All patients deserve an equal opportunity for a successful health outcome when they receive care. Yet, available data show this standard does not reflect the current reality.
In 2020, Pediatric Rheumatology published the results of a longitudinal study that applied a treat-to-target (TTT) intervention strategy with clinical decision support (CDS) to evaluate racial and socioeconomic disparities in disease outcomes among children with polyarticular juvenile idiopathic arthritis (JIA). The conclusions of this study were startling: While outcomes improved for all patients, racial and socioeconomic disparities in JIA patient outcomes persisted throughout the implementation of the TTT-CDS approach. The study was not able to identify a single prescriptive solution to address these disparities, but the stratified quality improvement data can be used to narrow the divide in health outcomes.
“We can’t just do research,” said Jon Burnham, MD, MSCE, Associate Professor of Pediatrics, Children’s Hospital of Philadelphia. “There needs to be efforts toward implementing evidence-based solutions. It’s incumbent on pediatric rheumatologists and health systems to commit to measuring these health disparities so that we can mitigate them at the local and national level.”
Dr. Burnham will be among the experts sharing perspectives on Quality Improvement Approaches to Addressing Disparities in Health Outcomes on Sunday, November 13, from 5–6 p.m. ET, in Terrace Ballroom II and III of the Pennsylvania Convention Center. One practical first step for providers is to measure patient outcomes so the data can be stratified by demographic factors, such as race, ethnicity, insurance status, and other social determinants of health, he said.
One of the collaborators in the above-mentioned longitudinal study, Dr. Burnham will share the lessons he learned from the TTT program, including how the group standardized outcomes assessments for JIA patients, how they determined whether a patient had met their disease activity target, and how the clinicians applied CDS to assist with medication treatment choices.
“It can be as simple as developing a report that tracks patients with high disease activity. We can identify when the date of each patient’s last appointment was, figure out when the next appointment should be, and confirm whether the follow-up appointment is scheduled,” Dr. Burnham said. “To be a highly functioning team that achieves the best outcomes, I would argue this is a practical activity that we should take on.”
Researchers and providers continue to discover more advanced ways of looking at real-time data. For example, the Childhood Opportunity Index is a census-tract-derived variable that uses 29 unique indicators to map the quality of resources and conditions for children to develop in a healthy way where they live.
“In addition to race as a factor associated with disease activity, the Childhood Opportunity Index data tell a clear story about the relationship between outcomes and opportunities,” Dr. Burnham said. “We’re seeing the same pattern emerge across multiple outcomes that are important to patients and their families.”
While the session will be presented from the perspective of pediatric rheumatologists, the quality improvement data practices will be applicable to nearly all ACR Convergence attendees.
“Healthcare leaders, practitioners, researchers, and patient advocates are all stakeholders in thinking about how we can improve and optimize our healthcare system,” said Emily Smitherman, MD, MS, Assistant Professor of Pediatric Rheumatology, University of Alabama at Birmingham. “The principles we’re going to be discussing can be applied across the spectrum of care.”
She will address using a population management approach to identify potential gaps in care.
Mileka Gilbert, MD, PhD, Associate Professor of Pediatrics, Medical University of South Carolina, will discuss the application of quality improvement methods to overcome disparities in mental health screening.
Meeting participants have the option to attend the session in person or on the meeting website via livestream, or to view the session on demand.