Social Determinants of Health
Your mom may no longer be the person most concerned about your health. In 2019, members of the Healthcare Executive Group ranked total consumer health and population health services as their second and third biggest concerns, respectively. These healthcare executives’ concerns have created a new hot topic in the healthcare industry.
The topic? Social determinants of health (SDoH). Because most of my work and research at KLAS centers on population health, I’ve heard a lot of buzz about SDoH over the past year or two. My provider friends’ questions range from general to incredibly detailed. I’m far from an expert, but I thought I’d give brief answers to three of the SDoH questions I hear most often.
What Are SDoH?
Some people wonder what lies under the umbrella of SDoH. The better question might be what doesn’t. World Health Organization defines SDoH as “the conditions in which people are born, grow, live, work and age.” Talk about broad! Your city’s air quality, the school your kids attend, and how often you order takeout all qualify as SDoH, and there are countless more.
In fact, stakeholders in healthcare estimate that SDoH accounts for at least half of your health. That’s significant for many healthcare organizations, particularly those working to align their care with value-based reimbursement strategies. When providers are held accountable for your health, they have to care about SDoH.
What Are People Doing with SDoH?
Truthfully, SDoH strategies haven’t been adopted deeply enough or at enough organizations for anyone to be able to provide a reliable list of best practices. SDoH are simply too new at this point. But there are certainly some stakeholders—providers, payers, vendors, and even commercial companies—who are exploring and experimenting with SDoH.
Some provider organizations are gathering and storing SDoH data, unsure what to do next. Others are involving community and religious organizations in efforts to improve the health of high-risk patients. Some physicians are even writing food orders in place of prescriptions. Many other creative ideas are already in the works.
For instance, does it shock you to hear that two booths at HIMSS 2019 were occupied by Lyft and Uber? These are two examples of nonhealthcare companies hoping to help providers tackle certain SDoH. After all, many healthcare organizations would prefer to pay for a patient to be driven to the facility than to pay for a missed appointment.
What Should My Organization Do with SDoH?
Many provider organizations have SDoH on their radar but haven’t yet finalized or implemented an SDoH strategy. Creating such a strategy doesn’t have to be frightening. It’s as simple as the organization deciding which SDoH data they want, how to get it, and what to do with it.
Many providers are already feeling buried by data. Adding even more of it to their EHRs and other systems will only be helpful if it’s the right data—in other words, actionable data. It won’t help a physician much to know whether a patient has a Costco membership, but it could help a lot to know whether the patient has a gym membership.
Getting ahold of that data is the next step. Providers would generally like to rely on their EMR or population health vendors, but most of those vendors are not yet incorporating much SDoH data into their tools or the physician workflow. Another idea is to go straight to the patient. Providers can conduct evaluations when the patient is on-site for an appointment, or they can send a representative to the patient’s home to assess conditions there.
Finally, provider organizations must make sure their care teams are empowered to use SDoH data in their care plans. Sometimes, managing patient care means managing patient lives. Care coordinators live this reality every day when they text diabetic patients about their insulin levels or enroll CPOD patients in smoking-cessation programs.
There’s no one way to use SDoH data. Your organization will need to consider the options and decide what will be doable. A willingness to get started, try new things, and adjust as needed is probably more important than the initial strategy your organization creates.
My Challenge to You
Venturing into the new territory of SDoH may be intimidating. But the sooner provider organizations jump in, the sooner we’ll have best practices to share throughout the industry and the sooner patients will see the benefits.
If you haven’t started doing something with SDoH data, ask your population health vendor what they are doing. If you don’t have a population health vendor, ask your EMR vendor. I would love to get some emails from concerned executives asking me why their providers are suddenly interested in SDoH. Let the conversations begin!
Photo Cred: Shutterstock, arka38