Ashlee Wisdom, Co-Founder and CEO of Health In Her HUE
We can all appreciate the satisfying feeling of being deeply cared for or connecting with another human who can relate to us through shared experience, condition, or situation. For patients of color–especially Black women–seeking help from healthcare professionals can involve issues relating to race and the impact of systemic racism on the physical and mental well-being of themselves and their families. So how can patients of color truly feel cared for if they feel unable to connect–or unseen–by their provider who may not share the same lived experience? Ashlee Wisdom is tackling this challenge head on through her health startup, Health in Her HUE, a digital platform that connects Black women and women of color to culturally aligned and competent health care providers, health content, and community.
Ashlee Wisdom is an experienced public health professional. She is the Co-Founder & CEO of Health In Her HUE, a digital platform that connects Black women and women of color to culturally aligned and competent healthcare providers, health content, and community. Health In Her HUE’s mission is to reduce racial health disparities by leveraging the power of technology, media and community to improve health outcomes for Black women.
As a public health professional, Ashlee is a champion for health equity, and is passionate about taking an equitable approach to healthcare innovation. Most recently, she worked for an advisory firm, Junto Health, where she was the Program Director for the Strategic Ventures Group, an exclusive consortium of nationally-ranked health systems investing in health technology. Earlier in her career, Ashlee managed the recruitment and regulatory activities of a large-scale clinical trial at Weill Cornell Medicine. Prior to that role, Ashlee worked for a Federally Qualified Health Center, identifying and securing federal, state, and private funding, and establishing strong relationships between the health center and local community organizations and foundations. Wisdom also served as the Assistant Director of Grants Management in the Office of Population Health at NYC Health + Hospitals.
Wisdom received her BS from Howard University, and her Master of Public Health with a focus in Healthcare Policy & Management from New York University.
Show Notes
Ashlee Wisdom shares her experience and how she discovered inequities in the healthcare system. [03:09]
What should be included in patient-centered care delivery? [04:56]
How do we fulfill the health care needs of traditionally marginalized patients? [05:57]
How will technology transform health care in the future? [07:28]
How can we use data to measure the quality of health care? [11:49]
How can we encourage patients to share information on race and ethnicity to create a more equitable system? [15:13]
Are there any concerns among vulnerable populations and public health in the rise of investment capital in health care? [17:39]
What are the two ways we can train providers to become aware of systemic issues? [21:17]
How can we identify culturally sensitive providers? [25:19]
What major structural change could help health care become more equitable? [27:19]
Why is equitable and quality health care a benefit to everyone? [28:34]
Transcript
Jason Helgerson 0:00
Hi, I'm Jason Helgerson, and you're listening to Health2049.
Ashlee Wisdom 0:09
So I think an equitable approach to health care means providing care to these patients based on their unique needs and also based on the ways that they've been marginalized in the past. And so for patients of color in particular, that may look like connecting them to providers who are either culturally or racially aligned, or who have gone through the necessary trainings and are undergoing continuous trainings to provide more culturally sensitive and more culturally competent care to them, and really allowing patients to be the leader in determining who can provide the most adequate care to them. I think that that's really what it will look like.
Jason Helgerson 1:19
We can all appreciate the satisfying feeling of being truly cared for, connecting with another human who can relate to us through shared experience, condition or situation. For patients of color, seeking help from healthcare professionals can involve issues relating to race and the impact of systemic racism on the physical and mental well-being of themselves and their families. So how can patients of color truly feel cared for if they feel unable to connect with their provider who may not share the same lived experience?
Today's guest is the co-founder and CEO of Health In Her HUE, a digital platform connecting black women and women of color to culturally aligned and competent healthcare providers, health content and community. Ashlee Wisdom is actively seeking to infuse equity into the health care ecosystem through this work. It is my honor to hear Ashlee's vision for a more equitable health care future. I'm Jason Helgerson, and you're listening to Health2049. And it's my pleasure to welcome Ashlee Wisdom to our program. Ashlee, welcome.
Ashlee Wisdom 3:00
Hi, Jason. Thank you for having me.
Jason Helgerson 3:03
Great. So maybe we could start by asking you to give us a little bit more about your interesting background.
Ashlee Wisdom 3:09
Sure. So I started my career actually working for a federally qualified health center, I'm based in New York, that health center was based in the Hudson Valley. And that job actually opened my eyes to the inequities in the healthcare system. And I am very passionate about that issue. So I went on to get my Master's in Public Health, with a concentration in Health Care Policy and Management from NYU. And then from there went to work for an academic medical center, worked for New York City Health and Hospitals in their Office of Population Health, doing a bit of research, and clinical trial management and recruitment.
