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Adoption of Social Determinants of Health EHR Tools by Community Health Centers

Gold, Rachel, PhD, MPH ; Bunce, Arwen, MA ; Cowburn, Stuart, MPH ; Dambrun, Katie, MPH ; Dearing, Marla ; Middendorf, Mary ; Mossman, Ned, MPH ; Hollombe, Celine, MPH ; Mahr, Peter, MD ; Melgar, Gerardo, MD ; Davis, James ; Gottlieb, Laura, MD, MPH ; Cottrell, Erika, PhD, MPP

Annals of family medicine, 2018-09, Vol.16 (5), p.399-407 [Periódico revisado por pares]

United States: Annals of Family Medicine

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  • Título:
    Adoption of Social Determinants of Health EHR Tools by Community Health Centers
  • Autor: Gold, Rachel, PhD, MPH ; Bunce, Arwen, MA ; Cowburn, Stuart, MPH ; Dambrun, Katie, MPH ; Dearing, Marla ; Middendorf, Mary ; Mossman, Ned, MPH ; Hollombe, Celine, MPH ; Mahr, Peter, MD ; Melgar, Gerardo, MD ; Davis, James ; Gottlieb, Laura, MD, MPH ; Cottrell, Erika, PhD, MPP
  • Assuntos: Community health services ; Electronic records ; Family Medicine/General Medicine ; Health aspects ; Internal Medicine ; Medical records ; Medical research ; Methods ; Original Research ; Primary health care ; Social aspects ; Social medicine
  • É parte de: Annals of family medicine, 2018-09, Vol.16 (5), p.399-407
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
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  • Descrição: Abstract Purpose This pilot study assessed the feasibility of implementing electronic health record (EHR) tools for collecting, reviewing, and acting on patient-reported social determinants of health (SDH) data in community health centers (CHCs). We believe it is the first such US study. Method We implemented a suite of SDH data tools in 3 Pacific Northwest CHCs in June 2016, and used mixed methods to assess their adoption through July 2017. We modified the tools at clinic request; for example, we added questions that ask if the patient wanted assistance with SDH needs. Results Social determinants of health data were collected on 1,130 patients during the study period; 97% to 99% of screened patients (n = 1,098) had ≥1 SDH need documented in the EHR, of whom 211 (19%) had an EHR-documented SDH referral. Only 15% to 21% of patients with a documented SDH need indicated wanting help. Examples of lessons learned on adoption of EHR SDH tools indicate that clinics should: consider how to best integrate tools into existing workflow processes; ensure that staff tasked with SDH efforts receive adequate tool training and access; and consider that timing of data entry impacts how and when SDH data can be used. Conclusions Our results indicate that adoption of systematic EHR-based SDH documentation may be feasible, but substantial barriers to adoption exist. Lessons from this study may inform primary care providers seeking to implement SDH-related efforts, and related health policies. Far more research is needed to address implementation barriers related to SDH documentation in EHRs.
  • Editor: United States: Annals of Family Medicine
  • Idioma: Inglês
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