Healthcare and Diversity

Vindell Washington, MD, MHCM | Principal Deputy, Office of the National Coordinator

Disclosures

• The views expressed herein do not necessarily

represent the views of the Department of

Health & Human Services or the United States

Government (5 CFR §2635.807)

• No other disclosures

2

Determinants of Health

Powerful, complex relationships exist between health and

biology, genetics, and individual behavior, and between health

and health services, socioeconomic status, the physical

environment, discrimination, racism, literacy levels, and

legislative policies.

These factors, which influence an individual’s or population’s

health, are known as determinants of health.

Healthy People 2020

Influences on Health

• High-quality education

• Nutritious food

• Decent and safe housing

• Affordable, reliable public transportation

• Culturally sensitive health care providers

• Health insurance

• Clean water and non-polluted air

Diversity

Diversity = Difference

GOAL

Recognizing individual as well as group

differences, treating people as individuals, and

placing positive value on diversity in the

community and in the workforce.

All I Needed to Know About Diversity in Healthcare

I Learned in Kindergarten

Remember the first word you learned, LOOK.

Gender and Heart Disease

Heart disease is a diagnosis that has killed more women than men every

year since 1984.

A Look at the Evidence

Race and Heart Disease

Gap between death rates for blacks and whites remains as large as in 1950.

A Look at the Evidence

Patterns of declining county‐level heart disease mortality by

race–sex groups, continental United States, 1973–2010.

Adam S. Vaughan et al. J Am Heart Assoc 2015;4:e002567

© 2015 Adam S. Vaughan et al.

One of These Things(is Not Like The Others)

Do unto others as you would have them do unto you.

Treat other

people the way

they want to be

treated

St. Egidio DREAM Project

“A DREAM? Sant'Egidio Fighting HIV/AIDS in

Mozambique”, Chapter 10 in K. Marshall and L.

Keough (eds), Mind, Heart and Soul in the Fight

Against Poverty, World Bank, Washington DC,

2004.

St. Egidio DREAM Project Results

The DREAM model's effectiveness in health

promotion of AIDS patients in Africa; Oxford

Journals, Health Promotion International; (2009).

St. Egidio DREAM Project Results

U.S. Comparison

Laine C, et al. Adherence to antiretroviral therapy by

pregnant women infected with human immunodeficiency

virus: a pharmacy claims-based analysis. Obstet

Gynecol. 2000;95:167-173.

Improving the way providers are incentivized, the way care is delivered, and the way information is distributed will help provide better care at lower cost across the health care system.

Better, Smarter, Healthier

Source: Burwell SM. Setting Value-Based Payment Goals ─ HHS Efforts to Improve U.S. Health Care. NEJM 2015 Jan 26; published online first.

}“

{

PayProviders

Deliver Care

DistributeInformation

FOCUS AREAS

24

Encourage the integration and coordination of clinical care services Improve individual and population health Support innovation including for access

INCENTIVES

Bring electronic health information to the point of care for meaningful use

Create transparency on cost and quality information

Support consumer and clinician decision making

Focus Areas Description

CARE DELIVERY

INFORMATION

Promote value-based payment systems

– Test new alternative payment models

– Increase linkage of Medicaid, Medicare FFS, and other payments to value

Bring proven payment models to scale

Align quality measures

A health system that provides better care, spends

dollars more wisely, and has healthier people

Source: Burwell SM. Setting Value-Based Payment Goals ─ HHS Efforts to Improve U.S. Health Care. NEJM 2015 Jan 26; published online first.

25

Encourage the integration and coordination of clinical care services Improve individual and population health Support innovation including for access

INCENTIVES

Bring electronic health information to the point of care for meaningful use

Create transparency on cost and quality information

Support consumer and clinician decision making

Focus Areas Description

CARE DELIVERY

INFORMATION

Promote value-based payment systems

– Test new alternative payment models

– Increase linkage of Medicaid, Medicare FFS, and other payments to value

Bring proven payment models to scale

Align quality measures

Big Picture: A health system that provides

better care, spends dollars more wisely, and

has healthier people

Source: Burwell SM. Setting Value-Based Payment Goals ─ HHS Efforts to Improve U.S. Health Care. NEJM 2015 Jan 26; published online first.

26Pre-decisional. For internal discussion only. Do not distribute.

A health system that provides better care, spends

dollars more wisely, and has healthier people

Nationwide Interoperability Roadmap

27

Goals:2015-2017: Send, receive, find and use priority data domains to improve health care quality and outcomes.2018-2020: Expand data sources and users in the interoperable health IT ecosystem to improve health and lower cost.2021-2024: Achieve nationwide interoperability to enable a learning health system, with the person at the center of a system that can continuously improve care, public health, and science through real-time data access.

27

Commitments and Call to Action

Consumers easily and securely access their electronic health information, direct it to any desired location.

Share individual's health information for care with other providers and their patients as much as permitted by law and refrain from blockingelectronic health information.

Implement federally recognized, national interoperability standards, policies, guidance, and practices for electronic health information and adopt best practices including those related to privacy and security.

2828

Information about the health of individuals is the building block for a healthier community.

HITCOMP

• HITCOMP is a searchable database designed for educators,

workforce developers, current and future workforce members,

eHealth management, staffing experts and other interested

parties in healthcare information technology/eHealth.

30

Roles Competencies

31

Kayla and Kristine

UVA School of Medicine, Class of 2017

When you go out in the world, hold hands and stick together.

@ONC_HealthIT @HHSONC

QUESTIONS?

Vindell Washington, MD, MHCM

vindell.washington@hhs.gov

@VindellW