Research leaves little doubt that significant care quality disparities due to race, income, gender and even sexual orientation continue to trouble the U.S. healthcare system, but the greater challenge for providers is to pinpoint what to do about it, Permanente Medical Group CEO Robert Pearl, M.D., writes in a recent Forbes article.
"Politicians, pundits and executives proudly declare America's medical care is the best in the world. But it isn't," Pearl writes, later adding: "One reason the U.S. ranks so poorly globally is that health outcomes for certain racial, ethnic and socioeconomic groups fare so poorly domestically."
A particular focus of late has been on the care access disparities experienced by the lesbian, gay, bisexual and transgender (LGBT) community, struggles that are particularly acute in rural areas, according to CNN. In states like Nebraska, LGBT patients in rural areas not only are less likely to have health insurance than their urban counterparts, but they often face health issues related to discrimination and are treated by providers whose lack of knowledge about these issues can lead to poor outcomes, the article states.
Hope has arrived, however, in the form of expanded insurance coverage due to the Affordable Care Act, as well as creative solutions at the community level, he says. Examples of the latter include the Crossroad Health Center in Cincinnati's efforts to foster diabetes management in the Latino community; Harlem Hospital's addition of patient navigators and free breast cancer screenings; and Detroit community groups' initiative to improve blood-pressure control among African-Americans, according to Pearl.
And Kaiser Permante's own efforts have put the company in the 10 top percent in the nation for all racial groups across several clinical areas, Pearl notes. In the company's ongoing efforts to eliminate disparities, it has found particular success with some of the following practices, according to Pearl:
- Develop health education tools that cater to different segments of the population
- Invest in translation and interpretation services for bilingual patients
- Use electronic health records (EHRs) to track and measure the health outcomes of patients, and use this information to design better treatments
- Partner with the community to foster outreach and care coordination
At least one of these recommendations is backed up by the Department of Health and Human Services, which has encouraged providers to harness the power of EHRs to close health gaps, FierceEMR reported.