In between those two jobs, I became very passionate about addressing the inequities in the healthcare system, and particularly for women of color and black woman. And decided I wanted to build a startup. But if I was going to build a startup, I should probably work for one to really understand that landscape and so I left Health and Hospitals in the research space to work for a consulting firm where I was working with strategic health care investors, and got to really understand the business and venture capital side of health care. And in my time in that role, I became very interested and keen on how are investors and health care innovators approaching innovation through an equity lens, and I didn't really see too much of that happening. And so I wouldn't say the rest is history. But that's why I'm really passionate about what I'm building now with Health In Her HUE. So that's a bit about my professional background.
Jason Helgerson 4:34
Fantastic. All right. So very interesting background, both on the public health side but also on the entrepreneurial side of health care, which is a very exciting space today. So with that background and that diversity of experience, what is your vision for the future of health care? What will health and health care look like in the year 2049?
Ashlee Wisdom 4:56
Yes, I would say in health care we often talk about patient-centered care or personalized health care. But today, I don't think that that's truly what we're seeing. And so in 2049, I do believe and I hope that I'm right that patient's lived experiences, and their social and cultural contexts will be taken into account in care delivery. And I see that as being the future of health care because we're seeing a lot of consumerization of health care, and a lot of talk about the inequities. And so I think by centering patients lived, social and cultural contexts and experiences is the direction that health care will be moving in. And I believe that we'll see a more equitable or trending to become a more equitable healthcare system if that approach is taken.
Jason Helgerson 5:40
Great. So let's double click on this a bit. And let's talk about the patient experience as a start, what does a more equitable health care system look like and feel like to your average patient in the year 2049?
Ashlee Wisdom 5:57
Yeah, right now, patients of color in particular and there are a lot of intersecting identities, patients of color, patients who identify as LGBTQ+, they have been traditionally marginalized by the US healthcare system. And so I think an equitable approach to health care means providing care to these patients based on their unique needs, and also based on the ways that they've been marginalized in the past. And so for patients of color in particular, that may look like connecting them to providers who are either culturally or racially aligned, or who have gone through the necessary trainings and are undergoing continuous trainings, to provide more culturally sensitive and more culturally competent care to them, and really allowing patients to be the leader in determining who can provide the most adequate care to them. I think that that's really what it will look like.
Jason Helgerson 6:49
Great. So let's talk a little bit about technology. Obviously, your company is a web-based platform, and hence, because of that, it has the ability to connect with and support and help women all across the United States, but I guess my question gets into is, is a culturally competent, linguistically competent, truly person-centered health system in the future, how vital is technology? How will that technology really transform how services are provided, roughly 30 years in the future, in 2049?
Ashlee Wisdom 7:28
So I often say that the technology is critical in terms of making sure that health care is more equitable and accessible. It's not the panacea because we can definitely perpetuate some of the current inequities that we see if technology is not utilized in an equitable way. But to go back to how can it be critical and important in improving health equity?
We know right now, I'll speak in the context of Health In Her HUE, that many patients of color are actively seeking out providers who look like them who are culturally aligned, or who at least come vetted by other patients of color who've had positive experiences with providers. But there aren't enough providers who are black Latinx, black indigenous people of color, there's just not enough providers who come from diverse backgrounds. And we can go into all the reasons why that's the case. But that is a current state of affairs.
One of the ways that technology is well-positioned to help bridge some of these access gaps is, you might be a patient of color and in let's say Nevada or someplace that's really rural, you may not have access to a doctor who you feel they understand your unique lived experiences. But through telehealth, for example, you can at least have a consultation with a provider and ask them, look, these are the only doctors who I have access to, I really want to connect and speak with someone who I feel like understands my lived experiences. And those are some of the ways that patients will be more inclined to engage with the healthcare system and to engage with providers when they have access to providers who have traditionally been out of reach now that now they do have access to them. So that's just kind of one example that I can think of.
