How Software Helps Hospitals Address the Social Determinants of Health

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The advent of wearable devices, apps and passive monitoring software will usher in a new age of patient education and care. This Executive Summary outlines the exciting developments in the tech space and details the way hospital executives can prepare their facilities to address the social determinants of health.

Increasingly, hospitals are being tasked with tracking those metrics that have historically remained outside their purview: the social determinants of health.

What Are the Social Determinants of Health?

The social determinants of health include the sociopolitical and economic aspects of a person’s life that, while not necessarily tied directly to biological and genomic circumstances, nevertheless can have a profound effect on an individual’s wellbeing.

These can include:

• Nutritional wellbeing/access to healthy foods
• Job/economic security
• Transportation availability
• Drug and alcohol dependence
• Educational resources
• Peer pressure
• Community initiatives

What we’re finding is that a person’s zip code can have a far greater impact on health than anything a traditional physician might do in the course of a standard care plan. Take the healthiest person in the world, plunk them down into a food desert with few transportation and job options, and that individual’s health will suffer.

Healthcare Moves Beyond Medical Care

As facilities continue their move from fee-for-service to value-based care, increased attention is being placed on what happens to the patients after they leave the four walls of the hospital behind. In the subsequent 30-day window, readmission can trigger a penalty that impacts a hospital’s bottom line.

This places the impetus on administrators to figure out how, precisely, to ensure proper care of a patient once they’re no longer under supervision of the in-house medical team. Forward-thinking hospitals take this a step further, determining ways to keep the person out of the hospital in the first place.

There are two primary ways in which hospitals can address the social determinants of health:

1. Additional Staff and Resources – Hospitals can add dozens of case managers and post-acute care planners to check in with patients, providing these persons with the necessary telephones and other infrastructure required to enable proper oversight. Hospitals may also organize partnerships, education initiatives and other means of community involvement that aim to reduce the rates of hospital check-ins.
2. Software – Hospitals invest in and use mobile technology in order to passively monitor certain metrics of a patient’s health, including blood pressure, pulse rate, sleep cycles and more. In addition, software can provide educational materials, reminders about appointments, health check-ins and a way for patients to maintain contact with a physician or case manager.

Of these two methods, the software option offers distinct advantages. A software investment reduces the financial exposure created by adding staff along with the attendant costs associated with a part-time employee or an FTE. In a day and age in which capital and labor expenses are under increased scrutiny, where administrators must look high and low for a way to reduce expenditures, software offers an attractive method for addressing disparities in healthcare delivery.

Here’s how that can work.

Access

This is, in all likelihood, the most critical social determinant of health. Access to a trusted physician, affordable health insurance, transportation and price-friendly testing and prescriptions all play a role in overall wellbeing.

Software provides the connectivity required to address this serious issue. Imagine a world in which a hospital contracts with Lyft to provide transportation to and from the physician’s clinic for patients in need. Or one in which the coordination of prescription drug delivery to a patients’ doorstep occurs at the press of a button.

On the heels of escalating medical costs, it’s typically been payers that have invested heavily in these methodologies. But hospitals can help their patients and their own cost control policies through investments in software that increase access.

Telemedicine

Intrinsically tied to access is the proliferation of telemedicine, providing a patient a means of interacting directly with physicians.

Telemedicine as a concept is still in its relative infancy, and not all applications are as patient-friendly as they could be. Many hospitals still require the patient to visit their facility in order to interact with a specialist who might be hours away, a process that lacks efficiency.

What we’re likely to see is interactive applications become more intelligent, to the point where it’s feasible that a single patient could have multiple points of contact with numerous members of the care team without ever leaving home.

Here’s what a day in the life of a patient could look like:

• He or she wakes up and consults via email with a nutritionist, who recommends some diet approved breakfast options.
• In mid-morning, they gauge their blood sugar and weight and the software monitors whether the reading is in the appropriate range; if not, it can automatically route that data to a nurse or a case manager.
• After lunch, the patient has a pre-scheduled, five-minute check-in with their physician to touch base.
• A prescription delivery takes place in the afternoon because the software recognized that their current stock was running low.
• At the conclusion of the day, a designated family member is informed of everything that happened and invited to provide feedback of their own as to the individual’s temperament.

This isn’t science fiction. This technology exists right now. It can be used to help every hospital in the country to monitor the health of their patient population.

Education

It can’t be overstated how important knowledge is to empowering individuals to take control of their own health. Without the proper education, patients simply can’t be expected to lead their healthiest lives.

For the longest time, patient education amounted to sending the individual home with a pamphlet that described their condition and when to take their medication. We’ve graduated beyond that, but progressive hospitals can still do so much more.

Apps enable a patient to track their health in a fun way that wasn’t possible even a few years before. You should be building your post-acute care plan so that it looks more like Candy Crush than a medical journal.

As an example, imagine a physician who’s having trouble getting a post-cardiac arrest patient to stick to the proper nutrition schedule. He or she can tell them to reduce salt and eat more greens. Or, they can set that individual up with an app that provides a digital badge when they stick to the proper caloric and sodium levels for one, two, seven days in a row. By opting in to sharing data, they can compete with patients across the hospital’s network and even the rest of the country to see who can be the most nutritious. Along the way, the patient can receive daily, personalized education lessons that can be read in less than a minute.

Community

Hospitals also have a higher success rate for addressing the social determinants of health if they become highly visible within the communities they serve. After establishing partnerships with organizations like homeless shelters, food banks, schools, rehab centers, police departments, grocers and more, software can be used to help the case manager connect the individual to precisely the resources they need.

You’re going to start seeing counselors, social workers, even teachers become a part of the care team. How often does a physician interact with a pediatric patient? Maybe a couple times per year. How about a teacher? Probably every weekday. But how often does the teacher interact with the child’s physician? Through community outreach and software application, we now have a means of bridging the gap between disparate parties.

Get Social

Leading executives have taken a bold new approach to healthcare, one that looks beyond medical care into the world at large. Hospitals have an opportunity to effect unprecedented change, and software is what makes that possible.