Experts say hospitals must plan for providing care after an attack

Cybersecurity and patient safety

Experts offer advice for hospitals on protecting systems and patients

Tips and tough love

Criminals know smaller systems are vulnerable to cyberattacks

Targeting small hospitals

Hiyam Nadel, right, director of the Center for Innovations in Care Delivery at Massachusetts General Hospital, unfurls a list of responsibilities for nurses. Mike Golebiowski, corporate vice president of B. Braun Medical Inc., helps hold the list.

Health systems and hospitals need to make changes to stop the wave of nurses who are leaving the bedside.

The number of registered nurses dropped by 100,000 in 2021, the biggest drop in 40 years, according to a report in 

Nurses say they have been pushed to the limit

 throughout the COVID-19 pandemic. Some nurses have left hospitals and health systems due to frustrations with staffing, and some nurses have said they don’t feel hospitals are sufficiently concerned with their health and well-being.

A panel of nursing leaders at the HLTH Conference talked about the challenge of retaining nurses.

“This is an exodus from a profession that no one is talking about,” said Rebecca Love, chief clinical officer at IntelyCare, a company which uses a technology platform to enable nurses to find openings.

Should hospital nurses be working 12-hour shifts?

Nurses are shouldering an unreasonably heavy workload, the panelists agreed. Hiyam Nadel, director of the Center for Innovations in Care Delivery at Massachusetts General Hospital, illustrated the point of the rising demands on nurses, including documentation. She held up a page to show the list of duties she had earlier in her career.

And then, she unfurled a list of current responsibilities, which measured several feet.

“This is just impossible and not sustainable,” Nadel said.

Mike Golebiowski, corporate vice president of B. Braun Medical Inc., cited the onerous demands of nurses in filling out information in electronic medical records. Too often, nurses are being given additional tasks, he said.

“You just can’t ask nurses to do one more thing,” Golebiowski said. And he added that nurses “don’t have good work-life balance in the profession.”

With nursing staffing levels so low, some nurses are so overworked they aren’t getting lunches and struggle to even find time for bathroom breaks, and that’s pushing people out of the profession, Golebiowski said. “No one wants to work for a bad boss, a bad environment,” he said.

Panelists discuss the nursing crisis at the HLTH Conference in Las Vegas, Nov. 13. From left, moderator Bonnie Clipper; Rebecca Love, chief clinical officer at IntelyCare; Will Patterson, founder & CEO of CareRev; Mike Golebiowski, corporate vice president of B. Braun Medical Inc.; and Hiyam Nadel, director of the Center for Innovations in Care Delivery at Massachusetts General Hospital.

Will Patterson, founder & CEO of CareRev, a technology staffing platform for healthcare workers, said there’s clearly a shortage of nurses working in bedside positions at hospitals. It’s critical to get more nurses working in hospitals, but he said the working environments are going to have to become more attractive for nurses.

“It’s about changing how we actually think,” he said.

There’s also a troubling drop in the level of experience in hospital nurses on 12-hours shifts, the panelists said. The average tenure for nurses on 12-hour shifts dropped to 2.8 years in March 2022, down from 3.6 years in January 2021, according to 

. The Epic study found turnover in nursing is rising and underscored “the need for organizations to invest in retention and onboarding programs for nurses.”

While there are many new graduating nurses, many lack basic knowledge of duties such as starting IVs, and hospitals are left to do a great deal of training new nurses, Golebiowski said. Too often, young nurses are left to sink or swim on their own. “They don’t have that foundation,” he said.

Plus, with more nurses leaving, younger nurses don’t have as many experienced colleagues to help guide them as they gain experience, the panelists said.

The understaffing of nurses is being noticed by patients, Nadel said. She asked the audience at the panel session to think about their last interaction with a health system. “Probably most of you would say it wasn’t great,” Nadel said.

“Patients are angry, they don’t understand,” she added.

Government reimbursement models for hospitals are going to have to be adjusted to help health systems recruit and retain nurses, panelists agreed. It’s going to become more critical as health systems develop more options to provide care at home and outside of the hospital, they said.

The shortage of nurses demands more attention, and more creative solutions, from the healthcare industry, panelists said.

