Federal health tech leaders want to mine data for greater fairness

Designing a technology infrastructure with its target communities in mind increases the chances that these groups will adopt it. This, in turn, promotes greater equity in health care systems – a recurring message at last week’s 22nd ACT-IAC Health Innovation Summit.

The Biden administration has repeatedly called for equity considerations to be built into new policies or programs, and more federal leaders are grasping what this means for their particular agencies.

For the Department of Health and Human Services’ Center for Medicare and Medicaid Innovation, equity is “achieving the highest standard of health for all,” according to its Healthy People 2030 strategic update. the refresh is stronger data collection and intersectional analyzes for populations defined by race, ethnicity, language, geography and disability, to identify gaps in care and develop interventions to remedy. To do this, the CMMI said it will require participants in all new models to collect and report data to identify and monitor health impacts and disparity reduction, while existing models are incentivized to do so. likewise.

All new models will also include patients from historically underserved populations and safety net providers, such as community health centers and disproportionately shared hospitals – facilities that serve a significantly disproportionate number of low-income and low-income patients. receive payments from the Centers for Medicaid and Medicare Services to cover care for uninsured patients.

CMMI Deputy Director Arrah Tabe-Bedward said we spent a lot of time trying to understand and start collecting data to understand what the reach of the Center is and how it can engage more vendors to participate.

“We believe there are incredible opportunities to do this in advanced primary care models and [accountable care organization] models. This type of structure, of course, requires that there are many opportunities for effective and efficient exchange of information between providers and healthcare institutions, in order to optimize the patient experience,” he said. she stated. “And so to be able to get it right, as we move towards the very ambitious goal that we have set for 2030, to ensure that all of our Medicare beneficiaries, and the vast majority of those who are in Medicaid , are in this kind of aligned care relationships with providers.

Tabe-Bedward said CMMI wants to ensure there is technology to support these relationships and ensure care is optimized.

Some communities lack experience with AI and machine learning, or are actively suspicious of the technology, which hinders its implementation. Susan Gregurick, associate director for data science at the National Institutes of Health, said this very issue has been observed by the NIH’s AIM-AHEAD (Artificial Intelligence/Machine Learning Consortium to Advance Health Equity and Researcher Diversity) program.

“In this case, federated learning is the right approach. And I think one of my messages is that there is no one hammer for all the many use cases…we really need to adopt and adapt our technologies for the communities and research programs that we want really address,” she said.

As the White House Presidential Innovation Fellow in Technology Transformation Services, Nina Walia is passionate about accessible data. For healthcare data in particular, the troves of PDFs and documents used by providers keep valuable information trapped, resulting in a lot of redundant data entry.

“If we started just massaging and bundling and all embracing the idea of ​​optical character recognition versus computer vision, we could start extracting that data in an automated process so that that data could be machine-readable,” she said.

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