EHRs can help doctors integrate SDOH into patient care plans

Electronic health records (EHRs) can play an important role in determining patients’ social determinants of health (SDOH) needs and integrating those needs into care planning, a new study finds.

The study was designed to learn where primary care clinicians get SDOH information about patients, and the extent to which that information affects their decision-making at the point of care. To find out, the authors embedded card study surveys in the EHRs of 38 physicians at 21 primary care community health centers. The survey consisted of questions about where the clinician obtained patients’ SDOH information and how that information affected the doctor’s decision-making during a patient visit.

Data from the surveys revealed that SDOH information influenced care in about 35% of the visits, a result the authors say is consistent with findings from earlier studies in primary and specialty care. Other major influences included clinical factors, such as history and lab results (90% of visits), patient preferences (74%), and available resources (55%).

Another finding from the study was that SDOH influenced care more for male patients than for females. The authors speculate this may be due to men using primary care less than women, so doctors are more likely to address their social needs knowing they have fewer chances to do so. An alternative explanation, they say, is doctors giving greater priority to men’s needs generally than to women’s.

As to how respondents knew a patient’s specific SDOH needs, 76% said the information came from conversations with the patient, and about 64% said it was from previous personal knowledge of the patient. Other sources included reviewing information in the EHR (46%), communication from other clinic staff (18%), and paper screens for SDOH (12%).

The authors say their findings suggest that sources of data for SDOH are “complementary,” therefore “standardized screening complemented by an emphasis on personal connection and dialog during and/or following the formal screening process could be a powerful tool to facilitate patient-centered care.

“Our findings suggest that the combination of discrete SDOH information and directed conversations are likely to provide the nuanced data that enable personal care,” they conclude.

The study, “Patient-Reported Social Risks and Clinical Decision Making: Results of a Clinician Survey in Primary Care Community Health Centers” appears in the March/April 2023 edition of Annals of Family Medicine.