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How Do Clinicians Use Social Determinants of Health Info?

Some healthcare providers are using social determinants of health information in clinical decision-making, but there’s more room for EHR integration to play a role.

Healthcare providers consider a patient’s reported social determinants of health in around 35 percent of healthcare decision-making, according to a report in the Annals of Family Medicine. This underscores just how important it is for clinicians to have access to SDOH data.

The report indicated that integrating SDOH screening into the EHR, plus enabling clinicians to note observed SDOH from patient-provider communication, will be helpful in future clinical decision-making.

These findings come as healthcare continues its work to integrate SDOH into clinical care. At this point, it is widely agreed upon that social determinants of health are integral to understanding a patient’s health and well-being. Numerous studies have underscored how SDOH, like food security, educational attainment, and even the environment, impact patient well-being.

This latest study considered how knowledge about reported SDOH, gleaned from social determinants of health screenings and risk assessments, actually factors into a provider’s clinical decision-making.

In a survey of 38 clinicians working at one of 21 safety-net clinics, the researchers found that SDOH factored into clinical decision-making 35 percent of the time. It was more common for healthcare providers to consider SDOH when the patient was male or did not speak English.

Healthcare providers aren’t learning about a patient’s SDOH from one single source, the survey added. Clinicians are mostly hearing about SDOH from patient-provider communication on the topic (76 percent of the time) and they also use prior knowledge of a patient’s social risk factors to make clinician decisions (64 percent of the time).

It wasn’t rare for providers to also use SDOH information stored in the EHR, but it was far from as common as verbal communication on the topic. Just under half (46 percent) of providers used SDOH data stored in the EHR to make clinical decisions, and that was most commonly when data was documented in discrete fields of the EHR.

These findings demonstrate that, although important, efforts to store SDOH data in the EHR cannot be a panacea. Rather, it is how the data is stored and how that fits into the clinical workflow that is important, the researchers suggested.

“The findings presented here suggest that SDOH data sources are complementary, and that patient-clinician conversations may be crucial to understanding patients’ relevant life circumstances,” the researchers wrote in the study’s discussion section. “Social risk–related EHR tools and data collection workflows should therefore be designed and implemented to foster and support—not replace—these conversations.”

That all said, it will still be essential to consider how the EHR stores SDOH data in order to make it most usable for providers.

“Future research might explore the type of information clinicians consider to be SDOH and how they use the EHR to document and locate this data,” the researchers concluded.

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