The Personal View
While Kaiser’s vast practitioner network is honing this macro view of data, Trinity Health is focusing on the micro by streamlining the collection of patient
demographic information on the individual level. With
47 hospitals and hundreds of clinics, Trinity Health
is one of the largest Roman Catholic healthcare systems—and the 12th largest health system—in the
United States. The Novi, Mich.–based company unveiled
the Equity in Care project in 2010, requiring its staff to
electronically record patient language preference and
other demographic information at check-in. This involved
training patient registrars to collect information in a
Prevalence of
U.S. Adult Diabetes
Low Income
6. 2 times
Latino
3. 7 times
Black
4 times
Asian
1. 2 times
White
Source: Centers for Disease Control and Prevention
High
Income
standardized and culturally appropriate way. Research
has shown that when doctors know a patient’s race,
they can personalize care based on known illnesses
that exist in different groups, says Antoinette Green,
Trinity’s vice president of diversity and inclusion. “The
goal is to create a workplace of cultural competence
that is delivering the highest quality of care to every
patient regardless of race, ethnicity, culture or language,” she says.
Targeting certain groups based on their known risk
factors for disease is an important way to keep both
doctors and patients informed about proper prevention. For example, American Indians are twice as
likely as whites to have diabetes. In fact, nearly 18
percent of the American Indian population is suffering
from diabetes, according to a 2008 publication of the
Commonwealth Fund. The paper also found that nearly
15 percent of Blacks and 14 percent of Latinos have
been diagnosed with diabetes, compared with only 8
percent of whites. Heart disease and stroke are also a
source of inequality among Blacks and whites, according to a 2011 report by the Centers for Disease Control
and Prevention, which states: “Coronary heart disease
and stroke are not only leading causes of death in the
United States but also account for the largest proportion of inequality in life expectancy between whites and
Blacks, despite the existence of low-cost, highly effective preventive treatment.”
The Center of the Storm
Achieving equity in care means supporting underserved populations where they live and
work and allocating resources to
the front lines. Last year, Kaiser
Permanente granted $70 million to
its Safety Net partners—community
clinics, public hospitals and health
centers that treat underserved
people. “These organizations are
really at the center of the storm
when it comes to caring for people
who are uninsured,” says Dr. Wong.
Funds from Kaiser help these
centers make improvements in
acute and chronic care, prevention,
outreach, patient experience and
clinical outcomes. “It’s really a rich
set of different activities that are
being supported through a pretty
robust grant-making mechanism,”
Dr. Wong says.
Trinity also has several outreach
programs that bring top-notch medi-
cal care to diverse communities. In
2011, the company’s Community
Benefit Ministry spent $454 million
on programs geared toward poor
people and those who are uninsured.
That includes Trinity’s 13 specialized
emergency departments that focus
on senior citizens and the installation
of Community Connection Kiosks
that connect underserved patients
with local social services. In addition,
Trinity’s Holy Cross Hospital near
Washington, D.C., uses community-
based ethnic health promoters to
reach out to local communities that
have reduced access to healthcare
because of income, language barri-
ers or cultural differences.
