Creating an equitable approach to health care with MSHIELD

Comprehensive care for Michigan patients is more than clinical care alone.

July 2023
Value Partnerships Update

Comprehensive care for Michigan patients is more than clinical care alone. Learning about patients and looking at a complete picture of who they are and their environment allows providers to support them with a more complete and equitable care plan. Enter the Michigan Social Health Interventions to Eliminate Disparities, or MSHIELD, a Collaborative Quality Initiative that identifies and addresses the social determinants of health. According to current literature, SDoH accounts for 40% of health outcomes and continues to drive health inequities throughout the state.

According to MSHIELD’s evaluations, failure to address the social health needs of patients results in two primary health care issues: health inequities and low-value care. These issues lead patients into predictable patterns of inefficient care, which disproportionately impact underserved minority populations. Backed by this research, MSHIELD is providing all 20+ CQIs and partnering providers with tools to identify health inequities, address social health needs and achieve equitable health outcomes for all Michigan patients.

Partnership with communities

To address local health needs, MSHIELD works with community hubs, regional networks of organizations that provide care coordination services and connect patients to community resources. The work with community hubs extends to MSHIELD’s partnership with the Michigan Bariatric Surgery Collaborative with the two CQIs working to integrate social needs screening and referrals with bariatric care in Genesee County.

The project sees patients screened at the McLaren Flint Bariatric and Metabolic Institute followed by a referral to the Mid-Michigan Community Health Access Program for resources and services. Over 1,000 patients have been screened since June 2022, resulting in referral cases being resolved more efficiently for patients. The data from the project returns to MBSC, where the team plans to assess whether clinical outcomes vary due to unmet social health needs. Similar partnerships with other CQIs across the state are also being pursued by MSHIELD.

Creating a culture of equity

Creating a more equitable health care system for patients includes expanding provider knowledge around health equity and anti-racism. Across the CQI portfolio, MSHIELD is working to identify opportunities to incorporate an equitable and anti-racist approach, asking them to commit to 5 hours a month of critical reflection, action labs and self-guided tasks. The anti-racism labs, held throughout the year and led by MSHIELD Equity Advisor Sheryl Kelly, Ph.D., LP, allow easy access to time for learning and reflecting. The focus is on building an anti-racist mindset while simultaneously learning to identify and fix systemic racial inequities within health care.

Accurately representing patients

A key strategy in promoting health equity is to establish and implement standards for data collection. Using best practices in collecting demographic data, such as race, ethnicity and language, sexual orientation and gender identity and disability status is important to accurately represent the patients seeking out care.

To assist the CQIs with data collection, MSHIELD created a Best Practices in Measuring Health Equity Guide for the collection of data. The guide is meant to evaluate the CQI’s current practices related to data collection, identify areas for improvement and set goals to implement best practices. It will be available soon as a resource for all CQIs and their partnering providers.

The future of MSHIELD includes centering health equity in CQI work. Partnering with communities, creating learning spaces for providers and collecting efficient patient demographic data support their hope to create a more equitable healthcare landscape in Michigan. Closing these formerly overlooked gaps in care underpins what collaborative quality improvement is about-creating unfettered access to the best care possible for patients across the state.

To learn more about MSHIELD, visit michiganshield.org. For more information on the CQIs and other Value Partnerships programs, visit valuepartnerships.com.