I'll share one anecdote where that's kind of been the case with Health In Her HUE. We had a black gastroenterologist who was listed on our platform; she shared with us that a patient drove 3 hours to come and see her with her husband waiting in the car. Three hours because she felt like the specialist that she had access to was dismissing her pain and not taking her seriously and she couldn't find a black gastroenterologist locally. So she went on Health In Her HUE, found this specialist and felt it was worthwhile to drive 3 hours to go and see her to get that second opinion. And so one of the ways I see technology being a great asset in this instance is, this woman most likely had to take off time from work, her husband accompanied her, so that's probably both of them taking off time from work, if they had a telehealth platform that allowed them to easily connect with the specialist, that would have alleviated that time that they had to travel. They could have figured out, is it worth me driving three hours to see the specialist? In some instances, that may have been the case. But if they were able to have a virtual consult, they could have made that decision in a more efficient way versus having to take the time to travel out there. So I think that that's a powerful example of how technology can bridge access and also provide access, and also provide equity because this patient was able to see a provider who she felt would see her humanity and who would take her concern seriously.
Jason Helgerson 10:24
Yeah, so I think that's a great example. And I think helps the audience really wrap their head around the challenge, but also the opportunity here that technology can bring. It makes me think of one of our guests in the first season, who looking at behavioral health access through an equity lens, basically had come to the conclusion himself and he's a talk therapy provider, that you would never get to a truly equitable behavioral health system without artificial intelligence and the ability of people to access services, not only virtually but having machines actually be the talk therapist. It was his belief that you could never quite get to truly accessible culturally competent care without that technology. that we just couldn't hire and train our way and place individuals there in the community for that face to face type service. So it's interesting to think about the exciting possibility that technology brings and in terms of achieving a truly equitable health system. One of the things I wanted to dive in a little bit is in this future state, how will we measure equity? How will we measure quality health care, do you see that ultimately being different than it is today?
Ashlee Wisdom 11:49
I see it being a little bit different. I do think we're starting to think about ways in which we can measure whether or not our care delivery services or a system is equitable. I think the first thing is being intentional about data collection. One of the things that I've realized or come to be made aware of is that many people have not been collecting certain data and data around race and ethnicity. Even though we know that these inequities exist, it's almost like, if we don't see it, we can ignore it. I think now, especially with COVID, we recognize that we need data to see the state of affairs and figure out where we need to plug in solutions and address things from an equity standpoint, but if we don't have the data to recognize where the gaps are, and the disparities are, we're really just hoping that the solutions that we're putting out there actually helpful.
So I think data collection is one important thing, but I think we also start to measure and this is again, going back to data, measuring and tracking how engaged patients who are traditionally disengaged with health care, we're seeing that improved and seeing patients go to more preventative care services, that's probably an indicator that patients are finding the providers that are best meeting their needs. So I think that those are two things that come to mind. And also thinking, I know the social determinants of health is a buzzword in health care, especially in public health, but also really taking that into account and making sure that providers and people in health care are factoring that as well, because you can't really get a big picture of a patient and how their their outcomes are improving, if we're also not taking into account their social and cultural context and the things that they have access to and don't have access to.
Jason Helgerson 13:35
So one of the challenges in and I agree with you that we have not done a very good job systematically of collecting information on race and ethnicity. But as a former Medicaid director, over quite a few years, I remember that the debate that occurred and Medicaid programs in most states across the country don't do a very good job of collecting data when individuals enroll, and usually the questions around race, ethnicity are not mandatory. They're optional questions. And so when people apply for Medicaid enrollment, and so as a result, the reporting, the actual number of times that information is actually collected can be fairly low. And the argument against making those mandatory fields in the application was that they would deter individuals from applying for the program. The was concern was that people, by providing that information they may be discriminated against, or it'd be used against them in some way.
So I'm interested in what your thoughts are on this question around, whether it's Medicaid or Medicare, or for commercial insurance or anywhere else in the healthcare system, about what we can do to begin to really collect this information on a systematic basis because I think to a great extent that while we have studies that show that we have disparities, we aren't really able to collect it and track our progress in any sort of systematic way.
Ashlee Wisdom 15:13
Yeah. And I understand the sensitivity around making those questions mandatory. But I always push back on that framing, because I think if you share with people why you're collecting and what's the intention behind collecting that data is for, my conviction is that they'll be more inclined. And if we're transparent about wanting to address the inequities, and we find a succinct, but also transparent way of explaining how one intends to use that data, I think people will be more inclined, but just asking it and mandating it, people will feel like it's going to be used to discriminate against me or to cause me to not get access to whatever services and supports that I need. But if there's transparency around why the data is being collected, and how one intends to use it, I do think that people would be more open to sharing the data, especially if it's to their benefit.
