An EHR Association working group has made recommendations on how social determinants of health (SDOH) data should be captured in electronic health records.
The association’s Working Group on Social Determinants of Health and Health Equity recently published “Recommendations for capturing determinants” notes that there is currently a lack of consensus on which SDOH domains should be assessed by healthcare providers and a standardized approach to capturing the necessary information.
In fact, as inpatient organizations prepare to begin reporting on patient social determinant screening in 2024, the EHR Association advises that CMS consider postponing this requirement. “This delay would allow sufficient time to gather knowledge and learn from industry practices,” the task force said.
“The lack of uniformity in the prioritization and definition of social risk domains by different stakeholders results in the absence of a consistent, universally agreed upon and prioritized list of domains appropriate for assessment by providers,” wrote the workgroup. “This inconsistency often leads to overlapping domains, complicating the sharing and interpretation of this data. “The absence of clear guidelines for risk assessment and standardized representation of risks in EHRs hinders the effective sharing of data to inform interactions at the point of care.”
The white paper also says that the issue is further complicated because regulatory agencies do not operate in sync and because there is a growing proliferation of terminology. “To respond effectively to evolving policymaking, the industry must align with a standardized approach to representing risk and agree which risks are prioritized for collection and analysis.”
The white paper proposes several recommendations that it claims would provide a reasonable path forward for EHR developers and the healthcare industry:
• EHRs should standardize how they represent domain risk. (At a minimum, an EHR should be able to indicate whether a patient was assessed for a risk domain, whether that risk is present, and the method of assessment if a standardized instrument or questionnaire was used.)
• The standards industry should determine how domain risk is represented in data sharing.
• The healthcare community should list and prioritize which domains should be assessed. (The EHR Association said it recognizes the work of the HL7 Gravity Project in establishing a comprehensive list of standardized domains. It endorses this list as a critical guide for healthcare organizations and regulatory agencies in determining essential domains for evaluation should the industry determine that? New domains should be evaluated, collaboration with Gravity Project is encouraged to include them in its master list).
The EHR Association said an effective approach should facilitate the sharing of social risk data. Information captured in one system should be able to be seamlessly exchanged with another, improving value at the point of care, according to the whitepaper.
The white paper warns against requiring comprehensive examinations for all organizations, because it could place an undue burden on clinicians, particularly in settings where resources such as social workers and social workers are limited.
“The suggested approach is designed to accommodate a gradual transition toward broader adoption of standardized filters, in sync with the evolution and readiness of the industry to adopt these tools,” the Working Group said.
