This Black History Month, America’s Essential Hospitals spotlights Black history in the making at association member hospitals as they work to ensure the highest quality care for Black patients and pave the way for Black leaders in health care.
In a 2019 study by the Department of Population Health at the New York University’s School of Medicine, Washington, D.C. ranked second among the 500 largest U.S. cities for highest life expectancy gaps between racially and ethnically segregated neighborhoods.
Residents of the nation’s capital face a life expectancy gap of 27.5 years between the city’s most affluent neighborhoods and its most underserved communities, which house a large percentage of the city’s Black residents.
“[It’s an] unacceptable reality in one of the most powerful cities in the world,” says Michael Crawford, MBA, MHL, associate dean for strategy, outreach, and innovation at Howard University College of Medicine, affiliated with association member Howard University Hospital, in Washington, D.C., and founder and executive director of Howard University’s 1867 Health Innovations Project.
Having worked in health care for more than two decades, Crawford has long been familiar with the intersections of public health, finance, strategy, policy, innovation, and strategic partnerships in the space. In his previous role of chief of staff at Unity Healthcare, Crawford took an interest in the unique role digital health technology could play to eradicate gaps in care and offer patients within medically underserved communities greater medical autonomy.
This opportunity for self-efficacy, Crawford says, is critical at a time when patient access has been challenged, especially in the area of subspecialty care.
“When you consider health workforce shortages, particularly with patient populations in the catchment areas of American essential hospitals, you have subspecialty gaps,” he explains.
Patients at essential hospitals often face increased rates of chronic conditions that require specialty care, and workforce challenges have exacerbated under-resourced patients’ ability to receive consistent high-quality care.
Upon joining Howard, Crawford conducted an extensive qualitative and quantitative review, including a literature review and visits to health innovation hubs throughout the country to assess what could be done to improve health from a digital health perspective. Crawford discovered that only few hubs had a digital health and innovation approach to address health disparities and social determinants of health.
In 2020, Crawford founded Howard University’s 1867 Health Innovations Project, named for the university’s founding year.
Partnering with researchers, entrepreneurs, innovators, and corporate partners to tackle complex challenges confronting medically underserved communities, the project’s four main priorities are to increase access, improve patient experiences, increase treatment and care affordability, and improve outcomes through a digital health perspective.
The team collaborates with partners to develop digital health pilot projects and introduce digital health tools, particularly for medically underserved communities.
“We speak with entrepreneurs, either domestically or internationally, that desire to collaborate with us in this space, and then we develop pilot projects with clinical, technology, and quality of life performance indicators,” explains Crawford. “Then, we implement the pilot to determine whether or not the technology is efficacious or not.”
These technologies include artificial intelligence, machine learning and deep learning, sensors, wearable devices, mobile apps, virtual, augmented and mixed reality, facial and voice recognition, natural language processing, and data analytics platforms.
Many of the technologies enable patients to communicate proactively with their health team and manage their conditions. Crawford says these conditions include diabetes, hypertension, cardiovascular disease, mental and behavioral health, cancer, genetic disorders, neurodegenerative disorders, dementia, and Alzheimer’s disease.
“We believe technology can serve as a great equalizer in improving health conditions that disproportionately impact medically underserved communities if these solutions are developed in collaboration between patients and health professionals that fundamentally understand the needs of the community,” explains Crawford.
In addition to day-to-day projects, the 1867 Health Innovations team hosted a digital health equity summit in December 2022 that convened global digital health thought leaders to create an open dialogue surrounding ways to better cultivate a more digitally inclusive health ecosystem.
The team also launched a podcast called “21st Century Health,” which discusses topics at the intersection of digital health, health data, and health equity.
A Washington, D.C. metropolitan area native, Crawford says the opportunity to bring change to the region is particularly fulfilling.
“Any time that you have an opportunity to help communities improve their health and well-being, it is deeply rewarding for me, especially because our work has a direct impact on the Washington metropolitan region, a region I know well,” says Crawford.
Howard is one of the nation’s four historically Black colleges and universities (HBCUs) that offers a medical school, and Howard University Hospital is the nation’s only teaching hospital located on an HBCU campus. The 1867 Health Innovations Project is not only monumental for the opportunities offered to patients, but for the unique opportunities it offers its students and staff.
“It gives our faculty, staff, and students an opportunity to interact with cutting-edge technologies. Most importantly, it gives our health science students an opportunity to witness firsthand the transformative powers and limitations of technology through an interprofessional model,” Crawford explains.