HIMSS 2024 Dr. Bryan O. Buckley

Brian Urban:

Yes, this is the Healthcare Rethink Podcast live at HIMSS 2024, talking to the biggest innovators and changemakers, and this is completely impromptu. We have one of our good friends, Dr. Bryan Buckley, the Health Equity Director at NCQA joining us here. Bryan, what a lovely surprise.

Dr. Bryan Buckley:

Yeah, nice to see you, Brian, as well.

Brian Urban:

This is great because HIMSS is a newer conference slot on your schedule throughout the year. You're at a ton of social health policy conferences. How has HIMSS changed your perspective on the rest of digital health transformation as it exists today?

Dr. Bryan Buckley:

Well, one, this is actually a very important conference that I wanted to go to, especially given NCQA's role really in digital transformation. As we're thinking about our digital quality measures, as we're thinking about digital solutions, I wanted to make sure I was also understanding the lingo that everyone is using, but then also how we think about health equity by design and really looking and seeing on how people are incorporating health equity whole-person care into the work that they're doing.

Brian Urban:

I love that because whole-person care is something I think NCQA has been driving, especially with health plans. For the better part of the last decade here or so, your health equity accreditation program, absolutely exploding. I think last time I looked there was maybe 30 health plans? I don't even know what it's at now. It's probably well over.

Dr. Bryan Buckley:

Yeah. So 14-plus states now-

Brian Urban:

Wow.

Dr. Bryan Buckley:

... I think have adopted health equity accreditation.

Brian Urban:

Wow.

Dr. Bryan Buckley:

The list is growing each and every time.

Brian Urban:

Wow.

Dr. Bryan Buckley:

We just actually had our Health Equity Forum not too long ago in LA, and we brought together 400 Justice League folks together to really talk about how we actually can advance this work together.

Brian Urban:

It's amazing because every time I see you at a conference, we're in a different chair. You're hosting or speaking about something. I think the last time that I saw you speak was at NCQA Innovation Summit in Orlando, and you had an amazing panel. One of them was the health equity director, I believe maybe her title is Chief Health Equity Officer of CVS Health.

Dr. Bryan Buckley:

Yeah.

Brian Urban:

You also had an amazing-

Dr. Bryan Buckley:

Dr. Khaldun, yeah.

Brian Urban:

You also had an amazing group of other panelists come on there, Aneesh Chopra, the list goes on and on throughout NCQA's events they have in the Innovation Summit and beyond. How do you-

Dr. Bryan Buckley:

Yeah, just stay tuned to this Health Innovation Summit. I just finalized our panel, and so hopefully, we'll be announcing that shortly as well.

Brian Urban:

That's so exciting because it's not just talking about the movement with HL7 FHIR, which is critically important to quality data and capturing, but also what you're putting in place for programmatic solutions in terms of health equity. So you have your social needs screening. That's the biggest first step we saw in you all driving health equity to be integrated into health plans. How's that going so far, and what's the adoption been like? It's probably been a challenge, but it seems like health plans are really investing. A lot of health plans have a whole SDUH team or health equity program, not just social health workers that are a part of their clinical facing work, but they have more of a cohesive view. Is that what you're seeing?

Dr. Bryan Buckley:

A lot of the work that we're doing, I always like to remind people we work across the health continuum, so it's not just about health plans, but how are we working with healthcare delivery? How are we working with providers on even educating them on actually, how do you ask the question, "Do you have any social risks?" this is where I think the digital side of it actually comes in for when you were talking about HIMSS. We have to think of different modalities of how we actually engage people. There are some people that feel more comfortable saying things digitally. There are some people that like the paper version, but we have to find a way to get those results and make it digital.

Some people like having that conversation in the doctor's office, so the EMR system. So I think that is, we have been seeing a lot of great adoption. We've been coupling a lot of this work, not just about how we think about social drivers of health, but also how do we empower community health workers as well, and how do we build and scale those in organizations to be able to be your trusted messengers in the community to asking that question? A project that I had worked on in collaboration with the National Urban League, we just released a free education last year around how do you start and scale community health worker programs with community health workers actually helping to build that education?

