Comparing SDH Assessment Tools and Data Sets

Earlier this month, an AMA forum discussed the use of Social Determinants of Health (SDH) screening and assessment tool for incorporating, measuring, and addressing SDH. The conversation examined SDH data and the tools being used to collect and manage those data.

The question to be answered is: How can those tools use SDH data to improve health outcomes?

SDH Screening and Assessment Tools

The National Institute of Health (NIH) compared the following SDH screening and assessment tools (reference) in terms of the domains they cover, as well as various characteristics of the tools including whether they are in EHRs and whether they follow workflow rules:

• AHC HRSN
• HealthBegins
• UNM—WellRx
• Mosaic
• CMI—Kaiser
• NACHC—PRAPARE
• OCHIN

They concluded that...

Despite the importance of SDH data, and...emphasis on health care providers collecting and acting on SDH data, the adoption of EHR-based SDH data collection has been gradual...More research is needed to assess how to implement these approaches in diverse care settings and how to use SDH data once collected.

CDC's Extensive SDH Data Sets

The Centers for Disease Control and Prevention (CDC) published as PDF at this link in which it describes extensive SDH data sets in the following twelve domains:

1. Economy
2. Employment
3. Education
4. Political
5. Environmental
6. Housing
7. Medical
8. Governmental
9. Public Health
10. Psychosocial
11. Behavioral
12. Transport

SDH Evolution: What Path to Follow?

I welcome comments and ideas about the evolutionary path of SDH data and tools; questions include:

• Which data sets should next-generation SDH assessment tools should include?
• What should those tools do with those data to help improve healthcare outcomes?
• Should the tools be built into EHRs or be separate apps that feed data to EHRs?
• What guidance (decision support, referral recommendations, etc.) should the tools offer patients and their healthcare providers?