CIE Summit 2024: Embracing the Quintuple Aim to Advance Health Equity
Embracing the Quintuple Aim: Advancing Health Equity
MettaHealth had the privilege to attend the CIE Summit in San Diego, where numerous influential speakers shared their insights. Notably, Sonoo Thadaney Israni, Executive Director of Presence at Stanford Medicine, delivered a keynote address that set the tone for the event. Other esteemed speakers included William York, President & CEO of San Diego Health Connect and 211 San Diego/Community Information Exchange, Artrese Morrison, Interim Executive Director of Health Leads' Western Region, Anand Shah, Vice President of Social Health at Kaiser Permanente, and Chris Longhurst, Chief Clinical Innovation Officer at UC San Diego Health.
Keynote Insights: Integrating JEDI into AI Systems
Israni’s keynote highlighted the critical need to incorporate Justice, Equity, Diversity, and Inclusion (JEDI) into AI system development. She emphasized that addressing structural determinants of health is essential for advancing health equity. This shift from focusing on social determinants to structural determinants underscores the need for systemic changes that shape living conditions and ultimately influence health outcomes.
Addressing Structural Determinants of Health
To create meaningful improvements in health equity, we must shift from social to structural determinants of health. Israni stressed the concept of data colonization, where data collected for care is often monetized for products and services. She urged for ethical data governance that prioritizes individual care over profit, ensuring transparency and trust.
Addressing structural determinants of health necessitates a collaborative approach. Health and human services organizations should integrate networks that prioritize these determinants as key success metrics. This principle mirrors the "garbage in, garbage out" concept in computer science, emphasizing that the quality of inputs directly influences outcomes. By concentrating on structural reforms, health and human services systems can cultivate environments that significantly improve health outcomes for all.
Value, Ethics, and AI in Health and Human Services
Expanding on the need for ethical governance, Israni urged organizations to reassess their values to prioritize kindness and individual well-being over wealth and market share. This perspective is crucial for AI developers in health and human services, who must work to eliminate inherent biases in data sets to address health disparities.
Chris Longhurst of UC San Diego Health echoed these sentiments, discussing the practical application of AI to address health disparities. He highlighted UC San Diego Health’s AI for sepsis care, which has reduced mortality by 20% and addressed disparities among different populations, such as those with HIV. Longhurst noted, "It's not necessarily about eliminating bias in AI; it's about using AI to address health disparities."
It was also highlighted that working with developers to mitigate bias is crucial. All data sets carry inherent biases, and the goal should be to use AI to address these disparities, not to eliminate bias entirely. For example, AI models for sepsis care must consider local demographics to be effective in promoting health equity.
Practical Applications and Community Partnerships
The summit showcased practical applications and community partnership initiatives that embody these principles. For example, UC San Diego’s transportation pilot aimed to reduce hospital readmissions by addressing transportation barriers for individuals at high risk of unplanned readmission. This initiative highlighted how simple, community-focused solutions could lead to significant health outcomes.
In Phase II, this initiative expanded to address food insecurity, illustrating how addressing structural determinants of health can lead to tangible improvements in individual well-being. By integrating community information exchange (CIE) consent for standard treatment, they streamlined processes, making future pilots easier and more effective.
Design Thinking for Restorative Justice
Emphasizing the importance of design thinking for restorative justice, which involves learning about past harms and acknowledging them. This approach empowers communities by valuing their input on what problems need solving and what priorities should be addressed. By integrating restorative justice principles, health and human services organizations can build trust and create environments that foster healing and equity.
Moving Forward: A Call to Action
As we move forward, health and human services leaders are being called to embed JEDI principles into their strategies. This involves measuring equity and inclusion, engaging with communities, and ensuring innovations serve all populations equitably. Effective community partnerships and ethical data use are key components in creating a health and human services ecosystem that is not only efficient and effective but also just and inclusive.
Integrating responsibility for achieving equity into every aspect of operations, actively listening to and amplifying underrepresented voices, and refocusing on equity as the central goal of health and technology innovation are essential steps. By embracing JEDI principles, addressing structural health determinants, and fostering ethical data use, we can build a system that truly serves everyone and paves the way for a more equitable future.
For more information, please contact Metta Health at [email protected].