributes it to local nonprofit food pantries; investments in affordable housing throughout the Charlotte region; and a partnership with Legal Aid of North Carolina to provide legal advocacy to Atrium patients on insurance coverage, unemployment benefits, unsafe housing and other needs.

Fairview Health is aligning its equity data collection fields between human resources, patient data, and community characteristics to better understand the intersection between healthcare outcomes, diversity, equity and inclusion goals and health equity goals. The Minnesota-based health system has strengthened its engagement infrastructure by building on trusting relationships and enabling community voices to inform and influence both inside and outside the system. This includes local community advisory committees that include community-based organizations, public health and internal stakeholders such as physicians and administrative leaders.

Marshfield Clinic Health System is one of four healthcare systems in the state of Wisconsin to make a formal commitment to eliminate healthcare disparities in the state. It is developing an Ambassador program and Business Resource Groups to promote equity and inclusion in the workplace and has formed a partnership with the Cross Cultural Health Care Program for cultural competency consulting and training. Marshfield is forming partnerships with community-based organizations to address the social determinants of health needs of its patients, and is serving on the Governor’s Health Equity Council and other state and national collaboratives to address equity.

Mayo Clinic is building a health equity dashboard with key metrics that will be accessible to all departments and divisions within the organization. It has created an internal Community Coalition, made up of internal stakeholders that are focused externally with community-facing partners. The goal of this initiative is to align efforts on health equity and look for synergies in respective group activities. Mayo is also building a repository to house and coordinate all of the organization’s health equity activities. A Health Equity workgroup is made up of site liaisons who are partnering with clinical practice areas to collect health equity efforts from each site and share best practices.

To address healthcare access issues, MemorialCare has provided information and enrollment assistance in the Covered California healthcare exchange and other low-cost insurance programs. It also provides transportation support for those patients and families who are not able to access needed care due to a lack of transportation. MemorialCare provides support and services to community residents that removed barriers to care and increased access to healthcare and preventive measures. Health and wellness education classes have covered such topics as healthy eating, stroke prevention, diabetes, heart disease, cancer prevention and stress management.

Mount Sinai Health System maintains an Executive Diversity Leadership Board that includes hospital presidents, senior leadership and trustees and is accountable for leading and developing strategies to address structural and systemic racism; promoting, instilling and demonstrating anti-racist behaviors; driving equitable practices to enhance quality and outcomes centering on marginalized or oppressed groups; and reporting progress on outcomes and implementing recommendations for continuing improvement. The system’s areas of focus in this arena range from data analytics to education and training to supplier diversity.

NewYork-Presbyterian maintains the Dalio Center for Health Justice, which address the health disparities of employees, patients and communities through research, health education and programs that foster equity in clinical operations and enhance the culturally sensitive care provided by NewYork-Presbyterian. It focuses on comprehensive analysis to understand more fully social determinants of health, creating a robust and diverse health equity database to inform the center’s work in developing community-based initiatives, advocating locally and nationally for change, seeking grants, and producing an institutional equity report. It also focuses on examining and addressing unconscious bias in medicine and clinical trials.

NorthShore University HealthSystem is engaged with the city of Chicago in a five-year program to close what is, according to research, the largest life expectancy gap in the country. Neighborhoods just nine miles apart have a 30-year gap in life expectancy. NorthShore is working to accurately capture race, ethnicity and language preferences in its patient community and ensure that all patient perspectives are captured in measurement systems. The system is investing leading practices and new ways to listen to patients and understand social determinants of health and is partnering with like-minded community organizations to close the gap on health disparities across key preventive practices and chronic diseases.

Texas Health Resources’ Community Impact program uses cross-sector collaborative grants to address local community needs in resourceful and innovative ways. This data-driven, outcomes-focused approach pinpoints North Texas zip codes most in need of assistance and drives how Texas Health engages with leaders, influencers and existing resources within those underserved areas. This program is responding to health disparities, eliminating root causes of chronic disease and providing tools that instill lifelong health and well-being. And the health system’s Mobile Health Unit brings cancer screenings and other health services to residents throughout the Dallas-Fort Worth area.

Our next post will take a look at health equity initiatives in the medical technology sector.


Understanding the Role of HIPAA in Healthcare Innovation

May 25, 2023
10:56 am

As the healthcare industry has transformed throughout the years, the use of healthcare data has evolved as well. The Healthcare Leadership Council recently hosted a webinar entitled, “The Past, Present, and Future of Health Privacy Policy,” featuring a panel of legal experts who were able to provide a glimpse into the world of how privacy laws play a role in conducting research and collecting mass amount of data for purposes such as predictive analytics.

