Social determinants of health have a major influence on the health status of patients and their health choices. Included are tips for healthcare providers on how to add social determinants collection to healthcare software.
Until the pandemic, healthcare providers were not concerned with social determinants of health. Then it became clear that these same determinants greatly influence the health status of patients and their health choices. So how do you add this collection of social determinants to healthcare software? Let’s study the question.
Add SDOH: Preparatory Measures
So you’ve decided to collect social determinants in your clinic. To get started, you need to answer two important questions:
As a rule, this involves the choice between paper and electronic questionnaires.
Each data sourcing method has its pros and cons. For example, paper questionnaires are a more flexible option, as the provider’s employees can decide when to conduct an SDOH screening study and choose where the study boxes will be placed. In addition, paper screening is much more budget-friendly. On the other hand, paper screenings involve manual processing of the collected data, which is time consuming and error prone. Moreover, manual data processing can become yet another ‘brick in the wall’ of clinicians’ burnout.
In terms of SDOH digital collection, the trusted providers of providers or an in-house IT team typically build SDOH surveys into their EHR system as an opt-in screen. MercyOne, an Iowa-based healthcare network, took this approach, allowing their patients to remain in control of their data and answer the survey questions whenever they wanted. As a result, caregivers and patients build rapport and ensure that any new social needs are automatically reported to the healthcare provider. At the same time, this solution is significantly more expensive.
- Which determinant to focus on?
It is better to focus your efforts on societal challenges that are relevant to your community and that your organization can solve quickly and effectively by turning to your existing partnerships. For example, a clinic’s main patient population may include elderly patients or patients with disabilities. If a healthcare provider has a transport partner that makes the transport service possible, they can study the demand for the service among the patients. In this case, SDOH screening can help set up a patient transport service for non-urgent situations.
According to the American Public Health Magazine publication of May 2020, the absence of non-emergency transport to the point of care caused about 6 million people to delay their visit. Given that a large proportion of those patients could be an afflicted chronic condition, a no-show for them could lead to relapse and increased costs for health care providers. Rather, non-urgent transportation services (NEMT) can help carriers save up to $537 million annually, a 2019 survey found.
Collecting SDOH: Feasible Ways
So you have decided how you are going to collect SDOH and have chosen the social problem you want to solve. Now it’s time to move on to collecting data. Providers typically have three data collection options to choose from.
Determinant screening on location
This is the most common approach and involves clinicians and/or nurses offering patients to participate in the study at the hospital registry before, after, or immediately at the appointment.
While some patients tend to avoid a face-to-face discussion of their SDOH-related issues, others may feel comfortable discussing the topic. In fact, such an approach is quite popular among young adults, as according to a University of Michigan survey, 51% of younger patients are willing to discuss their social determinants in person. free to talk about the difficulties they experience, but also welcome explicit solutions to their social needs offered by their doctors. So if this patient population is the core of your clinic, you can collect data through friendly chats during appointments.
Interviews based on technology
Some providers have already succeeded in introducing a broad network of digital patient engagement solutions, enabling them to make efforts to collect SDOH through channels preferred by their patients. For example, they can design and send a mobile survey with social needs and related challenges.
When the challenges are discovered, the caregiver can help solve the challenges by connecting the patient to the needed service so that the patient can make decisions about overcoming their social problems. The healthcare provider can then offer follow-up interviews to see if the proposed solution was helpful and efficient for the patient.
Points to remember
While social determinant data collection interviews are intended to benefit the patient, they can touch on highly personal topics that patients are unwilling to discuss. Therefore, to successfully complete such a task, it is necessary to inform patients that:
• The study is voluntary
• Some questions can be skipped even if they have agreed to participate
• The interview can be interrupted at any time
This is especially true for children’s hospitals. While doctors need to know the circumstances in which a child lives in order to devise the most effective treatment, parents may feel uncomfortable when asked about the family’s food or housing conditions. They may fear that the hospital will call in child protection if a doctor finds the conditions substandard. Such situations feed the patient’s lack of confidence.
Therefore, healthcare providers should offer their clinicians communication training. During the sessions, clinicians and nurses can learn to build rapport by relying on the following step-by-step guide:
- Explain the importance of social determinants and why the physician should collect them
- Elaborating on social issues, the provider can help resolve quickly
- Reassure the patient that the problem can be solved
- Repeatedly emphasize that participation is voluntary
For those who have chosen to collect data through an on-site paper screening or face-to-face interview, it is vital to remember that data still needs to be entered into EHRs or it cannot help improve the quality of services for improve patients. To do this skillfully, health care providers could turn to a coding specialist who will classify social determinants more quickly and accurately according to official ICD-10-CM guidelines than medical personnel.
However you look at it, social factors have a major impact on both a person’s health and the decisions they make regarding their health. Fortunately, there is a clear strategy for adding social determinants to healthcare software.
First of all, providers should choose the appropriate poll type (manual or electronic) and key determinant to focus on. It’s also important to focus on the determinants that providers need to address.
When it comes to collecting data, providers have three methods to choose from. At this point, it is better to rely on specific patient populations, available funding and existing patient engagement solutions. Collecting and analyzing SDOH data can help healthcare providers reduce some of the social challenges their patients face and improve their health status while reducing their own operating costs.
Inga Shugalo is a healthcare industry analyst at Itransition, a software development company headquartered in Denver, Colorado. She focuses on healthcare IT and highlights the industry challenges and technology solutions addressing them.