Monday, Jul 31, 2023

Closing Gaps in Community-based Health Equity

Michele MillerHealth Equity Consortium

Dan DesmondHealth Systems Architect, Health Equity Consortium

HLTH

A rapidly shifting healthcare landscape challenged local public health (PH), healthcare providers, community-based organizations (CBOs), and technology organizations to collaborate and reimagine how information improves care.


When the COVID-19 pandemic began, Solano Public Health activated the California Health Medical Reserve Corps (CHMRC). CHMRC realized the need for and the benefits of real-time, bi-directional data sharing across the community, and, specifically between healthcare providers, CBOs, and PH. CHMRC leaned in on partners, like Microsoft, creating workflow improvements to share usable data to help guide the response and decision-making processes. Once connected and sharing data, community stakeholders could more effectively collaborate and tackle the challenges faced in helping Solano County’s rural communities, including the farm workers and their families. 


“CHMRC has developed partnerships with entities that you might not think are willing to work together – pharmaceutical companies, IT companies, and they are able to blend solutions that benefit everybody. And that approach, I think is extremely powerful,” Dr. Bela Matyas, PH Officer, Solano Public Health.


Formed in 2014, CHMRC is a federally authorized medical reserve corp and 501c3 nonprofit. CHMRC supports PH to educate and escalate disease prevention and improve community preparedness for disasters and threats. We operate year-round as a constant force, building bridges and key partnerships across CBOs, local healthcare providers, and the local PH authority. 


In 2021, CHMRC was inspired to launch the Health Equity Consortium (HEC) with multiple partners, including Microsoft. Today, HEC convenes partnerships to drive innovative solutions, guided by the common goal of building resilient and sustainable public-private collaborations. HEC seeks actionable ways to impact fundamental health equity challenges through the equitable distribution of preventive services, education, support, novel business models, and technology, including Microsoft’s.


With the use of Microsoft technology, HEC provides local situational awareness for healthcare systems and PH in a timely manner, allowing time to course-correct campaign messaging. HEC focuses on protecting the privacy of the data while realizing the opportunity for technology to support a common community need. It’s not technology first, but technology supporting and empowering individuals and organizations, to truly address health care inequities proactively and build trust going forward.


Privacy Preserving Collaborations and Data Cleansing 


“Trust is essential. Many individuals and organizations representing vulnerable and underserved populations are unwilling or unable to share data,” David Rhew, M.D., Global Chief Medical Officer & VP of Healthcare, Microsoft. 

HEC innovated a secure, trusted, and federated data environment for privacy-preserving collaboration though identifiable and de-identifiable health information. This solution allows organizations to develop common insights and analytics, without disclosing source data or Personally Identifiable Information (PII). 


HEC provides a secure enclave where data from multiple entities can be cleansed, analyzed, and insights extracted. Clean data and data providence are essential for trusting derived insights and analytics. HEC provides cleansing, with the use of Artificial Intelligence (AI), to ensure the data ingested adheres to the standardized Application Programming Interface (API) and desired formats, free of de-duplication - which in turn can be used to fill in missing data fields. Powered by the principle of privacy, HEC focuses on enabling data interoperability through a privacy-preserving environment; Compliance, Privacy, and Trust (CPT) are core to everything HEC delivers. 


As a result, HEC enables real-time community-based surveillance to better manage local outbreaks and future pandemics.


HEC assists PH in maintaining the integrity and privacy of data sets, and the AI that is running them. Seeking efficient and innovative ways to clean the data, we learned early on that the required infrastructure is extremely complicated. The broad scope of this work, coupled with the impact on care provider resources, reinforces the belief that PH should be focused on providing guidance and care, not data analysis and cleansing. 


A Triumph of Human Touch, a Business Model, and Technology 


“Our original belief was that providing better care would serve as our business model. However, we learned that by providing ‘cloud as a service to public health,’ the management of data ended up being the primary business value proposition for multiple stakeholders. By enabling bi-directional flow of data between CBOs, PH, and local healthcare organizations, we established the necessary infrastructure for care to be delivered anywhere, anytime. Applying AI to clean and help analyze the data made the data usable and actionable,” David Rhew, M.D., Global Chief Medical Officer & VP of Healthcare, Microsoft.


HEC’s initial value proposition was to increase vaccination rates, levels of screenings for conditions such as diabetes and hypertension, collect social determinants of health (SDOH), raise Medicaid enrollments and reach those with low levels of engagement in traditional healthcare. This focused approach continues to bring measurable benefits to local communities, PH, providers, and payers interested in improving community-based health outcomes and ratings. 

By leveraging Microsoft’s interoperability standards such as Fast Healthcare Interoperability Resources (FHIR), HEC facilitates the secure, bi-directional flow of data between CBOs, PH, and local healthcare organizations. This enables real-time case reporting and solves three problems for healthcare providers: 

  1. Delayed reporting of cases to PH, which can lead to financial penalties. 
  2. Oversharing of entire medical records, which is a Health Insurance Portability and Accountability Act (HIPAA) violation. 
  3. Non-compliance with 2023 US Department of Health and Human Services (HHS) and Office of the National Coordinator for Health Information Technology (ONC) proposed rules which require automated case reporting to PH and alignment with Trusted Exchange Framework and Common Agreement (TEFCA).


HEC’s model works for different populations and is designed to scale nationally and internationally. In addition to working in California, we are engaging with communities in Georgia, Mississippi, and Washington. If you want to know more about HEC innovations and solutions, please visit us at www.healthequityconsortium.org


We value our partners, especially Microsoft, whose vision and tech leadership were fundamental to the launch of HEC. If you want to know more about Microsoft’s solutions, please visit Microsoft Cloud for Healthcare | Microsoft.


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