How do you address health equity issues around the world and do a better job on diversity, equity and inclusion (DEI) initiatives internally?
These were the first 2 questions that Bansi Nagji, President of Healthcare at GoodRx, posed to the audience during his session on DEI in Healthcare at Asembia 2023.
It is no news that there is inequitable access to health care in the United States and that health care deserts are dotted all over the country, especially in the Midwest. According to a study by GoodRx, approximately 30% of black patients in the United States must cross county lines to access cardiology care, and about half of black and Latino patients do not have access to primary care.
“So we’re here spending hundreds of billions of dollars on a healthcare system that doesn’t serve the people who need it most,” Nagji said.
He also shouted out some organizations that are working to improve DEI in various aspects of this healthcare system. One of them is Merck, which has declared its commitment to improving diversity in clinical trials by ensuring that at least 50% of enrolled patients come from diverse backgrounds, in addition to improving community recruitment. and remove barriers to registration.
UC Davis School of Medicine is also on this list. Research shows that patient experiences and sometimes outcomes are improved when treated by healthcare professionals from similar communities. With this in mind, UC Davis has begun to focus on diversifying its admissions committee and staff—which also eliminates bias in the admissions process going forward—and cultivating potential physicians from the “hometown” of medically underserved areas who also wish to practice in these same fields.
With 20% of multiple myeloma patients being black, and although they may be diagnosed earlier but tend to be severely undertreated, Janssen of Johnson & Johnson has re-evaluated its patient engagement with this group. As a result, the “That’s My Word” campaign was launched to address gender disparities by raising awareness and disseminating information.
Nagji also pointed out that real healthcare DEI starts internally within the organization, preaching, “You can’t serve your customers well unless you look like your customers.
As for what GoodRx is doing in this area, there are a number of efforts. For patients, the organization focuses on improving awareness, access and adherence to healthcare. For employees, more than 40% of the organization’s workforce are women and nearly 50% are non-white.
Nagji also pointed out that we need to change the mindset of “What can organizations do to improve DEI? » to what duty organizations are doing to improve DEI? With this new perspective in mind, Nagji led a panel joined by Preeti Parikh, MD, medical practitioner and executive medical director at GoodRx, and Pierre Theodore, MD, executive director of health equity at Genentech.
Theodore began by emphasizing that when focusing on the patient, practices need to keep in mind that there is not just one patient at the center, as there are different populations who experience different barriers to care.
“It takes a very focused, concentrated effort to understand why a population may encounter a very strong structural barrier — a history of racism, sexism, misogyny, those kinds of things that can cause significant differences in outcomes,” Theodore said. “it takes this concept of being patient-centric and then building it to be much more robust in understanding that populations vary quite significantly in terms of the barriers they face.
When asked whether improving DEI in healthcare organizations required a bottom-up or top-down approach, Parikh and Theodore said the answer was not so black or white.
Theodore said there was no “silver bullet” approach, saying it needed to combine increasing diversity in the workplace, understanding cultural barriers and other barriers to employment. access such as transportation issues in the healthcare system, and consideration of environmental exposures and important risk factors different or all. encountered by the people.
For example, at Genentech, they’ve taken a broader approach in several areas, including how they engage customers, how they invest in healthcare provider diversity and education, how they deliver medicines, and more. . They have also focused more on the diversity of clinical trial participant groups and on conducting additional observational trials to see how diverse populations may interact with different drugs and solutions.
Internally, Genentech has also made commitments on the board to increase representation of Black and Latino executives and to ensure that Asian employees are equally represented in the ranks of individual contributors and executives.
Parikh welcomed the trends she’s seen in terms of more personalized patient care in clinical trials and more research aimed at truly understanding disparities in patient health care. According to the World Health Organization, South Asians represent 25% of the world’s population and 50% of cardiovascular deaths.
Stanford University has established a South Asian Research Organization, led by South Asian physicians and nutritionists to study risk factors that disproportionately affect South Asians. They focus on prevention and treatment plans, including lifestyle changes based on culture-specific, heart-healthy diets, as they have a South Asian nutritionist who has developed a diet based on South Asian diets. The organization also integrates gender and ethnicity into clinical trials and uses digital health content and health campaigns to raise awareness of research and empower communities to take action.
So what’s the next step?
Genentech has created a consortium of clinical trial centers to advance inclusive research and reach patients who have traditionally been overlooked in clinical trials. While the lack of representation is a reflection of the disparity rather than the cause, inclusive clinical research is crucial to providing patients with access to innovative healthcare. The company deliberately strives to place patients in clinical research protocols and ensure that their remarkable portfolio is accessible to a wide range of patients, which Theodore says brings him joy and pride.
At GoodRx, Parikh is excited about the focus on personalization in medicine and how this is increasingly becoming a dialogue. The organization also takes its awareness campaign to another level by creating different hubs, such as a Black Health Hub, Latino Health Hub, and Women’s Health Hub, to raise awareness in specific communities.
Additionally, they provide discussion guides for physicians and affordable solutions to make health care accessible, and collaborate with the community itself by involving patient advocates, patients and people who represent the community to be part of their content. The focus is on personalization, access and affordability to ensure the best health outcomes for everyone, Parikh said.