Eliminating Race-Based Clinical Algorithms in Healthcare Organizations

Eliminating Race-Based Clinical Algorithms in Healthcare Organizations

A recent survey conducted by the American Medical Association (AMA) has revealed that half of healthcare organizations surveyed have either eliminated or are actively working to eliminate race-based clinical algorithms and decision-making tools. These tools have historically used race as a proxy for genetic or biological ancestry, which can lead to inaccurate assessments and biased healthcare outcomes. Aletha Maybank, MD, the AMA’s chief health equity officer, emphasized the importance of this advancement during a special session on health equity at the AMA’s House of Delegates interim meeting in National Harbor, Md. In order to further explore this issue, the AMA plans to publish a peer-reviewed article to delve deeper into the topic.

The survey highlighted the efforts made by the Medical Society of Delaware as an example of progress. The society took steps to eliminate the use of the race correction factor in estimated glomerular filtration rate (eGFR) calculations throughout the state by contacting all known labs. This initiative demonstrates a commitment to providing equitable and accurate healthcare assessments.

The AMA surveyed a total of 84 organizations, including state and territorial health associations, specialty societies, and city/county health organizations. The rate of responses varied among different types of organizations. For instance, the survey received responses from 58% of the state and territorial health associations, but only 6% of the city/county health organizations provided feedback. Blair Aikens, MPH, senior data analyst at the AMA, noted that the lack of response from city and county organizations may be attributed to the absence of regular communication channels with the AMA.

Challenges Faced by City and County Health Organizations

According to Aletha Maybank, the AMA’s chief health equity officer, the capacity of city and county health organizations may be smaller compared to specialty societies and state associations. These organizations often have limited staff numbers, which can hinder their ability to actively engage with the AMA. To address this issue, Maybank stressed the importance of finding alternative means to reach out and connect with these organizations, such as exploring different survey formats.

Efforts to Incorporate History and Local Context

The survey also discovered that 74% of organizations have taken steps to ground themselves in history and their local context, while 72% have made equity a strategic priority. This signifies a widespread recognition of the need to address historical inequities and embed equity into organizational practices.

During the question-and-answer session at the House of Delegates meeting, members expressed frustration regarding the slow progress of diversity, equity, and inclusion (DEI) efforts. Lynn Parry, MD, a delegate from Littleton, Colorado, acknowledged the efforts made by her state medical society, but highlighted the existing disconnect between diverse communities and medical societies. It is necessary to bridge this gap to foster a sense of inclusivity and encourage participation from all healthcare professionals.

Many delegates raised concerns about involving medical students and residents in DEI issues. Jade Cook, a medical student at the University of California Los Angeles, stated that while her class is diverse, her colleagues are hesitant to join the AMA due to its historical shortcomings in valuing diversity. Sanjay Desai, MD, the AMA’s chief academic officer, addressed this concern and stated that the AMA is actively working to demonstrate the value of membership and engagement with the organization. Efforts include financial support to universities and engagement with students on the ground to showcase the impact of the AMA’s work.

The AMA is currently collecting information from House of Delegates members through a Strategic Planning Survey to inform the updated strategic plan for 2024 and 2025. This demonstrates the association’s commitment to continuously evolve, advance, and address the challenges faced in promoting diversity, equity, and inclusion in healthcare.

Healthcare organizations are making progress in eliminating race-based clinical algorithms and decision-making tools that inaccurately use race as a proxy for genetic or biological ancestry. The AMA’s survey sheds light on the efforts being made to ground healthcare in history, prioritize equity, and bridge the existing gaps. By recognizing the challenges and working collaboratively, the healthcare industry can strive for a more inclusive and equitable future.

Health

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