“They’re already short on nurses right now,” Golebiowski said. “It’s scary what’s coming around the corner.”

Some nursing leaders have said health systems need to 

allow nurses to focus on their nursing duties

 and find ways to remove other tasks off their plate.

The American Association of Critical-Care Nurses issued a report in August that said 

less than half (47%) of nurses feel their organization values their health and safety

. Two out of three nurses are considering leaving their position in three years, the group said, and among those thinking about leaving, 36% of nurses said they’d leave in a year.

the fatal shooting of a nurse and social worker

 at Methodist Dallas Medical Center last month, nurses have urged health systems and lawmakers to provide more protection for healthcare workers.

Articles

With more nurses leaving bedside roles, health systems need to find ways to retain skilled and experienced professionals. 

Nursing shortage requires hospitals to improve work environment, experts say

Health systems and hospitals are increasingly the target of ransomware attacks, and now federal officials are warning about a newer, emerging threat.

The Department of Health and Human Services’ Health Sector Cybersecurity Coordination Center, known as HC3, issued an 

 this month about a newer threat aimed at the healthcare and public sectors.

The HC3 advisory warns about “Lorenz” ransomware, operated by a group that typically targets enterprise groups rather than private individuals. The ransomware group is “known to target larger organizations in what is known as ‘big game hunting’,” the advisory stated.

The Lorenz ransom demands range from $500,000 to $700,000. The group has been known to release private health information publicly to pressure organizations to pay the ransom, federal officials say.

How hospitals can improve their cybersecurity

Authorities say the Lorenz ransomware was first identified in February 2021 and that healthcare organizations have been compromised.

The group tends to release private information differently from other ransomware groups, according to HC3.

If an organization is reluctant to pay, the Lorenz gang will put the stolen data up for sale to other ransomware groups. If the victimized organization still doesn’t pay up, the Lorenz group will release password-protected archives containing private information.

If the Lorenz group can’t sell the data and the victim still isn’t paying the ransom, they will publicly release the password for all the archives, allowing anyone to access them, HC3 says. They will also sell access to the organization’s network as well, officials say.

The Lorenz gang tailors its ransomware attacks for individual targets, the advisory stated.

Hospitals must do more to improve cybersecurity

John Riggi, the American Hospital Association’s national advisor for cybersecurity and risk, said in a 

 that the Lorenz group designs attacks specifically for different organizations.

“The fairly new Lorenz ransomware is unique in that its operators appear to customize their executable code to be target specific, unlike other ransomware operators which use the same ransomware code to target multiple unrelated victim organizations,” Riggi said in the statement.

“According to HC3, this may indicate that the hackers may be present for reconnaissance purposes for an extended time before executing the ransomware,” Riggi said. “What is consistent is that the Lorenz ransomware attack vectors are similar to other ransomware operators: phishing emails, compromises of known vulnerabilities and remote access technologies, and penetrating supply chains and managed service providers.”

While the Lorenz group has gone after targets globally, most of Lorenz’s targets are English-speaking organizations.

Unlike some other ransomware organizations, the Lorenz gang is a relative mystery and information about the group is fairly limited, federal officials say.

Ransomware attacks on hospitals are becoming more common

, cybersecurity experts say. CommonSpirit Health, one of America’s largest hospital systems, said 

it was hit with a ransomware attack in October

. Some hospitals had to reschedule appointments and some systems had to be taken offline.

Federal authorities issued a warning last month about 

a ransomware gang known as the Diaxin Team

 that was primarily targeting healthcare organizations and the health sector.

The Daixin Team has targeted the healthcare sector with ransomware and data extortion operations since at least June 2022, according to a federal Joint Cybersecurity Advisory issued by the FBI, the Cybersecurity Infrastructure and Security Agency, and the Department of Health and Human Services. The gang has engaged in “multiple” ransomware incidents in the healthcare sector, the advisory states.

While cyberattacks are costly to healthcare organizations, experts warn that 

 when systems are accessed and procedures are delayed.

Federal officials warn that individuals behind ‘Lorenz’ ransomware are targeting larger organizations, including those in the healthcare industry.

