Principles On Health Equity
The medical device industry, at its core, exists to ensure patient access to safe, effective, and innovative medical technologies that save and improve patient lives. We are committed to ensuring that our mission is not compromised by the perpetuation of health inequities.
Inequitable treatment of patients, including patients of color, has deep roots that are linked to issues such as access to quality care, economic inequity, racism, and conscious and unconscious bias. These issues have deeply affected the way in which patients view the health care system, and in many cases, the way patients are viewed and treated by providers and engaged in the process for developing technologies and therapies.
Issues of social and civil injustice highlight the need to address health inequities generally and particularly within communities and patients of color. For instance, public health data reveals significant differences in the mortality rates for patients of color who were stricken by COVID-19 versus White patients. Social determinants of health, access to health care, affordability of care, and underlying medical conditions contribute to these disproportionate impacts. The prevalence of certain chronic illnesses within communities and patients of color also leads to devastating health impacts and decreased life expectancy.
AdvaMed, the Medtech Association, and our members have an important role to play in this effort, as we make the technologies and tests that result in improved patient outcomes and in the accurate diagnosis of diseases. We are collectively engaged in efforts to ensure that our industry is doing its part to mitigate the adverse impacts of health inequities and to advance health equity.
AdvaMed welcomes the opportunity to be a catalyst in addressing these longstanding issues in the context of medical device development and deployment. Disparities and inequity within the domain of health care and access to care have persisted for far too long. AdvaMed is committed to long-term action to reach real solutions. The following principles and considerations are intended as initial steps to guide industry as well as interested stakeholders including clinicians, health care providers, and health care facilities as we all embrace the long- overdue call to address these inequities.
1. Promoting Inclusion and Equity in Healthcare
Principle: Quality health outcomes are directly tied to access to high quality and unbiased health care. Patients should have access to quality health care, regardless of their location, via physical or virtual means. Patients should be treated equitably when engaging in health encounters. Providers should be aware of the role of bias in the way they interact with patients.
Considerations: The association and its members should facilitate the dissemination of information and materials that promote the unbiased treatment of patients. This work will likely require partnerships with other health care providers, as well as patient and practitioner groups, on various issues including educating the industry and others on identifying, acknowledging, and addressing bias. AdvaMed will also work to develop and support legislation that promotes equity in patient care. AdvaMed will also work to advance efforts that improve patient access to health care facilities and providers, physically or virtually, and to improve access to health care facilities and providers in underserved communities.
2. Partnering in Education with Stakeholders
Principle: Access to and the use of innovative technologies requires exposure to their existence. Patients who could benefit from lifesaving and life-improving technologies should be aware of the innovations that are best suited to their health conditions. We will develop information and materials to increase patient awareness of innovative technologies. Any materials will present information in a clear, culturally appropriate, and accessible manner. We also commit to the development of programs and pilots to ensure that clinicians who treat patients of color are aware of the existence, use, and benefits of innovative medical technologies. Educational efforts should align with the promotion of equity in health care and should also inform clinicians as to the underlying causes of current inequities for patients.
Considerations: This work will require outreach to and partnership with clinicians to educate them regarding disparate trends in patient care, including access to technologies. Policy should account for access issues that may be tied to lack of awareness, lack of resources, or other social determinants that may impact patient health, as well as willingness to access technologies. Efforts will require engagement and partnership with others to target outreach and education to clinicians. In addition, efforts will require engagement regarding newly developed technologies to clinicians treating patients of color, specifically. This work may also involve alignment and partnership with patient and practitioner groups that represent the interests of patients of color.
3. All Patients Deserve Access to Innovative Technology
Principle: The mission of AdvaMed is to ensure access to innovative technologies which improve patient lives. Access to technology should not be predicated upon type of insurance or insurance status, socioeconomic status, geography, gender, or race. Access to the best technology to support care is also predicated upon education about and awareness of options. We will advocate to ensure all patients are aware of the utility and availability of devices which best address their medical conditions. Access to technology that improves care delivery, such as telemedicine or remote patient monitoring, also depends on ensuring a robust broadband infrastructure is in place to support these technologies. The COVID-19 pandemic illustrated the importance of providing patient access to safe and timely care outside of traditional settings, a need that persists today.
Considerations: AdvaMed may need to develop and disseminate materials for use by patients, providers, and facilities. This principle accounts for the need to partner and work with external organizations to advance this goal. The association and its members should support legislation that promotes affordable access to care and the end of discriminatory treatment of patients linked to insurance coverage. The association and its members should also support legislation to incentivize the expansion of broadband or high-speed internet access to rural and underserved areas, with a focus on access in communities of color.
4. Promoting Research Equity in the Medtech Industry
Principle: AdvaMed and its members promote innovation in medical technology development and design. Our methods for researching and developing these technologies should reflect the population of patients who will benefit from them. We will commit to the adoption of methods that promote improved recruitment of potential patients for clinical trials and medical device development.
Considerations: Policy should account for historic distrust on the part of some populations due to racially biased treatment in the past. Efforts will require engagement and partnership with other stakeholders and groups to bridge the trust gap among patients and to promote the need for involvement in studies and research. This work may also involve alignment and partnership with groups specifically advancing the need for diversity among clinical investigators. Policy should be reflective of the need for innovative approaches to recruit and monitor subjects, including the use of primary care providers and the use of telehealth and digital medicine.