1. Healthcare and Diversity
Vindell Washington, MD, MHCM | Principal Deputy, Office of the National Coordinator

2. Disclosures
• The views expressed herein do not necessarily
represent the views of the Department of
Health & Human Services or the United States
Government (5 CFR §2635.807)
• No other disclosures
2

3. Determinants of Health
Powerful, complex relationships exist between health and
biology, genetics, and individual behavior, and between health
and health services, socioeconomic status, the physical
environment, discrimination, racism, literacy levels, and
legislative policies.
These factors, which influence an individual’s or population’s
health, are known as determinants of health.
Healthy People 2020

4. Influences on Health
• High-quality education
• Nutritious food
• Decent and safe housing
• Affordable, reliable public transportation
• Culturally sensitive health care providers
• Health insurance
• Clean water and non-polluted air

5. Diversity

6. Diversity = Difference
GOAL
Recognizing individual as well as group
differences, treating people as individuals, and
placing positive value on diversity in the
community and in the workforce.

7. All I Needed to Know About
Diversity in Healthcare
I Learned in Kindergarten

8. Remember the first word you learned, LOOK.

9. Gender and Heart Disease
Heart disease is a diagnosis that has killed more women than men every
year since 1984.

10. A Look at the Evidence

11. Race and Heart Disease
Gap between death rates for blacks and whites remains as large as in 1950.

12. A Look at the Evidence

13. Patterns of declining county‐level heart disease mortality by
race–sex groups, continental United States, 1973–2010.
Adam S. Vaughan et al. J Am Heart Assoc 2015;4:e002567
© 2015 Adam S. Vaughan et al.

15. One of These Things
(is Not Like The Others)

19. Do unto others as you would have them do unto you.
Treat other
people the way
they want to be
treated

20. St. Egidio DREAM Project

21. “A DREAM? Sant'Egidio Fighting HIV/AIDS in
Mozambique”, Chapter 10 in K. Marshall and L.
Keough (eds), Mind, Heart and Soul in the Fight
Against Poverty, World Bank, Washington DC,
2004.
St. Egidio DREAM Project Results

22. The DREAM model's effectiveness in health
promotion of AIDS patients in Africa; Oxford
Journals, Health Promotion International; (2009).
St. Egidio DREAM Project Results

23. U.S. Comparison
Laine C, et al. Adherence to antiretroviral therapy by
pregnant women infected with human immunodeficiency
virus: a pharmacy claims-based analysis. Obstet
Gynecol. 2000;95:167-173.

24. Improving the way providers are incentivized, the way care
is delivered, and the way information is distributed will
help provide better care at lower cost across the health
care system.
Better, Smarter, Healthier
Source: Burwell SM. Setting Value-Based Payment Goals ─ HHS Efforts to Improve U.S. Health Care. NEJM 2015 Jan 26; published online first.
}
“ {
Pay
Providers
Deliver
Care
Distribute
Information
FOCUS AREAS
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25.  Encourage the integration and coordination of clinical care services
 Improve individual and population health
 Support innovation including for access
INCENTIVES
 Bring electronic health information to the point of care for meaningful use
 Create transparency on cost and quality information
 Support consumer and clinician decision making
Focus Areas Description
CARE DELIVERY
INFORMATION
 Promote value-based payment systems
– Test new alternative payment models
– Increase linkage of Medicaid, Medicare FFS, and other payments to value
 Bring proven payment models to scale
 Align quality measures
A health system that provides better care, spends
dollars more wisely, and has healthier people
Source: Burwell SM. Setting Value-Based Payment Goals ─ HHS Efforts to Improve U.S. Health Care. NEJM 2015 Jan 26; published online first.
25

26.  Encourage the integration and coordination of clinical care services
 Improve individual and population health
 Support innovation including for access
INCENTIVES
 Bring electronic health information to the point of care for meaningful use
 Create transparency on cost and quality information
 Support consumer and clinician decision making
Focus Areas Description
CARE DELIVERY
INFORMATION
 Promote value-based payment systems
– Test new alternative payment models
– Increase linkage of Medicaid, Medicare FFS, and other payments to value
 Bring proven payment models to scale
 Align quality measures
Big Picture: A health system that provides
better care, spends dollars more wisely, and
has healthier people
Source: Burwell SM. Setting Value-Based Payment Goals ─ HHS Efforts to Improve U.S. Health Care. NEJM 2015 Jan 26; published online first.
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Pre-decisional. For internal discussion only. Do not distribute.
A health system that provides better care, spends
dollars more wisely, and has healthier people

27. Nationwide Interoperability Roadmap
27
Goals:
2015-2017: Send, receive, find and use priority data domains to improve health care
quality and outcomes.
2018-2020: Expand data sources and users in the interoperable health IT ecosystem to
improve health and lower cost.
2021-2024: Achieve nationwide interoperability to enable a learning health system,
with the person at the center of a system that can continuously improve care, public
health, and science through real-time data access.
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28. Commitments and Call to Action
Consumers easily and securely access their electronic health
information, direct it to any desired location.
Share individual's health information for care with other providers and
their patients as much as permitted by law and refrain from blocking
electronic health information.
Implement federally recognized, national interoperability standards,
policies, guidance, and practices for electronic health information and
adopt best practices including those related to privacy and security.
2828

29. Information about the health of individuals is the building block for a
healthier community.

30. HITCOMP
• HITCOMP is a searchable database designed for educators,
workforce developers, current and future workforce members,
eHealth management, staffing experts and other interested
parties in healthcare information technology/eHealth.
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Roles Competencies

31. 31

34. Kayla and Kristine
UVA School of Medicine, Class of 2017

35. When you go out in the world, hold hands and stick together.

36. @ONC_HealthIT @HHSONC
QUESTIONS?
Vindell Washington, MD, MHCM
vindell.washington@hhs.gov
@VindellW