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Where to Start on Assessing Social Determinants of Health (SDOH)

June 27, 2019 by Dale Applegate Leave a Comment

Where to Start on Assessing Social Determinants of Health (SDOH)

We get it. Your practice has limited time, limited staff and too many best practices to implement. in our last blog, we made the case for WHY it is important to assess SDOH (insert link). This blog will focus on HOW to begin.

  1. Determine why assessing SDOH is important to your practice. This should align with leadership goals and be shared broadly with all staff members in the clinic and with patients.
  2. Determine your data collection and data reporting capabilities. If your electronic health record (EHR) cannot compile the results of screening scores, consider using Z codes to track results from your billing system. This resource provides you with the Z codes and the Logical Observation Identifiers Names and Codes (LOINC) codes to provide to your data analytics team.
  3. Determine the SDOH screening tool that best meets your needs. Here are three possible tools.
    • Protocol for Responding to and Assessing Patients’ Assets, Risks and Experiences (PRAPARE). This tool is used broadly in Federally Qualified Health Centers (FQHCs) and Community Health Centers (CHCs). It is embedded in several EHRs and can be administered using a paper version that can be given to the patient or by clinical or non-clinical staff within the EHR.
    • The American Academy of Family Physicians. What we find most appealing about this tool is that it is a short 11 questions and can be easily filled out by the patient.
    • Another short form with only 10 questions is the one created by the Centers for Medicare & Medicaid Services (CMS) Innovations Center. This accountable health community’s health-related social needs screening tool is used in accountable care organizations (ACOs) across the country, and this tool is also designed to be completed by the patient.
  4. If you are serving a specific population, or if you would like to review a broader section of SDOH screening forms, check out this website, which provides a comparison of all the publicly available SDOH screening tools.
  5. Practice talking with patients about SDOH. Collecting information on SDOH can be a sensitive topic for patients, and the questions may induce feeling of shame or be perceived as intrusive. Here are some neutral ways to introduce the topic:
    • Your opportunity for health starts long before you need medical care.
    • Health starts long before illness, in our homes, schools and jobs.
    • All Americans should have the opportunity to make choices that allow them to live a long, healthy life, regardless of their income, education or ethnic background.
    • Your neighborhood or job shouldn’t be hazardous to your health.
    • Health begins where we live, learn, work and play.
  6. Start screening! Get feedback from staff to make the process smoother, lessen fears and enhance confidence.
  7. Assess your data and determine next steps!

Up next: Working within a community to link SDOH


 

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