The HIMSS Electronic Health Records Association recently analyzed how healthcare organizations collect social determinants of health information.
While EHRA’s Social Determinants of Health and Health Equity Task Force sees great value in using SDOH to address healthcare inequalities, it calls for a gradual transition towards wider adoption of standardized screeners – in line with the evolution of the healthcare IT sector and its willingness to adopt new tools. – is the right approach.
WHY IT MATTERS
This past year, screenings for social determinants were voluntary under the Centers for Medicare and Medicaid Services’ Intramural future payment systemor IPPS, under which more than three-quarters of the nation’s acute care inpatient hospitals are paid for, according to the American Hospital Association.
But they are now required to report: Hospitals must report on their screening of patients for five social determinants: food insecurity, housing instability, transportation needs, utility issues and interpersonal safety.
However, among healthcare organizations that prioritize and define social risk domains by different stakeholders, there is no “consistent, universally agreed and prioritized list of domains suitable for assessment by healthcare providers,” the EHRA task force said in a report. white paper consolidating its recommendations for capturing SDOH data.
That inconsistency led to overlapping domains, complicating data sharing and understanding, the task force said.
“We recommend that (CMS) hold off on requiring new or different risk areas outside of these five factors to learn more from the provider community,” said Kate Jenkins-Brown, product manager for population health solutions at Meditech, and vice president of the task force, told Healthcare IT news.
In the whitepaper, EHRA proposed the following:
- EHRs must standardize how they represent domain risks.
- The standards industry must determine how domain risks are represented in the data exchange.
- The healthcare community needs to list and prioritize which areas need assessment.
- Risk assessment methods must remain flexible for the time being.
“We propose that regulators align with industry practices that emerge when inpatient organizations report patient screening results around the first five determinants,” Jenkins-Brown said.
She noted that the Gravity Project is “doing fantastic foundational work in its efforts to identify data elements and associated value sets for documentation of determinants in the EHR across four clinical activities: screening, diagnosis, goal setting, and intervention activities.”
In short, EHRA recommends a simple standard that indicates a risk area, for example transport unsafety; a classification of the presence or absence of risk, ideally using a yes or no format and, optionally, information about how the risk was assessed,” she explained.
THE BIG TREND
In 2023, the American Health Information Management Association studied how SDOH data is used in healthcare and found that a lack of standardization, inadequate training, and limited cross-sector use hinder healthcare equity.
After surveying more than 2,600 members and non-members, AHIMA discovered the need to translate patient needs into coded data for actionable use in addressing SDOH. The two main ways organizations use SDOH data are to refer patients to community organizations and to identify and assess needs at the community level.
Focusing on the documentation of SDOH needs and translating those needs into coded data for actionable use is fundamental, AHIMA researchers said.
“Effectively collecting, coding and using SDOH data is critical to improving health and healthcare outcomes,” said Wylecia Wiggs Harris, CEO of AHIMA, in a statement about the study.
ON THE RECORD
“We propose that CMS pause to allow sufficient time for the healthcare industry (providers, EHR developers and policymakers) to learn from the early years of this initial situation before moving to a more advanced screening requirement,” Jenkins-Brown said, “ such as requiring providers to act on the screening information or expanding the risk areas to be screened.”
Andrea Fox is editor-in-chief of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.