Erin Geygan, senior privacy counsel at Johnson & Johnson, explained that the organization is comprised of three segments – pharmaceutical, medtech and consumer health, which have invested $14.6 billion in research and development. Johnson & Johnson’s data privacy and security program identifies federal, state and global requirements around accountability and innovation, cybersecurity included. Erin noted the lack of harmonization with state laws on medical information privacy and other federal laws governing health information outside the scope of the Health Information Portability and Accountability Act (HIPAA). She also discussed the need to address the challenges facing data sharing for innovation, such as technical restraints, intellectual property risks and exclusive access. Johnson & Johnson believes that public policy on data privacy and protection should seek to provide appropriate protection and empowerment to consumers and patients while also ensuring innovation and provision of healthcare products and services are not impaired.

Jessica Kelly, legal counsel at Mayo Clinic, focused on the intersection of research and privacy and confidentiality. The road to research begins with preparatory activities such as recruitment, where data is needed to determine potential candidates for a possible study. Contacting those candidates for enrollment involves use of protected health information (PHI). She went into detail regarding authorizations to use PHI for current and future research as well as the use of waivers of authorization, which can be provided by institutional review boards when consent has not been obtained by the individuals and there is minimal risk to the privacy of those individuals. In closing, Jessica described two methods to achieve de-identification of PHI in accordance with the HIPAA Privacy Rule. Once the numerous identifiers have been removed from the data it is no longer subject to HIPAA.

Amanda Reese, healthcare regulatory and privacy counsel for Epic, highlighted the health grid of services that use data from Epic products across the industry, spanning from real-time prescription benefits, to retail clinics, rehabilitations centers and specialty diagnostics just to name a few. Amanda spotlighted Epic’s new life sciences program working to unify clinical research with care delivery, matching participating providers with clinical trial opportunities and supporting clinicians with point-of-care insights and predictive modeling. Regarding HIPAA, Epic is a business associate of its U.S. customers and therefore designs its software in ways that consider privacy throughout the data life cycle. Epic works with limited data sets per data use agreements and deidentified data through COSMOS, which is a program that involves data from more than 135 million patients used for research, public health and healthcare operations.

The Health Industry’s Progress Toward Equity and Eliminating Disparities: A Look at the Biopharmaceutical Sector

April 11, 2023
12:12 pm

For the Healthcare Leadership Council (HLC), an alliance of leading companies and organizations from every health sector, one of the most important priorities on which all of our members are unified is the need to advance equity within our healthcare system and to eliminate health disparities. It’s not enough to say that we have the greatest healthcare system in the world. We need to ensure that every American has access to care of the highest quality.

Last September, HLC, in coordination with the management consulting and technology firm ZS, published a comprehensive report on existing variations in care quality within the healthcare system and how each health sector, and the government, can play a role in addressing them.

What we’re seeing from our member companies in all sectors is that the commitment to equity is not just rhetorical. There are tangible actions taking place throughout the healthcare industry to create healthier futures for the population as a whole. We are going to use this space to examine many of the initiatives taking place, beginning with a sampling from the biopharmaceutical sector.

Amgen is partnering with multiple organizations to improve care delivery for cancer patients as well as those with cardiovascular and respiratory diseases. The company is working to incorporate the patient perspective across the drug development process to aid in its efforts to achieve representation of patients in clinical trials and throughout the process all the way to commercialization. As part of improving the clinical trial process, Amgen is partnering with community hospitals and health systems in an effort to execute clinical trials as close as possible to where patients live and work.  The company is also investing in the training and development of healthcare providers from historically underrepresented populations to increase the number of investigators and clinical trial staff who look like the patients intended to benefit from the medicines Amgen develops.

Bristol Myers Squibb, as part of the company’s global Diversity and Inclusion and Health Equity Commitments, has committed $150 million over five years to address health disparities, increase clinical trial diversity, expand supplier diversity, increase workforce representation, and enhance employee giving in support of social justice organizations. Separately, the Bristol Myers Squibb Foundation has also committed $150 million to address health disparities, increase clinical trial diversity and enhance employee giving. The funds are provided as grants to non-profit organizations intended to bolster community outreach and engagement, increase care coordination services, and ensure an ethnically diverse, culturally competent community health worker and patient navigator workforce. BMS also worked with HLC in spotlighting the work of the Center for Information and Study on Clinical Research Participation, which is working to bring greater diversity to clinical trials.

Genentech, as well, is committed to the concept that clinical research should reflect real-world populations. It is incorporating enhanced population, science-driven strategies and inclusive clinical research action plans across its research and development programs. The company partnered with several clinical research centers in launching the Advancing Inclusive Research Site Alliance. This coalition of clinical research sites works with Genentech to advance the representation of diverse populations in oncology clinical trials, test new recruitment and retention approaches, and establish best practices that can be leveraged across the industry to achieve health equity for all patients. Genentech is also sponsoring health equity regional symposia to identify health equity issues that matter most to the community and is investing in partnerships that provide healthcare and education in communities while contributing to positive change in our society.