Jason Helgerson 16:13
Gotcha. So I want to dive a little bit into, you mentioned your background as both on the safety net public health side of the healthcare system working for a federally qualified health center. But then you've also worked in venture capital and you are an entrepreneur starting a business. And I think one of the important megatrends in health care today has been the rise of investment capital into the sector. And with that, the launching of some interesting, innovative companies that, like yours, are seeking to yes, they want to be successful as a business and attract investors to support them in that effort. But they also have a very clear public health, goal and objective.
While I am enthusiastic about this entrance, there are others who are raising concerns about the potential impact of venture capital funding on the healthcare system and on the goals of organizations who receive that funding. And I'm just wondering what your thoughts are, are you an unabashed supporter or do you see potential concerns? Or what are your thoughts on the rise of investment capital in health care, in particular, with the focus on vulnerable populations and public health?
Ashlee Wisdom 17:39
Well, I'll say this, Jason, I don't want to use the word reluctant, my investors probably wouldn't want to hear that, but I'm a cautious capitalist because I do see the potential risk of dollars and health care is a lucrative business in the United States. I have a lot of concerns and questions about health care being seen as a business and that's why we see the inequities that we see, but I do echo some of the concerns and sentiments that people have about a lot of money being funneled into private companies and dollars, probably not being allocated to more of the safety net companies and organizations.
But I will say that I do think that startups are well-positioned to approach some of these big problems in health care. And I hate to use the buzzword, innovative ways and new and fresh ways that other organizations are not incentivized to do, like you apply for grants, you show that your program is being successful. But sometimes the status quo can be enough. And I do think that companies that are venture-backed, they're well-positioned to approach some of these large problems in different and unique ways that could potentially move the needle.
However, I do say that with a caveat that if we are not thinking about addressing these problems, from an equity standpoint, we're just building on and layering on solutions. without addressing the systemic issues that are causing many of these problems. We're not really moving the needle. So I know that this is kind of like a cop out response. I do think it's both and, but I do understand the concerns that people have with all this capital being funneled into health care through these startups and these private companies. And are they really driving equity, whereas these nonprofits and federally qualified health centers are supporting those people who are most in need. But I do think both have played their role. And I'm hoping that we one day live in the United States in a country where we don't have to rely completely on safety net organizations because we will see the healthcare system operating in a more equitable and an efficient way. Hopefully, that's 2049. But we'll see what that actually pans out to.
Jason Helgerson 19:57
I couldn't agree with you more and I aspire to the same. When you talk about your company, and obviously part of your objective is to connect women, particularly black women seeking care to providers, who are also either black or black women, and the research clearly shows that you can get to better outcomes because of shared experience and such. But what you also talked to is the idea of tapping into other providers who have been trained, and have received some special training or effective training, so that even if they don't have the same shared experience, they can be more effective and using that as a vehicle to meet the needs.
I'm wondering if you could dive a little bit more deeply into what kinds of trainings, how optimistic are you that that would work? And what the potential implications for all of this is for how we train providers, how we teach them? And how medical schools work, because I think sometimes it feels to me like we're talking about more the symptom as opposed to the core problem, which a core problem being how we educate physicians and other types of providers in the health system.
Ashlee Wisdom 21:17
I'm so glad you asked that question, Jason, because I always tell people that building Health In Her HUE, our large thesis is that connecting patients to providers who share their lived experiences, they're more likely to engage in preventative care services. And there's actually research that shows that there's a 40% increase in utilizing healthcare services. One study found when, I believe the participants were black male patients who were seen by black doctors, and that the doctors took more thorough notes, and the patients who are more inclined to adhere to their medical advice and guidance. And so while the data does show that, we're not advocating for a segregated healthcare system, we're not saying that black woman patients should only see black woman doctors or black doctors, but we do know that the outcomes do improve. So the nascent research is showing that.
However, to the point that I made earlier, there just aren't enough black and Latinx doctors to go around for every black patient that would want to see one. And again, that shouldn't have to be the case. So because of that, we do see an opportunity to provide trainings so that providers understand the lived experiences of black and brown people who are living in the United States, that there are systemic issues that cause the disparities and disparate outcomes that we see and help them understand that big picture. Why are black patients more likely to have diabetes and heart disease, like really understanding the social context behind how we got to where we are.
I think that level of education and training can be done in medical school, I love talking to doctors who have public health degrees. And I really wish that public health education was wrapped into the medical school experience, because there's so much that I learned in my graduate studies, and doctors really need to understand this. People who are caring for patients in a clinical setting really need to understand that they're not just dealing with the patient sitting in their office, but they need to understand the social and cultural contexts that this patient is having to move through. Because once they leave the office, they're having to navigate through a world that impacts the way that they're able to manage their health. So that's one thing.
