By Bruce Leyton
The realization that social determinants are critical indicators of a patient’s success or failure to comply with a treatment plan is finally gaining acceptance in the healthcare industry – especially for at-risk populations. These factors help providers gain deeper insights into a patient’s background in order to tailor healthcare services directly to their individual circumstances, ultimately reducing costs through care coordination and preventative care.
Providers have historically focused on current and past medical history – illnesses, chronic conditions, hospitalizations, family history, etc. to inform their treatment plans as that’s the only information they had available. With today’s onslaught of social determinant data, more and more pieces of the patient puzzle are being discovered and considered.
According to Healthy People 2020, social determinants of health are, “…conditions and environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.” Examples can include: social support, public safety, safe housing, access to food, access to health care, education, transportation, access to technology, literacy, exposure to crime, violence and poverty. In recent years, more focus has been placed on social determinants of health. According to the Robert Wood Johnson Foundation, “80 percent of clinical outcomes are attributable to the social determinants of health.” Some have even gone so far to say, “Your zip code matters more than your genetic code.”
Thankfully, recent data has led to organizations and providers beginning to understand the value and importance of looking at the patient from a holistic perspective – one in which the patient is not just someone with a medical condition or diagnosis, but someone who has been shaped by their financial, religious, physical, and social environments.
In the past, the challenge for organizations has been the lack of interoperability across the multiple platforms in which the patient’s data is collected and stored including ACOs, IDNs, health systems and their associated EMRs, patient portals, etc. This leads to the inability for providers to see the whole picture when it comes to their patients – anything from missing an appointment, to not knowing if a patient could afford his medication, or even whether the patient is compliant with his medication regimen. With the advent of Master Data Management (MDM), all the pieces of the puzzle can be aggregated into one place, so we can see a “golden view” of the patient. This “golden view” takes social determinants of health into consideration and has become essential for providers, patients AND payers.
With MDM, providers are able to:
• Gain insights about how to maximize revenue and minimize costs
• Be proactive versus reactive when helping patients make informed decisions about their health
• Track outreach to change social behavior
• Enjoy better disease prevention and management
• Expect better outcomes
• Establish a higher level of trust with their healthcare provider
• Integration of medical data with financial, census and geographical data
• Improved management of resources
According to the 8th Annual Industry Pulse Survey, 80 percent of payers are taking steps to address social determinants of health, and, “Steps organizations are taking include leveraging community programs and resources, integrating medical data with financial, census and geographical data, including social assessments with a health risk assessment and training doctors to identify social indicators.”
As we step into the future of healthcare, value-based care is the new reality. Utilizing an MDM solution will be key to maximizing revenue, managing high-risk patient populations, optimizing cost savings, and providing the best quality care to patients.
To learn more about how MDM can help your organization manage social determinants of health data, click the button below to download the complimentary white paper.