Equitable Healthcare Delivery Through Digital Access

Better, smarter, faster. The future of connected health care relies on a powerful digital ecosystem and robust neural network to drive better diagnostics, intelligent operations, and seamless care anywhere. Join us as we talk to the experts about transformational roadmaps for this evolving landscape, what's working, what's needed, and how we get there together. Welcome to health care on air, presented by Verizon. Everyone, and welcome back to health care on air by Verizon. I'm your host, Robin Goldsmith, global lead for health innovation and strategy here at Verizon Business. So once again, we're here at five twenty twenty four in Los Angeles, California, and, very excited for our guest today. I'm joined by my colleague, Ned Cheney. This, it's nice to be here, Robin. Thank you so much for hosting this. I'm Nate Chaney. I'm global lead digital health strategy and health equity at Verizon, working with UC Davis doctor Ashish Atreja. Hi. I'm Ashish Atresha. I'm a physician executive at UC Davis Health. I currently serve as the role of CIO and chief digital health officer. I'll be speaking on behalf of this amazing community at UC Davis Health, doctor Courtney Lise, Kei Nakagawa, Mike Mashant, Jim Marsin, Jen Rosenthal, and, our chief health equity officer, doctor Henry Town. So you made you know, I I think I'm excited about Vybe. There's a lot of great announcements happening. So I'd like to start with the announcement you made today about your digital inclusion program and and and kinda dive into that and what that means for the the population that you serve. When I came to from New York City to Sacramento, I thought, New York, no one can be as diverse as New York City. Right? And I was wrong. Sacramento, I would say, is is third, fourth most diverse city of its size. It's one of the most diverse cities in the country. In fact, we have our medical school which is, ranked as the third most diverse medical school. And, we have a big mission for promoting equity, health equity. And as we look at health equity, there's so much health care delivery that's happening through digital channels, through smartphone, through patient portals, through text based programs. If people do not have that digital access, what we call is the digital determinants of health, and we don't solve that last mile problem, then a lot of other things cannot happen. They don't have access to the care. They can't make appointment in the right manner. Right? They can't have access to the records. Their medication is refill. So everything so we started focusing on what we call as a digital determinants of health as a super determinants of health. We were very lucky to get a federal earmark, for last two years, to really, enable digital health equity in the entire region. Our mission as a public university at UC Davis Health, part of the UC system, where, we have fifty percent of transplant patients in California, fifty percent of cancer patients in California, we take care of it. Our goal is to actually provide care to everyone and complete and not compete. So which means if we don't serve the society and the region where we are, then we're not serving our role. It's not just our patients. It's it's the entire population there. Right? So so with that lens, we started looking at how we can support community health and community engagement. And the two federal earmarks we got was extending the digital engagement we have, express care and telehealth, to a federally qualified health center. And then we got to focus on incarcerated population. So when we look at underserved population, that could be digitally underserved. That could be senior citizens, and we hope big initiative around that. That could be people who have language barriers, and we have a big initiative around interpreters since nineteen eighty five. And then that could be pockets of of population like incarcerated population who when they come out from the prison, they don't have any tools with them and many of them lack any care access, and they go back in medical issues back to the prison. So so we started looking at while we can solve many things on the physician side, there's a last mile problem we cannot solve, and that is the device, connectivity, and training. So and we're very happy with this partnership now that finally we have a very affordable way of providing the last mile, problem addressing that for the patients. So not only they have the devices at a very affordable rate, the connectivity, but as we have this tool, we can teach patients as well in digital literacy and really enable a different kind of health care experience than they have been used to. Wonderful. And, Ned, do you you wanna add from from the Verizon perspective and how this came together? Yes. I mean, it came together actually two years ago at a conference where doctor Suresh and myself met for the first time. And that relationship grew and evolved over the last couple of years, and we're working with doctor Estrasia's team to see how we can improve health outcomes for the underserved communities. And that's a focus and a mission that is a key, pillar for Verizon that we have been working together with the the team at UC Davis Health to bring, affordable connectivity. So connectivity is not just making calls, but connecting communities, connect connecting, members of underserved populations. So that's an area that has been big passion of mine, and it's been, our vision and strategies have aligned really well. Yeah. I you know, I every health system I talk to, health equity, SDOH is top of mind for every conversation. What do you think was catalyst that really, you know, for you guys, you I I'm sure you've been focusing on this for a long time. There's competing priorities. What made you decide to focus on these specific pilots and initiatives? Kinda how did you determine what was the priority per UC Davis at? So when I came in two years ago, we went to a clinical strategic planning, and there we put a vision of delivering tomorrow's health care today. But we did realize we cannot deliver tomorrow's health care today if it is not for everyone. So I think inclusivity and equity was the cornerstone, and we we talk about our mission is that no patient, no physician gets left behind. Right? And, so I think from that lens, we have been especially looking at pockets of populations, as we are getting more digitally AI ready, which populations have the biggest challenge to actually have the furthering the digital divide if we don't do it. So I think there's intentionality from our side to actually create those bridges. So we identify those set of populations, and then either we pool up our resources or we apply for funding, to be able to bridge that gap. Yeah. I mean, these are challenges no matter if it's New York City where I'm from and where you practice. But every you know, you go outside the large cities and even within them, there's challenges for equity, the digital divide, you know, elderly populations like you mentioned, rural areas where access to care is challenging. I