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8 in 10 Care Orgs Collect SDOH Data, But EHR Coding Challenges Persist

Eighty-three percent of respondents in an AHIMA survey listed staff training and education as a top challenge for EHR coding of SDOH data.  

Nearly eight in 10 healthcare organizations collect social determinants of health (SDOH) data. Still, challenges related to the EHR coding of this data persist, according to an American Health Information Management Association (AHIMA) survey.

NORC at the University of Chicago conducted the research. NORC surveyed 2,600 AHIMA members and nonmembers from a pool of 41,000 potential respondents in the early fall of 2022.

About three in four respondents (74 percent) indicated that their healthcare organization provided training on collecting SDOH data in culturally sensitive ways. Additionally, seventy-two percent reported training on documentation requirements to code SDOH assessments.

However, most respondents reported that workforce-related challenges were the top obstacle to collecting and coding SDOH data, suggesting that current training and resources may be insufficient.

Ninety-three percent of respondents ranked the lack of a trained workforce as the top collection challenge. Further, 83 percent of respondents listed staff training and education as one of the top three challenges when coding SDOH data.

AHIMA gave four policy recommendations to improve the standardized collection and integration of SDOH data.

First, they said that CMS and other relevant agencies within HHS should establish standardized, clinically valid, and actionable SDOH data elements for collection.

“This might include a limited set of evidence-based domains, such as food and housing, as priorities while other domains are considered optional,” AHIMA officials wrote.

“This would allow for a subset of standardized data elements to be collected in a consistent and comparable manner, while recognizing that diverse care settings may not have the same amount of time or resources to collect and act upon these data.”

They also emphasized that domains prioritized for collection should align across federal and state healthcare reporting requirements.

Second, AHIMA called on CMS to consider providing financial incentives to providers, Medicare Advantage plans, Medicaid plans, and commercial payers to collect and share SDOH data.

“Aligning incentives and protocols across CMS programs, commercial payers, and providers would ensure that stakeholders are working together to meet their community’s needs,” the officials wrote.

The third policy recommendation recommends federal financial and technical support to train providers and operations staff on how best to collect, code and use SDOH information.

“This should include a focus on cultural competency coupled with the recognition that different care settings may require different approaches,” they said. “It should also include continued and expanded research on how best to collect and code SDOH data, and the workforce skills needed to do so.”

Lastly, AHIMA suggested that the federal government provide funding, technical resources, and infrastructure to support coordination and connectivity between healthcare organizations and community-based organizations at the state and local levels.

“Many of the solutions to addressing SDOH needs rely on collaboration between the health and social services sectors,” they wrote. “This type of cooperation is happening in pockets at the local level. Many providers are reticent to ask their patients about their SDOH needs without first having the community-based support system to which they can refer the patient so that these needs can be met.”

“Federal incentives are needed for states to create better alignment—across coordinating agencies to improve coordination, collection, and, ultimately, impact,” the officials emphasized.

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