Hospitals warned of ransomware gang engaging in ‘big game hunting’

Calm CEO David Ko and Jay Shetty, Calm's chief purpose officer, talk with journalist and author Brooke Baldwin at the HLTH Conference in Las Vegas Nov. 14. (Photo: Ron Southwick)

Jay Shetty shared a lesson from his first day of “monk school.”

Shetty, the chief purpose officer of Calm, spent three years living as a monk and recalled seeing 11-year-old boy teaching 5-year-old children how to breathe. He said he was fascinated with “the idea that how we feel in our mind can impact our body.”

The popular author and podcast host is now playing a key role at Calm, the popular app focused on relaxation, sleep and meditation. He’s host of “The Daily Jay,” a short message on mindfulness. Speaking at the HLTH Conference in Las Vegas earlier this month, Shetty said he recently stood outside in New York City, and he listened to anyone who needed to unload some stress.

“I was out there for about 8 hours. I must have spoken to hundreds of people,” he said.

That day illustrated the profound mental health needs of many Americans, he said. And Calm is looking to play a bigger role in mental health and healthcare.

Calm announced in October that the company is launching “Calm Health,” which will offer mental health services through health plans, healthcare providers and employers. Calm said it will offer clinical programs to help people struggling with anxiety and depression. In the future, the company aims to provide mental health support for diseases such as heart disease and cancer.

Calm acquired Ripple Health Group, a healthcare technology company connecting people with healthcare options, in early 2022. Calm also offers mental health and stress relief to employers through Calm Business, a program utilized by 3,000 corporations, including Lincoln, Universal Music Group, and the Kraft Heinz Company.

However, Calm, which recently celebrated its 10th anniversary, may have the most visibility with its app, offering programs on mindfulness, sleep, meditation, and relaxation. Calm now has 4 million paid subscribers and says it has had 100 million downloads. The company, based in San Francisco, had a valuation of $2 billion in December 2020, 

 named Calm one of the 100 most influential companies of 2022.

“The product has really evolved over the last 10 years,” David Ko, Calm’s CEO, said at the HLTH Conference.

And he added, “We’re just getting started.”

Now, Ko said, he’s excited about taking the Calm brand and entering healthcare. He noted that there is much greater discussion about the need for behavioral health, and employers are recognizing the need to help workers with their mental health.

“This is where I feel like companies like ours and others can come together and lead the way in this important discussion,” Ko said.

The challenge of developing digital solutions for mental health

Mental health needs have surged during the COVID-19 pandemic. About one out of three American adults (32.8%) reported experiencing anxiety or depression, according to a June 2022 survey by the 

. At the height of the pandemic, as many as four in 10 said they were battling anxiety and symptoms of depression.

At the same time, there’s a shortage of mental health professionals. More than half of U.S. counties have no practicing psychiatrists, according to a 

. Ko envisions Calm as having an opportunity to make its mark and also fill unmet needs.

“This is where tech is going to have to play a big part of the solution,” Ko said.

“We can be a part of that solution going forward,” he added. “This is our step.”

Based on Calm’s reach and with the assistance of partners, Ko anticipates Calm can eventually help millions of people gain access to mental health services.

“From the tolls of the pandemic to financial uncertainty and workplace anxieties, people have turned to Calm over the past ten years to manage their mental health,” Ko said last month as Calm announced the launch of Calm Health. “As we move into healthcare, our goal is to reach even more people with clinical mental health tools and destigmatize the importance of regular mental health care.”

Telehealth reduced risk of overdoses in COVID-19 pandemic, study finds

Shetty, who joined Calm in February 2022, said he wants to make “mental health a mainstream conversation.”

“I want to make sure the world is a happier, healthier and more healed place for future generations,” he said.

Shetty also urged the healthcare and technology leaders assembled at the HLTH conference to develop more solutions aimed at helping people with mental health needs.

“The brains and superpowers that are in this room can make them scalable and accessible and affordable,” Shetty said.

The company’s app on relaxation and mindfulness is used by millions. Now, Calm is offering mental health services with ‘Calm Health.’

Calm moves into healthcare and is excited about its prospects

Maria Cristina Jimenez worked in healthcare for 30 years before becoming the chief executive officer of Coral Gables Hospital, and she was well-respected.

