Erika K Cottrell1, Katie Dambrun2, Stuart Cowburn2, Ned Mossman2, Arwen E Bunce2, Miguel Marino3, Molly Krancari2, Rachel Gold4. 1. OCHIN, Inc., Portland, Oregon; Department of Family Medicine, Oregon Health and Science University, Portland, Oregon. Electronic address: cottrelle@ochin.org. 2. OCHIN, Inc., Portland, Oregon. 3. Department of Family Medicine, Oregon Health and Science University, Portland, Oregon. 4. OCHIN, Inc., Portland, Oregon; Kaiser Permanente Center for Health Research, Portland, Oregon.
Abstract
INTRODUCTION: This paper describes the adoption of an electronic health record-based social determinants of health screening tool in a national network of more than 100 community health centers. METHODS: In 2016, a screening tool with questions on 7 social determinants of health domains was developed and deployed in the electronic health record, with technical instructions on how to use the tool and suggested clinical workflows. To understand adoption patterns, the study team extracted electronic health record data for any patient with a community health center visit between June 2016 and May 2018. Patients were considered "screened" if a response to at least 1 social determinants of health domain was documented in the electronic health record tool. RESULTS: A total of 31,549 patients (2% of those with a visit in the study period) had a documented social determinants of health screening. The number of screenings increased over time, time; 71 community health centers (67%) conducted at least one screening, but almost 50% took place in only 4 community health centers. Over half (55%) of screenings only included responses for only 1 domain. Screening was most likely to occur during an office visit with an established patient and documented in the electronic health record by a medical assistant. CONCLUSIONS: Screening documentation patterns varied widely across the network of community health centers. Despite the growing national emphasis on the importance of screening for social determinants of health, these findings suggest that simply activating electronic health record tools for social determinants of health screening does not lead to widespread adoption. Potential barriers to screening adoption and implementation should be explored further. SUPPLEMENT INFORMATION: This article is part of a supplement entitled Identifying and Intervening on Social Needs in Clinical Settings: Evidence and Evidence Gaps, which is sponsored by the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services, Kaiser Permanente, and the Robert Wood Johnson Foundation.
INTRODUCTION: This paper describes the adoption of an electronic health record-based social determinants of health screening tool in a national network of more than 100 community health centers. METHODS: In 2016, a screening tool with questions on 7 social determinants of health domains was developed and deployed in the electronic health record, with technical instructions on how to use the tool and suggested clinical workflows. To understand adoption patterns, the study team extracted electronic health record data for any patient with a community health center visit between June 2016 and May 2018. Patients were considered "screened" if a response to at least 1 social determinants of health domain was documented in the electronic health record tool. RESULTS: A total of 31,549 patients (2% of those with a visit in the study period) had a documented social determinants of health screening. The number of screenings increased over time, time; 71 community health centers (67%) conducted at least one screening, but almost 50% took place in only 4 community health centers. Over half (55%) of screenings only included responses for only 1 domain. Screening was most likely to occur during an office visit with an established patient and documented in the electronic health record by a medical assistant. CONCLUSIONS: Screening documentation patterns varied widely across the network of community health centers. Despite the growing national emphasis on the importance of screening for social determinants of health, these findings suggest that simply activating electronic health record tools for social determinants of health screening does not lead to widespread adoption. Potential barriers to screening adoption and implementation should be explored further. SUPPLEMENT INFORMATION: This article is part of a supplement entitled Identifying and Intervening on Social Needs in Clinical Settings: Evidence and Evidence Gaps, which is sponsored by the Agency for Healthcare Research and Quality of the U.S. Department of Health and Human Services, Kaiser Permanente, and the Robert Wood Johnson Foundation.
Authors: Steven J Korzeniewski; Carla Bezold; Jason T Carbone; Shooshan Danagoulian; Bethany Foster; Dawn Misra; Maher M El-Masri; Dongxiao Zhu; Robert Welch; Lauren Meloche; Alex B Hill; Phillip Levy Journal: Online J Public Health Inform Date: 2020-05-16
Authors: Jimmy Phuong; Elizabeth Zampino; Nicholas Dobbins; Juan Espinoza; Daniella Meeker; Heidi Spratt; Charisse Madlock-Brown; Nicole G Weiskopf; Adam Wilcox Journal: AMIA Annu Symp Proc Date: 2022-02-21
Authors: Jimmy Phuong; Stephanie Hong; Matvey B Palchuk; Juan Espinoza; Daniella Meeker; David A Dorr; Galina Lozinski; Charisse Madlock-Brown; William G Adams Journal: AMIA Annu Symp Proc Date: 2022-05-23
Authors: Donna J Biederman; Peter Callejo-Black; Christian Douglas; Heather A O'Donohue; Monica Daeges; Olamiji Sofela; Ashanti Brown Journal: Public Health Nurs Date: 2021-09-07 Impact factor: 1.770
Authors: Charlie M Wray; Marzieh Vali; Louise C Walter; Lee Christensen; Samir Abdelrahman; Wendy Chapman; Salomeh Keyhani Journal: Fed Pract Date: 2021-01
Authors: Deepak Palakshappa; Andrew J Benefield; Katherine F Furgurson; Michael G Harley; Richa Bundy; Adam Moses; Alysha J Taxter; Andrew S Bensinger; Xiangkun Cao; Nancy Denizard-Thompson; Gary E Rosenthal; David P Miller Journal: Popul Health Manag Date: 2020-09-14 Impact factor: 2.290