Improving health outcomes with community

Health equity refers to the concept that all people should have access to the resources and opportunities they need to achieve good health. Unfortunately, many people face barriers to accessing healthcare and other resources that can help them stay healthy – often related to social determinants of health (SDOH) like poverty, housing, and literacy that greatly influence health outcomes.  

In recent years, some of the greatest advances in health equity have been achieved with predictive analytics using AI.  

AI’s ability to make sense of unstructured data allows it to draw health conclusions from SDOH is immense. Healthcare providers and health systems can presumably predict and prevent adverse health outcomes using this technology, but even that isn’t enough to bridge the health equity gap.   

There are still questions left unanswered – like how can we make sure patients are coming in for their followup visits if they don’t have transportation, or how do we make sure patients are getting the best care if English isn’t their primary language?  

A new crop of digital health companies is answering these questions by approaching health equity efforts in a new way. By prioritizing community engagement and communication, they hope to overcome the particular needs of underserved patients.  

Leveraging community resources to improve health equity  

Stacy Lindau, MD, created NowPow, a tech tool that links patients to social services that can address their needs.  

Too often, the work of finding an appropriate social service for their patients falls upon already overworked healthcare providers who might not have the capacity or experience of sifting through government welfare programs. 

“Doing this work without technology is inefficient and frustrating, and it rarely results in high-quality results for the person in need,” said Lindau. 

By making it easier for healthcare providers to connect their patients with resources such as food banks, housing assistance programs, and transportation services, Lindau hopes to improve health equity.  

So far, the impact has been successful – even in unexpected ways.  

“We’ve found, through repeated studies, that if you connect people to community-based resources, half of the people who get this information will use it to help other people in their community,” said Lindau.  

“Doing this work is different from a drug or device intervention. If you connect patients to their community, it spreads beyond just the client or doctor. That’s powerful in terms of driving long-term change in communities.” 

NowPow enhances the referral process by utilizing diagnostic codes from electronic health records to pinpoint patients’ most pressing non-medical concerns. By employing matching logic and evidence-based proprietary algorithms, the software recommends appropriate community organizations that are equipped to address those specific needs. 

NowPow is one of many companies like it that are improving health outcomes by streamlining the referral process for patients to social and community services. Cityblock Health, Healthify, and Unite Us are offering similar programs across the U.S.  

“What’s exciting about this program is that we can turn a new page in care and look beyond the hospital bed or the physician’s office and look to the overall community. This will enable us to work as one team to help enrich the lives of patients and expand the definition of care,” said Israel Rocha, CEO of OneCity Health and vice president of NYC Health + Hospitals of programs like NowPow. 

Overcoming language, cultural, and communication barriers 

Language barriers can have a significant impact on health outcomes for individuals with limited proficiency in the language spoken by healthcare providers. Misunderstandings and communication breakdowns can lead to incorrect diagnoses, inadequate treatment, and even medical errors.  

The COVID-19 pandemic highlighted the consequences of language and cultural barriers in healthcare. One study found that when the COVID-19 pandemic first started non-English speakers were 35 percent more likely to die or need intensive care. According to the Center for Disease Control and Prevention, Black and Latinx people were 4.7 times more likely to be hospitalized from COVID-19.  

The National Academies of Science, Engineering and Medicine state that “racial and ethnic disparities are arguably the most obstinate inequities in health over time.” 

Abner Mason, former Chief Policy Advisor in the state of Massachusetts, created SameSky Health (formerly ConsejoSano) to combat these issues. 

“America is multicultural, but healthcare isn’t. We are on a mission to change that. Our underserved communities need and deserve greater engagement and access to healthcare designed and delivered with them in mind,” Mason stated in a press release.  

SameSky Health developed a Cultural Determinants of Health Engine that operates as a two-way communication platform between patient and provider. The tech tool uses cultural insights with the intention of building patient trust and can translate in more than 25 languages.  

Originally a language-based platform, SameSky Health expanded into addressing the challenges that often coexist with non-native English speakers living in the U.S. and now focuses on communication overall.  

“If you ask people in America today, ‘How do they communicate with their family and friends?’ the answers should be driving how we communicate with them in health care,” Mason said of SameSky Health’s health equity initiatives.  

“This is the way America communicates in 2022. And it’s definitely the way low-income Medicaid members communicate.” 

He believes that moving medical communications to text messaging is an issue of health equity.  

“If we say we want to meet people where they are and actually build trusted relationships with them — but we’re unwilling to communicate in the only way that they’re comfortable — then we ought to stop saying that we care about health equity.” 

Tech companies are playing an important role in bridging the health equity gap. By using technology to connect people with the resources they need, these companies are helping to improve health outcomes for underserved populations. 

Whether it’s providing culturally and linguistically appropriate healthcare information, connecting patients with community-based resources, or addressing the social determinants of health, technology companies are making a significant impact on health equity.