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Uncovering and furthering solutions to inequities in healthcare

For years, a critical component of Sutter’s health equity work has been increasing awareness among our health system leaders, clinicians and employees of this bias and of the importance of providing care guided by the principles of cultural humility. As more health systems work to expand their unconscious bias mitigation strategies, greater clarity and guidance are needed.

To address this, the institute recently hosted the Unconscious Bias in Healthcare Symposium alongside the California Medical Association, Physicians for a Healthy California and the California Primary Care Association, bringing together health equity experts, researchers, clinicians and policymakers for a day of focused discussion and problem solving. Insights from the event will inform the development of interventions and new evidence-based recommendations to help ensure future unconscious bias mitigation strategies are measurable and effective. These tangible recommendations will be released in early 2023 to help providers nationwide move closer to achieving the intended goal: improved and equitable outcomes for patients.

Bias can also exist in the scientific tools we use for clinical decision-making, affecting how we care for different groups of patients. Pulse oximetry (used to measure blood oxygen), which was so heavily relied upon during the pandemic, is a prime example. In September, our team published research that cites bias in the device, which could have led to significant COVID-19 treatment delays for Black patients. The findings—supported by a study published in JAMA Internal Medicine—not only contributed to our understanding of COVID-19 disparities experienced by communities of color, but also increased awareness around the need for changes to devices and our standards as a society in testing and approving them. I’m pleased that the Food and Drug Administration recently recognized this, too, and that our study adds to the mounting evidence under consideration to inform FDA deliberations regarding this specific issue.

Our institute is also focused on identifying bias in the algorithms used to determine patient risk factors for things like sepsis, hospital readmission and palliative care. Unwinding systemic racism from healthcare is an ongoing and multi-layered process that requires action from every facet of the healthcare industry. As health systems and other providers look to address bias in healthcare, we have an opportunity—and a duty to our patients—to get this right.

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