Maria Cristina Jimenez (Coral Gables Hospital)

Jimenez, 61, was killed Nov. 23, the day before Thanksgiving, in a murder-suicide, according to the Miami-Dade Police Department. Police said her husband, Antonio Mazzorana, 62, fatally shot her inside their home before taking his own life, 

 reported. The Herald, citing law enforcement sources, said Mazzorana may have been struggling with mental health issues.

Rebeca Sosa, chairwoman of the Coral Gables Hospital board, told 

“Everybody loved her,” Sosa told the 

. “Anyone who would call Cristina to help someone, she would always be there.”

Joshua Putter, president of the South Florida region for Steward Health Care, which owns Coral Gables Hospital, said the organization is “deeply saddened by the tragic loss of our colleague and friend, Cristina,” the 

“She was an integral part of our hospital and community,” Putter said. “She was a leader, colleague, friend, and bright light who will be missed every day. We extend our condolences and prayers to the family, and we all mourn with them."

Jimenez rose to the CEO position at Coral Gables Hospital in 2017, according to the 

. She had previously been the chief operating officer of the 245-bed acute care hospital.

The organization praised Jimenez for her work in helping the hospital earn The Joint Commission’s Gold Seal of Approval for total hip and total knee replacements.

When Jimenez was elevated to the CEO position, Sosa called her “an exceptional leader who has dedicated her entire career to the health and well-being of our patients and has worked hard to create a workplace environment that allows employees to thrive.”

Marsha Powers, then-CEO of Tenet Healthcare’s east Florida hospitals, said Jimenez was “perfect to lead Coral Gables because of her commitment to the hospital and her continued perseverance to deliver expert care to our community.”

Steward Health Care said Jose Molliner will serve as interim hospital president. Steward acquired Coral Gables and four other Florida hospitals from Tenet in 2021.

, Jimenez said her father and grandfather both worked in healthcare and were a strong influence on her. She also talked about her love of cooking and the joy of recently becoming a grandmother.

“I have always been passionate about healthcare,” she said in the interview. “Even from a young age, I wanted to help people and make sure I made a difference in their lives. When patients are hospitalized, it can be a vulnerable moment in their lives and being able to help people gives me a lot of satisfaction.”

If you’re struggling with thoughts of suicide, call 988 to reach the 

Maria Cristina Jimenez was hailed for her leadership skills. Police said her husband fatally shot her and then took his own life.

Coral Gables Hospital CEO, killed in murder-suicide, remembered as a ‘bright light’

Two former employees of the Department of Veterans Affairs created phony companies and managed to steal $2.9 million from the Dallas VA Medical Center, federal prosecutors say.

Both have pleaded guilty to theft of government funds, according to Chad E. Meacham, 

U.S. Attorney for the Northern District of Texas

. Randius McGlown, 56, entered a guilty plea in October, and Charles Gates, 54, pleaded guilty in November, prosecutors say. They now face up to 10 years in federal prison, authorities say.

McGlown worked as an inventory manager and acquisition utilization specialist at the Dallas VA Medical Center. He inserted the name of a company he created, G4 Logistics, into the facility’s vendor system in 2014, authorities say.

McGlown and Gates produced “phony purchase orders” for equipment and materials, prosecutors said. They used a purchasing card from the medical center to pay the bill, but never delivered any items, authorities said.

The VA money was deposited into an account controlled by an individual identified in court documents as “J.R.”, prosecutors said. That individual would deliver most of the money from the account and pay it to McGlown or Gates, and keep some of the money for himself, authorities said.

McGlown switched from G4 to another company he created, Caprice Electronics, in 2018. McGlown produced “fake invoices,” prosecutors said, and then used existing items in the medical center’s inventory to appear as if the materials were delivered, even though neither of the companies actually delivered on any of the orders, authorities said.

Acting Special Agent in Charge Patrick Roche of the VA Office of Inspector General’s South Central Field Office said the case should serve as a warning to those trying to steal money from the VA, which serves millions of veterans.

“Using their official government positions to steal millions of taxpayer dollars is an egregious crime that diverts resources from deserving veterans and erodes public trust. These guilty pleas should send a clear message that the VA Office of Inspector General will diligently investigate those who would misuse their positions to commit fraud,” Roche said in a statement.

