Organizations across the country are implementing innovative strategies to identify and address disparities in cancer care. However, these inequities are too vast and complicated for any one organization to solve on its own. Efforts to advance equity in cancer care will require true collaboration across the industry, yet there are few forums for organizations to share ideas and insights.
To create this space for sharing thoughtful and impactful strategies, Advisory Board hosted a cross-industry event, Promoting Health Equity in Cancer Care: An Innovation Showcase, where eight organizations presented their approach to advancing equity in cancer care. This piece will cover the key themes that surfaced across the event and provide a synopsis of each organization’s approach to equity.
There is no “one-size-fits-all” approach to addressing disparities in cancer care—interventions must be localized and individualized where possible. In practice this means:
Meet patients where they are, with what they need
Patients’ cancer journeys are unique and different, requiring organizations to meet patients where they are, rather than the other way around. For example, digital solutions to address care inequity can provide in-between visit support at scale, but may inadvertently exacerbate disparities by requiring access to Wi-Fi or certain technologies. Similarly, care navigators work to remove patients’ barriers to treatment, but if the navigators are not trained in culturally sensitive care, they might harm a patient’s engagement with their treatment. Consequently, organizations must center their approach to care on patients at the margins and with the greatest needs or they risk reproducing disparities.
Actively foster patient trust by continuously gathering patient and community input well beyond an intervention’s launch
There are many patient groups experiencing historical and contemporary marginalization and mistreatment by the health care system. The result is that many patients mistrust providers and are hesitant to seek care.
Health care leaders can rebuild this trust by proactively and continuously gathering, incorporating, and iterating on patient, caregiver, and community feedback. Some of the best ways to gather input are conducting focus groups and story circles with patients and working with patient and community advisory boards. But gathering input is only the first step. Incorporating feedback into the design of care solutions is the most important part—recognizing that patients’ perceptions and values impact how they experience a diagnosis, access care, and interact with providers.
Trust-building should extend to intervention maintenance by sustaining dialogue with patients and community partners. A more culture-driven and long-term component of trust-building should be adapting hiring processes to ensure that staff reflect the patient populations served and are trained to deliver culturally sensitive care.
Leverage diverse data sources to identify disparities, prioritize interventions, and track progress
To identify disparities in care, organizations often stratify clinical and patient experience data by various sociodemographic factors (e.g., race, ethnicity, gender, insurance status) or conduct retrospective studies. Some organizations take this further and leverage social risk and social determinants of health data to understand the needs of their patient population and prioritize interventions accordingly.
Organizations must incorporate performance tracking metrics into the design of an intervention to drive accountability. This data can then be used to demonstrate proof of concept, yield greater insight into existing disparities, and iterate on the intervention’s design.
Center the patient’s humanity within the solution’s design
By leveraging human-centered design and prioritizing the patient's perspective during solution development, organizations elevate the patient's humanity, thus driving inclusivity within any initiative. For example, organizations may add elements of personification to digital tools, like giving the platform a human-like name, using friendly animations, and providing empathetic responses to patient-reported symptoms. Or, where possible, organizations add a human-support element to otherwise digital tools.
For face-to-face initiatives, organizations strive to incorporate community building elements. For example, story circles to gather input and community events can connect patients and families going through similar experiences.
Equip caregivers to support solution adoption
A cancer diagnosis has a profound impact not just on a patient but also their family and support network. Some organizations proactively design initiatives or care solutions with both the patient and caregiver in mind—recognizing that patients’ loved ones play a critical role as part of the care team. For example, some organizations gather both the patient and caregivers’ language and communication preferences to ensure that caregivers can effectively support the patient in their care. Other organizations offer caregivers the same psychosocial or nutrition support as their patients. When caregivers are supported, they are better equipped to manage the patient’s needs and support patient motivation throughout the treatment journey.
