Yesterday, we shared a number of hot 2020 topics including Privacy and Security, Medical Coding Standards, and Patient Matching. As mentioned in that article, we got so many thoughts on the future of SDoH, that we decided to share those responses in a separate article. Enjoy these perspectives as you consider how SDoH will play into your plans for the new year.
Adriane K. Martin, DO, FACOS, CCDS Vice President at Enjoin
For decades the impact of various social determinants of health have been examined nationwide and worldwide. Yet, social determinants of health are not routinely addressed in the day to day business of caring for patients. Why? In part, it is the lack of incorporation or clear visibility of these elements in the EHR. Placing social determinants of health into a readily visible portion of the EHR allows the first step in addressing these factors to occur, recognition of a problem. Failure to include social determinants of health into the EHR or making the data difficult to access will prevent routine identification of these elements, which must be addressed to achieve a healthy individual and, ultimately, a healthy population.
Dr. Sanjay Seth, Executive Vice President at HealthEC
The challenge to overcome in SDOH is accurately collecting all the data across all points of entry: patients, hospitals and physicians’ practices. However, getting this data into the EHR is only the first step. Where the industry must focus is implementing survey and assessments instruments within the EHR to give actionable events or interventions based on the data. Risk algorithms must be developed and used for this next step to occur. Furthermore, I predict an expansion in the SDOH. We must move beyond housing, nutrition, transportation and food to also capture and incorporate financial health of the patient and their family.
Scoring methodologies to quantify the degree to which social determinants—and the programs to address them—actually impact an individual’s healthcare must be developed. We have not yet seen published studies that convert each social determinant issue into a scoring methodology. The ideal solution would be:
- Collect data from all points of entry and incorporate into the EHR
- Apply artificial intelligence/machine learning to determine the impact of the social determinant on a particular patient’s healthcare
- Provide recommended solutions and actionable insights
- Measure the performance of SDOH programs
Asking physician practices to complete this effort is impractical, focusing on patient care is enough of a struggle for them. These efforts to fully capture, analyze and use SDOH data should lie with the community: social agencies and government agencies that are required to help resolve SDOH issues. The future will see stronger collaboration between providers and community-based organizations to implement SDOH programs.
Julie Pursley Dooling, MSHI, RHIA, CHDA, FAHIMA, American Health Information Management Association (AHIMA) Director, HIM Practice Excellence
Social Determinants of Health (SDOH) is another headline that will carry into 2020 and beyond; peaking the interest of many healthcare stakeholders. New ICD-10-CM codes may be developed and redefined as federal, state and insurance initiatives start to adopt the collection of this important population health data. In addition, social risk code sets are under evaluation by national workgroups to determine duplicity and missing codes in other terminologies such as LOINC, SNOMED, CPT, and HCPCS. As new codes and data elements are introduced to the industry, HIM professionals need to incorporate them into their various workflows and reporting; educating staff on the importance of why the changes are needed.
Amy Fellows, Senior Advisor at Pivot Point Consulting
As a member of the Health IT Oversight Council for the State of Oregon’s Office of Health IT, we’ve been focusing on the importance of not just capturing SDoH in individual EHRs, but across the health information exchange — including healthcare providers, but also social service and mental health providers too. Everyone touching the patient needs to be able to access comprehensive information in the EHR to provide the most effective care for the individual — in both healthcare and home environments.
Bill Wagner, CHPS, CPCO, Chief Operating Officer at KIWI-TEK
Discussions of how addressing a patient’s SDOH can help improve care will likely continue. As healthcare providers look to integrate this information while caring for their patients, it will become increasingly important that this data is not only included in EHRs but that it’s easily accessible. In 2020, AHIMA will continue to advocate for this issue, leading discussions and providing guidance on how to integrate SDOH information in EHRs.
Documentation from social workers, nurses and, case managers can be the basis for obtaining more granular patient data and coding health hazards posed by social, economic, or psychological concerns. There are plenty of studies to support that providers can reduce their cost of care, reduce readmissions and improve outcomes by embracing the capture and coding of SDOH. If that is not compelling enough, the World Health Assembly approved ICD-11 for adoption as early as January, 2020. Among other changes, SDOH were addressed with more specific codes, code clustering and extension codes to enable more specificity in the patient record. Better to adopt best practices now than later.
Thanks to everyone who shared their insights and perspectives. It seems appropriate to share thoughts on SDoH on New Years Eve. We hope that everyone has a fun and safe Happy New Year!