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Using Social Determinants in EHRs Would Improve Health Equity

Incorporating social determinants of health into electronic health records (EHRs) would improve health equity and reduce disparities in care, according to The National Academies of Sciences, Engineering, and Medicine’s Health and Medicine Division — previously known as the Institute of Medicine.

EHRs provide hospitals and health systems with vital information about the patients and populations they serve, but often do not convey social determinants that matter outside of the clinical setting. The Health and Medicine Division created the Committee on Recommended Social and Behavioral Domains and Measures for Electronic Health Records to address the need to incorporate social determinants of health into EHRs.

An initial report out of the committee identified social determinants of health, while a subsequent report evaluated the implications of including each determinant in EHRs. Social determinant metrics were evaluated for usefulness and readiness — criteria that proved both the potential, as well as the availability, of each measure being considered. A final list of 12 metrics related to social determinants was created — four of which already are frequently recorded in clinical settings. The committee found that publishing information about these measures in EHRs would allow for more accurate clinical diagnoses, better assessment of community needs, and improved evaluation of population health.

However, the committee also acknowledged the barriers associated with incorporating social determinant data into EHRs. The panel specifically noted the lack of standardized measures for capturing information on social determinants, but said this challenge could be addressed by adapting the EHR certification process. The committee suggested that the Office of the National Coordinator for Health Information Technology help to standardize the way social determinant measures are recorded by updating the EHR certification process to include an evaluation of vendors’ ability to collect and transmit self-reported data.

Despite the challenges, the Health and Medicine Division concluded that the benefits of adding social determinants of health to EHRs outweigh the barriers. The agency said including the 12 metrics would improve health equity by allowing allow health care providers to consider information about a patient’s life outside of the clinical setting. Knowledge of a patient’s education, financial resources, and stress levels could help providers better diagnose and treat patients, reducing disparities in the health care system.

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About the Author

Madeline White is a research assistant at America's Essential Hospitals.

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