On this episode of “Quality Matters” with host Andy Reynolds, we explore the vital role of Sexual Orientation and Gender Identity (SOGI) data in healthcare. Our expert guests, Kellan Baker, Executive Director of the Whitman-Walker Institute, and Dr. Carl Streed, a primary care physician at Boston University, share why SOGI data are essential for delivering personalized health care interventions and improving overall health outcomes. Understanding sexual orientation and gender identity alongside other demographic variables like race and ethnicity is crucial for providing comprehensive and inclusive care. Emphasizing the importance of building trust within healthcare settings, our guests discuss how fostering a trustworthy environment encourages the sharing of sensitive SOGI information, which is vital for patient care quality.

The conversation addresses the challenges the current political climate poses and its potential negative impacts on LGBTQ health. We highlight the necessity of robust privacy protections to prevent the misuse of SOGI data and the role of the entire healthcare team in safeguarding this information. Additionally, we share insights into new resources from the US Department of Health and Human Services to enhance demographic data quality. Calvin emphasizes recognizing LGBTQ individuals as people with unique stories and the importance of methodological data collection. For further guidance, recommendations include resources from the Office of the Assistant Secretary for Planning and Evaluation at the US Department of Health and Human Services. 

Key Quote: 

“These are intimate areas of people's lives that we're dealing with in health care, and HIPAA was enacted to protect that information from exploitation and misuse. so it's incredibly sad to see state actors intentionally misusing the law. To take personal health information from patients, from families, from healthcare institutions, not just that incredible intrusion into the provider patient relationship, but then also to Press charges against healthcare providers, for providing medical care in accordance with their training and expertise. It's an incredible violation of HIPAA and something that should concern all of us, regardless of whether we're transgender or we provide care to transgender people.”

-Kellan Baker, Executive Director of the Whitman-Walker Institute

Time Stamps:

(00:44) Understanding SOGI Data

(03:26) Challenges and Misconceptions about SOGI Data

(05:51) Legal Issues and Misuse of SOGI Data

(11:01) Finding Trust in Healthcare Systems

(13:12) The  Future of SOGI Data Collection

Links:

Connect with Kellan Baker

Connect with Dr. Carl Streed

Learn more about the Whiteman-Walker Institute 

Learn more about the GenderCare Center at Boston University School of Medicine

In the first episode of a two-part series titled, 'In Data We Trust,' host Andy Reynolds and Tam Ward, Senior Vice President of Business Strategy and Operations at Oscar Health,  discuss the intersection of technology and health care to improve care equity, especially in underserved communities. 

Focusing on initiatives by Oscar Health, Tam highlights efforts to build culturally competent care networks and improve data-driven solutions for marginalized groups, including African Americans and the LGBTQ community. 

The episode emphasizes the importance of trust, transparent data sharing, and personalization in healthcare to address disparities and enhance patient experiences.

Key Quote: 

“If there was one ask I could have of those in a place of influence to help create standardization around provider data, it's share the attributes of the physician that are important to the patient and hold us accountable for doing what's right with that information.”

-Tam Ward

Time Stamps:

(02:32) Oscar's Approach to Culturally Competent Care

(04:57) Challenges and Solutions in Provider Data

(08:46) Building Trust in Healthcare

(10:58) Focus on LGBTQ+ Community

Links:

Connect with Tam 

Visit Oscar Health

Join us for an insightful conversation with North Carolina Secretary of Health and Human Services, Kody Kinsley, as he shares how growing up without health insurance influences his drive to improve health care access and affordability in his home state. Discover the transformative impact of the state’s recent Medicaid expansion and substantial investments in behavioral health.

Secretary Kinsley emphasizes North Carolina’s novel, bipartisan approach to improving care. The discussion covers innovative strategies for staffing the 988 crisis hotline and the unusual integration of the health care system and the prison system. Secretary Kinsley ends with reflections on leadership in an era of identity politics and his advice for quality advocates everywhere. 