The Department of Veterans Affairs, Office of Inspector General, conducted the investigation,  with assistance from the FBI’s Fort Worth Field Office, and the General Services Administrations, Office of Inspector General.

Read more from Chief Healthcare Executive

VA delays rollout of new electronic health record system until June 2023

VA should track canceled appointments more closely, watchdog says

The two created fake purchase orders and then billed the Dallas VA Medical Center. They entered guilty pleas in federal court this month and could spend a decade in prison. 

Former VA employees plead guilty to $2.9M embezzlement scam

Nasim Afsar, chief health officer of Oracle Health

Hospitals and health systems are paying more attention to 

, including the factors that affect the health of patients in their own neighborhoods.

Oracle Health is working with hospitals to reduce disparities in outcomes. Since completing 

the $28 billion acquisition of Cerner in June

healthcare is now the company’s primary focus

, Nasim Afsar, chief health officer of Oracle Health, discussed the organization’s work to identify the health needs in different neighborhoods. She also outlined how hospitals and health systems can improve health equity.

Why do zip codes play such an outsized role in a person’s health?

We all know that clinical factors aren’t the only influence on a person’s health and wellness. Where you live by country, by state, and even by neighborhood makes a profound difference. That’s why it’s important to bring social determinants of health into the EHR (electronic health records). Zip codes can tell us a lot about a person and are often indicative of the available resources in a community as well as people’s access to health clinics or to grocery stores with fresh, healthy fruits and vegetables. They also reflect income levels, with housing security and access to public transportation. These are all factors that play a critical role in an individual and community’s health and care.

How are we only recently seeing the role of one’s neighborhood as a key factor affecting health?

This is definitely not a new or recent phenomenon. For decades, public health experts, researchers and clinicians have seen the impact of zip codes on the health of individuals in communities across the globe.

However, over the past decade, as more medical records have been digitized and we are asking for and capturing more of these elements, we are able to have a better data-driven understanding and approach to the true impact of these indicators on health. Proactive relationships between health systems and communities help broaden healthcare and can be a game-changer. Data-driven insights should be integrated into the EHR to help providers identify those who might be at a health risk, food and housing insecurities and other factors.

How does Oracle Cerner’s Determinants of Health solutions help providers improve their health care and move closer to health equity?

Our job at Oracle Cerner is to create tools that enable clinicians to get back to what matters most – caring for patients. We have a real opportunity to not only raise awareness of but to also examine and identify how we can eliminate inequities today and into the future.

Rich data sets, dashboards and technologies such as Oracle Cerner’s data and insights platform can help providers access clinical, behavioral and social data about patients in one place, identify existing disparities and suggest community resources as part of a patient’s care plan.

Oracle Cerner’s Determinants of Health can help providers conduct community needs assessments to proactively address social risk factors. At the population level, you can see social risk factors like transportation barriers, food insecurity or housing instability all broken down by demographics. In June 2022, we added a new feature - the ability to zoom in to neighborhood groupings of 600 to 3,000 people to better understand and target social risk.

Why is this new capability so important? Consider Wyandotte County in Kansas – in the tool, you can see the entire county is coded red for being at high risk due to social factors such as lack of health insurance and a high prevalence of gaming and alcohol establishments. But that’s not the full story. The tool also shows that the eastern part of the county makes up most of this at-risk population. With this enhanced data, healthcare organizations can more accurately tailor and target their outreach and intervention programs.

What should hospitals and health systems be thinking about when it comes to “techquity”? 

Technology shouldn’t be something we think about – yet it should seamlessly connect to the most relevant data at the right time so clinicians can focus on the purpose of healing through compassionate connections with their patients. Technology and data insights are being used today to address health disparities, to prevent bias in care delivery and ultimately help improve overall outcomes in communities. Clinicians can look to understand how they can leverage a person’s social risk factors to provide proactive interventions that improve health and care. Many current systems are focused too much on reactive responses. Leveraging data enables us to be more proactive and prevent or minimize illnesses and diseases.

 solution helps organizations advance whole person care by identifying and intervening on social risk factors through action-oriented community analytics and social determinants of health capabilities embedded within care management workflows.

