HIMSS 2022: Learning about patient needs and taking action

Baligh Yehia, an Ascension executive, explains how the system surveyed patients about their unmet needs, and then worked to help them.

Two years ago, the Ascension health system began collecting data from patients to see if they needed help in some way.

It’s impossible to know about some unmet needs without asking, Baligh Yehia, senior vice president of Ascension and president of Ascension Medical Group. Yehia talked about the use of digital tools to survey patients in a session at the HIMSS 22 Global Health Conference & Exhibition.

“One out of 6 patients had some sort of identified need,” Yehia said.

He said he was surprised about the top concern cited by patients: loneliness. Some patients were craving some kind of human interaction. “That was a huge issue,” Yehia said.

“The amount of individuals that raised their hands and said they were experiencing that, and they would like some help with that, I think was really surprising,” Yehia said. “It crossed ages, it crossed racial ethnic groups and locations.” (In this video, Yehia talked about the effort to learn about patients' unmet needs. The story continues after the video.)

Patients also said they were having trouble paying for medications or paying for doctors’ appointments.

The information provided fresh insight into the challenges patients faced. However, some colleagues at Ascension said they shouldn’t just be surveying people, Yehia said.

If the system was going to be asking people about needs such as financial challenges or if there is violence in the home, they said Ascension should at least try to offer help in some way. Ascension sends an automated message asking where they need help and helps connect them to assistance.

“When you think about social determinants of health and asking these questions, clinicians and care team members really want to intervene,” Yehia said. “They don’t want to just ask the questions,” he said.

“So when you think about designing programs, it’s not just a questionnaire. It’s about, how do you put in place very specific interventions?”

For those experiencing loneliness, volunteers and chaplains connect with patients, he said. Those having trouble with medical bills or paying for prescriptions are also directed to assistance.

The interventions aren’t always perfect, Yehia said, but it’s important to be making the effort.

Yehia has been concerned about addressing health disparities throughout his career, including work with HIV and AIDS patients in Baltimore and Philadelphia. He formerly worked as deputy undersecretary for health in the U.S. Department of Veterans Affairs.

The COVID-19 pandemic has revealed some of the disparities in healthcare among minority groups. Black and Latino patients are more likely to die or require hospitalization due to COVID-19, according to federal statistics.

“Health equity and eliminating health disparity has to be a priority,” he said. And equity has to be an essential consideration as healthcare systems develop digital tools.

“If you don’t think about equity, you may roll out a product that leaves a group behind,” Yehia said.

In designing technology solutions, health equity must be a key consideration.

“Tech could do good and you want to make sure that tech doesn’t do anything bad as well in terms of exacerbating health disparities,” Yehia said.

Ascension has developed dashboards tracking how diseases such as diabetes are affecting different racial and ethnic groups.

In addition to addressing equity in patients, Ascension is also focused on reducing the bias healthcare workers experience.

“We are doing bias training but we are working to create the right culture,” Yehia said.

Part of changing the culture also means addressing when patients demonstrate bias toward clinicians and say they don’t want to be treated by a caregiver due to race. Yehia said it’s not acceptable to concede to that demand.

“That’s not our culture,” he said. “You can get care here or we’ll find you some other place to go.”