The Real World Realities of the EMR and Social Determinants of Health
Population health as a discipline has advocated for decades for a more holistic approach to community health. In this effort, researchers have identified and developed non-health indicators, known as social determinants of health (SDoH), to address the health of a community more broadly. Despite consensus about the importance of SDoH, establishing standard processes for collection, standardization, sharing and utilization of these measures has proven quite difficult. In this effort, electronic medical records (EMR) vendors have begun trying to integrate SDoH into their interfaces and workflow capabilities. This paper assesses the extent of those efforts to date using publicly available information about the platform, industry specific knowledge, and review of the case studies of two system-wide level attempts to implement SDoH collection in Epic (one of the leading EMR vendors). I find that effective standardization and utilization of SDoH data through EMR systems remains an elusive goal. The amount of variability in the screening tools, significant variation among EMR vendors, and the level of customer demanded customization in implementation make it almost impossible to see how SDoH data could be shared between hospitals in the same system, much less by healthcare providers in concert more broadly given the currently utilized approaches.
Recommended CitationMariano, Esq., Adam S. and Kaminski, MD, MBA, Mitchell, "The Real World Realities of the EMR and Social Determinants of Health" (2019). Master of Population Health Program Thesis and Capstone Presentation. Presentation 3.