How Community Resource Referral Platforms Improve Health Equity
Sarah Carroll, Director, Center for Care Transformation, and Sasha Cukier, Senior Analyst, Digital Impact Hub, AVIA
At AVIA, we’re proud to work alongside healthcare’s top thought leaders in digital transformation. We sat down with Sarah Carroll, Director at AVIA’s Center for Care Transformation, to learn about digital care challenges, trends, and what she loves about her work.
I see care transformation as helping health systems move from reactive, episodic, uncoordinated care to proactive, longitudinal, efficient care that delivers a terrific experience and outcomes at an affordable cost.
Care transformation puts consumers and care teams in the driver’s seat, supported by digital solutions to address whole person needs, including physical health, behavioral health, and social needs. For health systems, care transformation is where their mission can meet their margin.
Health systems are turning to digital solutions to prevent worsening health conditions that lead to higher costs. As Benjamin Franklin wisely observed in 1736, “an ounce of prevention is worth a pound of cure.” Healthcare leaders are using digital to practice prevention 235 years later.
For example, Boston Medical Center’s sickle cell clinic was experiencing a 25% no-show rate, twice the US average, until it implemented a solution to arrange convenient, safe rides for patients without reliable transportation. After implementation, the no-show rate dropped to 8.5%, patients received the critical care they needed, and the clinic yielded a 20x return on investment.
Many health systems struggle to capture a complete picture of each patient’s needs, including their social risk factors, such as food insecurity. This challenge limits their ability to achieve success with comprehensive care plans, especially for high-risk and underserved patients.
Health systems in our network are leveraging their EHR and other tools to scale standardized social needs screenings. Others are exploring patient intake tools and predictive analytics solutions to collect data for targeted outreach and more impactful interventions. In the future, I expect social risk factors to play a larger role in risk-adjusted payments and penalties. Smart health systems are laying the foundation to power their workflows with this critical information.
Over 50% of our Members have prioritized health equity, profoundly moved to better support their employees, patients, and communities of color. Racism and racial disparities are complex problems requiring comprehensive solutions.
While no one has the answer key, AVIA insights can accelerate action. We’ve selected the top 12 digital solutions that should be in every health system’s toolbox to deliver equitable care. We’ve seen a lot of movement in the Network to address social needs with a coordinated community network, enabled by a digital community resource referral platform. Others are getting smart on more accessible patient engagement, on-demand behavioral health tools, and remote monitoring solutions to support patients with chronic conditions.
I live three miles from the site where George Floyd was killed. Minneapolis, my hometown, has some of the greatest racial disparities in the country caused by inequitable distribution of resources, lack of cultural sensitivity, and implicit bias.
Healthcare has dramatically advanced over the last few decades, but we’ve left underserved communities and communities of color behind. This has to change. I would encourage my colleagues across the industry to ask about the progress being made at their organizations to address racism and advance equity, and then explore a growing number of innovative digital solutions to make progress faster.
In two words, it’s the network effect. Health systems look to AVIA and their peers across the Network to accelerate and feel confident in digital decision-making. I love working for AVIA because I’m able to learn from health systems about their challenges, identify patterns, and conduct research on solutions that are helpful for the industry at large. The problems facing our Members are complex, and AVIA approaches this work with humility and deep expertise that has been earned through countless conversations with health systems and solution companies.
If you’re interested in learning more about Sarah’s work at the Center for Care Transformation and how AVIA can help you reach your digital goals, contact us today.