A Global Focus on Health Equity
Dr. David RhewChief Medical Officer, VP of Healthcare Worldwide Commercial, Microsoft
Ann-Marie LeeSenior Director, Global Healthcare Business Strategy, Microsoft
The entire healthcare industry has been impacted by COVID-19 in an unprecedented way. The pandemic has had a substantial global impact, and in many ways, it has raised the bar on what we need to collectively deliver as an industry. These events have further highlighted disparities and health inequities that should be kept at the forefront of care delivery moving forward.
As defined by the U.S. Department of Health and Human Services, health equity is the attainment of the highest level of health for all people. Population-level factors, such as the physical, built, social, and policy environments, can have a greater impact on health outcomes than individual-level factors. The root causes of health inequity can be directly linked to a failure to address these population-level factors, one community at a time. In addition, linkages between science, policy, and practice are critical to achieving health equity.1
There is an urgent need to extend essential services and offerings to those who are disadvantaged due to socio-economic factors, racial injustice, advanced age, and other differentiators that are biologic or societal in nature. Microsoft is working closely with our customers, public health teams, and partners across the globe to achieve more for the communities they serve.
Currently we are focused on improvements in 3 key areas: vaccine equity, AI for health equity, and decreasing the digital divide.
To ensure the fair, equitable, and efficient distribution of the COVID-19 vaccine, health organizations and communities need a secure and interoperable platform that balances the complexities of the registration, scheduling, and supply chain distribution, with the broader public health mission to deliver a safe and effective vaccine in a prioritized manner.
Microsoft has been committed to helping public health agencies and healthcare providers to deliver the COVID-19 vaccine to individuals, around the world, in an efficient, equitable, and safe manner. Our vaccine management capabilities help healthcare providers roll out vaccination programs reliably while scaling and adapting to meet community’s needs as vaccination capacity and demand changes over time.
As vaccination rates have risen and in many communities plateaued, we have seen a shift away from mass vaccination sites to a focus on community-led outreach initiatives designed to address:
- Accessibility, by using mobile units and/or pop-up clinics in schools, parks, parking lots, and churches.
- Convenience, by allowing for walk-in appointments and offering vaccinations and other health services at family community events, and
- Hesitancy, through unpressured conversations led by trusted members of the community who are empowered with the right information and resources.
By listening to community leaders on how best to engage the populations they serve, Microsoft and its partners have supported local efforts to bring vaccinations and other essential health services to the high risk, vulnerable, and underserved.
Access to data has also enabled communities to make better informed decisions. Microsoft has developed interactive visualizations to help everyone understand the scope of the challenge and the progress being made towards ending the pandemic. Explore maps for COVID-19 Vaccinations, Risk Levels, Progress to Zero (P0), Rt, Testing, and Spread Analysis.
AI for Health Equity
The health of people and communities around the world has been improving over time. However, progress has not been equal across the globe, and there is a great need to focus on societal issues such as reducing health inequity and improving access to care for underserved populations. While researchers work to unlock life-saving discoveries and develop new approaches to pressing health issues, advancements in technology can help accelerate and scale new solutions.
AI can be used to identify and address human error, speed up time-to-treatment, and deliver insights for a host of social issues present in treatment and care. Doctors at Cambridge University Hospitals NHS Foundation Trust are using AI Technology, known as Project InnerEye, is a result of an eight-year collaboration between Cambridge-based Microsoft Research and Addenbrooke’s. Its aim is to save clinicians many hours of time laboriously marking up patient scans prior to radiotherapy.
Microsoft is committed to using AI to address social and treatment bias. As AI algorithms are developed it is key that healthcare providers do not miss, or misrepresent, marginalized communities. We know that it is important to work with providers to develop accurate models that help to eliminate bias. This translates to better data, better collaboration, and better care for all.
Ribera Salud, a healthcare business group and its technological division FutuRS, have implemented a predictive model, based on AI, which analyzes and processes the variables of each patient to predict their evolution, based on objective data analyzed by Microsoft Azure and its Machine Learning tools. Ribera Salud health group sought to improve the quality of care for patients, acting preventively based on predictions about the possible clinical worsening of patients’ conditions. This tool, supported by AI and, more specifically, by machine learning, has allowed Ribera Salud to have greater control over patient risks without incurring a greater workload for health professionals. That is why this model facilitates what is known as "Right Care, Right Now," that is, providing the right care at the right time to achieve optimal results for the patient.
The Americans with Disabilities Act of 1990 (or ADA) highlighted the need to provide accommodations to those with disabilities. Communication is fundamental to providing equal access. To be more inclusive and avoid biases that skew decision-making in AI and machine learning systems, Microsoft is investing in AI-powered innovations that can create new possibilities regardless of how a person listens, speaks, or writes. We are committed to increase the representation of people with disabilities in datasets and influencing future technology to ensure the global independence and inclusion of people with disabilities in society. Our AI for Accessibility Program invests in projects around the world seeking to address how to build experiences and data sets that are accessible for people of all abilities.
Decreasing the digital divide
Perhaps the most obvious implications of implementing or relying upon new technologies in public health are the risk of unequal access to such technologies, inequalities in the opportunity to benefit from such technologies and inequalities in the burdens generated by such technologies.2
Digital technology can play a critical role in bridging barriers to health equity, including care access and delivery; from creating personalized experiences for patients to staying connected with patients over the care continuum, wherever they are located.
However, we need to ensure that all individuals have access to affordable broadband and understand how to effectively utilize this essential technology. In 2017, we launched the Microsoft Airband Initiative to expand broadband access in rural America. Today, we are expanding Airband to U.S. cities that face some of the largest broadband gaps among racial and ethnic minorities, specifically Black and African American communities. As part of Microsoft’s Racial Equity Initiative, team members at Microsoft are working to modernize access and support underserved communities of color though Historically Black College or University (HBCU) engagements.
Global healthcare has been impacted by the pandemic, and the bar has been raised on what technology is needed to deliver essential services in an equitable way. While innovative technologies have always promised significant transformation for healthcare, it is now an imperative for organizational resiliency and to advance the health of people and communities around the world. Our partners and customers continue to inspire and motivate us to co-create solutions with communities for those who are often the most marginalized and impacted by health inequities.
Join us at the upcoming virtual discussion “Can Healthcare Bounce? Building Equity through Resilience & Responsiveness” on June 29, 2021 to learn more.
- Paving the Road to Health Equity - OMHHE - CDC
- Smith, M. J., Axler, R., Bean, S., Rudzicz, F., & Shaw, J. (2020). Four equity considerations for the use of artificial intelligence in public health. Bulletin of the World Health Organization, 98(4), 290–292. https://doi-org.lopes.idm.oclc.org/10.2471/BLT.19.237503