RT Journal Article
SR Electronic
T1 Adoption of Social Determinants of Health EHR Tools by Community Health Centers
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 399
OP 407
DO 10.1370/afm.2275
VO 16
IS 5
A1 Gold, Rachel
A1 Bunce, Arwen
A1 Cowburn, Stuart
A1 Dambrun, Katie
A1 Dearing, Marla
A1 Middendorf, Mary
A1 Mossman, Ned
A1 Hollombe, Celine
A1 Mahr, Peter
A1 Melgar, Gerardo
A1 Davis, James
A1 Gottlieb, Laura
A1 Cottrell, Erika
YR 2018
UL http://www.annfammed.org/content/16/5/399.abstract
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.