The Check Up: Dr. James E.K. Hildreth of Meharry Medical College

Beginning this August, Meharry Medical College will welcome the first class to its new School of Applied Computational Sciences. The program will offer master’s degrees in data science and biomedical data science. A strategic goal for the Nashville, Tenn.-based historically Black college is to bring awareness of and insights to health equity.

Dr. James Hildreth, president and CEO of Meharry Medical College, and Modern Healthcare Managing Editor Matthew Weinstock discuss steps educators and the broader healthcare industry can take to fully incorporate data and health equity into care delivery strategies to improve population health.

MH: Hello, I’m Matthew Weinstock, managing editor of Modern Healthcare. Thank you for tuning into the latest edition of the Check Up. Attention to health equity has grown in recent years, especially in 2020 and going into 2021 with the aftermath of the pandemic and what we saw around civil unrest following the murder of George Floyd.

But solving these problems means building a workforce that can really put data into perspective and action for providers and health systems. Earlier this month, Meharry Medical College, an historically Black college in Nashville, Tennessee, announced that it’s creating a School of Applied Computational Sciences.

They’ll offer master’s degrees in data science and biomedical data science. When that school opened in August, they’ve started to already screen some applicants for that now. I’m pleased today to be joined by Dr. James Hildreth. He’s the president and CEO of Meharry to talk about the school and also what other steps the industry needs to take to really address health equity. Dr. Hildreth, thanks so much for being with us today.

Hildreth: Thank you for having me. I’m pleased to be with you.

MH: So before we talk specifically about the school and sort of that broader issue of what you’re hoping to accomplish with it in health equity, I did want to get your reaction to CDC director. Dr. Rochelle Walensky, on Thursday, April 8th, described racism as a public health crisis. Certainly, she is not the first public health official to do that. We’ve seen that from other officials, as well as public health agencies and medical societies. But I’m wondering if you could sort of put in context when the CDC director talks about that, what that might mean for policy moving forward.

Hildreth: So I agree with the CDC director. I do think racism is a public health issue. And for me, it’s understood in the context of the social determinants of health, which we’ve all been speaking about a lot here lately. Those include educational attainment, where we live, the built environment, our economic status, access to healthcare, and the quality of the care. All of those things are impacted by structural racism in our country. And so I do think that if we’re going to address the social determinants of health. We have to address the underlying cause of some of those determinants, which turns out to be structural racism and bias. So I agree with her completely, and I don’t think the problem of health disparities and equities are going to be solved unless we also address the problem of racism. So I’m happy to hear her say that. And I do agree with her.

MH: And also, you’ve been involved in the Biden administrations, Health Equity Task Force. So are you seeing then sort of as an optic, at least from the Biden administration to talk about these broader issues?

Hildreth: Yes. I was very pleased that President Biden made it a priority for his administration to begin to unravel the structural racism that exists in our organizations, especially the federal organizations that have an impact on the lives of so many people. So I’m also pleased to be on the Health Equity Task Force. And our primary focuses deal with data and how data is used, communication, and also then the drivers of inequities and health. So I’m really pleased to be a part of that. And again, very pleased that President Biden has made this a priority for his administration.

MH: Got it. Great. So data, let’s talk about that in the new school year starting. Why do you feel like now, 2021, August of 2021 was the time to launch this new school? What was the impetus for that?

Hildreth: So I’ve been president now for almost six years. But when I started, I made it clear to the (college) board and to the campus that from my perspective, data science is imperative that we do it and do it at a high level. But also equip our students to understand it and do use it as well. Data is driving everything, and every day in this country, millions of patient-provider interactions occur. Huge datasets are accumulating. And if those data can be analyzed appropriately, we can do predictive analytics. We can improve the delivery of care, make sure the care is delivered equitably.

So as far as I’m concerned, it would be malfeasance on my part as Meharry’s leader if I didn’t give us the ability to do data science at a high level and more importantly, make sure our students could do it as well. And so I’m really excited about this because it’s the combination of a vision that we’ve had now since I started. And I’m really excited about what it’s going to do for our patients, for our students, and for our faculty who are going to be engaged in scholarship using these datasets.

MH: As a historically Black college. Do you feel like there’s something a unique perspective that you bring to, and that you can impart to the students who are rolled in this, that they might not get at another institution?

Hildreth: I think what I’m really excited about is to make sure that this really powerful tool that’s available for use and bringing it to bear on healthcare, and all of these things will now be in the hands of those who are focused on the underserved. For 145 years, we have existed to make sure that people who look like me, who are poor, who otherwise don’t have access to healthcare, can have it. We’ve also been training students who go out into the world with that perspective. So imagine now putting this powerful capability into the hands of those who have that perspective, I’m just excited, just thinking about what it’s going to mean for healthcare and for the people that we serve.

The field of data science and biomedical data science is not very diverse. And you may know the stories of algorithms that have been developed that reflect the same biases that the society has. So I think by having a diverse group of individuals involved in data science, creating these algorithms, and doing the analytics is going to change the healthcare ecosystem for… is going to change it permanently in a very positive way. So we’re really excited about that.

MH: That point is what I really want to delve into a little bit more because everybody’s talking about using AI or machine learning or data analytics, and we’re just starting to see a trickle of concern. It’s not… it doesn’t seem to be totally widespread yet, but that concern of that machine learning can have biases within it. So how do we address that?

