Navigating Health Disparities: Innovating Care Processes with Vanessa Guzman
A conversation with Vanessa Guzman
About this episode
In this compelling episode of The Healthy Project Podcast, I welcome Vanessa Guzman, the dynamic force behind Smartrise Health, a platform meticulously designed to re-engineer and enhance care processes across health systems and organizations. Dive deep with us as we explore the innovative methodologies employed by Smartrise Health in mitigating health disparities and promoting equitable care.
Discover insights into:
- The comprehensive re-calibration and redesign of care processes for health systems and plans, ensure a robust framework to address disparities.
- The meaningful impact and tangible outcomes of implementing Smart Rise’s strategies, including staggering savings and enriched community-focused programs.
- Educational platforms and fellowships aimed at empowering healthcare leaders and embedding a culture of health equity across organizations.
- The benevolent layer of Smartrise, reinvests a significant portion of revenue into charitable activities, thus perpetuating a cycle of giving and community upliftment.
Vanessa shares firsthand experiences and innovative approaches towards designing a healthcare model that doesn’t just identify, but also strategizes and implements practical solutions for bridging the gaps in quality care. We delve into not just the how but also the why behind creating a healthcare system that is equitable, accessible, and effectively addresses the root causes of disparities.
Connect with Vanessa and explore more about Smartrise Health’s pivotal role in championing health equity, redefining care processes, and shaping the future of healthcare delivery. www.smartrisehealth.com
Sources & Further Reading
- Corey on LinkedIn
linkedin.com
- X (formerly Twitter)
mobile.twitter.com
Full Transcript
4,658 words · about 23 min to read
Hello everybody. Thank you for listening to the Healthy Projects podcast. I'm your host, Corey Deion Lewis. I got another great one today. Vanessa Guzman, she's the CEO of Smart Rise Health. Got her here today. Vanessa, thank you so much for being here. I really appreciate it.
Thank you for having me. It's an honor, Corey, and I look forward to engaging and interacting with the audience. So thanks again for having me.
Yes, no problem. So before we get into the conversation, can you tell the people a little bit about yourself and what gets you up in the morning?
Well, a lot of things get up, get me up in the morning, especially my family, who I love. My daughter Ella and my spouse Mark and my two doggies are really my priorities. But I'm Vanessa Guzman, like you said, Corey, and I am the CEO of two organizations, SmartRis Health as well as AJA's Health, which is a woman health-focused organization. And what gets me up in the morning is my purpose. I use work. I use my relationships, I use my persona to really carry what my purpose is for a given day, which is for me, is to inspire and empower people to be the best versions of themselves. And I live by that and I enjoy that.
Oh, that's amazing. I love to hear that. You know, it's always fun asking that question because you never know what you're going to get. But I really enjoy that. You know, Vanessa, you know, I am, my whole platform is about health equity. So that's, those are the conversations I enjoy having. And as you know, you know, when you say health equity, that can mean an abundance of things. It's not just one. But I would love to talk a little bit about, you know,
Hahahaha
What sparked your interest in health equity and with Smart Rise? What was the genesis of that? What was the beginning?
Mm-hmm.
Yeah, I think it was a combination of a few things. First, my roots. My parents are from the Dominican Republic, Spanish speaking only, older, who I love dearly, but you can imagine some of the challenges that we encounter in making sure that they get the best help they can get. I think that's a big part of the why. The second why I think is my purpose, as I described earlier, I really feel that I have the agency to change myself and also help others realize what change looks like for them in their own world. And then I third is the biggest why is my professional trajectory. I'm a biomedical engineer by training, but also coach. So I was able to kind of created this ensemble of different services that I think are so helpful for health systems and health plans and people and individuals like you and I, who are just trying to live our day to day and see ourselves like, how do we fit in? How do we make the change? And that's when Smart Rise. came to fruition after so many years of working at a large health system in the Bronx, I realized I can create a platform where it serves as a conduit for communities to really connect with healthcare in a much more meaningful way. And for us to really seek value in the quality of care that we all should get, right? Not just certain groups or certain populations, but everyone, because I lived there myself. I had, you know, I lived off of Medicaid.