Key Quote: 

“We are very excited to have, after 10 years been able to finally expand Medicaid. And not only have we gotten it done, we've gotten it done well.  The other thing that's particularly exciting was a near billion-dollar investment in behavioral health. That is just so consequential to overall health and well-being, something that had also been forgotten and neglected for too long,”

-Secretary of the North Carolina Department of Health and Human Services Kody Kinsley

Time Stamps:

(01:48) Medicaid Expansion: A New Era

(05:11) Bipartisanship and Community Engagement

(06:37) Challenges and Solutions in Behavioral Health

(11:56) Innovative Approaches to Health Care and Justice

(13:23) Social Determinants of Health: A Holistic Approach

(21:09) Taking Pride in One’s Holistic Identity and Quality Gains

Links:

Learn more about Secretary Kinsley

University of Chicago professor and Doctor, Marshall Chin, joins us on Quality Matters to revolutionize medical training with his unique blend of improv and stand-up comedy. Discover how these innovative techniques equip medical students with the skills to care for diverse patients and engage in vital discussions about systemic racism and social privilege. By prioritizing active listening and real-time interaction, Dr. Chin's approach helps shift the perspective from merely addressing health disparities to fostering genuine health equity.

The episode culminates with actionable strategies to propel health equity forward, highlighting the importance of culturally tailored solutions and comprehensive interventions. We explore the power of honest dialogues about racism, power, and privilege, and discuss how lifelong learning and diverse experiences, akin to team sports, can drive systemic change. 

Join us for this enlightening conversation that underscores the critical need for continuous improvement and authentic community partnerships to pursue health equity.

Key Quote: 

“The thing about health equity is that it’s the right thing. Everyone wants to do the right thing. And it requires all this expertise and all these stakeholders. It has the community expertise. It requires the clinicians on the staff who have the frontline experience. It requires people who do quality improvement. It includes the data people. I mean, everyone has a role.” - Dr. Marshall Chin

Time Stamps:

(00:00) Achieving Health Equity Through Innovation

(05:55) Equity and Intersectionality in Healthcare

(14:28) Advancing Health EquityThrough Lifelong Learning

Links:

Resources Marshall Chin recommends in the episode include:

Health Care Payment Learning & Action Network.

Achieving Health Equity tools from The Robert Wood John Foundation

What Should Antiracist Payment Reform Look Like?

Cruelty and Health Inequity (abstract)

The book The Sum of Us: What Racism Costs Everyone and How We Can Prosper Together , by Heather McGhee, and discussed here

 Welcome to "Quality Matters," the podcast where we unpack the complexities of modern healthcare to shape a brighter future. Join us as we delve into the dynamic world of healthcare quality and innovation, exploring topics such as digital transformation, health equity, and quality standards.

Each episode brings together thought leaders, industry experts, and innovators to discuss the latest trends, best practices, and challenges shaping the future of healthcare. With a focus on convening voices from across the industry, "Quality Matters" provides a platform for meaningful conversations and collaboration.

Whether you're a health plan leader, a health IT professional, or simply someone passionate about improving healthcare outcomes, tune in to gain valuable insights and actionable strategies for driving positive change in healthcare delivery.

Because when it comes to healthcare, quality truly matters. Join us on "Quality Matters" as we shape tomorrow's healthcare today.

In this episode, we highlight two companies that leverage data from many different sources to create a more complete picture of a person’s health. The ultimate goal? Shifting away from the current model of “sick care” - where patients primarily see their doctors when they aren’t feeling well – to care models that prioritize long-term health and self-management with guidance from providers. These companies are helping lead the way to value-based care, from using AI to sift through patient-reported data and provide actionable insights, to integrating NCQA's HEDIS measurements into their data platform, thereby putting quality at the center of everything they do. Here, you’ll get a glimpse into the challenges and opportunities in our current data-rich health care ecosystem.