Hildreth: I think we address it by making sure that those who are involved in the process of creating the algorithms that are teaching these machines to learn or teaching them what they learn. Those individuals need to reflect in totality the populations that we’re trying to serve because it’s clear that implicit bias is a real thing. It is also clear that those implicit biases can be imbued in the artificial intelligence we create.

And only way to prevent that is to make sure that all of us are represented when those algorithms have being created. And I’m hoping that we will do for data science, what we’ve done for dentistry, for example. Many people don’t know that of the 2000 dentists in the United States, only 6,000 of them are Black, and Meharry Medical College trained 42% of them, which is an astounding thing to think about. So we’re thinking it may not be that profound. But we think that our School of Applied Computational Sciences can have a huge impact on diversifying a really exciting and impactful field right now, which is data science and biomedical data science. And I’m mostly excited about that.

MH: Sorry, sorry to cut you off there. Does that school, do the students in that school, will they be integrated into some of the other curricula? How do you bring these things together?

Hildreth: So there are going to be two ways that we see the school impacting what we do here. One is all of our students, whether they’re medical students, dental students, Ph.D. students, public health students, we’re incorporating into their curricular … a lessons and information about data science and what it means and how to use it. Then we’re also going to be training specifically students in new programs focused on data science and biomedical data science. So you can graduate with an MD degree having had courses in data science. And the reason why I want to do that is students can not get excited about something they’re not exposed to. I’m convinced that some of my dental students and medical students, when they get exposed to data science, will be so excited about it that they decide to pursue a career in that field.

So having MDs who know how to do data science, who are focused on the indigent and underserved to me is a really a powerful thing to think about. But we’re also going to have people who are specifically getting degrees in data science and biomedical data science. So there’s two groups of students. Our existing students in the traditional fields are going to be impacted by the data science. We’re also going to be training diverse students now in the fields of data science and biomedical data science.

MH: It’s interesting. And thinking about those doctors who get into it. We’ve seen the growth of the chief medical information officer.

Hildreth: Yes. Exactly.

MH: Certainly, there has been interested along those lines. So you referenced at the very beginning, or you talked about the beginning, the conversation that’s been happening around social determinants. Every health system is talking about social determinants or population health. As you think about what you’re trying to achieve with the school and broadly the attention to pop health, what’s missing. I mean, how are you hoping that we can continue to build off of health equity in the programs that are already in existence across the country?

Hildreth: Well, so Matt, one thing that’s missing are some honest, open, difficult conversations that need to be had within organizations about how they value the people who are part of their organizations and how to make sure that everyone can bring their whole person to work every day. Because when that happens, when each one of us can bring our whole selves to work, that’s when the magic happens. That’s when diversity can have the maximum impact. But unless there are some honest, open conversations about those kinds of things, it’s just not going to happen. And one mistake, I think that organizations make is you have to make sure that people leave their titles outside of the room when you’re having these conversations. Because oftentimes the minority individuals who are part of those organizations are often not part of leadership. And if you’re having those conversations with the power dynamics in place, it makes it very challenging to have the kinds of conversation I’m talking about.

So I think that we need to leave our titles outside the door, get in a room, and have some really good conversations about who we are, what we aspire to do, why we do what we do. And when that happens, there’s an understanding that can come about that’s not possible without that happening. And I think that’s part of what needs to happen in all of our organizations, including we do that here at Meharry as well. So to me, I’m excited to see those things beginning to happen. We need a lot more of them to happen across all of our organizations.

MH: Got it. And just a couple more questions, and we’ll wrap up here. If you were talking, if you could sort of for project into to the future, if you’re talking to the first graduating class of this school of computational science and they head out into the world. What’s your advice to them on how they can really impact change?

Hildreth: Well, what I would hope they would do is to take what they’ve learned and the passions they have and put what they’ve learned in the service of the passions they have to make change, real change in the lives of people who need them. That is a very powerful thing. I mean, as you probably know. It’s driving everything across many different organizations and businesses. And we need to make sure that those powerful tools are being used in a way that benefits all of us like precision medicine, for example. Thousands of genomes have been sequenced to make precision medicine possible. But it turns out that not very many of those genomes have been sequenced from people who look like me.

So precision medicine will be precise, but not necessarily precise for all of us. So I think a good example of that will be to hack some of these individuals to go and apply their skillsets on data that’s relevant to the whole population to make sure all of us can benefit from these powerful tools, not just a few of us. And so that would be my message to them. Take what you’ve learned, apply to the things you’re passionate about. And I think real magic will happen not just for the people we care about but for everybody. Everybody’s going to benefit from this.

MH: Right. Right. Well, Dr. Hildreth, we appreciate your time today. Makes it exciting to learn about the school that you’ve launched. We’d love to stay in touch to see how it unfolds over the next, certainly the first class the first year. But we appreciate all you’re doing to bring the issue of health equity to the forefront.

Hildreth: Thank you for having me.

MH: Thanks so much. Take care.

Hildreth: You too.

MH: And I’m Matthew Weinstock with Modern Healthcare. Be sure to come back next Monday for another edition of The Check Up.


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