On Health In Her HUE side, we don't think that there's ever going to be a one and done training that makes a provider culturally competent. And even providers of color have their own biases. So we don't think that there's one and done training that's going to make you a culturally competent doctor, we think it's an ongoing process. And one of the ways that we want to support that is through curating, the same way that we're creating content for the patients to inform them on how to best manage their health, we want to provide ongoing training content to providers that's CME accredited so that they're incentivized to stay aware of the issues that are disproportionately impacting patients of color. It's also a way of them becoming better doctors generally, and then also better doctors to patients who are more marginalized.
So that's really my perspective on it that on a macro level, medical schools really should incorporate public health learning into their curriculum. And then on the technology side, we're finding ways to support providers who really want to become better and more equipped providers for marginalized patients. And that's the way that we're approaching it. We don't think it's a one and done thing. We think it's ongoing learning, where we can support providers in knowing both the social and cultural context of patients of color, but then also the clinical and medical issues that are disproportionately impacting certain patient populations.
Jason Helgerson 24:52
So are you envisioning like a certification process or to use very health care centric the Continuing Medical Education Program or how will you, in essence, vet or help individuals that come to your website looking for culturally competent care, how will you help them vet and identify who it is that really is best suited to help them meet their needs?
Ashlee Wisdom 25:19
Yeah. So on the provider side, we don't believe in reinventing the wheel. So we do plan on curating existing educational content that CME accredited for providers and making it easier for them to find the content that will support them and being be more culturally sensitive providers.
And then we are also building out our own bespoke and custom content for providers who are listed on Health In Her HUE and that content will really be around the issues and diseases that disproportionately impacts women of color. So we plan on curating this content library, a mixture of existing content that we don't need to reinvent. Then also custom content that's specific to the unique needs of women of color and black woman so that providers on our platform are well equipped, they have access to it, and can engage with that content, get their CME credits. If they engage with that content, we plan to have it displayed on their provider profile.
So if I'm a patient, I go to Health In Her HUE, let's say have breast cancer, I can see that this doctor not only specializes in breast cancer, but also has taken some trainings. And I see it listed on their profile to show that they've done the extra work of understanding the specific things that black woman face or need to consider as they are given a breast cancer diagnosis, so to speak. And so that's the way that we're actually approaching that. We don't think that any provider is ever going to be completely done and just have this badge of honor saying that they're culturally competent. We do think it's an ongoing process. And that's the way that we're approaching it.
Jason Helgerson 26:50
Gotcha. All right. So now I want to ask you to think about all the things that you're already working on today in terms of your company, and your broader vision for an equitable health care system by the year 2049. If you could wave a magic wand and and make one major structural change happen in the American healthcare system, what would that major structural change be?
Ashlee Wisdom 27:19
The one that comes to mind, a structural change that I would make is the way medical school admissions, and making sure that diversity, equity and inclusion is really better reflected in that process so that there's a better pipeline of diverse doctors. So the point I made earlier, I don't think that every black patient needs to be seen by a black doctor. But I do think the lack of representation of diverse physicians is a big part of the problem that we see right now with the disparities. And so that is one of the structural changes that I would make, is making sure that medical school admissions process and even the way that medical school operates so that diverse medical students aren't dropping out because of the racism or the discrimination that they're facing while they're matriculating. That is one of the key structural changes that I would make if I could just wave a magic wand.
Jason Helgerson 28:14
All right, so we get to this point in the show where we like to ask our guests to take a step back and basically envision that world of 2049 and your vision for the future, your vision for an equitable healthcare system has been achieved. And in let's say we get there and hopefully we will, how will that make the world a better place?
Ashlee Wisdom 28:34
Giving equitable and quality health care to the most marginalized patients in the United States will ultimately impact everyone for the better. And so I think once we provide more equitable and targeted health care for those who have traditionally been underserved or overlooked, I think we'll see a more efficient healthcare system. We'll see costs go down and health care spend go down and we'll see outcomes actually improve. So not just spending lots of money and not seeing any improvement on health care outcomes. I do think that that will be the picture of health care if my vision for what health care will look like actually comes to pass.
Jason Helgerson 29:16
All right, well, on that very optimistic and inspiring comments, we'll end the interview there. I want to thank Ashlee Wisdom for coming on the show and sharing her vision for health in the year 2049. As always, thank you for listening to Health2049. If you enjoyed what you just heard, please subscribe to us on Apple Music and Spotify and share this podcast with a friend. Thank you and see you next time.
