Blues plan joins 12 health systems to address racial inequality in Philadelphia
The forming of the Regional Coalition is an effort to target 15 medical tests that may prevent minorities from receiving needed care.
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In an effort to target 15 medical tests that may prevent racial and ethnic minorities from receiving needed care, Independence Blue Cross is partnering with 12 major health systems in the Philadelphia area to remove race adjustments from the tests.
Called the Regional Coalition to Eliminate Race-Based Medicine (Regional Coalition), the group said the clinical decision support tools in question adjust results based on a person's race, potentially causing delays and inequities in care. The group will work together to phase out the use of race as a variable in some of the tools, and collaborate on alternative best practices that do not "reinforce a biological understanding of race," the group said.
The Regional Coalition includes Children's Hospital of Philadelphia; Doylestown Health; Grand View Health; Independence Blue Cross; Jefferson Health; Main Line Health; Nemours Children's Health; Penn Medicine; Redeemer Health; St. Christopher's Hospital for Children; Temple Health; Trinity Health Mid-Atlantic; and Virtua Health.
WHAT'S THE IMPACT
Clinical guidelines and clinical decision tools help doctors determine the best way to care for their patients. Race is, in some cases, still used as one of the variables in those tools even though, according to the group, it is not an objective biological trait.
Regional Coalition said using race as a variable can adversely influence the care a patient receives. It can also impact their outcomes. An example is the spirometry test, widely used to assess a patient's lung function. The equations used to interpret the test's results often incorporate race and assume that Black and Asian patients have a smaller lung capacity compared to their white counterparts. As a result, the group said, the test has failed to detect lung disease in many Black and Asian patients.
The Regional Coalition is focusing on 15 clinical decision tools to begin its work: Arteriosclerosis and Cardiovascular Disease (ASCVD) Risk Estimator; Breast Cancer Surveillance Consortium Risk Calculator; Estimated Glomerular Filtration Rate (eGFR); Fracture Risk Assessment Tool (FRAX); Heart Failure Risk Score; Kidney Donor Risk Index (KDRI); NCI Breast Cancer Risk Assessment Tool; Osteoporosis Risk SCORE; Pulmonary-function tests/Spirometry; Race-based Anemia Guidelines; Rectal Cancer Survival Calculator; Society of Thoracic Surgeons Short Term Risk Calculator; Urology STONE Score; UTI Calculation Guideline; and Vaginal Birth after Cesarean (VBAC) Calculator.
The Regional Coalition extends the work of Accelerate Health Equity, of which many of the participants, including Independence, are members. These organizations collaborate across the Philadelphia region to combat systemic racism and barriers in healthcare.
THE LARGER TREND
Last year, the American Hospital Association cited data showing that racial health inequities are associated with substantial annual economic losses nationally, including at least $10 billion in illness-related lost productivity and $200 billion in premature deaths.
According to the organization, eliminating health inequities also can lead to improved patient engagement in their care process and better health outcomes, decreased readmissions and improved performance in value-based contracts through better care management, among other improvements.
ON THE RECORD
"In many ways, race-based medicine has driven or contributed to the unacceptable health inequities that we see in the Philadelphia region and in other similarly situated communities across the country," said Gregory E. Deavens, president and CEO at Independence Blue Cross. "Our region is known world-wide as a destination for healthcare excellence. That's in large part due to the institutions represented in this Regional Coalition. This is another chance to show the spirit of innovation and exceptional leadership that are hallmarks of this great city and region by looking inward at how the medical establishment has unintentionally contributed to inequity over the years and resolving to change what has been 'business as usual.'"
Twitter: @JELagasse
Email the writer: Jeff.Lagasse@himssmedia.com
