Health Information Professionals Play Key Role in New Program Aimed at Boosting SDOH Efforts
Many physicians believe that to improve health outcomes and reduce healthcare costs in the US, healthcare teams must address their patients’ social determinants of health (SDOH). However, most physicians say they have little or no time for such efforts and lack the ability to effectively address patients’ SDOH, according to a recent survey by The Physicians Foundation.
The foundation has developed a new program that aims to reduce these frustrations, while helping physicians and healthcare teams address their patients’ SDOH through integrative, actionable steps. The new campaign, called "Let’s Take 5 to Address Drivers of Health," launched in April and focuses on incorporating evidence-based approaches into clinical care settings.
AHIMA spoke with Gary Price, MD, president of the foundation, about how the campaign will prepare physicians for SDOH conversations with patients and the essential role health information (HI) professionals play in the process.
Q. What led to the "Let’s Take 5 to Address Drivers of Health" campaign?
A. The campaign itself is the culmination of more than a decade of work on behalf of The Physicians Foundation to assess the impact of drivers of health on not only healthcare costs and outcomes, but on the environment that physicians practice in. Over the last 10 years, it’s become increasingly clear that drivers of health have an enormous impact on the cost and quality of our healthcare. It's also become apparent that they also have an enormous impact on the frustrations that lead to physician burnout. In the past, physicians have neither had the time or the tools to address the drivers of health that are probably affecting about 70 percent of patient outcomes.
Recently, the Centers for Medicare and Medicaid Services [CMS] implemented two SDOH-related measures proposed by the foundation. Clinicians participating in the Merit-based Incentive Payment System [MIPS] can now voluntarily report the percentage of patients 18 years or older screened for the five drivers of health – food security, housing stability, transportation access, utilities access, and interpersonal safety.
In addition, under the Hospital Inpatient Quality Reporting Program, hospitals are now mandated to report how many patients 18 years or older were screened for SDOH and the percentage of patients who screened positive for one of the drivers of health needs.
Because of these new federal quality measures, we wanted to provide on-the-ground, practical steps to help physicians implement [a framework for] asking patients about drivers of health, but also acting on that information once they collect it. And of course, this does involve, to a large degree, health information data.
Q. What are the components to the "Let’s Take 5" campaign?
A. There are several components. There's a new website on the Let's Take 5 campaign, and on that website, there are two very important resources. The first is a five-step implementation guide to prepare a practice for the integration of drivers of health considerations into their practice. This is a practical guideline to not only begin to ask patients these questions, but also to design a screening process to make sure that validated tools are used in that process.
Even more importantly, no physician wants to ask a question about a problem without being able to direct patients to potential solutions. So part of getting ready for this is establishing a referral process, which involves a lot of information technology and organizing of resources. Next is to implement the drivers of health screening process into your practice, and our tools give guides on being flexible, learning from the implementation, and refining it. And then the final step is submitting to the CMS MIPS system, and we have important links to that.
The other resource on the website is a conversation-starter. This is a five-step guide to preparing your healthcare team to begin having these kinds of conversations, making sure that it's done in a way that both the patient and team member are comfortable with, and tips on asking and acting on the questions that will make the whole process not only more efficient, but almost certainly more effective.
Q. What role do HI professionals play in the program?
A. They're going to play a major role. The implementation of this approach is going to require a team effort, not only within hospitals and among care teams in smaller practices, but the health information community is going to be critical in helping us develop more efficient and evidence-based ways to collect the data. Then, as this data is collected, linking the patients to resources they need, but also looking at the data and helping us to analyze what works and what doesn't. And of course, that's the next step – to evaluate the effectiveness of the different ways we try to deal with these driver of health needs. Documenting that and the metrics surrounding it is going to be absolutely critical to the decisions healthcare policymakers make about funding our healthcare system.
A. We're hoping that providing these resources will make it easier for the entire healthcare system to begin doing the screening for SDOH, but also to begin developing innovative strategies to collect the information and, more importantly, act on it. This is going to require development of a greater awareness of best practices in asking the questions, collecting the information, and then using that information to link to local resources to address patients' [SDOH] issues. Those resources haven't been organized in a systematic way up until now because there was really no reason to. So, we're really happy to be participating at sort of the grassroots level, not only in the implementation of this, but also the development of better evidence-based ways of collecting and acting on data.
Q. Establishing a strong data collection system is an important part of the screening process. How should healthcare teams establish an optimal data collection method for this process? How can health information professionals assist?
A. We believe that, initially at least, this will be a decision which will vary depending on regional, community, and even practice/institutional level factors. Each site will need to review the needs of their population, as well as the resources within their organization and their particular community. The platforms available, their flexibility, and potential fit with available screening tools and workflows will be areas where the expertise and input of health information professionals will be critical. Innovation, as problems are recognized and solved and best practices are developed, will be very dependent on a collaboration between our health information leadership and clinical teams.
Our online resources include many helpful links to tools, which already exist regarding validated screening tools, as well as a framework for beginning to implement successful methods for reporting these new measures.
Q. What are some of the potential broader impacts of the campaign?
A. In our implementation guide for the practices, we start out by mentioning how important it is for everyone on the team to understand why this is being done and its potential [for helping] patients. In addition to what it will do for a patient's health, we know that if we can make this easy for the healthcare team to address and make referrals, we can make the care they give less stressful for them, less frustrating. We're hoping we'll reduce physician burnout as well as burnout in all other members of the healthcare team, including health information professionals.
They might not experience frustration at the front lines the way a physician or a nurse might, but they can play a crucial role in helping us develop efficient ways that enable us to address drivers of health without using inordinate amounts of time or creating head-banging frustration on the part of [those] on the front lines trying to help the patient.
What we're really looking forward to is the development of really great ways to not only address drivers and health issues, but to integrate attention to those into healthcare at the primary care level, begin to improve the quality of health outcomes, [and] also have a major effect on healthcare disparities within our healthcare system.
Alicia Gallegos is a freelance healthcare writer based in the Midwest.