Using Technology to Advance Health Equity at the Community Level

Today, nearly 1 in 4 hospitalized patients in the US experiences medical harm, and many more struggle to access the critical and preventative care they need. Medical harm, poor health outcomes, and limited care access can affect anyone, anywhere, but certain populations are at higher risk. A 2022 National Healthcare Quality and Disparities Report found that Black and American Indian patients receive lower-quality care than White patients for 40% of quality measures, including higher rates of postoperative sepsis, pulmonary embolism, and acute kidney injury. Others face health inequities based on sexuality or English fluency: research has shown that members of the LGBTQ+ community are more likely to encounter challenges accessing care and that people with limited English proficiency (LEP) are at higher risk of experiencing health care disparities in accessing care and screenings across a variety of settings.

Other nonmedical factors can impact health outcomes and the quality of care received. These factors, known as health-related social needs, include housing and food insecurity status, disability, age, gender and more. Patients with certain health-related social needs may be at greater risk for inadequate diagnosis or treatment due to inappropriate care coordination, fragmented communications, and lack of a safety culture that embraces patient individuality and promotes family engagement.

Addressing the system inequities that pervade the current health care environment is key to fostering safer care for all within our communities. To do so, health care leaders must take a holistic approach that includes using data and technology to assess patients’ health-related social needs, improve patient safety, and identify drivers of risk and inequity.

Identifying Risk Factors With Connected Technology

Hospitals and health systems house large swaths of data, but much of this data exists in silos—in fact, 97% of health care data today goes unused due to disconnected operations. Connecting and sharing data both within and across health care organizations can help hospitals and health systems identify the health-related social needs of their communities and address care inequity.

Imagine a local hospital serving a community with a large LEP population is seeking to evaluate its effectiveness in reaching and treating this demographic. By aggregating and analyzing patient data, they evaluate how care outcomes and adverse event rates for their non-English-speaking patient population compare with the organizational average. After finding higher-than-average rates for both medical harm and suboptimal care outcomes, they dive further into the data and identify factors associated with medical harm among their LEP patients. The analysis indicates that those who saw a unilingual provider and who received phone communication rather than email communication experienced poorer outcomes. With this information, the hospital creates an action plan to provide more equitable care, including hiring more multilingual staff and implementing a phone system with multiple language options to better serve all members of their community. This is just one example of how connecting data can enable health care organizations to provide safer, more equitable care.

New Safety and Equity Measures Provide a Framework for Progress

Stalled progress in patient safety and health equity has prompted the development of multiple evidence-based measures and guidelines. Assessments like the Accountable Health Community (AHC)’s Health-Related Needs Screening Tool can help health care organizations capture patient demographic information and pinpoint critical nonmedical factors that can impact an individual's overall well-being and health outcomes.

In one step to advance health equity among a medically vulnerable group, the US Centers for Medicare & Medicaid Services (CMS) released an Age-Friendly Hospital Measure, which will assess hospitals’ commitment to improving care for patients 65 years or older receiving services in the hospital, operating room, or emergency department. This measure consists of 5 domains that address essential aspects of clinical care for older patients, including key health-related factors such as social isolation, mental wellness, and vulnerability to elder abuse.

Additionally, the CMS’s Patient Safety Structural Measure (PSSM), published in 2024, marks a monumental step forward in addressing the core challenges impacting our health care system, serving as a patient safety roadmap for encouraging open, empathic communication along with incident reporting and data sharing as an engine to drive improvement. Part of the fiscal year 2025 Hospital Inpatient Prospective Payment System (PPS) rule, the PSSM is an attestation-based measure designed to assess whether hospitals have implemented strategies and practices to strengthen systems for safety across 5 domains: leadership commitment to eliminating preventable harm, strategic planning and organizational policy, culture of safety and learning systems, accountability and transparency, and patient and family engagement. Patient safety is intrinsically tied to health equity, and prioritizing alignment with the PSSM by implementing tools that support patient safety and improve communication and transparency around harm will enable hospitals and health systems to provide safer and more equitable care.

The Path Forward in a Time of Change

As the country looks toward potential changes in the coming months, the future of policies and regulations around health care safety and equity is still uncertain. However, one thing is clear: regardless of partisanship, Americans agree that patients everywhere deserve access to safe and equitable health care. By fostering accountability and transparent communication and making the technology changes needed to streamline operations and unlock actionable data, hospitals and health systems can address their communities’ health-related social needs and provide safer, more empathetic care.