Health equity, SDOH key priorities for ONC, says deputy national coordinator
Photo: HIMSS Media
At the first Friday of the two-day Office of the National Coordinator for Health IT Tech Forum, Deputy National Coordinator Steve Posnack flagged a common theme across the agenda: a focus on social determinants of health, equity and strengthening public health.
"These are things that are of immediate interest and have immediate effect in terms of overall pandemic response," said Posnack.
"These are also ONC priorities and priorities for the secretary [of Health and Human Services] and the administration as a whole," he added.
The questions, he said, will be: "How we can continue to make progress in these areas? How we can continue to look at how health IT can make an impact for these areas and identify where there are still challenges we need to overcome."
Posnack added that much of this is a matter of cumulative work effort across many different segments of the healthcare industry.
He encouraged attendees to consider how they can approach "health equity by design" – a term that's been used by ONC before. The goal is to "[build] in the concept of equity … up front, and make that part of the culture of health IT implementation and use."
However, as Shilpa Patel, associate director for health equity at the Center for Health Care Strategies, pointed out during a breakout session, health equity and social determinants of health are not necessarily synonymous.
"Health equity ... means that everyone has a fair and just opportunity to be as healthy as possible," said Patel.
"Addressing SDOH may not necessarily impact health equity, but that does not diminish the importance of SDOH, especially on health," she said.
Although intervening on social determinants does reduce social needs, that may or may not reduce disparities, she continued.
Furthermore, she continued, "Most organizations that say they're addressing SDOH are not actually addressing a community's underlying social and economic conditions, but are rather mitigating the current social needs of individuals."
In other news, mitigating someone's individual need does not necessarily address the systemic issues causing that need.
She also stressed the difference between social risk factors and needs: They don't always correlate with each other, which is why engaging with patients about their needs is crucial.
Uncovering and reducing disparities will take a number of specific steps, she said. It requires understanding where and why disparities are occurring, applying an equity lens; considering the best ways to analyze and track them, sharing results within and outside the organization, and using data to support sustainability.
"Using data strategically allows payers and organizations to discover and prioritize differences in care, outcomes and experiences across patient groups; plan equity-focused care transformations and measure impact, and then tell the story of how patients and communities are experiencing healthcare," she said.
It also takes culture change, said Patel's colleague Anne Smithey, a program associate at the Center for Health Care Strategies.
"Cultivate an internal culture of equity to strengthen approaches so colleagues understand the need to advance health equity," Smithey said.