By Andy Aroditis, NextGate
In the pursuit of population health and accountable care success, providers are increasingly looking for tools that extend out into non-clinical or traditional healthcare settings to provide a complete picture of one’s health. Because individuals are heavily influenced by socioeconomic and behavioral forces, stakeholders are recognizing the significance of social determinates of health (SDOH) data in achieving value-driven, community-based outcomes.
The primary reason why social factors are considered to be so impactful is because only about 20 percent of health outcomes are determined by clinical care. The remaining 80 percent is determined by non-clinical factors, most of which are influenced by geography and socioeconomic conditions. This explains why communities with poor overall health status can actually overshadow a thriving healthcare system that surrounds it.
Tired of EHR systems that only provide a limited view of their patient’s needs, progressive healthcare organizations are leveraging patient matching tools as a strategic advantage to integrate SDOH data more quickly and efficiency. Patient ID matching is also a natural place for growing provider organizations to track individuals uniquely amid consolidation and increased M&A activity.
Patient identification tools for many institutions are rapidly transforming from a line of defense against duplicate medical records to the default approach for interoperability and enterprisewide connectivity across highly-diverse systems and locations. Much of the growth is coming from cloud-based patient matching applications that extend an organization’s ability to scale and leverage evolving sources of data outside the health system, including public health agencies, alcohol and drug recovery programs, and behavioral health organizations.
Since social determinants now make up the majority of factors contributing to population health, building a total picture of an individual to offer intervention and support will require accurate patient identification and cross-system interoperability outside the hospital's four walls. Complementing extensive clinical data with SDOH will allow care managers to make more informed care decisions and apply data-rich insights into a patient’s treatment plan.
Interoperability And Patient Matching Bridge The SDOH Gap
Deploying analytics tools to social needs data is showing signs of promise, particularly as organizations seek to reduce the likelihood of readmissions. When screening for social needs is combined with one’s medical record, this critical data can be more readily collected, stored, accessed, and put to use across many settings and locations.
Tools that offer reliable patient ID matching and medical record management, facilitate the ability to track individuals uniquely across a diverse set of systems and facilities to enable a clear and holistic view of a given patient and promote a more consistent patient experience. This important step in meeting social needs gives providers the opportunity to find potential gaps in care by seeing the entirety of a patient’s medical history.
Incorporating SDOH data into electronic medical records with use of patient matching technology can help organizations identify at-risk individuals and reduce readmissions among its vulnerable populations. In fact, a new study found social determinants of health contributed to more than 50 percent of hospital readmissions. By tracking individuals across disparate clinics and public health agencies, health IT leaders can leverage such data as reading level and water purity into its care services.
Intervention And Accountability
Exerting control over social determinants isn’t the end goal of providers, but to offer interventions outside of clinical care to improve value-based, population health. Screening and intervention are logical steps in assessing social determinants but knowing how to effectively collect, track and manage this data will be critical. So far, solutions have been mainly focused on intervention and engagement with limited to moderate success and no guarantee of a return on investment. Until more innovative solutions or partnership opportunities emerge, reliable patient matching and interoperability tools will be an imperative foundation to painting a more complete picture of an individual and offering insight into their ability to benefit from specific care plans.
With a greater understanding of the significant impact of social determinants, providers can begin to implement tools and strategies that incorporate these factors for better patient engagement and outcomes, reduced cost and duplication of services, and enhanced clinical decision making and coordination of care. Gaining access to complete and accurate patient data that flows freely across boundaries will be catalyst for improving community health and well-being as well as a key factor in helping individuals overcome the socioeconomic barriers that place their health at risk.
By building social needs into the patient data capture process, providers can track individuals across the care continuum, thereby improving the likelihood of care plan success and prospering in an era of increased accountability.
About The Author
Andy Aroditis is CEO of NextGate, a global leader in healthcare enterprise identification.