From the Director

Expecting Success: Developing Solutions to Eliminate Disparities

Even in the 21st century, our health care system provides poorer quality care to patients who are Hispanic, black or don't speak English. Yet within a relatively short period of time, about half of America's population will be non-white. Program Director Bruce Siegel, M.D., M.P.H., introduces Expecting Success: Excellence in Cardiac Care, a national initiative to reduce racial and ethnic health care disparities. Led by The George Washington University, 10 U.S. hospitals will identify and test quality improvement strategies across the continuum of cardiac care, sharing their lessons nationwide via this newsletter.

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What's Working

Going 100 Percent Online – What It Means for Quality Cardiac Care

It is estimated that only about six percent of hospitals and health systems nationwide, including the Bronx-based Montefiore Medical Center, have computerized physician order entry systems. In addition, Montefiore will soon have a fully computerized electronic medical record for its patients.

Through its significant investments in health information technology and the Expecting Success grant, Montefiore is moving toward 'electronic equalization' – where consistent, known interventions are provided to all heart failure patients across the continuum of care.

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Spotlight On...

Located in New York City, Montefiore provides medical care to the more than 1.3 million residents of the Bronx, as well as from nearby Westchester County and patients referred from across the nation and around the world.

At-a-Glance:

• Number of staffed beds: 1,023
• Hospital type: Large academic medical center
• Community location: Urban
• Number of myocardial infarction and heart failure patients annually: 4,000

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Disparities Dialogue

Moving Beyond Documenting Health Care Disparities

The 'inverse care law' suggests that those with the greatest health care needs often have the least resources to address them. African Americans and Hispanics are more likely than their white counterparts to live in poverty, have multiple chronic illnesses, suffer from more severe diseases, and therefore require more, not less medical care. Kevin Fiscella, M.D., M.P.H., family practitioner and researcher at the University of Rochester School of Medicine, shares his perspective on why the U.S. health care system should address each population according to its specific needs and provide high-quality care for everyone.

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RWJF Perspective

Foundation Launches Diverse Programs to Address Disparities in Health Care

Numerous research studies show that African Americans and Hispanics routinely receive lower-quality health care treatment than whites – even when income level and insurance status are equal. While research conducted to date has validated such disparities, Risa Lavizzo-Mourey, M.D., M.B.A., Robert Wood Johnson Foundation president and CEO, explains why the focus must now move toward developing and testing solutions.

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