Attendees at the second day of AHIP 2023 went deep on issues driving access to health care with discussions on policy, equity and more. Among Wednesday’s most interesting discussions, physician Reed Tuckson, co-founder of the Black Coalition Against COVID & co-founder of the Coalition For Trust In Health & Science, facilitated a conversation with Jocelyn C. Frye, president of the National Partnership for Women & Families, and Alexis McGill Johnson, president and CEO of Planned Parenthood of America, on women’s access to health care.
McGill Johnson, who leads an organization that operates nearly 600 health centers and serves 2.1 million patients every year, works to promote racial and social justice, increase health equity, reduce bias and discrimination, and provide opportunities for people to lead healthy, meaningful lives. McGill Johnson, who is trained as a researcher, has also written about culture, equity and race.
Frye is the first Black woman to head the National Partnership since its founding in 1971. She has also helped spearhead the Women’s Initiative at the Center for American Progress, leading work that targeted a wide range of issues, including the gender pay gap, employment opportunities and economic stability for women, gender-based discrimination and violence, and the Black maternal health crisis.
Here are some other highlights from Wednesday:
Health equity: More than a goal
Promoting health equity has been a longstanding goal for stakeholders in health care for quite some time, but inequities exposed by the COVID-19 pandemic heightened the conversation and actions around it. For some health care entities and leaders, equity is more than just a buzzword or initiative. It is a lived experience, a mission and a calling.
The panelists on Wednesday morning’s kickoff keynote, “Health Equity Investment, Innovation and Scale: Moving from Vision to Impact,” shared stories and experiences around health equity and how those experiences have shaped their views and ambitions to improve it.
For Darrell Gray, chief health equity officer at Elevance Health, it’s about the shared experiences in his community as a father, husband, community advocate, gastroenterologist and researcher. The turning point for Pooja Mittal, Health Net’s chief health equity officer, was seeing her mother, who was also a doctor, treat pregnant migrant farm workers who miscarried after the fields they were working in were sprayed with chemicals. While doing rounds in medical school, Nema Stephens, the national medical director for health equity at Cigna, saw many other African Americans undergoing dialysis, which prompted her to pursue nephrology and be part of a solution. David Williams, executive vice president and chief medical officer at CareSource, overcame the odds as a foster child in Mississippi who lost both of his parents in an accident as an infant. He went on to earn his medical degree and inspire people close to him.
Intention, commitment, follow-through and fostering trust are all needed to improve equity within health care, the panelists said. “We didn’t arrive at these disparities overnight,” said Gray, who added that systemic change is necessary to remove boundaries, unhelpful structures and biases.
Leveraging data and meeting communities where they are can go a long way toward these efforts. Mittal cited work that Health Net has done in California to identify equity improvement zones in the state by homing in on areas where inequities are prevalent and using data and initiatives such as community impact councils to identify and implement solutions. “We’re being intentional about creating regional work,” Mittal said. Other panelists detailed tangible efforts their organizations are taking internally and externally to root out inequities and unconscious bias, and to promote diversity, equity and inclusion.
Gray stressed the importance of being plugged in to the communities that health plans and health care providers serve. “Being present in the community when you don’t have anything on the agenda builds trust,” Gray said. Intentional collaboration with organizations that share the same mindset around health equity can help accelerate the work, Williams added.
Mittal likened the benefits of improving health equity to the curb-cut effect, where a law or action taken to help underrepresented or vulnerable groups – adding sidewalk indentations for wheelchair users to improve grip, for example – creates added value for the community at large.
The human cost of health inequities can’t be overemphasized, said Stephens, who added, “Failure is not an option. We’re losing lives every day to preventable diseases.” Acting with urgency to create systems that foster health equity is imperative, Gray said. The key is giving those who need equitable health care a reason to believe it is possible.
“Progress moves at the speed of trust,” Mittal said.
Treading carefully with ChatGPT
The use of ChatGPT has burgeoned since its release in late November 2022, with hundreds of millions of people now using the artificial intelligence-based chatbot and about a billion people visiting the website each month. ChatGPT is being widely deployed across health care, too, as evidenced by the vast number of attendees who raised their hands when asked if they have ever used the app during the session “Will ChatGPT Change Health Care (and for the Better)?” in a packed conference room.
But while ChatGPT holds promise for helping health plans and providers reduce burdensome and burnout-inducing work like scheduling patients, managing payments and paperwork for doctors, as well as to help inform clinical care, population health initiatives and treatment plans, its best use currently is as an assistant that can do the heavy lifting on onerous tasks to free up time to focus on patients, panelists said.
Guardrails must be put in place for equitable and responsible use of ChatGPT, said Jonathan Burow, vice president of consumer experience and digital transformation at Independent Health. Until the tool becomes more nuanced and aligned with an organization’s values, filtering mechanisms must be part of the usage framework, Burow said, adding that Independent thoroughly tests and vets all generative AI tools internally using synthetic data before putting anything in front of patients.
Being cognizant of data inputs and monitoring the technology’s outputs is crucial to the use of ChatGPT in health care, said Burow and Cora Han, chief data officer at UCHealth. Critically assessing data inputs and focusing on inclusion of all patient populations in the early stages of implementing ChatGPT is imperative to avoiding inaccuracies, inequalities and bias, Han added.
ChatGPT can be persuasive and understanding, which might lead people to overrely on it, despite the fact that it can sometimes offer up inaccurate information. “ChatGPT certainly does not suffer from a lack of confidence,” said Jackie Ejuwa, vice president of health transformation at Blue Shield of California and session moderator.
It’s hard to put full trust in ChatGPT given that it’s still in its infancy, Burow said, but the technology can be applied across health care to help with patient outreach and education, as well as mitigate everyday pain points that plans and providers face. Educating workforces on ChatGPT, along with being transparent with patients on its usage and having a fully formed risk plan in place, can help establish parameters around ethical use, Han and Burow said.
Guidelines can also prompt thoughtful innovation, Han said. “There needs to be human input at appropriate times.”
Regardless of the benefits and risks of employing ChatGPT in health care, one thing is clear: It’s here to stay, and stakeholders need to get comfortable with and used to it.
“No matter how you approach AI, the time to do so is now,” Burow said.
Takeaway quote of the day
“I learned that by going toward something uncomfortable, I got relief.“ – Jewel, singer, author and mental health advocate, and the co-founder of the nonprofit Inspiring Children Foundation and Innerworld, a virtual reality mental health platform