HEALTH EQUITY ADVOCATES LAUNCH CAMPAIGN IN MASSACHUSETTS TO ELIMINATE RACISM IN PATIENT CARE WITH AN INNOVATIVE, RACE-CONSCIOUS APPROACH

Sep 19, 2022

FOR IMMEDIATE RELEASE
September 22, 2022

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Michael K. Frisby
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HEALTH EQUITY ADVOCATES LAUNCH CAMPAIGN IN MASSACHUSETTS TO ELIMINATE RACISM IN PATIENT CARE WITH AN INNOVATIVE, RACE-CONSCIOUS APPROACH

The Healing ARC Framework Can Revolutionize Care in Hospitals, Health Facilities

BOSTON – A prominent group of health professionals, community leaders, and healthcare equity advocates today launched a campaign to raise awareness of successful race-conscious approaches to healthcare delivery in Massachusetts that target institutional racism and can bring transformational change to health care systems.

The campaign will educate hospital administrators, lawmakers, social justice advocates, communities, and more about the value of race-conscious interventions, such as those implemented under the Healing ARC framework. The Healing ARC is a collaborative approach that helps rectify patient care inequities, while countering the notion that race-blind solutions effectively fix systems broken by racism.

“We are advocating for an approach to address racism in health care by enlisting the community and health care institutions as equal partners, equally motivated to identify and address health and health care inequities with race-conscious strategies that are absolutely necessary for people confronting the effects of structural racism that is killing them, their family members and their friends,” said Dr. Camara Jones MD, MPH, PhD, a member of the Healing ARC Campaign’s Advisory Committee.

Dr. Jones, the Leverhulme Visiting Professor in Global Health and Social Medicine School of Global Affairs King’s College London and Past President of the American Public Health Association, said the Healing ARC framework incorporates the three necessary stages for eliminating racism – naming it, documenting it, and collaborating to repair the harm. Currently, Brigham and Women’s Hospital (BWH) in Boston is using the Healing ARC framework to eliminate an inequity in patient care delivery. 

In 2015, a study by physicians at BWH found that over a 10-year period, on average, fewer Black and Hispanic patients diagnosed with heart failure in the Emergency Department were admitted to the specialty cardiology unit that improves patient outcomes. In response, the physicians developed a race-conscious, Healing ARC care model to address the racial inequities and enhance accountability.

Under a pilot program at BWH, when the emergency room treats a person of color with heart failure a new, more equitable, process is in place.

If a physician selected admission to the General Internal Medical service for the patient rather than the cardiology service, the clinician receives a “Best Practice Advisory” from the electronic health record system. The message reads: “Patient is from a racial or ethnic group with historically inequitable access to the cardiology service; consider changing admission to Cardiology unless extreme census or overriding clinical reasons for General Medicine service.”  The physician can either change their decision and admit to cardiology or override the Best Practice Advisory and continue admission to general medicine.

Through the pilot, which began earlier this year, results show the digital tool is impacting the admission of Blacks and Hispanics to cardiology.

“Historical data shows improved health outcomes for patients sent to cardiology specialists, including lower 30-day readmission rates and better follow-up rates compared with patients who were admitted to general medicine,” said Dr. Michelle E. Morse, Assistant Professor at Harvard Medical School and Chief Medical Officer and Deputy Commissioner for New York City’s Health Department.

Dr. Morse co-led the original study and developed The Healing ARC with Dr. Bram P. Wispelwey. BWH doctors Michael Wilson and Regan Marsh are engaged in implementing the application, and all of them are on the Healing ARC Campaign’s Advisory Committee. Dr. Morse is also applying the Healing ARC framework in New York City through the Coalition to End Racism in Clinical Algorithms (CERCA), which seeks to end race adjustment in clinical algorithms and accelerate connections to care for patients of color whose care was delayed by the racist practice. Recently, CERCA released an inaugural report, saying “race-based equations were often built upon now debunked race-as-biology theories.” The Healing ARC framework is also being applied at the University of Virginia Medical Center. 

A major component of The Healing ARC framework is developing innovative approaches to collaborating with the community. “Wisdom Councils” are organized in communities of color that have suffered from health disparities, empowering community voices to shape the implementation. Stage one of the framework requires providers and institutions to acknowledge that racism contributes to inequitable health outcomes. Stage two is designed to redress the harm by providing restitution to the harmed population, including opening access to services and care historically denied. Stage three is to facilitate closure through reconciliation and agreement that the harm has been redressed.

The campaign’s objective is to expand Healing ARC applications to more hospitals, healthcare facilities, and public health institutions, while explaining why the care delivery model at BWH is needed, what it can achieve, and why race-conscious interventions are required to dismantle racism in healthcare. Dr. Wispelwey, an Instructor in Medicine at BWH and Instructor at the Department of Global Health and Population at the Harvard T.H. Chan School of Public Health, maintained that racial inequities found at BWH are unfolding elsewhere.

“We believe the Healing ARC framework can make a transformational difference in patient care,” Dr. Wispelwey said. “The approach addresses two antiracism goals by providing clinician education through acknowledgment of a racial inequity and providing a path of redress for patients of color.”

About the Healing ARC Campaign

Our campaign educates hospital and healthcare system administrators, lawmakers, social justice advocates, civic and community leaders about the effectiveness of race-conscious interventions, such as those implemented under the Healing ARC framework. By implementing applications under the Healing ARC framework, America can prevent inequities in healthcare and improve the quality of life for many families and individuals.

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