Health Equity

Don’t just hope for health innovation equity—make sure it happens

Andis Robeznieks , Senior News Writer

The quest to make sure digital health tools are an asset for patients and physicians and not a burden brought AMA leaders to the Health Information Management Systems Society’s (HIMSS) Global Health Conference. 

Achieving optimal health for all

The AMA is confronting inequity at the system and community level to bring health equity to marginalized and minoritized communities in the U.S.

The AMA is also looking to ensure that augmented intelligence (AI)—often called artificial intelligence—and other digital health tools are integrated into health care practice in a manner that advances health equity rather than diminishes it. And the way to do both is to have physicians involved on the front end when these IT products are created, said Bobby Mukkamala, MD, the immediate past chair of the AMA Board of Trustees.

“We identify opportunities to integrate the perspective of practicing physicians into the development of this—hence, our presence here is huge, so that we can influence the development of your work product and help us take care of our patients,” said Dr. Mukkamala, an otolaryngologist in Flint, Michigan.

“The AMA has the unique opportunity to ensure that the evolution of AI—augmented intelligence—and digital medicine benefits patients, physicians and the health care community,” he added. “We want to leverage the ongoing engagement for improving outcomes and professional satisfaction.”

The conference drew some 35,000 professionals from across the health IT sector to Chicago, home to both the AMA and HIMSS. Almost 29,000 people attended last year’s conference in Orlando.

“Today's digital technology—from wearables to AI—offer almost unlimited potential to transform health care, but ‘potential’ is the important word when we’re talking about digital health, because we know that so few digital health tools marketed to everyday consumers—or even to physicians—live up to their claims,” Dr. Mukkamala said.

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He also noted that digital health technology, such as telehealth, can be a “great equalizer in medicine” by improving access to care for some historically marginalized communities.

“We know that this won’t happen by accident—in fact, if technology isn’t intentionally developed for the purpose of being that equalizer, it can backfire and serve to widen that gap,” Dr. Mukkamala said.

“So if we're serious about identifying and eliminating those persistent health care disparities that contribute to such poor outcomes for marginalized communities, we have to create that future,” he added. “This work is too important to leave to chance.”

Seeking optimal health for all

Joining Dr. Mukkamala was AMA Senior Vice President and Chief Health Equity Officer Aletha Maybank, MD, MPH, who noted that her job description is to “facilitate a process across the entirety of the AMA that would lead to embedding equity.”

AMA policy defines health equity as “optimal health for all,” and calls for the AMA to promote access, research, data collection and equity in care.

Noting that “equity is distinct from equality” in that equity involves recognizing that we do not all start from the same place, Dr. Maybank quoted physician researcher Camara Phyllis Jones, MD, MPH, PhD, who said “to get to health equity, we have to first value all individuals and populations equally.”

To this concept, Dr. Maybank said many people would respond that they do, in fact, respect everyone equally—but the harsh reality says otherwise.

“If you look at our data—the data of the systems and the institutions we work in—it shows that we don’t value all people equally,” she said. “If we did, we would have outcomes that would actually demonstrate that.”

In addition to inequity in health, Dr. Maybank noted that another manifestation of placing unequal value on others is seen in the way innovators from historically marginalized communities—and especially women—lack access to funding capital.

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One way the AMA is addressing this is by serving as the lead sponsor for the In Full Health Learning and Action Community, which encourages development of digital solutions that address the needs of historically marginalized communities while ensuring that new tools don’t unintentionally embed bias.

In Full Health was sparked by the AMA’s strategic plan to embed racial justice and advance health equity. HIMSS serves as one of the effort’s founding collaborators.

Inequity in health innovation is being driven by two interconnected-but-distinct gaps, Dr. Maybank said.

These involve the health innovation solutions that are being funded, resourced and adopted—what they focus on and how they’re designed, in addition to who is controlling opportunities to drive innovation in health care and who is making funding decisions and securing capital for new health care solutions.

“The critical questions to be asked and answered are: Who's benefitting from what's being created? Who's not benefiting?” Dr. Maybank said. “Who's being harmed? What are the unintended consequences and how do you mitigate those consequences?”

Physicians, investors, solution developers, funders and others interested in participating in the influence of the health solution ecosystem are invited to join the In Full Health Learning and Action Community.