Social determinants are defined as the conditions in which people live, work, are educated, and build relationships. Social determinants affect the level of health care a person can afford. Given the high degree of influence of social determinants on treatment efficacy, it is necessary to record and integrate them into an electronic health record (EHR).
The use of social determinants in healthcare
Doctors should take into account each patient’s social status and quality of life. These aspects affect the speed and degree of recovery, as well as the risks of the rehabilitation period.
The main determinants includes:
- financial state;
- possibility to buy healthy food;
- access to good transport, including personal vehicles;
- level of pollution at the place of residence;
- possibility to receive emergency medical care.
Statistics say that the quality of outpatient and inpatient treatment accounts for only 10-20% of the recovery in the long term. The remaining 80-90% depends on the social conditions of the patient’s life.
In such a way, treatment becomes less effective if the patient can’t afford the expensive medication they need. That’s why doctors consider the patient’s financial capabilities when prescribing a treatment regimen. This is especially important after inpatient treatment or a complex surgery.
Integration into the healthcare sphere
Social determinants must be included in the EHR. This allows medical personnel to access complete information about patients promptly and take into account individual risks. Thanks to the electronic format of medical records, data can be successfully integrated and become available to doctors from various medical institutions.
Medical facilities will receive only the necessary data that can directly or indirectly influence the results of the treatment. Therefore, first of all, the goals of the survey are assessed. Knowing how the resulting data will be applied is vital. It is recommended to start with a few basic parameters, such as the patient’s occupation, financial state, and the place of residence.
The importance of IT support
Standard EHRs do not have a field for information on the social conditions of a particular person. But such a field is needed. What is more, it should become a generally accepted standard so that employees of different hospitals can quickly access this information. Otherwise, they will have to constantly question the patient and wait for the answers, and this is not always convenient or possible.
For many organizations, building a tool for social determinants into the existing infrastructure becomes a challenge. This challenge can be easily solved if the hospital has an IT department. In other cases, the hospital can resort to the help of IT outsourcing companies such as Andersen , and entrust the integration of social determinants in the EHR to them.
A more difficult task is to build a single network where patient data from various medical centers can be recorded. This requires the development of standardization and uniform coding principles. For a small IT department, completing such a task will either be too difficult or take a lot of time. Here is where the help of IT outsourcing companies becomes even more relevant.
Development of standards and encoding
Medical centers can serve their patients independently by creating an infrastructure for processing data on social determinants that affect health. The maintenance of such services must be at the level of the healthcare system.
Clinical coding becomes a critical factor in the industry. There are over 1000 codes used to document the following data:
- initial information collected;
- assessments of the patient’s condition;
- full diagnostics;
- selection of a treatment regimen;
- alterations to the treatment regimen.
The current codes are unable to cover all the social conditions of patients. Their usefulness is limited, as in many cases, using them makes little sense. Inpatient treatment usually involves no more than 2% of the information.
It is essential to develop standards that will include the necessary information. Both IT specialists and medical personnel should take part in their development. General standards will require physicians to ascertain the living conditions and financial well-being of patients. In this case, treatment will be prescribed within the capabilities of a particular person.
Interaction with IT companies or relevant departments is important in the medical field. In this case, electronic health records are supplemented with important information about the social conditions related to the health and life of the patient. This increases the effectiveness of the treatment and recovery period.