Can you offer a little more insight on how geospatial modeling identified patients at risk for diabetes and hypertension at an African American church in South Carolina?

Roper St. Francis Healthcare, using geospatial mapping within Oracle Cerner technology, analyzed publicly available information and identified other institutions that patients frequent, such as churches. In collaboration with the Roper St. Francis Healthcare chief diversity and inclusion officer, the analytics team cross-referenced African American patients that had a high prevalence of diabetes and hypertension with the location of churches they attended. Working with the church, the chief diversity and inclusion officer provided literature, engaged church leaders and identified nurses who were members of the congregation to conduct screenings and outreach. This helped the system to step outside of the four walls and help ensure that community members received care in environments they trusted, ultimately impacting their health for the better.

Can you share more about the screening tool used to help the University of New Mexico Health Sciences Center spot the tie between social determinants and poor health outcomes in the diabetes population?

Within its Oracle Cerner platform, the University of New Mexico Health Sciences Center uses a screening tool to determine the correlation between adverse social determinants and poor health outcomes in populations with diabetes and other chronic conditions. The results led the organization to hire community health workers for its primary care clinics and its emergency room, to help make a more positive impact in vulnerable patient populations. Their Office of Community Health plays a vital role in advancing health and health equity, recognizing social determinants, such as housing, education, food, transportation, utilities, income and social inclusion, play a far greater role in health.

Where should hospitals or health systems start on health equity efforts?

Improving the health of populations without understanding the conditions in which they live is a difficult undertaking. Having accurate, localized community data within the EHR is crucial to addressing social risk factors and improving community health. This same data can also be used to advance health equity – a specific focus of many of our health systems here in the U.S.

What can smaller hospitals or health systems with more modest resources do to use data to address disparities?

Addressing inequities in healthcare is not easy, whether you’re a critical care hospital or a large integrated delivery system. And we have developed the Learning Health Network. Today a group of more than 100 health systems from 43 states, including small community hospitals and academic medical centers, share de-identified EHR data for the purpose of advancing clinical research. More than half of the health network members are small critical access hospitals who now have the chance to bring clinical studies to their rural communities. Healthcare is about people helping people – and the Learning Health Network is a very definition of that.

By design, diversity has become the Learning Health Network’s superpower. Clinical trials that run through the health network have three times the national average of Black and Hispanic participants. Take for example, Osmond General Hospital - a 20-bed critical access hospital in rural Nebraska. For the first time ever, they enrolled in their first clinical trial earlier this year for early detection of colorectal cancer. One of their patients who qualified for the study tested positive on her at home screening test. This prompted her to go in for a colonoscopy which confirmed a diagnosis of cancer. She is now undergoing treatment potentially years earlier into the disease.

This example brings to life the major benefit of the Learning Health Network – and how caregivers and patients are able to access leading therapeutics, diagnostics and medication sooner.

How do you ensure technology solutions to improve health equity don’t actually exacerbate disparities?

This is an area of increasing assessment and work for all of us in the healthcare industry. Data that’s entered into electronic health systems can reflect societal bias. Therefore, machine-learning algorithms that build off of data, can reflect and exacerbate disparities. To eliminate this, we have to take a proactive approach on multiple levels, including education at the delivery side to ensure we are bias-free in our documentation and data collection, and active monitoring and surveillance to ensure we are looking for and eliminating bias when identified in systems. This requires broad conversation and commitment from all of us.

How should hospitals and health systems work with the community in addressing health disparities?

Despite commitment across healthcare organizations to address health disparities, some have found it hard to detect and address inequities. An important step is to build relationships and infrastructure to support community engagement - something that historically hasn’t been considered. We haven’t always looked to what happens in clinics and hospitals without considering the full picture. However, what happens outside the doctor’s office and in daily life can influence decisions we make and opportunities we have. Robust, thriving relationships can help communities together understand how to identify gaps and address them to ensure better health and care for individuals, communities, and neighborhoods.

In an interview with Chief Healthcare Executive, the chief health officer of Oracle Health talks about the role of data in closing disparities. She also offers guidance for hospitals aiming to improve equity in care.

