Dr Kate Burke of PatientsLikeMe On 5 Things We Must Do To Improve Patient Outcomes for Underrepresented Populations
Provide more cost effective clinics, providers and pharmacies in underserved areas. As we have talked about increasing clinics, providers, and pharmacies will reduce the need for travel which is a significant barrier for these communities.
Healthcare disparities continue to affect underrepresented populations, leading to unequal patient outcomes. Social, economic, and cultural barriers often hinder access to care, appropriate treatments, and equitable health services. How can we bridge these gaps and ensure that all patients, regardless of background, receive the highest standard of care? In this interview series, we are talking to healthcare providers, policy makers, community leaders, researchers, and anyone who is an authority about “How We Can Improve Patient Outcomes for Underrepresented Populations”. As a part of this series, I had the pleasure of interviewing Dr. Kate Burke.
Dr. Kate Burke is an emergency medicine physician and served as the Chair of Emergency Medicine at Milford Regional Medical Center where she practiced for 34 years. Dr. Burke is a clinical leader focused on solving complex problems with an expertise in strategic and operational execution. Dr. Burke is co-founder of What Did the Doctor Say, LLC (acquired by PatientsLikeMe) and is the Sr. Medical Advisor at PatientsLikeMe.
Thank you so much for joining us in this interview series! Before we dive into our interview, our readers would like to get to know you a bit. Can you tell us a story about what brought you to this specific career path?
I always wanted to become a doctor and was very fortunate growing with two amazing role models- my mom was an operating room nurse and my dad was a general surgeon. I made hospital rounds with my dad on Saturdays and worked in his office in my later years. I loved science, and medicine just seemed like home to me. After attending Williams College I went off to Boston University School of Medicine followed by residency training in surgery and emergency Medicine at UMASS Medical School. Subsequently,
I practiced Emergency Medicine for 34 years caring for thousands of patients with a wonderful team of providers at Milford Regional Medical Center in Milford, Massachusetts. I loved working on the front line 24/7/365. I became Chair of my Emergency Department, taught Emergency Medicine for 30 years at UMASS Medical school and was very active in my specialty of Emergency Medicine at the state and national level. I was elected President of our Massachusetts chapter and represented our state at the national level for 20 years as part of the Council of the American College of Emergency Medicine. Later in my career, I co-founded What Did the Doctor Say (WDDS)a health tech app for recording doctor visits. My WDDS team and I subsequently joined PatientsLikeMe (PLM) and that is where I found my second home outside of the Emergency Department as the Senior Medical Advisor at PLM. One of the facts that drew me to PLM is that PLM is a free online platform open to all patients, caregivers and families 24/7/365. PLM is a place where patients can meet others with similar conditions, get answers to common questions, find healthcare related resources and track important health metrics.
Can you share the most interesting story that happened to you since you began your career?
I’ve met and treated thousands of patients and every single story is interesting! We don’t have the time to go through all of them. I will say that every single story is interesting in its own way because every patient brings their own unique set of experiences and challenges. Healthcare is full of patient journey stories just waiting to be heard and no matter how big or small, they all hold valuable lessons.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
“Be Kind”. My parents, a nurse and a doctor were wonderful loving mentors who practiced kindness throughout their lives. I greatly admired my mother and throughout my life observed her demonstrate kindness in all her interactions with others. She treated everyone with kindness and set such an incredible example for myself and my 6 siblings. Kindness has always been at the core of my emergency medicine practice and showing it to patients and their loved ones made a real difference during challenging times.
How would you define an “excellent healthcare provider”?
An excellent healthcare provider is someone who listens to the patient, caregiver, and family.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
I have several key resources and influences that inspire me to be a better healthcare leader. First and foremost, all of my patients have made me a better healthcare leader because they have been my most valuable teachers. As I mentioned earlier, by listening to my patient’s journey, I was able to pull valuable lessons that either helped me fully understand the scope of their needs or helped shape the way I better served the next patient.
Staying informed about current events on both the local and national levels from a clinical and health policy level has been incredibly beneficial to me. I regularly engage with a variety of reputable news sources, including the Boston Globe, Wall Street Journal, Washington Post, New York Times, and National Public Radio. This helps me stay updated on clinical and health policy developments. Additionally, my memberships in the Massachusetts Medical Association and the American College of Emergency Medicine grant me access to monthly journals featuring the latest medical research and health policy articles. I also make it a point to read STAT Medical News, which focuses on medical and biotech news, particularly around pharmaceutical research and pressing health policy topics. For evidence-based medical information, I often consult UpToDate, which excels in covering clinical care and research. My interest in AI and healthcare leads me to resources like Open Evidence, an AI-driven platform that provides summaries and collections of evidence-based articles in response to clinical questions.