Right.
until the age of 21. And I know the things that now I was missing out on before because of coverage issues. And just the whole trajectory of getting care for my parents really taught me so much that I was in a good position of now then packaging that and delivering it to our customers.
Yeah, that's great. Can you talk a little bit about how you package that for your customers? Like, you know, the reason why I ask, you know, one of the earlier in my, you know, health equity, you know, learning and trying to, you know, figure out what this was, one of the barriers or disparities that I would run into a lot or hear about were people in low socioeconomic status couldn't understand certain technologies or they couldn't afford the certain technologies, especially around we're talking about telehealth or any of those technology services. What has been your experience with that? Has that been something that brings true for you or what does that look like for the packages of the platforms that you have?
right.
Absolutely, and digital health, you touched on a really good example, is a prime example of what went wrong even during COVID, when we had 80% increase in adoption of telehealth literally overnight, because that's the way we could receive care and access care. But what that did was, because it was implemented with less of a health literacy mindset, right, in considering what that rollout would be, or that design of that product would be, is that...
Mm-hmm.
We widened the disparity for groups that weren't yet there when it comes to digital understanding or even health literacy. And we had a ton of connection issues of people trying to access that health in any meaningful way. And data has shown it, studies after studies have shown how different groups accessed care differently during coding or even after. You know, you can even off topic, right? Like you go to a restaurant and you need like a QR code. By the way, not everyone has a cell phone at hand and not everyone is in the position of knowing what to do with this QR code. Digital health is no different than that. So it's taking those considerations when we work with customers on what are you working on, on what are the care redesign aspects that you're looking for. And then smart rise comes in and almost in simplified version basically creates almost like a guardrails around. Well, let's make sure that... there's balance measures to make sure that no population is left behind, that we're identifying measures to make sure that we are assessing engagement rates over time so that again, no population is left behind. And more importantly, how are, how is the program, whether it's digital or any other program, how is it having an impact on the quality of health related to the population that they're looking to impact, whether it's maternity health, or vaccines for pediatric population, or improving medication adherence for older individuals. Those are all common programs. So the way that we package it is by introducing specific checklists and almost standards of care to make sure that we are all lifting all populations across the spectrum to access better care.
Right. So what I hear you saying, and definitely correct me if I'm wrong, but it sounds like with the big digital health boom, they wouldn't think about nobody.
Mm-hmm. No, they were thinking about, okay, we need to make sure we see patients and we get paid. That was the priority, right? A very feed-per-service mindset, absolutely. And we weren't ready for that. Over time, of course, in working with many organizations, we have seen improvement over time. There's better IT support, there's better patient education and caregiver education as well, to make sure that instructions are clear to both patients and the team.
Right. But there wasn't an equity lens for that.
seeing the patient, but yet more importantly, that the patient still has access to the caregivers behind the screen, like that's still very important. And not all aspects of care, by the way, can be handled over a Zoom, right? And that's really important to understand what are the appropriate standards of care or conditions that are appropriate to be seen on a screen versus in person. So those are some of the things that we continue to work on now. Of course, we have still a digital divide and we have unfortunately,
Right.
widened the disparity across different groups. So now it's like, how do we engage those groups that were left behind and say, no, they'll trust to me to make sure that they that they're trusting the technology and embracing how their information is being shared. Those are all so important. That's as important as getting the care itself.
No, absolutely. You know, and going back, I wanna touch on that trust piece that you were just talking about, because, you know, that's one thing that, just for people of color or, you know, that are in this country, trust is a big issue, especially with your healthcare experience. And now when you add, you know, a digital piece to that, it feels like people automatically distrust it because, you know, it's...
Yeah.
huge.
they don't know what it is or it's not explained well. Can you talk a little bit more about, you know, the effect of somebody's healthcare experience and how, you know, how digital health, can digital healthcare, how can they get that trust back when trust was our, trust was never there to begin with?
was never there to begin with. Right, right. And, you know, I give it to everyone, there's a lack of trust for very, very good reasons, right? From studies and research and misdiagnoses and people of color being used or tokenized, right? For specific aspects of care for specific outcomes. So I just want to acknowledge that there's a reason for that. And now we need to make sure that trust is instilled or integrated into how we deliver care. But to answer your question, the way we build trust is through the provider-patient relationships. We're talking straight care delivery, right? There's other ways. But if we're talking from a doctor perspective, it's really a relationship. Two people can tell you exactly the same exact thing, but depending on the relationship that you have with that person, you could perceive it as welcoming and as, yes, I'm going to take action.