Oracle Health’s Nasim Afsar discusses tech and equity in healthcare

Panelists at the HLTH Conference talked about improving health equity. From left, Eboné Carrington, managing director of Manatt Health; Amaka Eneanya, head of strategy and operations for Fresenius Medical Care; Bechara Choucair, senior vice president and chief health officer of Kaiser Permanente; Taylor Justice, co-founder and president of Unite Us; and Charlotte Owens, vice president and head of health equity and patient affairs at Takeda Pharmaceuticals.

Since the emergence of the COVID-19 pandemic, many healthcare leaders and experts have said the pandemic has vividly illustrated the inequities in health treatment and outcomes among disadvantaged groups.

Eboné Carrington, managing director of Manatt Health, said those disparities in healthcare among minority groups and those with lower incomes haven’t exactly been hidden. The fact that so many are genuinely surprised by health inequities indicates the conversation needs to move forward, she said.

“When no one is disadvantaged, then we’ll be on the way to health equity,” she said.

Carrington led a discussion on health equity with other healthcare leaders at a panel at the HLTH Conference in Las Vegas earlier this month. They talked about ways to close disparities in health outcomes.

CMS leader says health innovation must be available to everyone

Health systems need to think about the conditions of health and equity in the communities where their patients live, said Bechara Choucair, senior vice president and chief health officer of Kaiser Permanente.

Efforts to improve health equity must focus on the patient, Choucair said. Kaiser Permanente engaged in a text messaging campaign to gain a better understanding of the needs of its members. The organization eventually helped 100,000 people sign up for food assistance, Choucair said.

Kaiser Permanente has made some progress by “putting the patient’s voice at the center of the table,” Choucair said. That involves visiting individuals in their homes and asking them what they needed. It’s easy to sit in a conference room and try and come up with solutions, Choucair said, but organizations need to be reaching out and engaging with their communities for human-centered solutions.

Health systems say equity is a goal, but many aren’t budgeting for it

Charlotte Owens, vice president and head of health equity and patient affairs at Takeda Pharmaceuticals, said she had experience with health equity long before that phrase had become widely known.

“Most of what makes us healthy is outside of the healthcare system,” she said. “It’s about your personal ecosystem.”

“If that environment Isn’t healthy, you don’t have a good chance of being healthy,” Owens said.

Healthcare organizations looking to improve health in their communities need to partner with organizations and leaders in those neighborhoods, she said.

“If the problem sits in the community, the solution probably lies there, too,” Owens said.

Taylor Justice is co-founder and president of Unite Us, a technology company that connects health and social services providers. He said it’s important to do more than track how many people are being referred to social services. Ultimately, providers need to be sure people are getting the care they need.

“Put referrals to bed. Referral is only hallway there. The focus needs to be on the outcome,” Justice said.

It’s critical to examine the data to be sure interventions are successful, and to see where efforts are falling short.

“If we want to measure success, we need to be able to look at the good data, the bad data, and look at those gaps,” he added.

Amaka Eneanya, head of strategy and operations for Fresenius Medical Care, is leading a team working to address inequities in kidney disease.

Race is often misused in healthcare, she said. It’s useful to track race in efforts such as vaccination, to make sure that Black or Latino neighborhoods are gaining access to vaccines, she said.

But race is often used improperly in clinical algorithms and screening tools, potentially delaying some patients from getting treatment, she said. Race modifiers in algorithms used to measure kidney function have delayed Black patients from obtaining proper treatment, according to the Coalition to End Racism in Clinical Algorithms.

“Stopping with just race is lazy in your clinical algorithm,” Eneanya said. “You need to go beyond that.”

Justice also said that offering services to help individuals who have food and housing needs is actually more cost effective than having to treat more complex health conditions down the road. “Those services are usually far less expensive than a clinical intervention,” Justice said.

Addressing health equity involves coordinated effort of healthcare organizations, social services and government agencies working together, panelists said. “Health equity is really about a whole of government approach,” Carrington said.

“This isn’t on one sector to solve all of the problems,” Justice said. “This is all of us coming together.”

Several experts discussed ways to close disparities among disadvantaged groups during a panel at the HLTH Conference. They stressed working with communities and measuring data to see if interventions are working.