As social determinants of health (SDH) play a more prominent role in healthcare, more providers are looking for ways to incorporate social needs into electronic health records. But documenting SDH alongside other health information in EHRs isn’t so easy, according to a recent study published in the Annals of Family Medicine.
Researchers with Kaiser Permanente conducted a pilot study to develop EHR-based social determinants of health data tools for documenting and summarizing screening results for social needs and making related referrals. They also assessed the adoption of these tools and found numerous challenges.
Documenting SDH could facilitate the adjustment of care plans to ensure better clinical results and referrals. Additional documentation of social needs can also help support how community referrals impact health and identify resources gaps. Still, adopting SDH into EHRs can bring about staff concerns about screening for social needs “when little intervention is possible,” according to the study.
“SDH documentation, review, and referral-making in EHRs can be feasible and useful, but is challenging to adopt,” Rachel Gold, PhD, MPH, senior investigator at Kaiser Permanente Center for Health Research, et al. wrote.
Specifically, researchers found three key barriers in the implementation of EHR-based SDH data tools:
- Created a fragmented view of the patient that did not support the patient’s narrative and resulted in data in multiple places.
- Could add a layer of difficulty collecting and acting on SDH data.
- Necessitated another data entry step if SDH information was collected on paper first.
However, it can be done. Part of the challenges is simply with using EHRs, which can take time to adopt within a workforce. Training new staff in SDH workflows is just one barrier to adding this additional screening. Providers may need to conduct waves of rollouts with SDH-enabled EHRs.
A “clinic champion who was trusted, EHR-savvy,” and able to customize EHR views to support workflows and use adoption data workflows was critical in facilitating the uptake of these tools. Staff motivation was also a key factor.
As these data tools are developed, vendors and programmers also need to ensure the documentation asks patients with a social need if they want assistance and what kind of assistance they want. Adding a label to referrals, such as “no follow-up needed,” could also be beneficial to these data tools, according to researchers.