SXSW: Transforming Health through Partnerships and Transparency

From left to right are Faith Mitchell, Star Cunningham and Brian Gragnolati.

This week, as part of the South by Southwest (SXSW) festival’s Interactive Health and MedTech track, the American Hospital Association and leaders from the field have been sharing how hospitals and health systems are advancing health in their communities. 

AHA partnered with Energizing Health to create opportunities for health organizations, community advocates, entrepreneurs and philanthropic organizations to innovate and collaborate around health equity by eliminating systemic barriers, reducing inequities and building healthier communities. In addition to AHA, participating organizations include the Aetna Foundation, the Robert Wood Johnson Foundation, the Cambia Health Foundation, the St. David’s Foundation, the American Heart Association and the American Cancer Society, as well as civic, hospital and community leaders from across the country. 

Read on for session highlights and watch for full coverage all week in AHA Today, as well as key takeaways in the March 19 issue of AHA Market Scan. You can also follow along with AHA on social media or using #SXSW.

Innovative Partnerships Transforming Health – Unique partnerships are transforming health and health care across the country. What factors should partners consider and where can they look for others with similar goals?

In this session, panelists explored the process of finding common ground to develop objectives and strategies, leveraging relationships to engage public health, and scaling future work.

AHA Chairman Brian Gragnolati, president and CEO of Atlantic Health System, shared how hospitals and health systems like his own have been looking downstream and forming partnerships with local systems and government to tackle the social determinants of health and manage risk.

“An incredible interdependence is required to enable communities to be healthy, and that’s ultimately what we’re all trying to do,” Gragnolati said. “Unfortunately, health care has been designed around how care is funded, rather than keeping communities healthy. … It is unbelievably fragmented, inordinately expensive and, to a great extent, rewards the treatment of illness rather than promoting wellness. We need to pivot, and to do that, we have to figure out how to change that the way we pay for health care.”

New models like accountable care organizations and patient-centered medical homes are encouraging us to think differently, he said.

“Experiments to reform the care delivery system have been going on across the country and they allow us to work differently with others to create effective partnerships,” he said. But the uptake has been slow, he added. “We have to broaden the conversation, we can’t let it get polarized if we’re going to create grassroots health.”

4D Healthware is examining alternatives to face-to-face care models, such as telehealth and remote patient monitoring. Founder and CEO Star Cunningham noted that new payment models are opening up more options in that space.

“Technology can be the great enabler and equalizer” for organizations working to connect care and services to address the social determinants of health, said Cunningham.

She also talked about obstacles startups may encounter when trying to work with hospitals and health systems, notably around speed of implementation.

“Health care has to run a little faster,” said Cunningham. Startups and providers “have to figure out how they are going to run together.” 

Grantmakers in Health helps connect organizations and foundations with like goals. President and CEO Faith Mitchell stressed the need to dialogue with affected communities to ensure solutions will truly address the community’s unique needs. 

“Think about wellness: our system is perversely oriented toward illness,” said Mitchell. ... The whole point [should be] to keep people out of hospitals and healthy.”

Gragnolati said forums and open discussions within communities are key.

“I really think conversations like this, and the ability to meet others, is a critical piece” of this work, he said.

The panel, moderated by Umair Shah, M.D., executive director of Harris County (Texas) Public Health, also discussed how government groups like health departments can partner with hospitals. For example, Gragnolati shared how the events of 9/11 led his former hospital in suburban Maryland to work more closely with the local health department and NIH to enhance their emergency response and strengthen the overall system.

Transparency in Healthcare, One Note at a Time – Patients want greater access to their medical information, and not just high-level summaries. During this session, a patient advocate and several physicians shared how the OpenNote project is helping patients gain access to detailed clinical notes related to their care.

The project started with a pilot in three organizations and has grown to more than 200 organizations in all 50 states, giving more than 38 million people access to their health information. 

“It’s not a health IT project, it’s a change management project,” said Liz Salmi, senior strategist, outreach & communication, OpenNotes, Beth Israel Deaconess Medical Center, and a brain tumor patient. She added that the work does not require new technology for EHR vendors, only new processes and pathways.

Atrium has been up and running since 2015. “It’s remarkable to see the adoption from physicians and how it’s been embraced by patients… this is truly a movement. We’re seeing transformation happen before our eyes,” said Rasu Shrestha, M.D., executive vice president and chief strategy officer, Atrium Health. “We’re trying to change the very premise of how to practice health care … while there was initial pushback from the physicians… they are coming to us now and embracing it.” Moving from paternal to participatory.

People who read their notes are more engaged in their care, following their prescribed course of treatment more closely. They also indicate that they trust their providers more, said Catherine DesRoches, associate professor of medicine, Harvard Medical School, OpenNotes. Shrestha noted that 80 to 90 percent of patients at Atrium who access their online portals also access their notes.

This kind of transparency requires rethinking the way physicians are trained around note-taking and communication, the panelists agreed. For example, Beth Israel Deaconess Medical Center is asking patients to give feedback on notes to residents in training. “It tells them how they are doing on communicating with patients in this medium,” DesRoches said.

Changes in practice could also help combat clinician burnout. Shrestha noted physicians spend about 40 percent of their time on documentation, not talking and empathizing with patients. Leveraging new technologies like artificial intelligence and voice-to-text software can lessen that burden and improve clinician-patient communication, he said.

The session was moderated by Bryan Vartabedian, M.D., pediatric gastroenterologist, Texas Children’s Hospital, who described his own evolution of note-taking and sharing as a physician.

For more on the OpenNotes project, visit https://www.opennotes.org/.