Merging Social Determinants Data into EHRs to Improve Patient Outcomes
Physicians routinely track details about a patient’s diabetes or high blood pressure in electronic health records (EHRs). But what about other factors that may compromise the patient’s health, such as inconsistent access to food or on-the-job exposure to air pollution? A paper published in the Annals of Internal Medicine in 2014 found that “residence within a disadvantaged U.S. neighborhood” is a factor in hospital readmissions at about the same rate as chronic pulmonary disease.
Nearly 80 percent of office-based physicians use EHRs today, but most of these systems are not designed to collect data on social determinants. Given the growing body of evidence about the health effects of social factors, however, there has been a push to bridge that information gap. If EHRs screened for social determinants of health, physicians could triangulate that information with clinical data to map a more comprehensive path to patient care. Such data also could help care providers achieve their population health management goals and inform health equity research.
In 2014, the Institute of Medicine (IOM) issued two reports based on the premise that health care providers and health systems can more effectively influence patient and population health if they have information on social and behavioral determinants. Specifically, IOM suggested EHRs capture sociodemographic, psychological, and behavioral factors, as well as individual-level social relationships and community-level data.