At a recent virtual event hosted by the Office of the National Coordinator for Health Information Technology (ONC), PerfectServe CEO Guillaume Castel appeared as a featured panelist in a health equity-focused discussion titled, “Innovations in and Implementation of Equity by Design.”1 The panel was organized to explore the different ways organizations around the country are working to change the status quo when it comes to health equity in the United States.
What is Health Equity?
Health equity is a broad topic, but the CDC offers the following explanation:
“Health equity is achieved when every person has the opportunity to ‘attain his or her full health potential’ and no one is ‘disadvantaged from achieving this potential because of social position or other socially determined circumstances.’ Health inequities are reflected in differences in length of life; quality of life; rates of disease, disability, and death; severity of disease; and access to treatment.”2
Technology companies like PerfectServe are perhaps not traditionally considered part of the “tip of the spear” when it comes to moving the needle on health inequalities. But in a world where care delivery and patient-to-provider interactions are increasingly facilitated by digital tools, and the makers of those tools count hundreds—even thousands—of healthcare organizations as customers, technology should be a central part of the discussion.
So, how does PerfectServe think about health equity, and what part do we play in advancing these efforts? Guillaume offered some useful insights during the panel discussion.
Learning from Stakeholders
When he spends time with PerfectServe’s customers, Guillaume says that they “tend to force me to focus on three things”:
- Bringing joy back to caregivers: “It’s been hard for caregivers in the last few years, particularly since the beginning of the COVID crisis.”
- Helping them strategize around how to retain caregivers: “The great resignation that is impacting all industries [has had a particularly] massive impact on the healthcare industry.”
- Better patient engagement: “Helping them get smarter on engaging and connecting with patients more effectively, and helping them to do it the right way.”
Guillaume also highlights some of the troubling health inequalities PerfectServe has learned about through collaborative research efforts with partners:
- “Over the last decade, infant mortality rates have been two to three times higher amongst the Black population in the United States.”
- “In a study we did with one of our clients [located in] the Northeast, [we saw that] wait times [in the ER] are four times higher when English is not your first language.”
- “[Healthcare] disparities and inequities cost our overall economy about $300 billion a year.”
- “The average annual health expenditure is about $1,800 higher for food-insecure adults.”
This kind of feedback and insight is invaluable—it comes directly from people with firsthand experience about persistent challenges in the industry. It allows PerfectServe’s leadership team to design company strategy in a way that can alleviate some of these pain points and inequalities by equipping provider organizations with better technology.
“We’ve taken those things to heart,” says Guillaume. “We’ve spent a ton of time thinking about how we can build products that actually have an impact in these areas. And because we serve, primarily, the provider space, which are hospitals and physicians, […] it’s really forced us to think about ways to have an impact.”
Standardizing Patient Experience—Regardless of Location
Guillaume further notes that standards of care are not always uniform, even in multiple facilities within the same health system.
“We’ve noticed that care is being provided very differently, depending on where the hospital is located,” he says. “We’ve spent a significant amount of time wiring processes [guided by our technology] to ensure that care is uniform, that people can expect the same level of attention, whether they’re being admitted in New Jersey or California.”
At the root of this is facilitating effective care team communication and collaboration, which has been PerfectServe’s specialty for 25 years.
“We focus on building products that foster better coordination and engagement,” says Guillaume. “So, what does ‘coordination’ mean to us? It means that clinicians [in any setting] are going to communicate more naturally, that messages will get to the right person at the right time, that care is going to be more seamless, and that patients are going to have a better experience, regardless of who they are and where they’re coming from.”
Fostering Better Patient Access and Engagement
For many underserved populations in the United States, it’s simply not a common expectation that proper care will be readily available when it’s needed—the trust and positive experiences others can draw from are just not there. Guillaume sees two of PerfectServe’s solutions having an impact in this area.
“We’ve also [focused on] products that improve access for patients. What it means is that we’re going to build tools to optimize scheduling for clinicians so they know how to build their days most effectively,” says Guillaume. “And on the other side of the equation, that means we can optimize the patient scheduling aspect so that people can be seen more effectively. We know there’s a massive problem about believing in having access to the health system, and we know that underprivileged populations tend to be seen in the emergency room when they could probably adhere to a form of care that relies more on access to a primary care provider.”
Research has also suggested that more engaged patients tend to have better health outcomes. Along those lines, one of PerfectServe’s core products exists specifically to facilitate intuitive, multichannel, location-agnostic, and easy-to-access communications between provider and patient.[/vc_column_text]
“We’ve also built tools to engage with patients where they’re not in the hospital, or in the care of a clinician. Increasingly, care is moving outside of the hospital,” says Guillaume. “For health system administrators, it’s paramount to stay engaged with the patients, regardless of where they are. And so we’ve got engagement tools that check on patients when they’re home, or just not in the hospital.”
And although most adults in the U.S. have smartphones at this point, it’s still the case that not all patients can or want to engage with providers using an app or patient portal that requires a login. “When we think about building good products to help our clients actually connect with their patient populations, we take that into account and make sure that there are ways to communicate with patients who aren’t going to download an app,” says Guillaume.
He further notes that the care team frequently includes the patient’s family and friends: “They often play a very important role in making sure [the patient] comes back for a health visit and adheres to their medications.” For that reason, PerfectServe’s patient engagement solutions were designed from the start to support text message, video, and phone interactions that can loop in family, friends, and even other caregivers as needed.
Who Builds the Products?
Within the healthcare system, bias doesn’t just exist among providers—it can also exist among the people who build the products they use every day. Because PerfectServe is part of the latter population, Guillaume points out that diversity is key to understanding blind spots.
“We believe that diversity amongst our ranks—whether they are engineers coding the products or strategy people thinking about what to build—matters. A bias in the engineering ranks leads to bad products. And so, we spend time thinking about who should be on the team, why they should be on the team, what their perspectives are, and what biases they may have. And we believe that healthy disagreement is good for that. For instance, a tool for a male surgeon in New York may look very different than a tool that is thought through for a nurse in Arkansas. And yet, we have to build tools that all clinicians can use effectively. So, we’re being very deliberate about thinking through all those areas.”
Finding the Right Balance
As the healthcare industry evolves—sometimes rapidly, sometimes not so much—Guillaume is constantly thinking about the ways in which PerfectServe’s technology can make health systems better and communities stronger to help bridge the health equity gaps that still exist in the United States. There are many levers to pull as part of these efforts, but by building tools that make it easier for clinicians to coordinate care while improving patient access and engagement, Guillaume believes PerfectServe will continue to have a major role to play.
But clinicians are ultimately the bedrock of care delivery, so in any discussion about health equity, it’s important to find the right balance between patient needs and provider wellbeing.
“At PerfectServe, we think about patients a lot, but I must admit to you that our clinicians are exhausted,” says Guillaume. “And we have to maintain a balance, when we think about new products and new solutions, between what is best for patient populations and what is most productive, most conducive to effectiveness for our clinicians. They’re burned out, they’re underappreciated, and I think they need better tools to [do their jobs].”
Thankfully, achieving health equity is not a zero sum game. PerfectServe remains committed to finding new ways to make the care delivery process better, safer, more accessible, and more satisfying for patients and providers alike.
12022 ONC Virtual Annual Meeting. (2022, April 13). Innovations in and Implementation of Equity by Design. The Office of the National Coordinator for Health Information Technology (ONC). https://www.healthit.gov/news/events/2022-onc-virtual-annual-meeting
2CDC (2022, March 3). Health Equity. Centers for Disease Control and Prevention. https://www.cdc.gov/chronicdisease/healthequity/index.htm