A significant initiative by the Regional Coalition to Eliminate Race-Based Medicine in Philadelphia has successfully removed race adjustments from four critical clinical decision support tools. This move marks an important step towards addressing racial disparities in healthcare across the region.
The coalition, comprising 12 major health systems and coordinated by Independence Blue Cross, has transitioned to race-neutral tools in lung, kidney, and OB-GYN care. Dr. Seun Ross, Executive Director of Health Equity at Independence Blue Cross, emphasized the importance of this change, stating, “The work that each health system has done is already leading to improved outcomes in our region and over time will save and extend lives.”
One of the most impactful changes involves the kidney function test (eGFR). The new race-neutral calculation has helped 721 patients move onto or up the kidney transplant list, with 63 receiving transplants in 2023 alone. Other modified tools include spirometry for lung function, the vaginal birth after cesarean (VBAC) calculator, and gestational anemia guidelines.
These changes are expected to have far-reaching effects. Black and Asian patients with lung disease will be diagnosed earlier, Black patients with chronic kidney disease will be identified sooner, and more kidneys will be available for transplantation. Additionally, Black and Hispanic pregnant individuals will have equal opportunities for vaginal births after C-sections, and Black pregnant people will be more accurately diagnosed with anemia.
The coalition’s work extends beyond these four tools, with plans to address race adjustments in ten more clinical decision support tools. This initiative represents a crucial step towards eliminating systemic racism in healthcare and ensuring equitable treatment for all patients, regardless of race or ethnicity.
