The Health Equity Factor: Columbia University’s Health Policy & Management Conference

On Friday, April 21, 2017, health care leaders, faculty, students and alumni came together to discuss where equity fits within the evolving health care system at Columbia University Mailman School of Public Health’s 2017 Health Policy and Management Conference.

Michael Sparer, Professor and Chair, Department of Health Policy and Management, Columbia University, kicked off the conference by reminding the audience, “it’s more important than ever with our evolving health care system to discuss how we can all work together and encourage a more equitable and better health care system for all.”

Sparer introduced Dr. Robert Fullilove, Associate Dean for Community and Minority Affairs and Professor of Clinical Sociomedical Sciences, for the first keynote address. Sharing his personal family history with the Civil Rights Movement, Fullilove described a continuous struggle for a more equitable health and social system in the United States. “Health disparities have always been linked to our culture’s history and have continued to persist. We need to engage with our communities and work together to reform the system so that it is culturally competent,” he said.

For the second keynote address, “Health in Five Digits”, Congresswoman Robin Kelly shared her goals for a healthier United States and explained how zip codes are linked to health status. “Health equity is achieved when our zip codes stop determining our health, with the first step being affordable care for everyone,” she said.

The conference’s first panel focused on how telemedicine is removing physical barriers and adding an additional layer to patient access. Panelists Karen Moran, Vice President, Head of Specialty Products, EmblemHealth, Peter Fleischut, Chief Innovation Officer, New York-Presbyterian, and Katherine Ryder, Chief Executive Officer, Maven, detailed their organizations’ implementation of telemedicine.

“At EmblemHealth, we are working on ways to put forth a telemedicine solution that matters to our consumers and meets them where they are. Telemedicine can be a more effective way to provide people with access to basic care for more minor illness or injury that does not involve the use of an urgent care or emergency department, which allows those more acute settings to treat patients with complex needs. This strategy can also be a critical tool in managing overall costs while getting people care they need”, Moran explained.

Telemedicine has become crucial in providing quick and easy access to care for patients. A 2017 American Well Consumer Survey found that among those who have a primary care physician, 65% are interested in accessing their doctor through telemedicine. “Prior to telehealth, we didn’t have enough coverage in-house. Now, we can provide access to care in under an hour and are making it easier for patients to get health services they need outside our facilities,” Fleischut observed.

On the question of whether telehealth can create more equities in health care, Karen noted, “telemedicine can be a win for consumers, providers and health plans in this regard. While there are still important equity issues to be addressed around areas such as language, it can create equity that may be missing as it relates to individuals who have challenges in physically accessing brick and mortar locations due to either financial or physical challenges.  While there continues to be opportunity to improve equitability, generally I would say there is more goodness in this technology than there are gaps.”

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