Shaping policy to measure and improve equity in health care systems

Small changes in health care processes can make profound shifts in equity and inclusion. Those steps matter not just for gender and LGBTQ equity and inclusion, but in equity for patients of all racial and cultural backgrounds.

Between 2017 and 2023, the number of Penn Medicine patients who identify as nonbinary increased from 14 to more than 4,000.

The reason? Providers simply started asking patients about their gender identity. These patients had always been cared for in the system, of course; Penn just worked to add a nonbinary gender option to the electronic medical records software. This effort not only focused on gender identity, but was part of a larger initiative to optimize Penn’s capture of patient data on race, ethnicity, ancestry, and preferred language.

Jaya Aysola and PJ Brennan.
Penn Medicine’s Jaya Aysola and PJ Brennan. (Image: Penn Medicine News)

For Jaya Aysola, an associate professor of medicine and pediatrics in the Perelman School of Medicine, it’s an example of how seemingly small changes in health care processes can lay the foundation for profound shifts in equity and inclusion. Those steps matter not just for gender and LGBTQ equity and inclusion, but also to make health care more equitable for patients of all racial and cultural backgrounds.

“It’s a technical, behind-the-curtain fix, but it has such meaning,” she says, “because you’re identifying people who were never recognized before in your organization, and for the first time these patients are feeling seen within their health care system.”

Aysola is also the founder and executive director of Penn Medicine’s Center for Health Equity Advancement (CHEA). Through CHEA, she has led efforts to bring greater equity to the health system since 2015—years before equity and inclusion became major priorities for improvement in other health systems. Now, Penn Medicine’s efforts are helping provide a road map for policy for equitable health care, with a new statewide program that issues incentive payments to hospitals for taking key steps for equity.

With the support of Penn leadership, including the GME office, Jeffrey S. Berns, vice president and associate dean of Graduate Medical Education, and PJ Brennan, chief medical officer, Aysola developed the Blueprint for Health Equity and Inclusion, a five-year strategic plan intended to bridge the gap between thought leadership and hands-on practice.

Aysola also established CHEA within the office of Penn’s chief medical officer, with executive sponsorship from Brennan and Eve Higginbotham, vice dean for Inclusion and Diversity. That positioning would prove to be essential in implementing systemwide changes, she says.

This story is by Ilima Loomis. Read more at Penn Medicine News.