“L.A. has some of the most innovative and experimental payers and providers in the country, and a huge and diverse patient population. Add to that an exploding tech talent base, and there’s no better place to build and test the next great healthcare technology, model or service,” says Kevin Zhang, Partner at Upfront Ventures, the largest venture capital firm in Los Angeles with $2B assets under management and member of ScaleLA, a community of startups in the L.A. healthcare sector.
This clustering of innovation brought together more than 300 of the brightest minds in L.A. recently for the Southern California chapter of HIMSS 2019 annual conference. On their minds was how health IT can be leveraged to address health disparities and increase health equity for all populations – especially the most vulnerable in L.A., including the homeless and Latinx communities.
The L.A. area healthcare providers, payers, government agencies and tech startups see tremendous potential for increasing health equity through information and technology. There’s a palpable sense of determination to enhance patient engagement, improve documentation of social determinants of health, and address barriers to high-quality patient care for vulnerable populations who have multiple chronic diseases and higher health risks.
Innovation Hub: ScaleLA
Los Angeles is positioning itself as the next hub of U.S. healthcare innovation. In 2016, ScaleLA was founded to “empower entrepreneurs to chase solutions to the systemic problems that face our society.”
In 2018, the group opened a 15,000 square foot health innovation space in West L.A. called “The 10th Floor.” The goal is to build collaboration and communication between startups, community leaders and the public sector. ScaleLA supports over 50 startups in the health, wellness, and life science industries by providing office space, industry specific programming and strategic introductions with partner payers, providers, investors and government figures.
Taylor McPartland, CEO of ScaleLA, explains, “It’s ScaleLA’s mission to provide innovators and entrepreneurs with the resources they need to secure funding, build partnerships with healthcare leaders, and provide value back to the community.” Included among ScaleLA’s partners are many of the region’s most prominent healthcare providers and entrepreneurial executives.
Omkar Kulkarni is chief innovation Officer at Children’s Hospital Los Angeles (CHLA) and a member of the ScaleLA Steering Committee. “Boston, Seattle, Chicago, Denver and other cities with health tech ecosystems have strong hubs that enable the comingling of entrepreneurs, investors, providers, payors and government officials,” he says. “I’m excited that L.A.’s growing digital health sector now has ScaleLA as another hub, and we at Children’s Hospital Los Angeles look forward to being an active, supportive member of this health tech ecosystem.”
As part of the SoCal conference, HIMSS presented the top award in the CHLA/HIMSS Latinx Health Equity Developer Challenge award to Ariel McNichol, co-founder and CEO of MotiSpark, a health tech startup located in the ScaleLA space. MotiSpark earned first place in a competition seeking solutions to improve health equity among Latinx youth in California. MotiSpark capitalizes on behavioral science and the addictive power of smartphones to inspire positive changes in health via personalized motivational videos.
Interoperability in Community Clinics
Community Clinic Association of Los Angeles (CCALAC) has a mission to promote community clinics and health centers as providers and advocates for expanding access to quality health care for medically underserved people in Los Angeles County.
Aisha Iqbal is Director of Health IT at CCALAC and remembers when she first took on this role in 2013 to coordinate data at 65 community health centers, serving over 1.6 million uninsured or underinsured patients. At that point, all the patient information was recorded on paper charts. The process of transitioning their 350 sites to electronic health records (EHR) and joining health information exchanges has helped the association improve care by achieving interoperability between health systems, hospitals and specialty care.
The association made a critical advance in understanding and serving patients by implementing PRAPARE, a 21-question assessment of social determinants among their underserved patients. In 2017, eight organizations participated in the pilot funded by Blue Shield of CA which secured responses from about 2,500 patients of varying populations.
Findings showed 43% of patients did not have adequate material security (housing, food, etc) and led to identification of the Top 5 social determinants of health risks for their population: Less than high school education, non-English speaking, uninsured, lack of transportation, and unemployment. The data is now integrated into the community clinic EHRs.
Healthcare Delivery + Social Services
“Health disparities and social determinants of health are a predictor of the cost of care of an individual. What we’ve been missing is an integration of social services with the delivery of healthcare,” says John Baackes, CEO of L.A. Care Health Plan, the nation’s largest publicly operated health plan serving over two million members. During a fireside chat at the Southern California HIMSS Chapter conference, Baackes shared that his organization strives to identify the social determinants that define members on an individual basis, recognizing they differ from one person to the next.
“If we aren’t addressing that 25 percent of our members are homeless – we’re never going to be able to provide appropriate care,” says Baackes. “If we’re going to move the needle in health disparities we need solutions aimed at people in the circumstances they are in.”
L.A. Care Health Plan aims to identify social determinants and mitigate them. This includes methods to integrate social services into the health plan so care managers can become agents for housing subsidies, CalFresh food stamp program, and other social safety net programs often in bureaucratic silos that require those in need to spend a week moving between offices in order to sign up for services.
As a sign of commitment to integrating healthcare and social services, L.A. Care Health Plan invested $20 million over a five-year period to an agency that matches homeless individuals with housing. “If we’re not housing people when they’re ambulatory, what are we going to do with them when they become older?” says Baackes. “At some point, they’ll be on the street and sent to an ER and then to a nursing home. Boom – housing problem solved. But now we’re paying for it out of our tax dollars when we could have provided housing earlier.”
As a more economically effective solution, L.A. Care leased recuperative beds for homeless patients and then found them permanent housing. Baackes sees these kinds of solutions as essential to moving the needle on the issue of social determinants of health. “A health plan serving this population must take on the bigger role of matching the needs of the member to other social services that they’re eligible for -- and making that connection happen.”