A notable inspiration for me is Dr. Daniel Kraft, an oncologist and medical futurist. Through his work with Digital.Health and NextMed, he advocates for accessible healthcare for all patients. I am also a long-time admirer of Susannah Fox, whose book Rebel Health: A Field Guide To The Patient-Led Revolution In Medical Care highlights the intersection of health and technology. Her insights, along with her blogs and talks, have deeply influenced my perspective.
I am inspired by the contributions of E-Patient Dave and Dr. Danny Sands, who are leaders in the Society of Participatory Medicine. This organization an important patient-led organization dedicated to patients and caregivers access to medical records and personal health information. Their efforts resonate with my commitment to patient-centered care.
Moreover, I greatly respect Dr. Don Berwick’s work on measuring patient outcomes to drive systems improvements in healthcare. As a leading expert in performance improvement, he emphasizes the importance of metrics in enhancing care delivery through the Institute for Healthcare Improvement.
Lastly, I follow the work of Dr. Eugene Litvak, CEO of the Institute for Healthcare Optimization. He educates healthcare leaders on optimizing patient flow. Dr. Litvak recognized the significance of measuring patient throughput from admission to discharge, identifying ways to decrease morbidity and mortality for all patients requiring scarce hospital resources.
These individuals and resources collectively shape my approach to healthcare leadership, driving my commitment to improve patient care and outcomes.
Are you working on any exciting new projects now? How do you think that will help people?
Yes, I’m currently involved in an exciting project at PatientsLikeMe (PLM) implementing Ella, an AI-powered health assistant developed by Ema and integrated into PLM’s platform. Ella is designed to provide personalized, evidence-based guidance for women’s health and wellness throughout various life stages. What makes this project particularly impactful for underserved populations is its focus on delivering tailored, culturally sensitive support. By combining expert medical knowledge with real-world patient experiences, Ella offers accessible, understandable health information to patients who might otherwise struggle to access medical advice.
Ok, thank you for that. Let’s now jump to the main focus of our interview. What are the primary barriers that underrepresented populations face when seeking healthcare?
From the perspective of a medical director for a large online patient community with a 34-year background practicing Emergency Medicine, the top five barriers that I’ve seen underrepresented populations face when seeking healthcare are the lack of access to care, lack of insurance coverage, underinsurance, health literacy barriers, and finally, cultural and language barriers.
Limited access to care affects many people, especially in rural and underserved urban areas. There is a shortage of providers and pharmacies which makes it really tough for people to get the care they need. One of the ways PatientsLikeMe is addressing this issue is by providing a free platform where members can put their experiences living with a condition in context, connect with members who are living with the same conditions, and find answers to their questions. Data generated by members are systemically collected and quantified while also providing an environment for peer support and learning. We are also enabling and encouraging members to improve self-care, reduce avoidable ER visits, make more informed healthcare choices, improve treatment adherence, and sustain behavioral change that is critical to so many health conditions.
Many patients also lack insurance coverage and are unable to afford high deductibles along with out-of-pocket costs. Additionally, there are people out there with no insurance or who are underinsured. This is a big problem and worse in states that have not made the simple decision to expand Medicaid to patients in need. The cost of healthcare and medications is prohibitive for many people in the US. One of the ways PatientsLikeMe is helping combat this is by working with a range of organizations that have specific experience engaging and serving these communities, like Optum Perks.
The health literacy barrier is another major hurdle. Many individuals in underrepresented populations lack resources to help understand health information, treatment options and how to access care. Sadly, discriminatory practices exist in the US due to both conscious and unconscious bias leading to distrust in the system and avoidance of seeking care. At PatientsLikeMe, we foster health education by offering easy-to-understand resources, empowering patients from all backgrounds to make informed healthcare decisions and advocate for themselves.
And finally, cultural and language barriers exist, leading to poor communication between patients and providers which leads to misdiagnosis and delayed care. One of the ways PatientsLikeMe is addressing this issue is by helping patients integrate their symptoms, treatment outcome, EMR, lab, and sensor data in one place on our platform, so they can better manage their health and easily share with their care team our Doctor Visit Guide (DVG).
I am extremely grateful for the opportunity to work with so many dedicated patients helping one another and the PLM staff improving the overall site experience as much as possible.
How can healthcare providers build trust with patients from diverse backgrounds, especially in communities that have historically experienced medical neglect or discrimination?
Building trust requires demonstrating a commitment to your community with outreach and cultural education for all your staff. My advice to future providers and those currently practicing is to step back and acknowledge the medical neglect and discrimination that has happened, and work on changing the institutional culture your organization may harbor.
