Finding upstream solutions to address the social needs of patients will become even more crucial as the impact of COVID-19 will linger in many communities long after the pandemic has subsided. Such was the common theme discussed during Modern Healthcare’s most recent Social Determinants of Health Symposium June 2.
Stakeholders said now was the time to address the gaps in both healthcare services and socio-economic supports that have contributed to some communities experiencing the worst outcomes from the outbreak. In places like Louisiana, African Americans make up 31% of the state’s total population yet accounted for more than 54% of COVID-19 deaths as of May 26, according to the Kaiser Family Foundation.
“I think in some ways (COVID-19) has exacerbated some of the existing dynamics in place around what I would call a fragmented system for delivering social services to address social needs,” said Marc Rosen, director of healthcare integration and translation and movement advancement for the YMCA of the USA.
Although organizations have been adapting to provide services and resources to needy communities, he said the outbreak shows stakeholders must collaborate more closely to efficiently and robustly address the social determinants of health. “If we don’t, I think we’re already seeing that the stakes are too high,” Rosen said.
Throughout the pandemic, YMCAs across the country have mobilized to provide temporary housing, operate food distribution services, conduct wellness checks for seniors, and provide child care services for essential workers, he said, warning, “We can do these types of things over the short term, but they are not sustainable.”
In Ohio, ProMedica leveraged its existing programs addressing patients’ food, shelter and financial needs to help meet increased demand caused by the outbreak, said Brian Miller, the Toledo-based system’s chief medical information officer. There’s been a 15% increase in patients who have expressed a need in one of those specific areas since the pandemic started, he said.
The system was one of the first in the country to make social needs screening a routine part of its care delivery, conducting more than 3.2 million screenings in the last decade. Information gleaned from those assessments sparked initiatives to address food insecurity and housing instability, as well as direct investments to revitalize economically distressed neighborhoods.
Last December, ProMedica invested in a data center that will help the system design more effective interventions. “We feel like our standardized interventions around how to attack food, money and shelter needs are going to be well-poised to respond to the challenges of COVID,” Miller said.
Using data more wisely has allowed Intermountain Healthcare to better identify social needs among communities of color, said CEO Dr. Marc Harrison, one of the keynote speakers. As a result, the Salt Lake City-based system connects with the appropriate community partners who are able to more effectively deploy resources. “There has to be mutual good, there has to be value that moves in both directions,” Harrison said. “Hospitals really need to think hard about how do they serve the folks that are supporting them.”
Working closely with local governments to design new approaches to public health is also key, said Dr. Bechara Choucair, chief health officer at Kaiser Permanente and also a keynote speaker.
Lorie Wright, CEO of Family Healthcare, a primary-care clinic in Utah, acknowledged concerns over staff safety led her organization to initially limit access to some services. But that allowed Family Healthcare to increase outreach efforts. Community health workers conduct wellness checks via phone or videoconferencing and also help patients manage chronic health conditions.
“We’re walking a tightrope all the time in this situation that we’re in,” Wright said. “As we know COVID isn’t over. We want to keep learning from this and keep reaching out more.”
Many speakers cited CMS’ temporary easing of telehealth regulations as key in helping expand access. But Dr. Ram Raju, vice president and community health investment officer for Northwell Health, feared that the nation’s digital divide may widen.
“We need to create an equal playing field for everyone,” Raju said. “We do not want to create another healthcare disparity based on a person’s ability to get in touch with a doctor because they either lack the knowledge or resources to connect with them.”