How Truveta is aiming to improve health equity

When it comes to data, Charlotte Baker says she feels like a kid in a candy store.

Baker is the director of epidemiology and health equity lead for Truveta, a company formed and governed by some of America’s top U.S. health systems. Truveta gathers de-identified patient data from more than 700 hospitals around the country.

Now, Truveta is offering more data and insights on social determinants of health.

“I get to really help pose some really cool questions for a tremendous internal research team, as well as really help the health systems come up with interesting ideas and good ways to use social determinants of health (data), and to really hope that we can use this data for saving lives,” Baker says.

In an interview with Chief Healthcare Executive®, Baker talks about the work that Truveta is doing, the potential for data to close gaps in health disparities, and advice for hospitals and health systems that are looking to improve health equity.

“We can have a more equitable future,” Baker says. “We know we want a better clinical outcome. We know we want our systems to run better. This is the way.”

Truveta is pulling together an enormous amount of data, she says. “We want to use it, we want others to use it. And you know, the sky's the limit.”

(See part of our conversation with Charlotte Baker in this video. The story continues below.)

Maternal health

Truveta is supported by 28 large health systems, including Providence, Tenet Healthcare, Northwell Health, Advocate Aurora Health, AdventHealth, and more.

Earlier this year, Truveta added information on 28 social determinants of health, including income, education, housing needs and more, on nearly 80 million de-identified patient journeys, the company said. Working in partnership with Lexis-Nexis Risk Solutions, Truveta now has more than 400 different social drivers on health for those looking to gain more insights.

• Read more: Health equity can’t be ‘a side hustle’

Truveta has developed more data on the social determinants of health involving maternal health outcomes. Federal data shows maternal mortality remains a sobering problem. Maternal deaths rose 40% in 2021 compared to the previous year, according to figures released in March by the National Center for Health Statistics.

Baker said Truveta is looking at social determinants of health data in preeclampsia and the risk of heart failure.

“There's a huge problem with maternal health,” Baker says. “We don't have enough information about it.”

Baker marvels at the granular data on health equity now available on maternal health. Beyond arbitrary income levels such as whether the patient earned more or less than $25,000 annually, Baker says there’s data available within a few thousand dollars, allowing a more detailed picture of patients who may be struggling to pay for groceries.

“We know that there's certain medications that require you to eat to take those medications,” Baker explains. “Those are the types of questions we can really start to answer and dive into.”

In addition, Truveta is getting physicians’ notes about patients, which can offer critical information.

“When we talk about patients who maybe are low income, not being able to have good outcomes, that patient level information in those notes is going to tell us what the doctor wrote down about that patient, and what the patient said to them,” Baker says. “That is so rich. That is some amazing information.”

When asked why there isn’t more known about maternal health when it’s long been acknowledged as a serious problem, Baker said the data simply hasn’t been available.

“It takes a lot of time, it takes a lot of money, it takes a lot of resources, it takes really big brains,” Baker says. “And the fact that Truveta has been able to do that is really a testament to people just going, ‘You know what? We're tired of talking about it. Let's do it.’ So the big thing, I think, is that we've been able to create this data set in such a way that we now can get to the nitty gritty of answers.”

Even though some healthcare professionals and researchers have been alarmed by America’s maternal health failures for years, Baker says there’s a greater sense of awareness and urgency to help patients have better outcomes.

Health systems have reached the “turning point between, we know something, and we're going to do something,” Baker says. “And I think everybody's on the spot right now … you've got to do something.”

• Read more: Making health equity sustainable: Helping patients and the bottom line

Better interventions

With more detailed information on health issues in patients with poor outcomes, hospitals and health systems can gain more knowledge on the causes of their health issues.

With Truveta’s data, Baker says, “ I can see every single thing about this patient, everything they've done, everything they've said, within the clinical system. And then I can tie it with these really cool social determinants of health and pieces of information. It means that we're really being able to look at this in a whole new light.”

With more insight on the cause of patients’ health challenges, Baker says, “ We can actually create some better interventions, because we know exactly what we're looking for.”

The added details on social drivers of health hold promise beyond maternal health, Baker says. Health systems can gain more knowledge on patients with rare diseases. Hospitals are hampered by limited data on less common conditions.

"You've got not only enough patients, but you've got more data about them," Baker says. "As an epidemiologist, I am floored. I'm super excited, like a kid in the candy shop.”

• Read more: Hospitals and health equity: Examples of novel strategies

Focus on prevention

With more health systems focusing on closing disparities in underserved populations, Baker stresses the importance of efforts to address the social determinants of health.

“You’ve got to spend a lot of time on prevention,” Baker says, adding, “We know that prevention is far less expensive than the cure.”

While race and ethnicity aren’t going to change, health systems, working with partners, can take steps on food insecurity and other social drivers that can be addressed and make a real difference in the health of communities.

“I've seen some different clinical systems, where they hold farmer's markets to make sure that their patients have access to those fresh foods, making sure that you're having ride-shares for appointments, making sure that patients can get to appointments,” Baker says.

In some cases, health systems may need to start some of their own efforts, which Baker says will still be less expensive than treating patients in the intensive care unit down the road.

“Figure out where you want to put your money,” Baker says.

Hospitals may need to partner with some social service organizations or government agencies for some programs, Baker says.

Smaller hospitals in particular should work with community partners on issues such as housing, food and education programs. “Find those community partners,” she says.

Hospitals also need good data to determine where patients and communities need more help. She says hospitals can look at their own data, or they can turn to Truveta for assistance or even other community partners.

“I think it's really about partnership,” Baker says. “And that's the beauty of what Truveta has been doing. Because you can't do this alone. You can't do any of this alone. If I'm trying to solve a housing problem, I can't just do it by myself, I’ve got to talk to other people. So the same thing goes with health. If I want to solve a health problem, everything else is involved.”

“So that's where the beauty of social determinants and knowing about that is helpful,” Baker says. “But you've got to talk to those around you.”