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Reinventing the hospital for the modern, inequitable era

July 1, 2020, 7:02 PM UTC

Good afternoon, readers.

For the rest of July, The Capsule will be going daily rather than weekly. Yes, that means you’ll get the day’s health news every afternoon in your inbox for the rest of the month (except for this Friday, July 3, in observance of Independence Day).

Fortune and IBM Watson Health have joined forces to create a new ranking of America’s top 100 hospitals. Based on 11 important criteria such as clinical outcomes, patient experience, and financial health, among others, this list attempts to suss out the health providers that are truly serving patients and communities well even if they don’t have brand name recognition. I encourage you to parse it through.

The rankings’ release was accompanied by a fascinating conversation on Tuesday moderated by Fortune editor-in-chief Clifton Leaf with experts such as IBM vice president and chief health officer Dr. Kyu Rhee, American Medical Association GVP and chief health equity officer Dr. Aletha Maybank, St. Joseph Mercy Hospital president Alonzo Lewis, American Heart Association CEO Nancy Brown, and Stanford Health Care president and CEO David Entwistle. 

The main question: How do you build the hospital of the future—not just with cool gadgetry and cutting-edge data science, but with the help of communities at large in order to address the widespread medical inequities highlighted by the coronavirus pandemic?

St. Joseph Mercy’s Lewis became the organization’s president mere weeks before the COVID-19 outbreak began in earnest and constrained hospital capacity. “We have an incredibly engaged medical staff. It made it very easy for me to step into the leadership role,” he said. “Often times you’ll see our senior leadership team on the front lines with colleagues to see what’s creating adverse outcomes and figure out what we can do about it.”

A large part of the problem is that hospitals and the medical community have been slow to pick up on a more holistic view of health care, including the socioeconomic factors that can have a profound impact on how Black and brown people interact with the system.

“The AMA needed to have a more explicit focus on health equity and what that meant for the AMA and for the field of medicine overall,” said Maybank, who is the first chief health equity officer at the nation’s largest physician trade group.

“How are we addressing the systems we know create harm for our patients? Racism, classism, sexism, all of these things that we know affect outcomes. My work is really: How do we make these injustices visible? COVID has made a lot of those injustices visible to more people.”

But turning this realization into action requires a multi-pronged approach, according to the panelists. “As a physician you learn a lot about the physiology of disease. But when you’re out in the real world you realize health care is a team sport,” says IBM’s Rhee.

“Leveraging that requires understanding the community. How do we bring hospitals and communities together, including by sharing datasets?”

Delving deeper into local community information is a fundamental matter of trust. And that sort of trust stems from better physician education and a more refined approach to incorporating on-the-ground information into a hospital’s business model.

“From my perspective, there’s a parallel that needs to happen in medical education of helping physicians understand the totality of health,” said Maybank. That could include having members of the local community on local hospital boards.

For Maybank, the ultimate question is: “How do we embed equity” into our system of care.

Read on for the day’s news, and see you again tomorrow.

Sy Mukherjee


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