The episode begins with a conversation with leaders from Welldoc. Welldoc is a health tech company developing patient-facing apps to support self-management of chronic conditions. Using an omnichannel approach, their apps gather as much data as possible from sources including remote monitoring devices, like wearables, and clinical data.

Chief Analytics Officer, Dr. Anand Iyer, and Chief Medical Officer, Dr. Mansur Shomali, explain how Welldoc uses AI to parse the patient information, ultimately helping doctors and patients work together to construct an effective path to wellness.

Jessica Robinson is Chief Platform Officer for health care digital developer The Garage. Jessica manages all aspects of the product life cycle, from the spark of innovation through design, development, testing, and roll-out. Founded in 2012, The Garage aims to utilize digital tools to help providers shift from fee for service models to value-based models of care.

In this interview, recorded live at NCQA’s 2023 Health Innovation Summit, Jessica explains how The Garage works with Management Service and Accountable Care organizations, among other provider groups, to develop digital applications that help clinically integrated networks across 34 states harness the full extent of the population data available to them. The Garage also utilize NCQA’s HEDIS measures into their platform, allowing networks to visualize the full patient care team across the entire care continuum and deliver optimized quality care to their patients.

For information on NCQA’s Health Equity Forum, click here: https://events.ncqa.org/healthequityforum

The course of the Digitalization of Health doesn’t always run smooth. But for every set of pain points a provider might experience, there are companies developing technological solutions – platforms and tools – that not only guide us through digital transformation but identify crucial patient and population data along the way.

In this episode, we talk with two health tech leaders, interviewed during NCQA’s 2023 Health Innovation Summit in Orlando, Florida, about their strategies and successes in using digital tools that can ultimately reveal and resolve gaps in health care delivery.

Sebastian Seiguer, is co-founder and CEO of Scene Health. Scene Health is a company focused on medication “engagement”, a comprehensive approach that means more than just getting patients to take their medicine. They provide personalized medication support by combining video technology, clinical coaching, and validated interventions to improve medication adherence rates. Within the tapestry of their mission is the clear goal of reaching and engaging with diverse, vulnerable, and hard-to-reach populations.

Upendra Patel, CEO of AaNeel Infotech, is finding ways to support clinicians through EHR, or Electronic Health Record, interoperability. AaNeel Infotech worked with Medstar Health to transform an isolated risk calculator into a FHIR-based app. Upendra’s company helped them use the SMART on FHIR methodology. That’s FHIR as in “Fast Health Interoperability Resources” and SMART as in “Substitutable Medical Applications and Reusable Technologies”. Using the SMART on FHIR approach, AaNeel Infotech helped create an app called “Mobilizing a Million Hearts”, which integrates the Million Hearts Longitudinal Atherosclerotic Cardiovascular Disease risk calculator into the MedStar Health EHR system and allows Medstar providers to get an even more comprehensive view of their patients at risk for cardiovascular disease.

This episode of “Inside Health Care: a Podcast by NCQA” features three interviews recorded live at our Health Innovation Summit in October 2023. Among many panels and presentations was an incredible session titled “Health Equity Trailblazers: Where Vision Meets Commitment.” Health equity leaders discussed their organizations’ health equity strategies, vision and lessons learned, delving into how leaders can commit to and advance health equity priorities. Each of this episode’s guests sat on that panel then sat with me for a deeper dive. These leaders, each in their own way, want to inspire us to action.

Dr. Joneigh Khaldun is Vice President and Chief Health Equity Officer for CVS Health. In this role, she advances the company’s data-driven strategy to improve access to services, address social determinants of health and decrease health disparities. She is a sought-after speaker and thought leader who has appeared on Meet the Press, MSNBC and CNN, among others, and she has testified before Congress.

In her past work, as the top doctor leading Michigan’s COVID response, she is credited with the state’s early identification of and actions to decrease disparities, and in 2021 was appointed by President Biden to the national COVID-19 Health Equity Task Force. She is a practicing emergency physician who earned her MD from the Perelman School of Medicine at the University of Pennsylvania.

