Commentary
The Healing ARC (acknowledgment, redress, and closure) is a care delivery model developed in response to documented racial inequities in access to specialist inpatient cardiology care and designed to be broadly applicable for addressing health inequities.
Racism is an ongoing public health crisis, and racial inequities in health, many of which are institutionally derived, have proven resistant to attempts at their rectification. Brigham and Women’s Hospital and The University of Virginia Medical Center (UVMC) have documented a specific racial inequity in access to specialty cardiology care for Black and Latinx patients with heart failure. Due to the urgency of this issue for patients, the institutions designed Healing ARC — acknowledgment, redress, and closure — as a pragmatic model for addressing documented institutional racial inequities in health care delivery. Because specialist inpatient cardiology care is a limited resource at the Brigham and UVMC, at a minimum, fair redress necessitates providing that which has been historically denied, i.e., equitable access to care. The organizations’ solution is to offer a targeted, race-conscious admission process for heart failure patients until the racial inequity in care delivery is eliminated. To achieve this, they have developed a computerized clinical decision support system (CDSS) to address a racial health inequity. This race-conscious CDSS, which will be evaluated prospectively for impact, is designed to address two antiracism goals simultaneously: clinician education through acknowledgment of the racial inequity and redress for Black and Latinx patients.