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Achieving Organizational Health Equity Outcomes

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Utilizing Trexin’s EPIE framework allows organizations to assess, design, and implement a Health Equity program that will improve the quality of care for all patients.

As identified in our previous Trexin Insight Paper (TIP), Delineating Health Equity, the nature of collecting and isolating health disparity data creates a need for payers to delineate and establish a Health Equity program. While Health Equity (HE) is an established initiative and has gained traction over the last few years, it remains an ever-evolving goal of improving quality of care for our members. To build and sustain a lasting, relevant, and valuable program that continuously considers the population it serves, payers should routinely assess the current state of their HE programs by measuring the dedicated capabilities and resources within—and ultimately strive toward integrating these programs into their Value-Based Care framework.

Trexin’s EPIE approach provides a full-scale HE program framework that is designed to assist your organization in assessing, designing, and implementing a HE program. It is compartmentalized to apply to any Payer regardless of the current state.

In our third and final installment of our introductory HE TIPs, Mo and Isabelle break down each phase of Trexin’s HE framework, “EPIE”, and highlight key outcomes. Each phase details the necessary steps to take to ensure your organization’s HE program evolves and aligns with the continuous goal of improving quality of care. EPIE stands for Establish, Promote, Identify, and Execute.

ESTABLISH – TOP DOWN

Imagine your annual wellness exam with your doctor. Your doctor may check vitals – such as blood pressure, pulse, temperature, or your respiratory rate – and ask you a few questions. Their goal is to better understand the current state of your well-being so they can provide direction on how to stay healthy.

Similarly, the Establish phase of EPIE examines and determines the top-down health of an organization’s HE capabilities. This phase ‘checks the vitals’ of what is necessary to constitute a healthy program: clear roadmap and vision, defined charter, established governance or Executive Steering Committee (ESC), and, most importantly, a clear mission-statement and decision framework that can support your organization’s HE operating model.

Just as doctors do at wellness exams, we listen, assess, and determine strategy to achieve your organization’s HE goals. Rather than listening to your heart, we listen to key stakeholders through conducting voice-of-the-customer interviews or holding vision and scope workshops. These interviews help us to define strategy and tactics to create an actionable capability map, which ultimately allows us to create a roadmap for a clean bill of organizational health moving forward.

PROMOTE INSIDE AND OUT

As the primary objectives of the framework are to build opportunities and platforms both internally and externally, the Promote phase of EPIE is a crucial component as it increases transparency and bolsters collaboration.

By determining clear, cross-enterprise communication channels, we establish a flow of data-driven decisions and communication. These channels can take multiple forms, such as blog posts, monthly newsletters, or public and accessible dashboards. Open communication allows for defining a collaboration framework that considers both the interests and culture of your internal organization and the external community which your organization serves.

In achieving an open and steady flow of communication, organizations can begin shaping a culture of equity internally and externally. Internally, this happens by opening the necessary space to formally prioritize equity and then demonstrating this prioritization through internal initiatives designed for and by employees of all backgrounds. Externally, this happens through engaging in collaborative partnerships with health and non-health sectors. This bridges the gaps between the members it serves and the health organization to advocate, promote, and address Social Determinants of Health (SDoH). It also enables an organization to begin building a structure of equity—allocating capacity and resources to promote equity, initiate the collection of data, and assemble a framework to monitor and address individuals with social risk factors.

Once the platforms we need to communicate and collaborate are established, we must then analyze our available data, aggregate SDoH and Quality of Care (QoC)/Affordability of Care (AoC) data and apply outcomes (decision and collaboration frameworks) from stages 1 & 2 (E & P) to identify what issues to tackle first.

IDENTIFY – (AND ANALYZE)

The Identify phase of EPIE is what determines your program backlog. This step is critical to understand the varied factors of SDoH and how they affect the population an organization serves.

Data Teams should be directed by outcomes of the decision and collaboration frameworks built in the E and P phases to identify health disparities and contextualize issue areas.

Identifying the causes of health disparities requires the use of both quantitative and qualitative data. SDoH can include education, housing, employment opportunities, healthcare, and public health systems. To determine the varied factors that contribute to health disparities which impact the overall population, this must be broken down into the differences in health outcomes among the diverse groups in the population. Using this, Data Teams will be able to communicate to leaders which health outcomes pose the greatest opportunity to be able to be addressed through the frameworks built in the earlier phases.

Achieving this will help to determine which health outcomes align with the culture of equity an organization has established in the P phase. Leaders will be able to determine the program backlog. This Identify phase will give leaders the opportunity to organize, plan, and create actionable steps backed by data to Execute intervention projects to mitigate the identified areas of inequity.

EXECUTE – GROUND UP ACTION

The Execute phase of EPIE is where organizations that have a structure of equity and leaders that are backed by the culture of equity internally and externally can implement intervention projects to mitigate the identified areas of inequity.

The implementation of various projects requires a very defined and tactful approach to project management. Project management is a very crucial element of the Execute phase. Successfully done, project management will help leaders ensure project success.

To achieve this, projects at the operational level will align with the HE goals and objectives to address the health inequities that an organization has identified. Project governance becomes critical in this final phase of EPIE, as it aids in ensuring projects that are critical to the health of the population are meeting the requirements established by leadership. By determining requirements, leadership will also determine project success criteria and define Key Performance Indicators to support project success.

If you would like to learn more about our EPIE approach and updated HE program assessment, please click here:

Whether your organization is interested in advancing HE and not sure where to start or you have already kicked off a multi-year HE program: Trexin’s capabilities and expertise can help you “get to done”.

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