The In Full Health initiative is dedicated to creating a community that centers equity within health innovation investment, development, and purchasing efforts. Part of these efforts includes establishing a framework for shared understanding around issues of equity that can enable us to have meaningful conversations and drive change.
With this goal in mind, the In Full Health initiative — along with founding collaborators and advisors — has created a Solution Development Toolkit designed to help solution developers ensure that the health innovation products or services they are building are meaningfully advancing health equity.
Dr. Chris Gibbons, MD, MPH, is the founder and CEO of The Greystone Group and a member of the AMA External Equity & Innovation Advisory Group whose input was essential in the development of the toolkit. Here, he shares his reflections on the drafting process and discusses why the toolkit is an essential resource for developers who want to create more equitable health solutions.
Key Toolkit Takeaways
1.
The toolkit provides a common language and vocabulary for discussing health inequities clearly and directly.
2.
Issues of health inequities are complex — and addressing them in the health innovation pipeline is going to take dedicated work, reflection, and collaboration.
3.
The “Ten Actions Solution Developers Can Take to Center Equity in Health Innovation” presented in the toolkit provides a helpful starting point for assessing and understanding equity in health innovation — even if the full assessment seems daunting.
In Full Health (IFH): What was your approach for developing the Solution Toolkit and who was involved?
Dr. Chris Gibbons: The process really was the initial brainchild of Chelsea Hanson and Aletha Maybank at the AMA. Initially, they brought on 15 external advisors, and I’m one of them. Together, we had a series of meetings over many months to talk about these health equity issues, strategize, understand where the priorities are, and essentially come up with the draft outline of the principles.
In addition to that, an external third-party organization, CareContent, did interviews with approximately 30 leaders from around the country who had been doing this kind of work for a long time and got their feedback about the same types of issues. That information was collected, synthesized, and analyzed in a report given to the AMA.
The AMA then shared it with me and the advisory board for our expert input, suggestions, and revisions to produce the final document. Now, we plan to have even more validation with a wider audience.
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SUBSCRIBEIFH: Why was the feedback process — and including multiple collaborators and reviewers — so essential to creating the IFH Solution Toolkit?
Dr. Chris Gibbons: There is no evidence that the majority of solution developers today have meaningful expertise or experience in health equity or with marginalized and underserved populations. Also, individuals from underserved communities are usually not meaningfully nor iteratively involved in the design or development of digital health solutions developed today. Yet many founders and developers say they are creating solutions for “all.” It is hard to imagine how these solutions could be the best solutions for individuals from underserved populations.
We wanted to make sure that this was not the case with the development of this toolkit. We believe this is one of the best ways to help ensure that it is an objectively valuable tool for those who are serious about making improvements in this area.
Expressing Gratitude
Luis Belen and the folks over at the National Health IT Collaborative for the Underserved have been doing this kind of work since 2008 in many different kinds of communities. Their expertise in engaging underserved populations, thinking about their problems from their perspectives, speaking with them, and communicating with policymakers is very, very deep. They are one of many whose perspective and input were absolutely invaluable to the creation of the toolkit.
Dr. Chris Gibbons, MD, MPH
Founder and CEO, The Greystone Group | Member, AMA External Equity & Innovation Advisory Group
IFH: Could you provide an overview on how to engage with the Solution Toolkit and which types of audience(s) this may be most helpful for?
Dr. Chris Gibbons: Many products say, “Oh, they’re designed for everybody.” But there’s plenty of evidence to suggest it’s exceedingly difficult to build a high-quality product just for everybody. This toolkit actually outlines methodologies that can be used to assess a solution or idea. It can help solution developers understand how their tool will or will not likely be impacting one or more inequities.
The toolkit was put together really targeting solution developers, but it can also be utilized by people who are investing in, purchasing, or making resource allocation decisions. It can help you look at solutions you may want to invest in to see if there is objective evidence that it would likely improve a health inequity.
IFH: Is there anything important someone should keep in mind when utilizing the Solution Toolkit? What kind of mindset do you need going into this?
Dr. Chris Gibbons: Truly — humility. To be quite honest, it’s very easy to believe that you have the answer. It’s also easy for us to get our friends, relatives, and those close to us to give us feedback and validate our understanding. But far too often, those people who are giving the feedback are limited to people who are like the solution developers themselves and not like those from underserved communities.
Because of this, there are going to be things that developers are not even going to think of. As a result, the designs may just not be as ideal for users from marginalized communities. You’re not a terrible person if you get feedback that says, “This is just not going to work,” or, “We need to change this.” It just means that you weren’t informed about that. This is something you hadn’t experienced or you didn’t know. That’s when it’s time to just be humble and say, “Okay, what do we need to do to go forward?” In the end, it’s all about humility.
IFH: Why is the toolkit such an important tool for solution developers to use?
Dr. Chris Gibbons: We’ve proven to ourselves that we haven’t gotten it right yet. So what do you got to lose? This is an evidence-based methodology. We’ve got the experts putting this together who have really been involved in doing this from the community. This can only help.
IFH: What’s next for the toolkit?
Dr. Chris Gibbons: We see the toolkit as a living, dynamic document. Even though it’s gone through multiple levels of development, review, and refinement, we think that it’s always best to continue that process going forward. We strongly encourage feedback about it, and we are very excited to be able to share it with the In Full Health community.
From problem identification, to initial solution ideation, through ongoing evaluation and iteration, the toolkit is designed to help solution developers ensure that the health innovation products or services they are building, meaningfully advance health equity. Download the toolkit today.
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