Merck is continuing to partner with community-based organizations, clinical trial investigators and others to advance clinical trial diversity initiatives and ensure that the company’s clinical trials are diverse and inclusive. The company is also focusing on equity in care delivery, collaborating with organizations to develop innovative initiatives to improve access to prevention, diagnosis, and treatment across the patient journey. Merck has made clear that it will continue to partner with community-based organizations to build trust in the community and better address the needs of underserved patients by meeting them where they are.

Pfizer is continuing to lead on health equity as a connector through its Multicultural Health Equity Collective, which is addressing health disparities among the most vulnerable and historically underserved populations. The company is continuing to pursue policies that promote data collection, interoperability and outcome measures that advance health equity, supporting efforts by stakeholders to develop standards informed by clinical development, post-marketing and education. It is prioritizing efforts to eliminate barriers, increase access, and raise awareness of the clinical trial process among diverse populations. And because Pfizer products span diseases for which underserved populations experience increase morbidity, it is ensuring that its patient assistance programs reach populations most in need while continuing to focus, as well, on social determinants of health.

Our next post on this topic will take a look at the health equity initiatives of some leading hospitals and health systems.


Embedding Health Equity into the Core of Healthcare

April 04, 2023
7:44 pm

The Report of the Secretary’s Task Force on Black and Minority Health was released in 1985, serving as a catalyst for the U.S. Department of Health and Human Services (HHS) to begin addressing health disparities, and Congress to form the Office of Minority Health within HHS the following year. Today, much of the progress in this arena is taking place in the private sector. The healthcare industry is taking steps to achieve health equity with considerable vigor and with some lessons learned under its belt. The Healthcare Leadership Council (HLC), representing all health industry sectors, released a report in January 2023 with ZS, entitled, “Addressing Health Equity: Practical Solutions to Address Variations in Care,” identifying multiple structural barriers in both the private and public sectors that contribute to existing health disparities. The report was followed by a release stating HLC members’ commitment to shared principles aimed at eliminating health disparities. HLC also recently hosted a webinar, “Breaking Down Barriers to Achieve the Highest Level of Health,” in which representatives from its member companies discussed current strategies and overarching philosophies. The panel was made up of three participants:

  • Joneigh Khaldun, MD, Chief Health Equity Officer, CVS Health
  • Josette Gbemudu, Executive Director, Health Equity and Social Determinants of Health, Merck
  • Keith Dawson, Principal Science Leader, Global Health Equity and Population Science, Genentech

Dr. Khaldun opened by describing CVS’s enterprise-wide health equity strategy, highlighting the need to empower all employees by educating them about systemic inequities and providing tailored training for cultural competency. Dr. Khaldun also talked about measuring what matters to uncover inequities and utilizing these insights to design programs and policies to address them effectively. Examples of specific programs included CVS’s Community Equity Alliance, which aligns academic, community and healthcare partners to expand and integrate community health workers into care teams, and its workforce innovation training centers, which support job training needs across the country. Dr. Khaldun noted that disparities took centuries to develop, and that health equity is a journey that will not be achieved by one initiative in a short period of time.

Josette Gbemudu echoed Dr. Khaldun in that there must be internal integration of health equity across an entire business and not just through one initiative. She pointed to Merck’s $650 million commitment to improving maternal health globally and how it is using the learnings to embed health equity into its core business functions. Citing numerous statistics to show the broad range of disparities, Josette shared that Merck is not just focused on addressing social determinants of health barriers such as food insecurity, health literacy and health access, but it is dedicated to strengthening the entire health ecosystem. Merck Foundation launched a $20 million initiative to advance equity in U.S. cancer care. Josette emphasized that many communities have historically been unable to access screenings, which leads to later diagnoses and poorer outcomes. The alliance is utilizing a collaborative approach to build community partnerships in order to address barriers to care.

Keith Dawson discussed Genentech’s efforts to develop solutions that will broaden inclusion of historically underrepresented groups in clinical research so that all patients can realize the full benefits of personalized healthcare. He stressed that clinical research is not benefiting all groups equally, that genomic data is not diverse enough and that Blacks and Hispanics are not informed about clinical trial opportunities. The diversity of patients enrolled in clinical studies is highly correlated with site personnel diversity, he pointed out. Keith stated that Genentech prioritizes fostering belonging and cultivating an environment where all are included. The Advancing Inclusive Research Site Alliance Partnership was created to develop an ecosystem based on trust and meeting patients where they are. This alliance uses an external council of advisors and patient and provider partnerships to provide educational tools to improve awareness of clinical trials. It also distributes grants to external organizations striving to address inclusive research, equity in care and workforce diversity.