Integrating Social Determinants of Health into the EHR

April 03, 2020 - It’s now considered common knowledge that providers need to address a patient’s social determinants of health. These factors such as an individual’s financial situation, ability to get healthy food options, and access to reliable transportation can be more important to an individual’s 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. If a patient cannot adhere to his hypertension care plan if the medication is too expensive for him to buy every month, then outcomes will suffer. Similarly, outcomes will not improve for an obese patient, if she cannot afford healthy food options or get to a grocery store miles away from home.

But providers are often unaware of this information and some have previously felt it was not their responsibility to address. Only as the evidence has grown have providers felt a push to incorporate these non-traditional risk factors into their clinical decision-making.

“Slowly but surely, the evidence base is showing the benefits of doing social needs screening and social needs interventions. Until recently, there wasn’t an empirically strong evidence base, even though intuitively it’s quite obvious that if you can address the patient’s food insecurity, it’s going to help their diabetes outcomes,” said Rachel Gold, PhD, MPH, senior investigator at Kaiser Permanente Center for Health Research and lead research scientist at OCHIN, Inc.