Right.
or know what is that person talking about, depending on who just said that same thing. Right? So providers are not excluded from that. Of course, to give to merit providers, they only have about seven to 15 minutes to do their thing. So how people ask me all the time, well, how do you build that in? It's everyone's job. It's not just the doctor's job. It's the office, it's the ambiance, it's making sure that we're using proper pronouns, it's about understanding, like taking the time.
Yeah.
out of the entire throughput, not just the doctor visit, but the minute that the patient calls to schedule an appointment, to what you do with them after the visit, that all counts as part of that encounter, as part of that relationship, right? So it's building like a long-term marriage with your doctor. And that's how you build, it's the same type of factors, communication, good, good instructions.
Yeah.
Um, shared decision-making, those are all important factors, just like in the marriage or any other relationship that really carry over into healthcare. That's, that's the primary. The secondary, which is as important in my, my eyes is building trust through already trusted members. And that is the community. So the community, we have members who are well trusted. We're talking about your food pantry, right? Your, your Medicaid offices. We're talking about
Mmm.
your community centers, your daycare centers. We're talking about anything, faith-based organizations, right? Where people already seek care or some sort of service and then working with or through them to carry out some of that clinical education and empowerment and good information, not misinformation, that often gets lost in the nuances of social media and other forms of communication that we're bombarded with every day. So that's really how we build trust over time.
Yeah, and all those things you mentioned, Vanessa, from the care teams. I feel like, I don't feel like a lot of clinics really utilize their care team well. Cause a lot of patients that go in and say, I'm seeing the doctor, but you may have a pharmacist, a case manager, a health coach. You know, there are so many that can utilize, take that 15 minute.
everyone.
you know, appointment to, you know, now you have a 20 minute appointment with your health coach that's helping you with your goals or with your pharmacist or with, you know, the unit clerks or whatever the case may be. And then, then you take those community-based organizations and all of that improves that patient, in my opinion, that patient engagement, that patient experience, you know, because like you need that patient, the patient needs to be engaged in their care in order to get well or to improve what they need to improve.
Absolutely.
Right, and to have the agency to advocate for themselves, right? Because we often traditionally, back in the day, right? We often relied as, you know, with the provider, as being the expert, and relying in almost several of our groups, right? So she'll be in communities of color, see doctors as figures of authority, and therefore whatever they say, that's it. And you know what? That's not how it works, is shared decision making.
Yeah.
You should have the ability to ask questions, to feel comfortable asking questions, to getting and obtaining the care that you need and the information that you need to make appropriate decisions about your health because your health only belongs to you. And really having a good understanding of what are the steps in managing my condition and being aware what those steps are. But also more importantly, that speaks to your culture. One thing online I'm sure you've heard a million times when you go to the doctor is like, okay, well, this is your BMI for hide and wait.
Mm-hmm.
Oh, yep.
Uh, right. And then they, and then they throw this, this one liner, you know, maintain a healthy diet and exercise. What does that mean? What does that mean to me as a Dominican person? What does that mean to another person who, who perhaps has access issues, right? To go to the gym or other, what does that mean to people who have kids and don't do not have time, trust me, to go to the gym or other things, or to even cook at home, you know, people rely on takeout or other things. So how do you, how, who, and how.
What does that even mean?
Do we take the time to understand those other lifestyle and cultural factors that influence how you would diet and exercise? And that's usually the missing link. So when you have a nutritionist or a life coach on site, those are generally other people who help you walk through that journey, right? And then social workers for those who perhaps need additional help in navigating some of those services that are non-clinical. And those are as important as the clinical piece.
Yeah.
Yes. So Vanessa, I am a clinical health coach. So I work at a federally qualified health center. So this is my wheelhouse, so to speak. And whenever I get a patient in my office, from whatever culture, as soon as their provider says, hey, I want you to see the health coach, and they may have a goal of reducing their A1C, whatever the case may be, as soon as we start to talk about diet,
There you go. Yes.
it goes to, you're going to tell me I can't eat my foods. And I'm not trying, I think, I don't think for the longest time culture was not really thought about, but people's culture, they hold on to those. It's so important. And even thinking of the black culture, how we had to create our own culture, now you're telling me the foods that my ancestors survived off of, that I have a...
