Health equity hindered by SDOH coding roadblocks

AHIMA researchers say the complex nature of the collection, coding, use and exchange of social determinant data requires more cross-sector coordination and federal investment.
By Andrea Fox
11:27 AM

Photo: MONTY_RAKUSEN/Getty Images

A new American Health Information Management Association study aimed at finding a better understanding of the operational realities of how social determinants of health data is used in real-world healthcare scenarios, finding a lack of standardization, insufficient training and limited cross-sector use.

WHY IT MATTERS

The study, conducted by NORC at the University of Chicago, surveyed more than 2,600 AHIMA members and nonmembers from a pool of 41,000 potential respondents between August 24 and September 9, 2022.

Respondents included coding professionals; managers, directors and vice presidents of health information management; HIM team members and executives. 

SDOH data can offer additional insights to help enrich clinical decision-making and improve health outcomes. It includes the conditions in the environment in which people are born, live, learn, work, play, worship and age that affect a wide range of health and quality-of-life outcomes and risks.

Analysis of the survey data revealed a lack of standardization and integration of the data into patient medical records – even when the data is collected within the organization, AHIMA says.

Additional key findings included insufficient training and education on how to capture, collect, code and use SDOH data, as well as limited use of the data to communicate between healthcare providers and community-based referral organizations, according to the researchers.

Policymakers, providers and key stakeholders can advance comprehensive solutions to address the challenges illuminated by this survey, according to Wylecia Wiggs Harris, AHIMA chief executive officer.

"While a multitude of changes are needed, a focus on the documentation of these needs and translating those needs into coded data for actionable use is foundational," the researchers said in the study report

AHIMA's four policy recommendations include:

  • Developing a set of standardized, clinically valid and actionable SDOH data elements for collection.
  • Incentivizing the collection of SDOH data. 
  • Extending federal financial and technical support to train providers and operations staff on how best to collect, code and use social needs information.
  • Federal funding, resources and infrastructure to support the coordination and connectivity at the state and local level between healthcare organizations and care-based organizations.

Despite a "limited number" of critical partnerships in place, the study found that the top two ways that organizations use SDOH data are to refer patients to CBOs and to identify and assess community-level needs, the researchers said.

"Healthcare systems and CBOs need better alignment on a core set of SDOH standards that are harmonized across platforms," they said.

"They also need validated tools and processes to support closed-loop referrals to demonstrate positive health outcomes as well as return on investment in SDOH interventions."

THE LARGER TREND

The obstacles to healthcare fully leveraging SDOH and potential solutions include disparate and siloed data from multiple sources, a prevalence of unstructured healthcare and the fact that certain stakeholders are not subject to HIPAA regulations, according to Rahul Sharma, CEO of HSBlox, a health IT vendor for the administration of value-based care programs.

He told Healthcare IT News that overcoming SDOH data challenges is a matter of "digitization of the data, forming a longitudinal health record for the patient across different data sets for better predictive and risk score analysis and by ensuring that data is shared in a secure and permissioned basis only."

Technologies that can bring standardized approaches for sectors to coordinate and work together securely are critical, and 2023 could bring progress in SDOH technology said experts from Unite Us, a company that builds coordinated care networks of health and social service providers.

ON THE RECORD

"The effective collection, coding and use of SDOH data are vital to improving health and healthcare outcomes," said Wiggs Harris in the statement. 

"Health information professionals play a pivotal role in how SDOH data is collected, shared and ultimately used to improve health and healthcare outcomes."

Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org

Healthcare IT News is a HIMSS Media publication.

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