The Healing ARC is centered as a race-conscious intervention that addresses structural racism in patient care, while empowering Black & Brown communities
— Dr. Bram Wispelwey
BOSTON, MASSACHUSETTS, UNITED STATES, December 7, 2022 /EINPresswire.com/ — Foundation Focuses on Anti-Racism and Power Building to Transform Healthcare
Speaking at a virtual forum hosted Tuesday by the Universal Healthcare Foundation, Dr. Bram Wispelwey, Dr. Marcella Nunez-Smith and Universal’s President Frances G. Padilla cited the importance of implementing race-conscious interventions to address structural racism in healthcare.
”We anticipate that in the next decade our work will really be…embedded in that journey to build grassroots power for equity and justice in healthcare,” said Padilla, who moderated the panel. “And we know that racism is the through line. So, what I want to start with is asking why race-conscious approaches are needed to address structural racism in healthcare.”
Dr. Wispelwey, an Associate Physician in the Division of Global Health Equity at Brigham and Women’s Hospital (BWH) and an Instructor at Harvard Medical School, said there aren’t effective alternatives to race-conscious interventions. He noted that Dr. Nancy Krieger, a professor at the Harvard T.H. Chan School of Public Health, says the only alternatives are to be race blind or misuse race ignoring “the historical, social and political construct.”
Dr. Wispelwey recalled participating in a study at BWH that found, on average, in 2015 that fewer Black and Hispanic patients diagnosed with heart failure in the Emergency Department were admitted to the specialty cardiology unit that improves patient outcomes. In response, the physicians developed a race-conscious, care model called the “Healing ARC,” which addresses racial inequities and enhanced accountability.
Under the Healing ARC, which was introduced as a pilot program this year, when the emergency room treats a person of color with heart failure a more equitable process is in place. If a physician selected General Internal Medical service for a patient of color rather than the cardiology service, the clinician receives a “Best Practice Advisory” from the electronic health record system. The message reminds the physician that the patient is from a racial or ethnic group with historically inequitable access to the cardiology service. The physician can either change their decision and admit to cardiology or override the Best Practice Advisory and continue admission to general medicine.
At the forum yesterday, Dr. Wispelwey recalled the climate at the time the Healing ARC was developed.
“In my intern year, it was the peaking of the first wave of the Black Lives Matter movement,” he said. “It was the year Eric Gardner was killed, Michael Brown, Tamir Rice. And what we were noticing as residents because we worked in multiple areas of the hospital… when we were on general medicine, cardiology, that the patients weren’t the same. The patients coming in with heart failure were not sort of the same. We had our beautiful new cardiology building with nice lights and single rooms. And you had our general medicine, the Brigham Tower. With shared rooms and different sort of standards of care.
“And we know there were actually different outcomes and(when) heart failure patients would go to both of those services. What we noticed is that patients of color were more likely to go to general medicine. We looked at 10 years of data. And actually, we found out later that folks had looked at this data before and seen it had gone back even further. Two-thirds of White patients went to the cardiology service, but only half of Black and Latinx patients.”
Dr. Wispelwey said that even when controlled for all of those outside factors, such as insurance or whether the patient had a cardiologist, “we still had institutional racism.”
Citing the three stages of the Healing ARC engagement, Dr. Wispelwey, said, “The ARC stands for Acknowledgement, Redress and Closure.” He added that the Healing ARC seeks to close the “trust gap, massive trust gap” that many patients of color feel with regards to their healthcare providers and care. Healing ARC includes a “Wisdom Council” to channel community voices and insights to the BWH. Dr. Wispelwey is a leader of the Healing ARC Campaign, a prominent group of health professionals, community leaders, and healthcare equity advocates who are inspiring race-conscious collaborations that can help rectify patient care inequities in hospitals and care facilities.
Dr. Nunez-Smith also discussed the need to build relationships with the community to overcome anxieties.
“We have to speak truth about things like cost, payment and reimbursements,” she said. “And the policies to support it. We have to talk about data. What are we collecting? Who gets to make decisions? We have to talk out what we do with the data? How do we involve community wisdom and data governance? And then God, we have to really invest in these relationships that we claim to hold so dear.”
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