What role does cultural competence play in improving patient outcomes, and how can medical professionals be better trained to meet the needs of underrepresented groups?
Helping and caring for a patient requires respecting the individual patient and family. As a provider, you cannot expect a good outcome caring for someone you do not respect and vice-versa. Including cultural competence training and building a culturally diverse staff on your team is necessary to meet the needs of underrepresented groups.
Can you share any successful strategies or programs that have been implemented to reduce health disparities and improve outcomes for underserved communities?
Successful strategies include building a culturally diverse team of providers in locations easily accessible to underserved communities has been shown to improve health outcomes. One example is the Racial and Ethnic Approaches to Community Health (REACH) program funded by the CDC. They reduced disparities in heart disease, diabetes, and high blood pressure across groups of patients including African America, Hispanic, Asian and Native American communities. REACH partners with local organizations to tailor interventions that are culturally appropriate and effectively improving health equity.
How can technology and telemedicine be leveraged to reach underrepresented populations who may face geographic or financial barriers to traditional healthcare services?
This is a great question and the work I am a part of at PatientsLikeMe reflects how we can leverage technology and expand healthcare services. As we’ve talked about, rural areas and underserved urban areas face geographic barriers due to the lack of providers in their area. Telemedicine has proven to reduce the need for travel by offering consultations remotely. Digital health tools such as remote monitoring devices and health apps, have drastically improved over the years in providing patients with the ability to manage their conditions and access real time medical data without needing to visit a clinic. As a digital health app, PLM attempts to bridge the gap to ensure all patients can achieve equal outcomes by offering tools for symptom tracking, treatment insights, and peer support. I think of PLM as an open patient and caregiver-friendly medical provider waiting room where you can see if there is another patient like you to talk to! Everyone compares notes on how to manage and understand the condition they are living with. With a model like this, it effectively provides information and emotional support without the need for geographically limiting healthcare visits.
As a “healthcare insider”, if you had the power to make a change, can you share 5 changes that need to be made to improve patient outcomes for underrepresented populations? Please share a story or example for each.
1 . Provide more cost effective clinics, providers and pharmacies in underserved areas. As we have talked about increasing clinics, providers, and pharmacies will reduce the need for travel which is a significant barrier for these communities.
2 . Make healthy food, clean water, transportation and housing an essential component of health care. How can you get healthy if you have no place to live? How can you find healthy food if all you have are convenience stores making up the food desert option?
3 . Provide access to mobile phones and the internet so patients can join online patient communities like PatientsLikeMe and learn about access to care, medications, support and telemedicine services.
4 . Build a culturally diverse staff in all the clinics and hospitals starting in nursing and medical school. A diverse healthcare workforce is better equipped to understand and address the unique needs and cultural values of their community. When healthcare providers share cultural and linguistic backgrounds with their patients they can build stronger relationships rooted in tryst and empathy which leads to better communication and more accurate diagnoses.
5 . Provide Health Education starting early in grammar school through high school as a critical component of the curriculum. In turn, this will empower patients to better understand what their bodies are telling them and how they can address health concerns as they appear.
What specific steps can be taken to ensure that medical research and clinical trials are more inclusive of underrepresented groups, and why is this important for improving overall patient outcomes
Simply speaking, the steps we need to take to ensure research and clinical trials are more inclusive are to first make a concerted effort to perform clinical trial recruitment in the underserved clinics, pharmacies and doctors office. Next, make the clinical trial recruitment available online. Then by using the power of influence, find patients with similar cultural background that may have participated in the trial and ask if they can become a spokesperson.
It is important to make clinical trials more inclusive so that the clinical data received from the medical research represents everybody across all ages, genders, socioeconomic groups, ethnicities and of course this includes all normally underrepresented populations. In fact, this information is critical for improving overall patient outcomes for all patients.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 😊
Prioritize healthcare in the U.S. budget and expand access to services by offering patients personalized care plans that streamline their health journeys. Personalized care plans are all about creating a healthcare approved designed for each patient versus a one sized- fits all solution. These plans consider a patient’s health needs, lifestyle, and their goals. For example, if you are managing a chronic condition, a personalized plan could include a customized medication regimen, specific dietary recommendations, and exercise routines that integrate well with your life and goals. By catering to individual needs, personalized care plans empower individuals to take a more active role in managing their health in turn, improving patient satisfaction and outcomes while also making the healthcare experience efficient and manageable.
How can our readers further follow your work online?
Please visit PatientsLikeMe.
Thank you so much for these insights! This was very inspirational and we wish you continued success in your great work.
Dr Kate Burke of PatientsLikeMe On 5 Things We Must Do To Improve Patient Outcomes for… was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.