PT  - JOURNAL ARTICLE
AU  - Gold, Rachel
AU  - Bunce, Arwen
AU  - Cowburn, Stuart
AU  - Dambrun, Katie
AU  - Dearing, Marla
AU  - Middendorf, Mary
AU  - Mossman, Ned
AU  - Hollombe, Celine
AU  - Mahr, Peter
AU  - Melgar, Gerardo
AU  - Davis, James
AU  - Gottlieb, Laura
AU  - Cottrell, Erika
TI  - Adoption of Social Determinants of Health EHR Tools by Community Health Centers
AID  - 10.1370/afm.2275
DP  - 2018 Sep 01
TA  - The Annals of Family Medicine
PG  - 399--407
VI  - 16
IP  - 5
4099  - http://www.annfammed.org/content/16/5/399.short
4100  - http://www.annfammed.org/content/16/5/399.full
SO  - Ann Fam Med2018 Sep 01; 16
AB  - PURPOSE This pilot study assessed the feasibility of implementing electronic health record (EHR) tools for collecting, reviewing, and acting on patient-reported social determinants of health (SDH) data in community health centers (CHCs). We believe it is the first such US study.METHODS We implemented a suite of SDH data tools in 3 Pacific Northwest CHCs in June 2016, and used mixed methods to assess their adoption through July 2017. We modified the tools at clinic request; for example, we added questions that ask if the patient wanted assistance with SDH needs.RESULTS Social determinants of health data were collected on 1,130 patients during the study period; 97% to 99% of screened patients (n = 1,098) had ≥1 SDH need documented in the EHR, of whom 211 (19%) had an EHR-documented SDH referral. Only 15% to 21% of patients with a documented SDH need indicated wanting help. Examples of lessons learned on adoption of EHR SDH tools indicate that clinics should: consider how to best integrate tools into existing workflow processes; ensure that staff tasked with SDH efforts receive adequate tool training and access; and consider that timing of data entry impacts how and when SDH data can be used.CONCLUSIONS Our results indicate that adoption of systematic EHR-based SDH documentation may be feasible, but substantial barriers to adoption exist. Lessons from this study may inform primary care providers seeking to implement SDH-related efforts, and related health policies. Far more research is needed to address implementation barriers related to SDH documentation in EHRs.