What is ‘techquity’ and why should businesses pay attention?

By Jay Bhatt, D.O., managing director of the Deloitte Health Equity Institute and the Deloitte Center for Health Solutions, Deloitte Services, LP

I recently returned from the second annual ViVE conference in Nashville. This year’s sessions covered a wide range of health care topics, including virtual health, ransomware and cybersecurity, interoperability, digital health…and health equity. About 7,500 health care executives, innovators, investors, and industry observers participated at this year’s event. 

I was joined on stage by my friend and colleague, Dr. Fatima Paruk, MD, MPH, Chief Health Officer at Salesforce—a cloud-based Customer Relationship Management (CRM) platform. Dr. Paruk previously served as chief medical information officer at Microsoft US Health & Life Sciences and was chief medical officer of analytics and consumer wellness at Allscripts. Appropriately, we were featured on the “Techquity Impact stage.” Techquity is the idea of using technology as a tool to make health and health care more equitable. 

What is health equity? The Deloitte Health Equity Institute defines it as the fair and just opportunity for everyone to achieve their full potential in every aspect of their health and well-being regardless of race, gender, ability status, or ZIP code. But health equity is not limited to health care companies. It is a business issue. Many employers are responsible for the health costs of their employees, which makes them stakeholders in employee health and wellness. Lost productivity, preventable illnesses, and high medical costs can have an impact on an organization’s success and profitability. In the United States, health inequities add about $320 billion a year to annual health care spending, according to Deloitte actuaries (see our report on the Economic cost of health disparities).

Dr. Paruk noted that while Salesforce is a technology company, it is also a values-driven company where values such as trust and equity are at the core. She acknowledged that some people might wonder why a tech company is paying such close attention to health equity. Here’s why: Deloitte estimated chronic care costs related to health inequities were costing Salesforce about $68 million a year. This estimate made it possible for Dr. Paruk to assemble a team that could look more closely at how Salesforce is addressing health equity—both internally and externally.

Three strategies to identify and address inequities

Dr. Paruk told attendees that her company’s efforts to address health equity started with a growth mindset, adding that it was important to make sure the company did not inadvertently exacerbate the issue it was trying to improve. “We admitted that we were not the experts and that we didn't know everything, but knew we had to start somewhere and learn as much as we could,” she said. “That became the foundation for significant progress last year.” We discovered that Salesforce had already been doing a lot of work around enabling health equity from a product portfolio and functionality perspective, especially in making products more accessible. For example, Slack enables work from anywhere. Products across Salesforce’s portfolio leverage automation for better work experiences and could reduce burnout and improve mental health.

Here are a few strategies we discussed that could help business leaders identify and address health inequities:

• Collect, measure, and interrogate data: Improving health equity often begins with data and measurement. You can't manage or improve what you don't measure. A close examination of data can help identify potential gaps. Benefits management and human resources teams can often provide high-level information about annual spending on chronic illnesses among employees. Unfortunately, other types of data (e.g., productivity loss, impact from mental health issues), which could help create a more complete picture of costs tied to health inequities, might not yet be considered. Dr. Paruk said “that was a challenge” because the data doesn’t exist, or it is not being looked at as part of a more holistic picture of employee health.
• Prioritize the challenges and set goals: Once the challenges have been identified, organizations should try to determine which ones to address first. Data should be tracked systematically and rigorously. A company, for example, might want to look at claims data to determine if there are differences in primary care visits, uptake of preventive care services and acute presentations of chronic diseases or readmission rates among men and women, or among people who live in different ZIP codes. If differences are identified, consider strategies to address them, and set goals for reducing the gaps.
• Look downstream to find upstream opportunity: Publicly available data might reveal some of the drivers of health that could be negatively impacting employees. What are the root causes of health inequities that occur every day? Employees who have diabetes, for example, could face worsening conditions such as end-stage renal disease or amputation if they don’t proactively manage their condition. Several years ago, an examination of claims data in one state revealed that residents of a rural county had strikingly high instances of lower-extremity amputations among residents with diabetes. After peeling back the onion, it wasn’t surprising. This small county had more liquor stores per capita than any county in the state. There were also fewer public outdoor spaces dedicated to physical fitness, and there were fewer primary care providers per capita compared to other counties.

Deloitte, Salesforce commit to advance health equity

At this year’s World Economic Forum meeting in Davos, Switzerland, Deloitte Global and Salesforce joined 37 other multinational organizations in signing the Global Health Equity Network Zero Health Gaps Pledge. The Pledge is a commitment to help advance health equity and support better health outcomes. Since then, nearly 60 companies have signed the pledge.

And in March, Deloitte joined the American Heart Association (AHA) and the Society for Human Resource Management to collaborate on the AHA’s Health Equity in the Workforce Initiative.  The goal of the initiative is to help positively impact the health of and ensure positive and equitable health outcomes for the 10% of the workforce who earn less than the national median income (about 10 million people) by 2025.

Every company is a health care company

Health inequities have been part of my reality for as long as I can remember. But the stark and disproportionate burden highlighted and exacerbated during the COVID-19 pandemic, helped to trigger change. Business leaders are now beginning to understand both the moral case and the business case for improving health equity. 

As I have said many times in the past, addressing inequities in health care is about more than doing the right thing. There is also a strong business case to be made for having equitable health. Let’s call it a moral imperative that has business solutions. Health equity should not be a side gig or an afterthought. Instead, organizations should try to evaluate their products and/or services through a lens of health equity. The practice of techquity can help companies understand how health inequities affect their employees and their bottom line. At the end of the day, every company is a health care company.

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