Achieving health equity requires integrating social determinants of health (SDOH) data into healthcare. Challenges arise due to data complexities and the traditional focus on medical care. However, federal initiatives and collaborations are promoting the use of SDOH data. Healthcare organizations are implementing programs to assess social needs and improve health outcomes. Data sharing, standardization, and analytics play crucial roles in identifying and addressing SDOH factors. By combining medical and social interventions, healthcare can advance toward equitable and holistic care.
As the healthcare industry continues its transition to value-based care, understanding the influence of social determinants on patient health has become crucial. However, the integration of social determinants of health (SDOH) data poses significant challenges, hindering progress in achieving health equity.
Addressing Social Determinants:
A recurring cycle of hospital visits plagued a diabetic patient, with dangerously high blood glucose levels. Surprisingly, the root cause was not a medical complication but rather the absence of a working refrigerator to store insulin. This anecdote emphasizes the impact of non-medical factors on people’s health, highlighting the need to prioritize various determinants beyond medical care.
Recognizing the Importance of Social Determinants:
While medical care is vital for treating illnesses, it plays a minor role in maintaining overall well-being. Awareness is growing regarding the significance of social determinants, which are responsible for up to 80 percent of a person’s health. However, understanding the interrelationships among these factors and effectively responding to them remains a nascent endeavor in the healthcare industry.
Barriers and Changing Incentives:
The fee-for-service healthcare model has traditionally incentivized providers to focus on medical care rather than preventive measures. Insurance companies, too, have lacked financial incentives to prioritize long-term health outcomes. However, as reimbursement methodologies shift towards value-based care and federal initiatives emphasize population health, the industry is recognizing the importance of health equity and curbing escalating healthcare costs.
Complexities in Data Integration:
SDOH refers to the environmental conditions in which individuals are born, live, learn, work, play, worship, and age. These determinants influence health, functioning, outcomes, and risks, often resulting in inequalities. However, incorporating SDOH data into existing electronic health records systems poses challenges due to the multifaceted nature of health determinants and the limited information traditionally recorded in these systems.
Federal Initiatives and Collaboration:
Government agencies, such as the Centers for Medicare & Medicaid Services and the Department of Health and Human Services, are working to address SDOH by developing frameworks, setting objectives, and promoting the collection and use of comprehensive demographic and SDOH data. The Office of the National Coordinator for Health Information Technology is collaborating with various stakeholders to advance the exchange and utilization of SDOH data.
Overcoming Data Challenges:
Data collection and sharing related to SDOH face hurdles due to the lack of standards. Electronic health records were not originally designed to capture SDOH data, resulting in unstructured information typically found in clinical notes. Efforts such as the United States Core Data for Interoperability and the Gravity Project aim to develop data standards and improve the sharing of SDOH information through standardized terminologies and technical advancements.
Healthcare Organizations’ Initiatives:
Many healthcare organizations are implementing programs to assess SDOH needs and improve health outcomes. Medicare Advantage plans and Medicaid initiatives are increasingly addressing social needs that impact health through partnerships with community-based organizations. As value-based care methodologies gain traction, there will be greater emphasis on preventive measures and addressing SDOH shortfalls to improve care quality and reduce costs.
The Role of Data and Collaboration:
Effective SDOH interventions require comprehensive and well-rounded data to identify social needs that directly affect individuals’ health. Collaboration among multiple entities, including health plans, community organizations, and healthcare providers, is essential in tailoring programs to meet the diverse needs of populations. By gathering insights through data analytics and fostering interoperability, healthcare can advance toward a holistic approach to care.
Finally, Integrating SDOH data is essential for unlocking health equity. Despite the complexities involved, ongoing initiatives and collaborative efforts between stakeholders, facilitated by standardized data exchange and advanced analytics, offer hope for achieving broad and nuanced solutions. By addressing social needs alongside medical care, healthcare can enhance member engagement, foster trust, and positively impact health outcomes for individuals and communities.
