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Leveraging SDOH Data to Improve EHR Workflow and Service

A short time ago, we published an article on the impact of the Social Determinants of Health (SDOH) on COVID-19 and how they revealed a disproportionate and devastating  blow to minority and underserved populations. But, SDOH can also have a positive impact on healthcare when you leverage the data to improve EHR workflow.

The social economic, community and lifestyle factors that make up SDOH data can be used to predict health needs, preferences, and outcomes as well as improve the odds of successful patient treatment. Leveraging these analytics is the first step to learning more about your healthcare operation and developing a care coordination model around patient and business needs at insurance companies, hospitals and healthcare systems.

In addition to improving health outcomes, SDOH data can also help control costs and improve practice efficiency and quality of care from scheduling appointments through maintaining comprehensive information about medical conditions on to follow-up care and billing and claims processing.

A landmark bill

For these critical reasons, in March of 2021 Congress passed the Social Determinants of Health Act of 2021 (S. 104/H.R. 379). This landmark legislation authorizes the CDC (Centers for Disease Control and Prevention) to create a program to:

  • Improve health outcomes and reduce health inequities by coordinating CDC SDOH activities.
  • Improve capacity of public health agencies and community organizations to address SDOHs.
  • Coordinate, support, and align SDOH activities at CDC with other federal agencies, such as the Centers for Medicare and Medicaid Services (CMS) and others.
  • Collect and analyze data related to SDOH activities.

These are also the reasons your healthcare business must stay up-to-date on SDOH data and leverage it into your operation.

The first step…identify which population and health outcomes to target

During this first step, you will want the organization to evaluate such questions as:

  • Do we want to supplement current clinical models with scores built only from socioeconomic data?
  • Do we want to combine socioeconomic data with clinical data to create new predictive models?
  • Which targets/conditions will best be affected by SDOH data and health-risk scores?
  • Why are certain individuals at risk? What social determinants are most driving that risk?
  • Is that information actionable? What do we need to do to turn insights into value?

“When starting out in deciding how to address social determinants of health, it can be easy to get overwhelmed by the options—after all, social determinants of health can improve health outcomes in a variety of use cases. We suggest starting with clinically validated social determinants of health data to evaluate needs at the population and individual levels to make these decisions.”

Here’s why addressing SDOH data is important

Addressing social determinants requires the integration of this information into the EHR. Otherwise, providers will not be able to use it for clinical decision-making.

It’s now common knowledge that providers need to address a patient’s social determinants of health, such as individual financial situation, ability to get healthy food options, and the like can be more important to health outcomes than the actual clinical care he receives. In fact, commonly cited statistics show that clinical care influences just 10 to 20 percent of a patient’s outcomes, while social determinants of health impact the remainder.

Integrating SDOH data into EHR and clinical workflow

Regardless of the method of collection, this information needs to be incorporated into a patient’s medical record for providers to use it for clinical decision-making. This requires a large adjustment of clinical workflow. Providers must select how they are screening for SDOH and which areas are addressable.

This adjustment is a whole lot easier with the help of Blue Eagle’s consultants (BEC). We can help you adjust and understand the fine balance of being alert to important information, without being overwhelmed with too much information. Building this into existing EHR infrastructure can be challenging without outside help.

Interoperability…a serious problem with attempting to implement SDOH data into EHRs

According to an article in EHR Intelligence, “Interoperability remains a major challenge because even though we have datasets available to us through the federal government or through local organizations and local community groups, that data is often not brought into the EHR system.” The article went on to say, “A lot of the focus right now is on generating a summary of care from that encounter and maybe passes it onto the next provider or potentially accessing historical clinical information on the patient. But there is not a lot of interoperability between clinical organizations and non-healthcare or non-clinical organizations.”

To solve the interoperability issue, the article recommends leveraging and improving SDOH data standards.

The distinct advantages of standardized SDOH data

Health systems can achieve four central goals by standardizing SDOH data within the EHR:

  • Improve health, lower cost, and advance health equity (the overall goal).
  • Assess SDOH needs.
  • Link patients to community services.
  • Develop sustainable business models to fund access to community services.

To meet these goals, health systems need an SDOH strategy that will leverage data for risk stratification as well as connect patients with appropriate community services. Doing so requires data interoperability, common sets of values, and the capability to harness SDOH data.  

Social Determinants of Health (SDOH) are where health begins — the social and economic realities of our families, communities, workplaces, schools, and neighborhoods.

Leveraging SDOH data is imperative

“Strategies that leverage social determinants of health (SDOH) data are gaining attention for their ability to paint a comprehensive picture of health and address social and economic risk by connecting patients in need with the appropriated community services,” according to Health Catalyst. The article goes on to say that, “money, power, and resources at the global, national, and local levels shape these conditions and that SDOH significantly impact health inequities... SDOH data captures patient choices and genuine experiences at a level traditional health data sources (which exist primarily within the four walls of healthcare) cannot.”

While the delivery of healthcare is essential to staying healthy and getting well, it is not the only determinant of health. Other factors such as psychosocial factors and environmental conditions in which people live, work, and age can have a far greater influence. That’s why your operation must tune into the SDOH.

Overcoming barriers and integrating the SDOH into your workflow

Business Insider says that, “The coronavirus pandemic afflicted the US healthcare industry at a time when it was already experiencing rising rates of chronic disease, doctor burnout, and staff shortages—but it especially took a toll on some of the most vulnerable, at- risk communities across the country.” That’s why it is critical to overcome any barriers to incorporating SDOH data into your healthcare business as soon as possible and improve access to quality healthcare.

The most efficient way to integrate SDOH is to turn to Blue Eagle Consulting (BEC). Our consultants can help you understand the data and make it a part of your EHR workflow. We can add resources as soon as possible. Get the outside help you need now. Blue Eagle’s training/consulting experts will help you analyze your current operational situation, understand where you need support, train your staff and help you plan efficient, effective operations management. If you have a project coming up or a need that we can fill please call us at 1 (866) 981-1095 or email info@blueeagle-consulting.com.

To download the PDF version of this article, click here.