Electronic Health Reporter

Garth Graham, M.D., M.P.H., specializing in cardiology, is the current president of the Aetna Foundation and former deputy assistant secretary at the U.S. Department of Health and Human Services (HHS) during both the Bush and Obama administrations. Here he discusses the Aetna Foundation, improving quality of care, how the health IT community continues to change, how can it best be used as a positive tool for better health outcomes, even at the individual level.

Tell me about the Aetna Foundation and your role within the organization? How does the Foundation impact healthcare community?

The Aetna Foundation is the philanthropic arm of Aetna, Inc. funding a number of activities across the country that promote thought-leadership and community-based impact as well as research around improving health outcomes. As the Foundation’s president, I oversee the philanthropic work, including grant-making strategies aimed at improving the health of people from underserved communities.

Overall, at the Aetna Foundation we seek to impact the healthcare community by supporting research and organizations focused on improving the health and wellness of individuals throughout the United States.

How do you go about working to improve the health status and quality of care of the individual and community?

Our Digital Health Initiative is the most recent example of our efforts to fund both national and local programs that are striving to limit healthcare disparities among vulnerable populations, as well as increase positive health and wellness outcomes for individuals. Through this initiative, we are supporting technology that can empower individuals with the convenience and control to meet their personal health and wellness goals.

We hope that by arming individuals with the best possible tools to improve their health, we can ultimately build healthier communities.

Tell me about your funding methods and how you determine where the money to support programs goes?

All organizations we are supporting through our Digital Health Initiative must meet strong evidence-based criteria. These criteria include sustainable projects that can demonstrate scalability; projects that have the potential for positive societal impact; digital health programs that leverage available evidence, such as population health data or health care data; and digital health support built on a strong foundation of behavioral or applicable theory and grounded in research.

When organizations come to us we ask that they either demonstrate how they’ve met these criteria previously and/or how they plan to meet them with the upcoming project. Our ultimate goal is to make an impact in vulnerable communities nationwide and our funding helps support organizations with goals that align with that mission.

Tell me about how your view of the health IT community has changed since you were with HHS?

A lot has happened in the health IT space over the past few years. From the federal government standpoint, there has been a tremendous focus on electronic health records and how to promote them in the clinical community. Since leaving HHS, I have seen that individuals are also starting to look more at how technology can be used to influence behavior change. This has evolved from just looking at health information technology as a methodology that focuses on electronic health records, to looking more at how technology can positively impact behavior change in individuals and communities for improved health outcomes.

Moving onto technology and its impact on healthcare, how can it best be used as a positive tool for better health outcomes, even at the individual level? Mobile technology: How does it specifically have the ability to impact vulnerable communities nationwide? What are some of the most vulnerable communities?

Technology has the potential to be a very powerful tool in transforming communities and positively impacting individual’s behaviors. In fact, most individuals today are already using technology as part of their daily lives. According to Pew Research Center, one in three individuals have used mobile phones to access information about health in general. By impacting individual health, you can then impact community health. It all starts with the individual and meeting people where they spend their time is a great way to encourage positive health behaviors.

Not only do vulnerable communities experience disparities in healthcare, studies have shown that heart disease and diabetes are two of the top 10 causes of death for African Americans (CDC). Certainly, the link between access to health care and reduced health risks has been made, and that is one motivating factor in working to eliminate disparities in care. The disparities in care is shown again in African Americans who are 4 times more likely to experience high blood pressure, yet are less likely to have their blood pressure under control (HHS). Innovative solutions are critical when considering ways to empower vulnerable communities with tools that allow them to manage their own health.

We see unique opportunities to help close this gap in health disparities by leveraging digital health. Promising research shows that African Americans, Latinos or individuals between the ages of 18 and 49 are more likely to gather health information from their cell phones than other groups (Pew Internet). This shows the enormous potential that digital health offers in transforming the way we manage overall health and wellness, especially when trying to reach vulnerable communities.

How is the Aetna Foundation helping vulnerable communities with digital health technology?

In an effort to positively impact health outcomes in vulnerable communities, we have given more than $1.2 million in grants to 23 local organizations across 13 states that are impacting health and wellness in their communities through the innovative use of technology. These grants are part of a larger $4 million, three-year digital health commitment for the implementation and evaluation of technology innovations to help address public health concerns. Additionally, the Aetna Foundation supported a call for papers in the March issue of the American Journal of Public Health. By supporting research on digital health technology, we are working to further its overall goal to improve health in vulnerable and minority communities.

What types of organizations is the Aetna Foundation currently supporting through this initiative?

The Aetna Foundation is funding a number of grantees who are working on community-based activities using technology as a way to improve health outcomes. Currently, we are supporting a diverse group of organizations, including regional hospitals, healthcare organizations and grassroots interventions all focused on convenient ways to leverage existing technology to improve health.

One of the many organizations we are currently supporting, Institute for eHealth Equity in Cleveland, Ohio, created a program called Text4Wellness that examines how individuals can use two-way text messaging in faith-based communities to improve health outcomes within the congregation. By funding programs like this, we aim to make health information easily accessible to vulnerable communities by using tools that conveniently fit into individuals’ daily lives.

How can people use technology like smart phones to take charge of their own health? What other technologies and tactics can actually benefit patients and “engage” them?

We believe that digital health technology can serve as a powerful equalizer for improving health education and access to care among minority and low-income communities by reaching people where they are spending time – at school, at church, in their neighborhoods and on-the-go. Our Digital Health Initiative encourages individuals to use technology that fits into their daily lives, and also advocated for incorporating one’s healthcare provider into the decision making.

Whether you prefer to use an app to track daily workouts or exchange emails with your doctor before choosing a new food product, the overall goal is to meet you with the technology you’re already comfortable using—where you are already using it. This ease of use offers an impactful, simple way to create positive health outcomes.