The Regional Coalition to Eliminate Race Based Medicine (Regional Coalition), launched today. The Regional Coalition will work with its members to remove “adjustments for race” from 15 clinical decision-support tools commonly used that could negatively impact patient outcomes.
Children’s Hospital of Philadelphia is part of the Regional Coalition, as are Doylestown Health and Grand View Health. Also included in this coalition are Jefferson Health Main Line Health Nemours Children’s Health Penn Medicine Redeemer Health St. Christopher’s Hospital for Children Temple Health Trinity Health Mid-Atlantic Virtua Health. Independence Blue Cross has convened this group to focus on 15 clinical decisions support tools that can adjust results depending on race. This could cause delays and inequities with care. The group will collaborate to eliminate race as a factor in certain tools. The group will also work together on alternative best practice that does not reinforce the biological understanding of race.
Clinical guidelines and clinical decisions tools assist doctors in determining the best care to provide for their patients. In some cases, race is still used in these tools, even though it’s not an objective trait. The use of race as a factor can negatively impact the care that a patient gets. This can have a negative impact on their outcome. The spirometry is a test that’s widely used to measure a patient’s lung function. In many cases, the equations used to interpret test results include race. They assume that Black or Asian patients will have smaller lung capacities than their white counterparts. The test failed to detect lung diseases in many Black and Asian people.
To begin, the Regional Coalition will focus on 15 clinical tools:
- Arteriosclerosis and Cardiovascular Disease Risk Estimator
- Breast Cancer Surveillance Coalition Risk Calculator
- Estimated Glomerular Filtration Rate (eGFR)
- Fracture Risk Assessment (FRAX),
- Heart Failure Risk Score
- Kidney Donor Risk Index (KDRI)
- NCI Breast Cancer Risk Assessment tool
- Osteoporosis Risk SCORE
- Pulmonary-function tests/Spirometry
- Guidelines for Anemia Based on Race
- Rectal Cancer Survival Calculator
- Society of Thoracic Surgeons’ Short-Term Risk Calculator
- Urology STONE Score
- Calculation Guideline for UTI
- Calculator for Vaginal Birth After Cesarean (VBAC).
Independence is a member of Accelerate health equity, and many participants are also members of this Regional coalition. These organizations work together in the Philadelphia region to fight systemic racism and health care barriers.