It's not available, right?
It's not available that now I hold true and powerful and I can't eat that is like well, I'm not saying that's not what I'm saying And it's so it's having the important thing is we can have that 40 minute conversation now when before They would just their doctor would say hey change your diet and then they just keep it moving
Right, right, right. And that means so many different things for different people. And it starts with the socioeconomic piece, right? And that's what creates those disparities because generally, select organic food is much more expensive than none. So what do you do then, right? What are the alternatives? Do I cook recipes that are not connected to my culture at all? Sometimes I just don't have the cash to do that, right? And to toss it on the side.
Yeah.
Right.
And those are all so important considerations. And we have a lot of expertise in the community. And as a health coach, you know that you become almost like the patient's advocate because you want to see them succeed, but there's no two people who, even though they may have the same biometrics, the same A1C, the pathway to reducing their A1C is going to be totally different because their pathology, their person, their lifestyle, their environment, there's so many other factors that influences their ability to be successful. And that becomes your purpose is to advocate them and find that path.
Absolutely. So I know we kind of talked about this before he went live, but I didn't ask not maybe one question from the questions I had, so I don't want to go back. Yeah. So I do want to ask one question in a different way. So out of all the social drivers of health, where you work with Play, all that good stuff, someone's socioeconomic status, to me, is up there. You know? It was really good.
Hehehe
This is so much fun, yes.
on the other.
really, really important. How do we address, from your experience and what you do with your profession, how do we address that social driver of health?
Yeah, I mean, it's complicated, but I'll divide it by stakeholder type, or by person type, because we all have power to change that, right? We just have different corners of the problem in front of us and behind us. So for health systems, we often recommend that they partner with community partners, all the examples that I mentioned earlier, food pantries, barber shops, right? Like everything that the patients access.
Right.
Yeah.
on a social community level, parks and recreation, and then design some sort of referral process that enables the health system to identify these are your gaps perhaps, or opportunities to access better care, right? That are influenced by social factors. And then this is where to go to seek that help. And hopefully, you know, if the health system has some of the resources in place to close the loop, meaning that they're able to track whether or not the patient went, got the service, was helpful.
Right.
and has addressed that opportunity, right? Not everyone has the ability, but we highly recommend that you do close that loop because otherwise you're just, right, throwing resources at a problem, but we don't really know whether or not we're empowering patients or helping them, you know, address immediate issues. So that's one way for health systems, obviously, and care teams to become just more involved and aware of what some of those socioeconomic barriers could be, because that could influence how they engage the patient. the clinic or at the hospital, right? So awareness is an important piece as well for caregivers. For payers or health plans, you know, we still have a way to go with reimbursing for some of these socioeconomic or social determinants of health, as they're often called. Even the assessments, you know, we've gotten better at documenting those assessments in, you know, care records, electronic health records, but we have not yet seen a huge improvement in
Mmm.
provider compensation for taking the time for doing some of that work. So most of the clinics and hospitals that are doing this are really doing it because they know it's right. They have seen or started generating evidence that it will impact quality of health. It will impact total cost of care, which is how we all survive, right, in the world of value-based care. And then the third is the community, the community, you know, being able to continue to service the patients as member, respected the community.
Right.
I'm really asking the hard questions. I'm like, what will it take to get there to the next step? Right? All those things are really important instruments and really leveraging the community as that source of building that trust that will take time, by the way. This is not going to happen overnight. I think our communities will realize changes and dynamics and relationships over time as we continue generating evidence that they see that they're being treated like everyone else, right? And that's going to be important. And as people... Corey, you know, it's important for us to ask questions. It doesn't matter where you're at, whether you feel that you don't know enough or you feel like, you know what, I don't have enough education or not for that, or I haven't even gone to school for that. Making sure that you're leveraging resources that oftentimes come from the health plan, right? There's like home care services, there are often health coaches that come with that. The health systems often provide, you know, different programs. The challenge with with that is trust again, Corey. And, um, a lot of people don't want people coming over to their homes, right? To do assessments and all that. Um, but making sure that, that you receive the information that you ask the appropriate questions so that you do create that comfort because a lot of these services are out there. You just have to either accept them and access them, um, or ask because sometimes they are there, but unfortunately, you know, people like you and I don't necessarily hear about them. So that's important to receive. know the source of where you're getting the information is so important because there's a lot of misinformation out there that will just honestly retract any form of improvement we've made over the years. So we all have, in short, we all have a role. And I think the more we continue practicing the role that we have in addressing some of these social gaps, the more improved results we're going to see over the next five to 10 years.
