Bringing Social Determinants of Health into the Health Care Paradigm

Currently, the Director of Population Health Informatics at Northwell Health, Harpreet Gulati, joined the New York-based healthcare chain as Senior Program Project Manager in 2015. He has been instrumental in addressing the social determinants of health and employing technology initiatives to ensure health equity to the patient population to accomplish overall well-being. Prior to joining Northwell, he was a Senior Project Manager at Emblem Health.

In an interview with Healthcare Tech Outlook, Harpreet Gulati, Director of Population Health Informatics at Northwell Health, talks about health equity and how the pandemic has propelled the shift towards addressing factors that influence health outside of the healthcare facility setting.

Could you give us an insight into your journey?

I’ve spent the last 15 years in the healthcare industry and have seen both sides of the pendulum-payers and providers.

In my current role, as the Director of Population Health Informatics OCIO at Northwell Health, I support my team and the department by providing Operational oversight to the various Population Health Technology Solutions and Innovative Digital Transformation Initiatives for improving the population health outcomes We are implementing AI, ML, Analytics, and other technology solutions to meet business demands such as care management, remote monitoring, tele-health, community health initiatives, etc. Our team works as a liaison and help provide strategies related to operational efficiency and healthcare solutions through the lens of achieving an overall holistic approach to Population Health. We understand the core business needs of our service line, and we match it out and implement the most appropriate technology solution that serves the need - whether it is in-house care management tool or external vendor implementations. We manage and support these implementations with our IT Partners.

What are the technological innovations you have seen evolve in the health care industry?

Technology is ever-evolving, and the health care industry is also keeping pace with it. Nevertheless, while choosing technological tools, we have to be accountable for multiple factors like federal regulations, HIPAA compliance, Interoperability, Acceptance, ROI, and the likes. There has been a huge boom in technology innovation in the past five years, with organizations making the best use of available technology to address the needs of the patient population and promote Total Health.

The whole dynamics of healthcare is changing as we move away from fee for service model for hospitals to value-based care. With the change in this revenue model, the role of technology and analytics become imperative for success. Multiple risk stratification analytical models are being developed to identify and follow the high risk patients and provide continuum of care outside of the health system setting.

The pandemic has further propelled the paradigm shift. With rapid need, our technology has advanced multi-folds as we promote remote monitoring, virtual visits, and tele-health has become a reality. We are in a major overhaul in how we deliver tailored health services to our patient populations. We are further learning about how each community needs are different and further understanding how we cannot have blanket strategies that don’t match all of our patient needs so therefore are hence even more committed to working with them to help them thrive.

What are the major challenges in the health care space today, and how can technology be leveraged to overcome them?

Over the past few years, health equity has become the buzzword around social determinants of health. It is about providing everyone fair and just access to healthcare. The move from fee-for-service to value-based care has accelerated the need to address the socio-economic factors/ social determinants of health (SDoH).

The pandemic has exposed the unsaid divide in our healthcare system for our underserved populations. The data proves that for certain demographic regions and populations - Hospital admissions, Infection Rates, Mortality Rates were much higher than the national average.

Northwell as an organization has setup a community health service line to explore opportunities to promote community health. We are making investments in technology solutions that help address the community needs. We have piloted multiples technology initiatives, using AI and ML to bring to light the social determinants of health influence on the patient populations we serve.

What are the technological initiatives that you’ve taken to create a comprehensive healthcare equity strategy?

We are working of many IT initiatives that help support addressing social determinants of health. One of the biggest gap was to identify the social factors that impact our patient’s health. We implemented health screeners across our health system - inpatient and outpatient facilities. The self-administered screener helps us capture these factors like living conditions, access to healthy food, financial hardships, safety, physical, and mental abuse, substance abuse, transportation issues, legal issues, etc. This helps build an index score for the demographic regions with the highest needs.

We have implemented a social referral platform to generate, track and manage referrals to Community Based Organizations to help address the SDoH. The referral platform is integrated with our EHR systems which helps close-the-loop for the social referrals. Using these technology initiatives, we are able to identify the SDoH and help connect with patients with community resources to address/mitigate them.

What do you envision for the company?

The pandemic has shown us how health care disparities affect the population around us. There is consistent data that shows certain demographic areas, race/ethnicity based population’s experienced disproportionate rates of illnesses and death due to COVID-19. This has generated concerns the healthcare sector and there is a push to incorporate social determinants of health into the total health care paradigm. Healthcare organizations are forced to account for factors that are external to the healthcare setting and greatly influence patient’s health.

As we explore the fundamental role of population health in revitalizing health systems beyond the pandemic, we are now pushing the use of ICD 10 – Z Codes billing for measures addressing the Social Determinants of Health. There are many community-based organizations promoting and developing structures and processes to support equality and make healthcare accessible for all.

What advice would you give to young professionals aspiring for a journey like yours?

Historically, healthcare had been on the back foot for innovative technology solutions. Advancements in medicine, tele-health, remote system monitoring and the likes, have forced the use of innovative technology solutions. Several big IT firms and start-ups are looking to capitalize on this push and gain market in this territory. The way we see healthcare will totally change in the coming years and I am really excited to be a part of it.

There is tremendous opportunity in this sector for young, innovative, disruptive thinkers to be a part of this HealthCare Technology Revolution and help reach the goal of “Total Health”.