Brian Urban:

I love that because I think a lot of your approach and then NCQA as well is to have health equity, not with a dollar sign next to it, but we have to have it authentically integrated. I love that you're looking at it from a digital perspective in terms of an EMR, so electronic medical records. Are you seeing a lot of the social needs screening data getting integrated into EMRs and becoming actionable, or is that really the next big step?

Dr. Bryan Buckley:

We're on a journey, and I think it's the adoption. Right now, we know within health, just the health field, I'm not going to say healthcare, the health field, there's so much fragmentation. Even a panel I was listening on earlier is thinking about how does emergency departments and ambulance folks actually ask those questions? How do they see what's going on? So I think it's figuring out where all the data is, and I think that's where we're on that journey of, how do we create a one-stop shop for people to really connect all the dots?

Brian Urban:

That is extremely helpful because I think if you talk to some other speakers, they want to tell you a solution or an exact thing. But I think having a realistic view of what you just explained, that we're on a journey. We're not there yet, but collectively we can do this together.

Dr. Bryan Buckley:

Exactly.

Brian Urban:

So looking a little bit forward here, I looked at the plans that you have for NCQA and the ecosystem in '25 and '26, it's amazing. In terms of health equity, but also in terms of data quality capturing with HL7 FHIR and really addressing interoperability, which is something you just spoke to. So can you give us a little bit of a teaser of what's ahead and how NCQA is helping address interoperability?

Dr. Bryan Buckley:

Yeah, so to preface it as we're talking about health equity, 'cause some folks have asked me, "Oh, health equity is this, and interoperability is that." I think as we're talking about whole-person care, I think that's the key part of interoperability we know. The simple way I say health equity is, is we're looking at your identity and we're looking at where you are, 'cause we know location and your identity and how you express yourself in the health system means something. There's sometimes differences in how people are treated. But when we're talking about interoperability, it's about capturing all those little pieces and data points. What religion? Where do you live? Do you live near sidewalks? Do you have public transportation? There's so many parts about the continuum of how we actually show up, the whole idea of the built environment, 'cause I know you're also-

Brian Urban:

Yes.

Dr. Bryan Buckley:

... team public health as well. So I think as we talk about intersectionality, well, right now, we're still talking about identity and demographics and kind of one dimension. Oh, let's do race/ethnicity stratification, which I think you have to start, or let's look at SOGI data, how we collect that. Those are all one-offs, but at one point, I think through interoperability, we'll actually start seeing being able to look at intersectionality and looking at compounding disparities and how do we actually have more targeted initiatives to actually making sure that people can thrive and be healthy?

Brian Urban:

Wow. I like that because you're talking about the whole view, and it's great to segment things, but the whole view is critically important to being able to address disparities. I am so excited that you're here. NCQA is leading a lot of digital transformation, a lot of policy improvement, I'll say, needed now more than ever, Dr. Bryan Buckley, give me a little bit of a view ahead of what you're taking away from HIMSS that might impact your work the rest of '24.

Dr. Bryan Buckley:

Ooh, that's a good one. Well, as I said, we're on a journey, especially when it comes to the digital transformation journey, we have a roadmap moving forward. I think the one thing that has impressed me is that one, we're actually a lot further along that journey than I originally had thought. You know I'm going to mention my Justice League here.

Brian Urban:

You got to.

Dr. Bryan Buckley:

We know there are so many superheroes across HIMSS right now, and we're all trying to figure out what's the best way. I think with this collective intelligence that we're seeing here at HIMSS, I see a brighter feature on how we're actually going to do this work.

Brian Urban:

That is exciting. I always love your optimistic view because you're always moving forward. Dr. Bryan Buckley, director of Health Equity at NCQA. Thank you so much for joining the show.