Giving Compass' Take:

• Social determinants of health are important to record for doctors to obtain a complete picture of patients' health history. However, medical professionals are running into barriers in documenting SDH factors in electronic health records. 

• Researchers say that although there are barriers to documentation, it is a tangible goal to have patients record more information about social determinants of health. 

• Read about how philanthropists are addressing SDHs when trying to improve health systems. 

Integrating social determinants of health (SDH) data into EHR systems may help providers address the economic and social risks that negatively affect patient health.

A team of researchers from Kaiser Permanente, OCHIN, Multnomah County Health Department, Cowlitz Family Health Center, and University of California San Francisco implemented a suite of EHR tools designed to collect SDH data at three Pacific Northwest community health centers as part of a pilot study testing the effectiveness of EHR-based SDH documentation.

“We used several implementation strategies to support tool adoption in the pilot CHCs,” explained researchers. “Each clinic identified an SDH champion and staff members were engaged in tool development.”

Between 97 and 99 percent of screened patients indicated a potential SDH-related need, according to researchers. Nineteen percent of patients received an SDH-related referral to address this need.

At one clinic, only 15 percent of patients requested help for an SDH-related need. Another clinic reported that only 21 percent of patients requested help.

Ultimately, providers identified three key barriers limiting adoption and use of the tools:

  • First, some participants reported that EHR-integrated SDH data created a fragmented view of patient health, with “relevant data in multiple places.”
  • Participants had trouble collecting and acting on SDH data available in patient EHRs. Lack of staff familiarity with EHR systems and excessive EHR tool customization partly contributed to these problems.
  • Finally, adding an additional data entry step into clinical workflows to transfer SDH data from questionnaires into patient EHRs negatively affected clinical efficiency.

While study results indicated the EHR tools may be inefficient, researchers pointed out that it takes time for users of any new health IT tool to adapt to changes in clinical workflows. Researchers concluded that integrating SDH data into EHR systems is feasible and potentially useful if clinics consider several factors when implementing new data collection tools.

Read the full article about social determinants of health by  Kate Monica] at EHR Intelligence