AHA: Standards for capturing social risk factor data in EHRs need work

The Department of Health and Human Services should support efforts to create standards for capturing social risk data in electronic health records.

That information is critical for providing effective care to patients, according to the American Hospital Association. The national organization included the suggestion in response to an HHS request for information on provider and health plan approaches meant to improve care for Medicare beneficiaries with social risk factors.

The AHA contends that while social risk factors—such as access to food, and safe and stable housing—can impede a person’s ability to maintain or return to a state of health, collecting social risk factor information in the EHR and using it to shape the care plan is a complex and dynamic process.

“Many hospitals have pointed to EHRs as a potential mechanism for not only capturing social risk factor data in a more standardized fashion, but also making it accessible to clinicians when delivering care,” states the group’s letter to the HHS Office of the Assistant Secretary for Planning and Evaluation.

However, the problem is that “much work remains before hospitals can accurately capture social risk factor data in EHRs,” according to the AHA.

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In particular, the association is calling on HHS to focus its efforts on enhancing standards for capturing social risk factor data in EHRs.

Although EHR certification standards developed by the Office of the National Coordinator for Health IT hold promise for promoting greater standardization, the AHA’s letter points out that significant gaps remain.

“Additional work is needed to standardize the data collected in electronic form, test EHRs to confirm the consistent implementation of the standards, and crosswalk the standard data to social risk factor measures or well-established social risk factor screening tools,” states the letter.

The AHA recommends that ASPE work with ONC, the Centers for Medicare and Medicaid Services, providers and health IT vendors to develop or refine standards, implementation requirements and guidelines to support the effective capture and use of social risk data in EHRs.

“The successful development of these EHR standards could enable further development of tools to help identify and address social risk factors at the patient and population level,” concludes the AHA. “This could better target interventions and hospital population health strategies.”

At the patient level, the AHA believes a “positive screen for a social risk factor could provide a clinical decision support tool linking clinicians to internal or community partner resources that may benefit a particular patient,” while at the population level, “hospitals may be able to use mapping and visualization tools to help illuminate geographic areas of communities that are particularly at risk, or better detect associations between social risk factors and health outcomes.”

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