Collaborative to Advance Clinical Health Equity

Duke Health’s Collaborative to Advance Clinical Health Equity (CACHE) is a community-driven initiative that is harnessing the power of data science to identify and eliminate racial disparities in healthcare. CACHE uses health equity as a new lens for understanding quality in patient experiences and outcomes.

What Is CACHE?

Racial inequity in healthcare results from the interactions between healthcare delivery systems and the communities they serve. Duke owns the issue of healthcare disparities by looking in the mirror of our clinical outcomes and viewing these data through the lens of race and ethnicity to address the root causes of disparities.

We believe that Duke Health, in partnership with the patients, families, and communities we serve, is poised to harness these data assets to identify and eliminate racial disparities in health outcomes.

What Does Duke Health’s CACHE Program Do?

At Duke CACHE, a four-step process drives our approach to dismantling inequities in healthcare…

1. We identify clinical outcomes that significantly impact patient health and well-being.

2. We evaluate those outcomes for the presence of racial, ethnic & socioeconomic disparities.

3. We work with patient to understand the underlying factors that drive these disparities.

4. We intervene to address root causes of disparities, both inside & outside of the healthcare system.

Early Results from CACHE Projects

How CACHE Works

The CACHE model relies on partnerships at Duke Health and across the Durham community to define disparities in outcomes. Then, by leveraging data analytics, predictive modelling, and machine learning, CACHE measures conditions of interest and identifies ways to improve care delivery.


  • Project management
  • Data sourcing
  • Data analytics
  • Measurement development
  • Predictive modeling
  • Data integration
  • Data governance
  • Community implementation
  • Health policy/economics

An Integrated Lifecycle Process

A Vision for Lean Healthcare

  • Enable patients and clinicians to define activities that add value versus those that are wasteful
  • Understand existing processes, so that when changes are made, we can anticipate the effects
  • Standardize and improve processes that provide value; eliminate ones that don’t
  • Create flexibility, capacity and standards that enable the care delivery system to respond to changing patient needs
  • Build this improvement process into every aspect of our daily work

An Agile Approach to Portfolio Management

This agile process is applied to each CACHE project and managed through its lifecycle by a Tiger Team comprising key resources capable of ensuring project success in all dimensions.