Dr Rachel Gold: Gaps Remain in How Technology Can Help Address Social Determinants of Health

August 15, 2018

Technology is starting to help identify patients with social determinants of health issues, but there remain gaps in connecting that data in the electronic health record (EHR) to resources, said Rachel Gold, PhD, MPH, investigator at the Kaiser Permanente Northwest Center for Health Research and lead research scientist at OCHIN.

Technology is starting to help identify patients with social determinants of health issues, but there remain gaps in connecting that data in the electronic health record (EHR) to resources, said Rachel Gold, PhD, MPH, investigator at the Kaiser Permanente Northwest Center for Health Research and lead research scientist at OCHIN.

Transcription:

How is or isn’t technology being used to identify, documents, and address social determinants of health?

The technology is starting to help us identify and, certainly, document social determinants of health. In helping to address these social determinants, there’s this gap in terms of how do we make sure that if you identify a patient with a given social need, within the EHR, is there a way to identify local resources that are appropriate for that patient? Identifying resources that are near their house, or, for example, some housing agencies won’t take people who are under a certain age, won’t take men, won’t take people with a criminal history, or something along those lines.

So, you have to make sure the resources are appropriate to a given patient before you refer them. You don’t want to send someone to a resource that they can’t actually use. The biggest gap is closing the loop. If you’ve got a healthcare provider referring a patient to a food bank, can they find out that the patient actually made it there, or that they accessed the resources? Can the food bank know that the patient is there because their medical provider sent them there? I think that’s a real gap with how do we make sure there are appropriate, up-to-date, community lists available that you can access quickly through the EHR, and how do you close the loop so that the care team knows that the patient accessed the services that they were sent to? Otherwise, you’ll have a care team referring a patient, for example, to a food bank, and then saying, “okay, well, we took care of that,” but actually the patient didn’t make it to the food bank because they might have a transportation barrier, and they didn’t take that on for some reason.

So, they might look to the EHR and say, “I refer this to address their food needs,” but you don’t know that they actually made it to that resources unless we had a way to close that loop. And, I don’t have an answer for that yet. I know there are some entities out there trying to solve that problem, but we don’t have anything that’s being applied nationally, but it’s kind of a couple different experiments going on around the country right now.