guess I'd you know, you're kind of leading, you know, and and doing such amazing work. What would be some advice to other health care systems that, you know, they're trying to tackle a lot of different priorities and and they wanna really address underserved communities? Any advice to get started and kind of what through your own experiences? And there's been amazing communities. We work closely with National Digital Inclusion Alliance. I think my only, piece of advice is this is a common challenge for us of all. And health systems are not typically trained or have resources, to address that, at that level. But there are resources outside health systems as well. There are many community resources. There's many public resources as well. The goal is what we call is to really look at open innovation, which means looking outside your organization to say what's out there. And this is a common challenge for everyone. So how do we meaningfully partner with everyone else? Instead of working in a silo and doing a small SDH program, what can we share, learn, and empower other organizations and do it together? And those organizations can be health system. Organizations could be health plans. Organizations could be, mayor mayor of the office, public agencies. All of those agencies, you know, homelessness, what is being challenged, which is being addressed as well. So all of them have to come together and then mix it whole. Mhmm. So, actually, to be a catalyst for that, we analyze today, social determinants of health challenge. Yes. So while we are solving together the last mile problem for the patient, there's also a lens of the physicians and the clinicians. And there's a big gap that clinicians like me are actually blinded to the gap patients have because these gaps which patients have get buried into the social worker or case manager or prior physician notes, but they don't bubble up at the time when I'm meeting the patient. So many times, the decision we should be taking and the discussion we should be having doesn't happen because we don't have awareness of the patient's gap. So so at the same time, while we we are very committed to solving the last mile problem, empowering patients Mhmm. We also have the same thing. No physician gets left behind. And that's not just access to digital tools, but access to better kind of information to make the right decision. So we launched the challenge today through our collective of valid AI, which is fifty health system health plans and partners including Verizon working together. So we solve bigger challenges like so SDOH. And the challenge we have is, can we imagine a time when all these gaps in care, which happen because of social determinants of health, language barrier, literacy barrier, mental health barrier, housing, and, food, insecurity barrier, they come up as easy as a blood pressure. Right? So when a physician opens the chart or the nurse opens like we see a blood pressure or a heart rate, we're able to see SDH gaps right there. There's a three sixty view of the patient. They're they're everything outside their, you know, their health condition, but all the factors that play such a big role in getting access to care, nutrition. It's so so needed and it's overdue, I would say. And that's fifty percent of health risk a patient has that can be addressed by medication or surgery. So and then that is my plea to everyone is to actually join forces to do it together. And, we need to have scalable models and really have a different kind of peer delivery in the future using the power technology. I love two things you said. I mean, you you kinda talked about it, the power of partnerships. It's gonna take a village, as they say, to really change health care for the better and and leave no patient or physician behind. So taking care of our most vulnerable patients, making sure they have access to care, making sure our clinicians are given the right tools to do their job in an efficient way and and not, you know, address the burnout challenges that are prevalent everywhere. So we're here at Vyv. Anything else that you're seeing that you're excited about and and things that you you know, with your valid AI program, how do you drive that forward? How do you get more folks to the table to really work together to to promote these initiatives? The session we had today was with Mickey Tripathi, the ONC lead, as well as we had VA, and, we had a position from Chai as well. So I think, part of it is we are as a I think we are incredibly grateful to Mickey Drepati needing this way of creating interoperability standards with DEFCA and others because then we can leverage gravity projects. So the goal is not to do alone. There's so much good work that's happening in pockets. Right. Right? So the first part of our mini challenge is to bring all the things that's happening together, which means there's a gravity project which actually talks about standards of SDOH. And our team, Mike Mashant, Kei Nakagawa from our team has been intricately involved with that part. So how do we bring that great community on standards of data and build on top of that. Absolutely. Then, amazing, opportunities with Tesco and interoperability. Right? Can we settle those standards? So if there's a SDOH that is identified as a discrete data, then we can leverage the standard which Gravity Project has done but use the fire and n h l seven to actually transmit the data to everyone because the goal is not just for a health system. If you see any community worker, if you see any FQHCs, they should have the same level of information. Right? So so you can see already see the interoperability world and the standards work working very much together. But then we take the work we need to be doing is free text notes using generative AI as a collective from valid AI, creating discrete data from free text notes, bubbling it up. So then we are generating, creating value from those hidden notes and using the standards to get it out. Then we build a layer on top of it like a smart on fire app where the clinicians can see in the EMR. We need a lot of partnership with the EMR vendors. Exactly. So then we go and we can easily see that. So and then we need to engage with, social service agencies to actually not only data from EHR, but actually data from about homelessness. Yes. Right? Data about job insecurity, food banks, we link all those data. So when someone we find, does not have transportation or someone has food insecurity, we can automatically link them with interventions which are available in the community. Right. Right? So so I think, so I think and there's a lot of amazing, amazing progress on all of those fronts happening here at Vybe being shared. Well, doctor Ochoa, thank you so much for joining us. Thank you both for the work you're doing really to address the most vulnerable and bringing everything together. Interoperability is critical. Again, like I said, it's gonna take a village, so thank you for leading the way. It was a pleasure to have you both. And thank you for joining us. 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