One of the most difficult aspects of being a CIO is in making sure teams recognize the affect their work has on patient care. What often happens, according to Ray Lowe, is that IT professionals “get lost behind the bits and bytes and don’t see the impact.” However, when they are able to see that technology can change peoples’ lives, “it’s really rewarding,” said Lowe during a recent interview with Kate Gamble, Managing Director at healthsystemCIO.
A perfect example is the work AltaMed Health Services is doing to improve health equity by leveraging social determinants of health data. It’s an area he believes is “ripe for opportunity” — and one in which his organization has an edge because of the partnerships they’ve established with community-based organizations.
In the interview, Lowe spoke about how AltaMed is incorporating SDoH data to provide individualized care — and why that’s so critical; the need for CIOs to incorporate three “I’s” into the role; and what he considers to be his ultimate objective. He also talks about AltaMed’s laser focus on social justice, and why it’s more important than ever for healthcare leaders to share knowledge.
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- With AltaMed’s Health Equity Accelerator, one of the key goals is to create customized SDoH screenings based on data and partner with community-based organizations.
- The challenge? Finding the right people and startups that will enable them to identify and address needs at the individual level.
- For Lowe, the appeal in coming to AltaMed was clear: “Social justice is at our core,” and “culturally sensitive care is one of our hallmarks.”
- One of the most important aspects of the CIO role is in helping IT teams see the impact of the work they do. “Oftentimes we get lost in the bits and bytes.”
- As healthcare leaders, “we have to help each other. We have to generously share what we’ve learned so we can all help each other and continue to change the way healthcare is delivered.”
Q&A with Ray Lowe, CIO, AltaMed Health Services, Part 2 [Click here to view Part 1]
Gamble: One of the areas you said you’re focused on is the Health Equity Accelerator. Can you talk more about that?
Lowe: We’re working looking at the data to create a customized SDoH screening so that we can do positive and negative screenings and really partner with community-based organizations. We want to partner with government policymakers as well, so that we can have proper legislation changes put into place. It really looks at how do you recognize the individual in addressing social determinants of health? And I think the term ‘SDoH’ may evolve and morph into something else, like perhaps personal determinants of health, so we can better understand what each person needs versus a generic population. It’s very genericized when we use these broad terms — we need to focus on how we impact the individual.
“Just scratching the surface” with social determinants
Gamble: What phase is the Health Equity Accelerator in right now?
Lowe: We’re aligning with the Health Equity Institute; we’ve actually done quite a bit of research around what are the opportunities we have to leverage data within our patient population. It’s very rich. We live in a market where we know, through the social vulnerability index, that there are huge opportunities.
Part of it, as we’re setting up the Accelerator, is how do we find folks that are beyond the edge of Aunt Bertha and Unite Us? So much of the innovation being done in healthcare can be tied to things like using a pill camera to do a GI tract. But how are we going to find the people and the startups that are looking to solve food scarcity by providing data and reading the data — taking it beyond food banks. How are we going to take a particular individual need and address it?
It’s pretty ripe. It’s pretty blue ocean in terms of what’s happening out there. People are putting their toes in the water; they’re doing electronic referrals and getting some follow up data if a patient has followed up. But that’s just scratching the surface. As we look to build the Accelerator, whether it’s modeled after the Cedars-Sinai Accelerator or something similar, it’s about bringing together a community of smart people with a really good social justice perspective so that we can extend the needs beyond just the referral.
SDoH awareness – “There need to be voices.”
Gamble: You mentioned before some of the misnomers around social determinants. What do you think can be done to address that and help educate people on what it really means?
Lowe: That’s a great question. One, I think there need to be voices. This is a very hot topic. I think healthcare providers need to do an assessment of where they are and how they’re addressing it. If they’re just sending a referral — again, through Unite Us or Aunt Bertha — they’re taking advantage of about 1 percent of the opportunity. Dr. Rajan Sonik (Director of Research at the AltaMed Health Equity Institute) and I are looking at how do we close out the remaining 99 percent. How do we build those linkages and have the data behind it to determine what the best outcome is for the patient? People need to understand where they are in this. A lot of it is primary care driven.
Strengthening the fabric
The other part is aligning expectations. What level of expertise do we expect clinical providers and staff to have in addressing social determinants? It might be unrealistic for people, with everything they have doing on, to be really well vetted. And we have to look at case management and care management in terms of how they are looking to address these needs, and how do we continue that beyond the care plan.
This goes back more to the social side and working with community-based organizations. I think there’s opportunity for that fabric to be strengthened. Looking at the health plans, they have an opportunity to incentivize the health delivery systems to address this. But there needs to be more thought around it, and more legislation and policy changes as well.
Delivering culturally sensitive care
Gamble: Is this focus on social issues part of what drew you to the organization?
Lowe: Yes. Social justice is at our core. We look to advocate for the patient — especially the underserved. AltaMed has been around for 51 years. We started as the East LA Free Clinic (later called El Barrio Free Clinic), where there were no medical services provided. It evolved into the largest FQHC in a family of companies.
Providing culturally sensitive care is one of our hallmarks. We deliver care that’s linguistically appropriate, making sure the patient understands what’s going on, and looking to have those services in the community so that there’s continuity
Gamble: So it was the organization that appealed to you, but also the role of CIO, which allowed you to have more of an impact?
Lowe: It’s interesting. Many of us get into healthcare because we want to make an impact. As CIO, when you look at how can you change people’s lives, it’s really rewarding. Oftentimes IT professionals get lost behind the bits and the bytes and they don’t see the impact.
I’ll tell you a heartwarming story. We were doing a team building event at a bowling alley; we all had our AltaMed shirts on. One of the patrons (whom I didn’t know) walked up to me and said, ‘Thank you so much for everything you’re doing.’ He had a lot of questions about Covid vaccination and the side effects.
As a CIO, when a person on the street thanks you for the work you’ve done, and you know that your team enabled the technology which then enabled the care delivery organizations and the operators to deliver what wasn’t there before, it’s amazing. It’s a big ‘wow’ moment. It’s a moment to celebrate because you’ve impacted so many people. That’s what we all have to do in healthcare. That’s what we are charged to do in healthcare.
Information, innovation & informatics
Gamble: Right. But it’s not always easy to tie the work that IT does to patient care and quality.
Lowe: This is where the forward-thinking CIO comes into play. I think the role of the CIO is information, innovation, and informatics. You need to understand how those come together so that you can have the right outcome. As a CIO in a healthcare organization, after you’ve gone through your big implementations, you really need to reset and look at what do we need to do to optimize? What do we need to do to improve the practice? How do we keep lifting the boat to a higher level so that clinicians work smarter and faster, and so that patient engagement and the patient experience is as seamless as pushing a button? As we optimize, we always have to keep that in mind — the quality, the patient experience, and the outcome — and making sure the right access is available to them.
“We have to share information”
Gamble: I think we’ve seen at with events like CHIME, where the conversation goes far beyond the bits and bytes. We definitely saw that at the Fall Forum.
Lowe: I thought that CHIME 2021 was fabulous. Learning about provider productivity, cybersecurity and more from people like Dr. Stephanie Lahr, Aaron Miri and Craig Richardville. To have those experiences and establish those connections is really great. As CIOs, we have to help each other. We have to share information. We have to share learnings. Because if I learn something from Geisinger and I want to implement it at AltaMed, we don’t have the ability to do it all. Midsize organizations don’t have the same ability to really transform, but we can see what other folks have done. I think we have to share generously what we’ve learned so we can all help each other and really continue to change the way that healthcare is delivered.