No, that's great. That's great. I know you briefly touched on Smart Rise in the beginning. Can we talk a little bit more about Smart Rise, hell? Tell me more about the platform. What's it focused on, and what kind of outcomes have you seen from it?
Yeah, for sure. So Smartrise Health is focused on re-engineering or redesigning care processes for different health systems, health plans, community-based organizations, pharmaceutical companies. So essentially we become the platform that identifies this is the root of any disparity that you may have or programmatic gap that's preventing you from achieving higher quality of care for different populations. this is how to fix it, and then we implement those fixes. So it's like recalibration, re-engineering, redesign. We also offer educational platforms so that we're helping the fish to fish, because eventually we want to make sure that we empower our customers so that they too can be part of that change. So we offer fellowship programs and learning collaboratives around health equity. So leaders.
Mm-hmm.
know what that means and what does it mean to build a culture of equity. And we've been, we've gained so much successes from that. We've helped countless, actually over, over 25 organizations alone achieve a combination of either health equities, accreditation, um, through some of the federal requirements. We've helped, uh, a lot of organizations achieve a value-based care incentive programs. to be specific, over $500 million in savings over the last four years. That translates to money that they can then reinvest in some of the work that we've been discussing here in this podcast. And then third, we help the philanthropic piece of it, right? So for me, when we first founded Smartrise, it was really important that we gave back to the community. So 10% of our revenue goes back into charities that we select every year.
Oh, awesome.
which is awesome. And we have so much fun in making those selections. So we have three right now that we work with. One is Girls on the Run of New York City. We also work with Bari Mission of New York City. And we also work with Fast Feet, which is a company that's completely oriented to helping children with disability run, right? And be active, you know, in their way. So it's all very much connected to the work that we do, but very much on the front end
Hmm.
Oh, very cool.
We're here with a mission. If you become our customer, you are literally directly giving back to the community in form of funds. And that's what keeps us standing every day.
Oh, that's amazing. And so it's almost like you are, I'm gonna create a corny analogy, because I'm really good at that. But it's almost like there was this, in the healthcare industry, they were going through with not clear vision and you're giving them contacts.
haha
We're giving them context and we're giving them, hopefully what I feel is a long-term feeding process, right? Because we don't want to be that consulting firm that goes in, does it and goodbye, right? For us it's important that our work becomes sticky, that generations carry the baton because that's the only way we're going to really realize some of these changes is when you really take it into your culture.
Mmm, yeah.
Right.
in many cases, the organization's culture, to really make these really insane changes. And by the way, hard to make. So that's why the platform helps with the engineering part where people get stuck, which is like, what do I do next? We unstuck them. But it's important that as we do that, we are firsthand impacting the communities for whom we're doing all this work for. Right?
Yep.
Right.
Yeah.
And that's really the most important aspect, I feel, of Smart Rises, that we close our own missionary group and goals through the work and the giving, obviously, that we provide.
No, that's great. And I will close with that. You know, Vanessa, thank you so much for being here with me today. For those that want to get to know you, know more about Smart Rise Health, where can they reach out? Where can they find you?
They can visit our website, www.smartrisehealth.com. You're gonna find a plethora of blogs and podcasts and educational material on health equity among other topics. So feel free to check us out. And of course there's links and forms to connect with myself and other team members as well. So we look forward to hearing from you and Corey, special thanks for having us in your program today.
Oh, of course, of course. Again, Vanessa, thank you so much for being here and everybody, thank you for listening to the Healthy Project podcast. I'll holler at you next time. All right, that's a wrap.
living.
Thank you.
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