By LISA EISENHAUER
Catholic health care systems, which provide special consideration for the poor and the vulnerable, must be steadfast in ensuring those populations benefit from technical innovations that can improve access to high-value care. Catholic Health World talked to Sara Vaezy, one of CHA's 2019 class of Tomorrow's Leaders and the chief digital strategy officer for Providence, about how that technologically innovative system makes sure its patient-facing digital platforms are accessible to low-income patients, including those insured through Medicaid.
Vaezy leads the development of the health system's digital strategy and road map, digital partnerships and business development, and technology evaluation and pilots. Prior to coming to Providence, she worked for The Chartis Group, a health care management consulting firm. She graduated from the University of California, Berkeley with a bachelor's degree in physics and philosophy and from the University of Washington's School of Public Health with master's degrees in health administration and public health focused on health care policy.
How can digital innovations address disparities in the delivery of health care?
Anytime we talk about disparities in health care, I think technology, generally speaking, has huge potential to democratize health care and make it widely available. It's just a matter of making sure we're directing our resources appropriately to serve the folks who are more vulnerable.
Do patients insured by Medicaid have access to personal technology and the technical literacy to make the most of digital tools such as DexCare? (DexCare is the Providence St. Joseph platform that gives patients the ability to book a same-day care appointment in a retail clinic, participate in a direct video visit with a provider or schedule a provider visit in the home.)
Our research and the research of a lot of other people who have looked into this would indicate that they do. Most folks have smartphones and are very plugged in. But (patients who are low-income) do have challenges and circumstances that need to be taken into account.
What are some of those circumstances?
For instance, while most Medicaid-insured people have smartphones, what they don't have is really rich data plans because data can be very expensive. So, data and data plans are an area where digital needs to be very sensitive. Therefore, digital tools need to be efficient in their usage and requirements for data. There are many technologies, for instance, that are SMS (short message service) or text-based, which is a very low-data way of communicating with patients.
Could the use of digital tools significantly improve access to care for patients insured by Medicaid?
It could improve access to care, but it could also improve access to things like information and trackers to manage health that keep patients engaged even when they're between actual visits. For example, prenatal care is not just the 14 or so recommended physician visits, but it's all of the nutrition information and questions that emerge between those appointments.
Providence St. Joseph Health considers the challenges of low-income people when developing digital tools, including smartphone apps like this one.
One of the ways in which digital tools are helping with this is through our partnership with a company called Wildflower Health. Wildflower provides personalized engagement for women and family health. In particular, Wildflower helps guide women through all the things they need to know and do during their pregnancy with content, trackers, and reminders among other things that support them in getting the prenatal care they need and following their care plans.
Could digital tools cut the cost of Medicaid?
Yes. Just to give a little context, Providence has made maternal and child health a top priority. We're one of the national leaders within this space. We have a Women and Children's Institute that's doing some amazing work. One of their main pillars, which crosscuts with our Medicaid regional improvement plan, is supporting our Medicaid-insured moms to deliver their babies to term.
One of the ways it's guiding women to do that is by ensuring that they get the prenatal care that they need and that they adhere to all the recommendations. If we can do that — help moms deliver their babies to term — what that could mean is fewer neonatal intensive care unit days, lower morbidity and mortality, and that can certainly reduce the total cost of care.
Do digital tools remove the human element from care?
No, we are meeting patients and providers where they are. The sacred encounter is what we're striving for in terms of making that experience where the patient and the provider are together, either physically or virtually, as rich and meaningful and supportive of both sides as possible.
Are digital innovations particularly important to Catholic health systems, given their focus on caring for those who are poor?
I think we can, as Catholic health care systems, leverage digital tools to care for people who may have limited access to transportation, or might be unable to take time off work to get medical care. Low-wage workers have these and other impediments to health care access. Digital tools can bring the care and information they need to them.
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