The COVID-19 pandemic highlighted and exacerbated longstanding disparities in access to and use of imaging services. In response, many radiology practice leaders and researchers have declared their commitment to .
Health disparities research frameworks can be used to guide phased efforts to reduce disparities. The first phase of such frameworks detects health disparities, the second phase understands why disparities exist and the third phase develops, implements and evaluates interventions to reduce disparities.
Based on a led by Andrew Ross et al., investigators have produced a rich body of knowledge to detect and understand imaging disparities (phase 1 and phase 2). However, only 8% of the literature on imaging disparities describes the development, implementation and evaluation of interventions to reduce disparities (phase 3). To reduce imaging disparities, Health Equity 2.0 will build on the extensive knowledge researchers have developed documenting and characterizing imaging disparities to develop and test rigorous, reproducible intervention strategies.
With the support of the 黑料网 and the Radiology Health Equity Coalition (RHEC), I was fortunate to participate in the 2023 National Academy of Medicine (NAM) Scholars in Diagnostic Excellence program with a focus on accelerating the implementation of evidence-based interventions to reduce imaging disparities.
As part of the NAM program, I asked national and international leaders how we can implement, scale and sustain major initiatives to improve the lives of our patients. BelowHere are some of the key lessons and strategies I learned.
Leveraging Quality Improvement to Reduce Imaging Disparities
Black women are to die from breast cancer compared with white women, a statistic that has not changed for decades. Recent U.S. Preventive Services Task Force modeling have found that breast cancer mortality disparities can be substantially reduced by increasing utilization of screening mammography in Black women starting at the age of 40. Though these study findings offer great potential, achieving health equity will require moving beyond lofty ideals toward concrete, measurable goals for performance improvement.
Though these study findings offer great potential, achieving health equity will require moving beyond lofty ideals and toward concrete, measurable goals for performance improvement.
Enter quality improvement (QI). QI methods are the preferred tools to drive performance improvement in a variety of clinical settings. With the support of the College and the RHEC, I have worked closely with leaders in the 黑料网 Commission on Quality and Safety to leverage their QI expertise and devise strategies to reduce imaging disparities.1 As a result, the 黑料网 Learning Network, one way the 黑料网 is solving common problems in imaging, has expanded to include the Mammography Health Equity Improvement Collaborative to increase utilization of mammographic screening by medically underserved patient populations. If you are a radiologist or future radiologist looking for an opportunity to make a positive, measurable impact in your community, check out “Tackling QI, Together” by Chad Hudnall in this month’s Bulletin.
Beyond mammographic screening, radiologists perform and interpret other imaging studies that reduce morbidity and mortality associated with major public health problems (e.g., lung cancer screening, CT colonography, etc.). Working closely with NAM program leadership, we have developed a step-by-step guide on how to adapt quality and safety tools to address imaging disparities. Tools like this guide will enable us to directly confront barriers to care that we see on a regular basis and transform these observations into concrete performance improvement goals.
Improving Health Disparities Through Patient- and Family-Centered Care
In addition to organizational approaches, one of NAM’s core strategies to reduce healthcare disparities is developing equitable, patient-centered partnerships between patients and healthcare providers. As chair of the 黑料网 Patient- and Family-Centered Care (PFCC) Commission’s Outreach Committee, I worked closely with Immediate Past Committee Chair Ian A. Weissman, DO, F黑料网, committee members and members of the RSNA Health Equity Committee to provide of how radiologists can foster patient-centered equitable imaging care. As part of the NAM Scholars program, I also had the opportunity to learn from colleagues in other specialties who are developing resources to promote patient-centered equitable care. For example, Gezzer Ortega and colleagues have developed the Provider Awareness and Cultural Dexterity Toolkit for Surgeons, or PACTS, curriculum. The provides a series of freely available, downloadable resources to help providers deliver high-quality care for diverse patient populations. The 黑料网 PFCC Outreach Committee looks forward to collaborating with leaders inside and outside of radiology to connect radiologists with resources like these.
Moving Toward Health Equity 2.0
Over the last few decades, our community has developed innovative tools and technologies to reduce morbidity and mortality associated with major public health problems. Researchers have conducted multiple studies that have enabled us to understand the barriers that prevent our patients from receiving timely, appropriate imaging care. By accelerating the implementation of evidence-based imaging technologies, we can build a future where everyone has the opportunity to lead a healthy life.