Insurers and providers increasingly need to adopt social determinants of health to understand and influence predictors of health outcomes, as well as support the use of information technology tools.
Identifying social determinants of health and integrating such data into electronic health records can help guide interventions for vulnerable populations, according to a recent report from insurance software vendor Ram Technologies.
Payers have repositories of claims and demographic data, making them particularly well positioned to create partnerships with providers and community groups to address barriers to improved health and overall well-being.
The Centers for Disease Control and Prevention defines social determinants of health as the factors in a person’s life that contribute to their current state of health. These include biology and genetics, individual behaviors, social environment such as income, gender and discrimination; physical environment such as crowded living conditions, and health services such as access to care and insurance.
For example, payers are working with the Center for Medicare and Medicaid Innovation’s State Innovation Model Initiative to improve population health. In some cases, Medicaid is helping individuals with housing costs.
Electronic health record systems are the technology foundation for developing and targeting interventions, but the EHR first may need an upgrade to accommodate new types of data such as patient questionnaires, activity trackers, other medical devices and demographic data, the Ram Technologies report states.
“Payers already house key demographic data and when they share it with providers, clinicians gain a more robust understanding of patients and may go on to collect additional data,” it notes.
This additional social determinants information can include tobacco use, illicit drug use, diet, exercise, isolation, pollution, noise, financial stress, education level, housing quality, access to transportation and food, and neighborhood safety. The more data included in the EHR, the deeper a payer or provider organization can dig down via data analytics and gain insights into an individual or population.
“For example, cardiovascular disease and depression may be linked to stress caused by insecure housing; environment factors contribute to asthma; obesity and diabetes may be tied to poor access to healthful food; and transportation may result in missed appointments,” according to the report. “Claims analyses tease out these and other associations that might otherwise be missed. Payers that share this and other data with clinicians and other partners arm themselves with the insights needed to truly make a difference.”