Interdisciplinary Team Works for Greater Health Equity
January 27, 2021 | 5 min. to read
An interdisciplinary group of clinicians and staff has formed to advance the delivery of equitable medical care to underserved community members cared for by Northwestern Medicine. The NM Health Equity Action Team (HEAT), an all-volunteer group, was launched in April 2020. The group has identified core strategies and begun important initial efforts to address the adverse health effects and healthcare inequities stemming from structural racism and other forms of discrimination.
“This initiative was born out of a long-simmering outrage over stark, persistent healthcare disparities,” says Mita S. Goel, MD, a member of NM HEAT leadership and an internal medicine physician at the Galter 18 clinic. “As healthcare professionals, we witness what our patients and their communities face because of inequities and discrimination — a significantly higher burden of disease and death from diabetes, heart disease, cancer and most recently, COVID-19. We came together to form NM HEAT in order to collaboratively lead through action.”
NM HEAT is currently housed within the division of General Internal Medicine and Geriatrics on Galter 18 at the downtown campus; the program includes partnerships and input from other NM primary care practices, NM’s Transitional Care Clinic, NM’s departments of Community Affairs, Financial Counseling and Marketing, safety-net centers, and the Center for Health Information Partnerships (CHIP).
Priority areas The six-member NM HEAT leadership team is inclusive of individuals from diverse backgrounds and identities, and is intentional about practicing from a horizontal leadership model.
NM HEAT identified four priority areas to promote equity and optimal health for all patients:
Financial and insurance assistance
Longitudinal commitment to equity
Financial and insurance assistance In the current economic climate, many patients who receive primary and specialty care at NM have lost their health insurance, or may be experiencing difficulty paying for medical care and other essential needs. NM HEAT developed strategies to help those patients continue to use NM as their medical home, including a partnership with Financial Counseling to support the application process for Medicaid and/or financial assistance.
NM HEAT also worked with Marketing and Translation Services to create a handout in English and Spanish with information about options for individuals who have lost insurance, including ACA exchange health plans, Medicaid and/or NM financial assistance. This information is available on the COVID-19 Resource Center at NM.org.
These handouts were included in paper mailings to 22,000 patients who live in neighborhoods hardest hit by COVID-19 and who are at higher risk for negative health outcomes due to the impact of racism and its adverse health effects.
The Galter 18 practice will pilot a screening process to identify patients experiencing food insecurity. NM HEAT worked in partnership with Community Affairs to facilitate access to immediate and long-term food assistance, including Subway and grocery gift certificates, Supplemental Nutrition Assistance Program (SNAP) benefits, food pantries, and home-delivered meals for eligible patients.
Most patients at the highest risk for adverse health outcomes require more than an annual exam and periodic in-person office visits to achieve a better state of health — and many patients face significant challenges to achieving even this minimum standard of contact. NM HEAT seeks to strengthen the continuum of care for these patients.
NM HEAT will launch a pilot program in February focused on telephone outreach to Galter 18 patients who have been lost to follow-up in an effort to address unmet health and social needs. Staff members will contact patients to screen for COVID-19 symptoms, provide education about the COVID vaccine, assess for food and housing insecurity, and explore barriers to medical care including transportation and financial stressors. NM HEAT is working in collaboration with Traci A. Kurtzer, MD, a gynecologist in Northwestern Medical Group, to facilitate staff trainings on trauma-informed care as part of these outreach efforts.
Many patients who receive specialty or inpatient care at NM receive primary care at safety-net clinics. These clinics’ resources have long been strained, and the current economic climate has only increased demand. NM HEAT seeks to identify improved care coordination efforts for patients who are “shared” by NM and safety-net clinics to support optimal health outcomes. Additionally, the group continues to advocate for improved access to primary care for patients with Medicaid.
Dr. O’Brien and two other internal medicine physicians — Jennifer A. Bierman, MD, and Daniel B. Evans, MD — have secured funding for a relationship with Near North Health Service Corporation to establish an Education Centered Medical Home Model, under which medical students and residents from Northwestern University Feinberg School of Medicine will work at the center. The relationship both extends the center’s capacity to serve patients and gives NM students and residents the opportunity to serve high-need communities.
Longitudinal commitment to equity
NM HEAT is dedicated to staff promotion and retention, and views this important advocacy work as a way to improve staff wellness and job satisfaction. The group has outlined several strategies to build capacity to address racism, violence, injustice and inequality:
Facilitate collaboration between clinical experts in NM and academic experts at Northwestern University whose scholarship focuses on health equity
Coordinate trainings for faculty and staff on antiracism and trauma-informed care
Provide professional development opportunities and compensation for nonphysician staff to participate in NM HEAT and other equity-related efforts
Advocate for promoting senior leaders in NM who better reflect the diversity of its faculty, staff, and patients
Advocate for creating NM senior leadership roles focused on health equity
The group welcomes ideas for future work and ways individuals are interested in contributing. Some areas of greatest need include support in information technology and informatics, fundraising, web development, and grant writing.