Collective effort required to address health inequities

The COVID-19 crisis has revealed weaknesses in healthcare that will require new technology and partnerships to strengthen it, according to an executive at one of the largest nonprofit healthcare systems in the U.S. 

Rich Roth, senior vice president and chief strategic innovation officer at CommonSpirit Health, said the pandemic has accelerated the use of technologies like telehealth and virtual tools such as symptom checkers. But for Roth, who is responsible for finding new technologies and business models to improve healthcare quality, it has also shined a light on health inequities and driven home a need for better collaboration with healthcare and non-healthcare organizations.

In this Q&A, Roth talks about healthcare challenges the pandemic has revealed, why people -- not technology -- are the key to healthcare transformation and the power of collective responsibility. CommonSpirit Health, headquartered in Chicago, serves 21 states and is focused on improving healthcare quality and health equity.

What has surprised you most coming out of this pandemic?

Rich Roth

Rich Roth: The pandemic laid bare many of the vulnerabilities that exist in our society. Therefore, I think what we're beginning to see is a deeper recognition of those vulnerabilities and those [health] inequities, and a new kind of emphasis from multiple organizations to try to address those types of things. I think that's so important because clearly a well-functioning public health system includes the provider world we live in, as well as others in health plan sectors, social service sectors and others. Ultimately, we all share a collective responsibility to address these barriers and make for better healthcare.

How important is data when it comes to addressing these health inequities?

Roth: Increasingly, patients may have social services issues. They may be food insecure, they may need legal assistance, they may have housing insecurity … If you can bring that data together, then you can understand that for these sets of patients that appropriate referrals are made and they're successful in addressing the housing issues, the legal issues, the food insecurity issues -- whatever the issue may be -- so that you can move forward to a better state of health.

For us, [bringing data together] allows us to move to more risk-based models or value-based care models that ensure we can focus on prevention as opposed to fee-for-service models where you're only reimbursed when people come and see you. … Leveraging these types of data over time is going to be helpful for us to understand where needs are the greatest and who do we partner with to fulfill those needs.

Ultimately, we all share a collective responsibility to address these barriers and make for better healthcare.

When considering making changes within a healthcare system to improve quality, how do you start?

Roth: The most important thing [we look at] is how do technologies meet operations in a way that they're understood [and] that they're part of the workflow. If a nurse or physician is used to turning left, left, left every single day for all of their training, and all of a sudden [we're] saying actually it should be left, right, right, what is the rationale for that, why should they [change how they work] and what are the benefits from that transformation and change? I think a lot gets focused on the technology. Technology is absolutely a piece, but what's really important is the human side, the people. … We want to focus much more on the human side of how do you use technology, partnerships and other things to transform care and really that's a change management opportunity.

How important is provider buy-in to the success of new technologies and new operating models?

Roth: Anytime we bring something new in, we really want to have the clinical leaders -- the physicians, the nurses, the operating leaders at the ground level -- alongside us helping to vet it, helping understand what are the barriers that might exist [from] a workflow perspective. … The challenge in a lot of the world is these technology decisions or partnerships are done at a higher level that don't [understand] what it's like to be on the ground. That's really hard work to do that and have those [clinical leaders] alongside you even when you're testing something. But if the goal is long-term scale, you have to start there with that deep engagement.

Has the pandemic affected how you will think about operations moving forward?

Roth: For our team and on behalf of how we're thinking about this, it has really impacted the need to build coalitions, partnerships and collaborations with organizations in the adjacent healthcare ecosystem, whether that be social services organizations, whether that be pharma and life sciences, whether that be the technology world.

Editor's note: Responses have been edited for brevity and clarity.