In a recent article in the Hospital & Health Networks, authors John Glaser and Tanuj Gupta look at the role of data to understand patients holistically.  They point out that human health seems to be determined both by biology and genes (internal factors), as well as external factors such as:

a) 20% – clinical care
b) 30% – personal choices (tobacco use, diet, exercise, …)
c) 40% – income, education, social circle, literacy, etc.
d) 10% – environmental factors (air, water, housing, transportation, etc.)

The last two (c and d) are called Social Determinants of Health (SDOH).

One can make a case that health IT in general and EHR in particular should address health more holistically by reaching out into the social circle and addressing personal choices and the SDOH more directly and holistically. Some providers have begun to link pre-admission and post-discharge care models in with the treatment, thus spanning a much larger spectrum from prevention to post-recovery ongoing engagement.

Consider how just a few of the following factors can readily be assessed from today’s EHR records:

To measure things like changes in fitness level or strains on social relationships, modern EHRs require access to both broader and longitudinal datasets.

According to a recent Healthcare IT News article, Epic and several other large EHR vendors such as Cerner, athena and eClinicalWorks are incorporating new data types including SDOH, population health and precision medicine to make EHR into CHR (“Comprehensive Health Record”). When asked what exactly is a CHR, Epic CEO Faulkner is quoted to have said that…

“… Epic is thinking about how to approach a CHR in three ways. First, the system will include information not in EHRs today; that’s where social determinants come in. Second, the CHR should include data about care delivered outside the hospital. Third, CHRs will incorporate information about care that was traditionally managed inside the hospital but has since or will in the future move outside a provider’s walls, whether via telehealth apps or otherwise.”

Of course, broadening understanding and customizing treatment based on more data is not a new concept. Explains Blain Newton, Executive Vice President of HIMSS Analytics:

“There is absolutely a need to ensure that a patient’s electronic health record is comprehensive,” Newton said. “The challenge has been, and will continue to be, the integration of data not only from within the various EHRs, but the disparate sources that are coming on-line that contain different types of PHI.”

We here at MedicalMime believe that more data can translate into more insight, customized treatment and better outcomes. That’s one of the reasons why we have put so much emphasis on the ability to easily customize forms, reports, and treatment plans. Expect our ongoing commitment to broaden the data and include SDOH into the PHI.

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