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Montefiore in the News
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Montefiore in the News

December 23, 2019

In a March 2019 interview with Healthcare IT News, Dr. Jacob Reider – CEO of the Alliance for Better Health and former deputy national coordinator for health IT – described the conversations he'd been having about social determinants of health with an array of different healthcare stakeholders.

"There's a lot of interest in this in this domain," he said. "Folks from federally-qualified health centers, so on the frontlines of the medical side. We had folks from states, and/or or former state leaders who are looking at this from a public health perspective. We had folks from social care providers. We had health plans. So we had this really broad cross section of the care continuum, all saying, 'Hey this is important and we would like to participate in some way, in figuring this out together.'"

The push to do a better job incorporating social determinant information into care and treatment plans gained momentum in 2019, as more and more provider organizations recognized the key role that housing, transportation, food security and other non-clinical factors play in patients' health.

If the value of addressing such variables is apparent, so too is the challenge many health systems face integrating SDOH into workflows, starting with the electronic health record.

"The first step is, how are we capturing information about identification of people's social care needs," said Reider. "Because in the medical universe we had ICD, and SNOMED-CT that we would use to capture information. I'm not saying we did it super well, but we had a reasonably good way of representing the fact that a patient had diabetes, using a certain coding system.

"We don't have a very good consistent, predictable, repeatable mechanism for expressing that somebody has food insecurity needs," he said. "Or is a domestic violence victim. Or has a behavior health challenge that makes it difficult to leave the house. Or that they have transportation challenges."

Still, said Reider, "people are starting to think about this in a way that I don't think they had been together before. There have been isolated instances of these conversations, but I don't think they've come together before."

As the year went on, there was more and more evidence to back up that idea – that cross-stakeholder efforts to pay more attention to SDOH were reaching critical mass. Among the many stories Healthcare IT News – and our sister publications, Healthcare Finance and MobiHealthNews – reported in 2019, the progress was evident:

Taken together, these innovations and success stories point to big changes ahead with regard to the ways healthcare care is delivered – and by whom.

"What we're seeing, which I think is fascinating, is that the team is is expanding beyond the practice, beyond the clinic," said Jacob Reider.

"We've seen the culture evolve to where the doc and the nurse and maybe there's a care manager there and that's new that they've all started working together," he explained. "And then they recognize, 'Gosh the food pantry is part of the team. The transportation of poor people, the housing coordinator, the social worker at the county Department of Public Health. These are all members of our team too. Wow.'"

Healthcare IT News is a publication of HIMSS Media.