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Remote Collaborative Specialist Panel Deployment to Address Health Disparities in the RICH LIFE Project.
Lena Mathews1, Edgar R Miller, Lisa A Cooper
1Author Affiliations: Johns Hopkins Center for Health Equity (Drs Mathews, Miller, Cooper, Marsteller, Ndumele, Antoine, Carson, Ahima, Daumit, Oduwole, Onuoha, Brown, Dietz, Avornu, Chung and Crews), Welch Center for Epidemiology, Prevention, and Clinical Research (Drs Mathews, Miller, Cooper, Ndumele, Carson, Ahima, Daumit, and Crews), Department of Medicine (Drs Mathews, Miller, Cooper, Marsteller, Ndumele, Ahima, Daumit, and Crews), Department of Psychiatry and Behavioral Medicine (Dr Antoine), Department of Emergency Medicine, Johns Hopkins University School of Medicine (Dr Avornu), Baltimore, Maryland; Department of Epidemiology (Dr Cooper and Carson), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; and University of California, San Francisco School of Medicine (Ms Onuoha), San Francisco, California.
A Remote Collaborative Specialist Panel showed limited but positive reception for managing hypertension and comorbid conditions in underserved populations. Modifications could enhance its role in addressing healthcare disparities.
Area of Science:
- Health Disparities Research
- Cardiovascular Medicine
- Health Services Research
Background:
- Individuals with low income and minoritized racial or ethnic groups bear a high burden of hypertension and chronic conditions.
- These populations often face limited access to specialist care compared to more socially advantaged groups.
- A Remote Collaborative Specialist Panel intervention was developed to address these disparities in comprehensive care.
Purpose of the Study:
- To describe the deployment of a Remote Collaborative Specialist Panel intervention.
- To assess the intervention's aim of comprehensive and coordinated management of patients with hypertension and comorbid conditions.
- To address health disparities through improved access to specialist expertise.
Main Methods:
- A mixed-methods approach was used within the Reducing Inequities in Care of Hypertension: Lifestyle Improvement for Everyone (RICH LIFE) Project.
- Participants with poorly controlled hypertension or uncontrolled comorbidities after 3 months were referred to the Specialist Panel.
- The panel comprised specialists in internal medicine, cardiology, nephrology, endocrinology, and psychiatry, discussing cases remotely. The RE-AIM framework was utilized.
Main Results:
- Only 6.3% of eligible participants (19 out of 302) were referred to the Specialist Panel, predominantly women (53%) and Black individuals (84%).
- Referral reasons included uncontrolled blood pressure, diabetes, chronic kidney disease, and medication issues.
- Barriers to panel utilization included perceived lack of need, a cumbersome referral process, and the remote nature; however, referring care managers found it valuable.
Conclusions:
- The Remote Collaborative Specialist Panel intervention was utilized minimally but received positively by referring clinicians.
- With necessary modifications to improve adoption, this panel model shows potential for addressing disparities in hypertension and multi-morbidity care.
- Further research is needed to optimize the implementation and impact of such remote specialist interventions.
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