Texas HIE to Link Social Determinants of Health to Patient EHRs

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February 05, 2018 – Methodist Healthcare Ministries of South Texas and the state’s health information exchange (HIE) HASA are partnering to launch a pilot project for linking social determinants of health data to patient EHRs.

The two San Antonio-based organizations will enable providers to use a more comprehensive picture of a patient’s health for complete care delivery.

As part of the partnership, Methodist Healthcare Ministries award HASA a $175,000 grant to expand its services to include social determinants of health data that may influence patient health. Using the grant, HASA will integrate social determinant data into its clinical data repository through a cloud-based app.

HASA Medical Director and University of the Incarnate Word’s School of Osteopathic Medicine Vince Fonseca, MD, will spearhead the program.

“We have heard from many physicians that HASA’s ability to provide clinical and up-to-date patient information at the time a patient needs care in an emergency room has become more mainstream,” HASA Executive Director Gijs van Oort told San Antonio Business Journal.

“At the same time, research shows that the reasons people seek medical care are not limited to physical or emotional concerns but are more affected by social conditions such as housing, transportation and the ability to eat regularly,” he continued.

According to the Centers for Disease Control and Prevention (CDC), social determinants of health include the conditions of the places where people live, learn, work, and play. These conditions can affect a variety of health risks and outcomes. Unstable housing, low income, unsafe neighborhoods, and substandard education are some of the major factors that can influence patient health. Incorporating social determinants of health data into patient EHRs may improve individual and population health management.

The pilot program aims to give physicians a more holistic view of patient health that includes any clinical, social, and behavioral risks, Fonseca told San Antonio Business. For example, Fonseca said the program could identify patients that have difficulty breathing but are unable to get to a pharmacy for their medication. As a result of their inability to access medication, these patients may be more likely to require emergency care.

The program aims to equip care managers with the information to connect patients with a variety of community services able to reduce the need for emergency visits.

HASA officials also stated the program could potentially make social determinants of health data accessible to emergency medical services (EMS) units to reduce the cost of emergency services for the community. The HIE will conduct the program at a Methodist Healthcare Ministries clinic this year.

The pilot project is an attempt to practically apply past evidence supporting the theory that adding social determinants of health data to patient EHRs can improve patient care.

One study earlier this year found standardizing social determinants of health data collection and presentation in Epic EHR systems can improve patient and population health outcomes in community health centers.

Researchers utilized an Epic EHR at the non-profit, community-based Oregon Community Health Information Network (OCHIN) and found systematically documenting patient’s social determinants of health data in EHRs helped care teams facilitate referrals to community resources.

“This could be especially useful in ‘safety net’ community health centers, whose patients have higher health risks than the general US population,” stated researchers.

Researchers also created EHR tools for reviewing social determinants of health needs, identifying referral options, ordering referrals, and tracking past referrals.

While the study provided evidence for the potential value of integrating social determinants of health data into patient EHRs, Methodist Healthcare Ministries and HASA have the opportunity to realize these benefits.

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