Name: IBM teams up with Johns Hopkins to propose new measures to ensure health equity
Uploaded: 2020-08-13
Duration: 10 min 5 s
Description: Members of both institutions join Fortune’s Sy Mukherjee on a Brainstorm Health virtual panel.

IBM teams up with Johns Hopkins to propose new measures to ensure health equity

Members of both institutions join Fortune’s Sy Mukherjee on a Brainstorm Health virtual panel.

IBM and Fortune teamed up to do its own rankings of hospitals, and there's plenty of others out there, including from U. S news, all sorts of other organizations. But one thing that they don't necessarily actually hit on is how they do on the issue of health equity itself. And so, you know, I'd like to turn over to our Panelists and ask, um, how do you measure that? And what do you think is the situation right now in the way that hospitals actually approached that specific metric? So besides, we're very proud of the partnership with fortune and the way in which we're really highlighting the heroic individuals at hospitals who are now addressing this covid 19 crisis. There's been a movement in healthcare around volume based care going to value based care. And during this age of covid, we're discovering, as we've talked about previously, the four curves of covid as it relates to the rise of not only infectious disease but mental illness, chronic disease as well as inequities. And in many ways, it's visibility moment. Many of these issues where they're always, but now they're becoming more accentuated with covid. So what's essential now is to rethink how are hospitals and health systems need to be reinvented in in in the future in the age of covid, plus post covid and how we we need to think about what measures matter or values based care, what values do we have. And so, to me, the values of science, resiliency, prevention and equity and community are going to be essential. So we did a study that showed that when we compared and looked at all rankings, including our own, there is no individual measure of equity. And so we believe it's essential for us to explore this, to build and develop it, to have a conversation about it and then to have hospital rankings. Integrate this into what they measure. And we're very proud to partnership with Johns Hopkins, the Center for Health Equity and the Bloomberg Health Initiative with Dr Sharfstein and Dr Hurston today so very excited about that. I think that sigh, the premise of your question was correct, and, uh, accused comments that this is something that is often overlooked in hospital rankings is absolutely true. We've published a paper in the American Journal of Public Health looking at all the different hospital rankings and just how little they pay attention to issues like community health and equity. So what would it take to change that? What would it take to integrate a measure to have hospitals oriented towards their job being not just taking great care of people who show up sick but actually preventing uh, illness in the first place in their community, helping their community become healthier and addressing causes of inequity? Um, that keeps entire communities from being able to maximize their health. In that regard, I think it's both covid and kind of the reawakening of understanding about racism. That crisis to that is fueling this, that this is a moment for every kind of institution in health care and beyond, including hospitals, to say, you know, what can we do to be part of the solution to the challenges facing this country? And so what we have done at Johns Hopkins working with IBM, Watson Health is to put a proposal for a, um for a new measure that would assess hospital contributions for community health and equity out for public comment. And if people go to um, American Health J a two dot e D u slash hospital measure that's American health dot j two dot e d u slash hospital measure. You can download the proposal. You can see where you can put in comments and if you'll turn to Dr Thornton from the Center for Health Equity to talk a little bit about what we have in mind. Thanks, Josh. And, uh, thanks so much took you inside for having us here today to talk about this. I think first thing to know is in our minds, the structure. The framework for the proposal is that the measure of community health and health equity should be evidence based and should rely on existing standards and practices. So in everything that we put forth as a potential, uh, metric component, we've tried to keep this as a central principle. We also one for the data to either be publicly available, Um, or it's easily and transparently collected from hospitals and health systems. And, uh, finally, we cannot overemphasize the importance of the public comment period to get the perspective from hospitals and health systems and the general public on what measures have meaning, uh, for them in their local communities. And I think this is just a critical point. So what components have we lifted up in the proposal as potential components in a community health and equity metric. The first is population level health outcomes with this idea that hospitals have the potential over time to impact health and well being of the population in their community and the two population level health outcomes that we've proposed are change or changes or trends over time in life. Life expectancy in the county where the hospital is located and preventable hospitalization change over time turns over time in the county where the hospital is located and hear what we've proposed are decadal trends so that it's comparing the local health population health environment to itself over time. The second component is about this core function of hospitals and health care providers. People do need hospitals when they're sick, and they need acute care for whatever ails them at that moment. But it's also a window of opportunity to be able to intervene on other underlying health challenges that might be facing them or provide access to prevention. So, so far what we've proposed in the document and that we are excited to get feedback around our several metrics, including the hospital as a tobacco free campus. The hospital as a place where tobacco cessation programs can be initiated during hospitalization. Hospitals. Ability to encourage healthy food choices. Um, for patients and employees. Hospitals. Uh, providing buprenorphine treatment for opioid use disorder in the emergency department. Um, for running hot hospital based violence prevention programs, uh, screening programs for intimate partner violence and referral to services and supports as needed, an appropriate providing infant sleep, safe sleep education and for being baby friendly. So these are all things that relate to a time when a person is coming to a hospital for services and there's an opportunity to connect, assess and intervene. The third component is the hospital. As a community partner, this is really emphasizing the potential role that hospitals have to engage in meaningful partnerships with other organizations in their community. And here we've included in the proposal uh, the hospitals, completion of a community health needs assessment in collaboration with the local Department of Health. Meaningful support of community based programs including hypertension control programs, diabetes prevention programs, home visiting programs, hospitals taking on a role in supporting school success supporting community based access to fresh and healthy food and investing in expanding or improving health access to healthy, affordable housing in their community. And then the final component relates to another aspect of hospitals. Role as anchor institutions as employers as a presence in local communities, that an economic engine. And in this domain, Hussein. The things we've proposed are, um, that hospitals demonstrate a five year plan for achieving diversity in their board and in top management. Um, that they demonstrate a set of goals for minority owned business procurement and measure progress towards the goals that they pay all employees a minimum hourly rate based on the local living wage, that they support access to affordable, high quality childcare for all employees. And here we're thinking comprehensively about part time and full time that they provide paid sick leave to all employees and that they adopt do not harm collections policy. And again, for every one of these, we've tried to model um uh reliance on existing evidence, best practices and examples of what hospitals are already doing the great work that is already happening in all of these domains. But we know we don't have everything, and that's why the general comment period the wisdom of people in the industry and in the community is essential