Dr. Ronald M. Wyatt is a renowned global health care quality and safety expert with a passion for advancing health equity worldwide. Dr. Wyatt is Founder and CEO of Achieving Health Equity, LLC. As a distinguished Senior Fellow with the Institute for Healthcare Improvement, he holds pivotal roles as Chief Science Officer and Chief Medical Officer at the Society to Improve Diagnosis in Medicine, an organization dedicated to enhancing diagnostic accuracy in health care. As an expert in hospital safety oversight, Dr. Wyatt holds a significant role in shaping the National Patient Safety Goal on Health Equity. His contributions to the National Patient Safety Plan, authored by AHRQ and IHI, underscore his commitment to advancing health care on a global scale.

Dr. Bryan O. Buckley moderated the Health Care Trailblazers panel at NCQA’s 2nd annual Health Innovation Summit. Dr. Buckley is NCQA’s Director for Health Equity Initiatives. In this position, he plays a key role in developing partnerships with funding and research organizations, care delivery systems, the managed care industry and communities to translate research knowledge and real-world evidence into development of equity-oriented products and programs. These include NCQA’s Health Equity Accreditation programs.

In this Inside Health Care interview, we explore GME — graduate medical education — and explore a few fundamental questions. How can we make sure today’s medical residents are paying attention to their patients? How do we teach residents to ask the right questions? And even more fundamentally, how do we make sure that the next generation of clinicians knows how to implement value-based models of care in order to focus on person-centered outcomes?

A value-based model helps patients envision what their lives could be a few months, or even years, down the line. And that’s the point at which clinicians can help patients develop a treatment plan to get them from point A to point B. That may be the best way to keep a patient healthy, boost their interest in their self-care and prevent repeat visits for the same problem.

So the questions stand regarding graduate medical education. How do you teach med school students the value of quality? How do you train them to follow a model of value-based care? And if your hospital’s HEDIS scores are low, how much of that is because of the residents? What's the correlation between medical residencies and health care quality?

Michael Kanter, MD, is a professor and chair of Clinical Science at the Kaiser Permanente Bernard J. Tyson School of Medicine in Pasadena, California. In his work within Kaiser Permanente’s health care system, he’s overseen the quality of care provided by 22,000 physicians to 12.2 million patients. He also was responsible for development of Kaiser’s national quality strategy. An expert in patient safety and clinical quality, he developed policy-based and software-based programs that decreased the number of missed or delayed diagnoses and increased patient engagement.

Jung Kim, PhD, MPH, is Assistant Professor for Health Systems Science at the Kaiser Permanente Tyson School of Medicine, and a protégé of Dr. Kanter. Dr. Kim explores approaches to health care and healing, including studies on the roles of acupuncture and other East Asian practices as complementary or alternative medical treatments for cancer, H-I-V and other conditions. As we’ll hear in our interview, Dr. Kim also investigates innovations in medical education residency programs, including analysis of email communication among medical students and new learning strategies for medical education.

We close 2023 with our annual year-end State of Health Care interview with NCQA President Peggy O’Kane. In this interview, Peggy talks with Vice President for Public Policy and External Relations, Frank Micciche, about NCQA’s progress in 2023—both in improving equitable access to health care and implementing digital transformation across the ecosystem. As you’ll hear, we’re hitting the ground running in 2024. With new digital products, digital quality implementers and digital solutions to reveal—and reverse—health care disparities, NCQA stands ready to take the lead on advancing quality for everyone.

Don't forget to sign up for NCQA’s next big event: the Health Equity Forum, coming up March 4th and 5th, 2024, at the Westin Los Angeles Airport. The Health Equity Forum convenes state officials, advocates and health care providers, showcasing the blueprint for creating and implementing statewide health equity strategies. Our next Quality Talks event is planned for Spring 2024. And as mentioned in this episode's interview, go to www.ncqasummit.com to learn more about our Health Innovation Summit, and click here to register for our next event, October 31-November 2, 2024, in Nashville.