Ethical worries may cloud use of SDOH data, eHealth Initiative says

While social determinants of health can greatly impact the effectiveness of healthcare delivery, they also pose ethical dilemmas for healthcare organizations.

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Jennifer Covich

The eHealth Initiative, which convenes stakeholders to identify and share best practices to improve care delivery through IT and promote data sharing, summarized its take on these issues through a white paper on guiding principles for ethical use of SDOH data.

During the past decade, research has shown SDOH significantly influence health, and providers and insurers are now considering how to use of SDOH data to identify patients with social needs and facilitate interventions to improve care.

“Because of the sensitive nature of this consumer data, we felt it was critical to put a stake in the ground around the ethical use of this data,” says Jennifer Covich Bordenick, CEO of eHealth Initiative. “Lots of industry groups are publishing papers and producing research, but there is not a lot of direction about how to use this data.”

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The Marshfield Clinic Health System is among the organizations working with health, says Susan Turney, MD and CEO at the clinic. “Addressing the social determinants of health is a must in healthcare today and doing so the right way is equally important,” she stresses. “This process lays the groundwork for how best to do that in an ethical, standardized way.”

To do so, eHealth Initiative stakeholders have developed five principals on the use of social determinants to ensure such data are protected and used only for individual or population health improvement purposes, says Eduardo Sanchez, MD, chief medical officer for prevention at the American Heart Association. “eHealth Initiative lays the groundwork by establishing a framework for the ethical use of SDOH to improve outcomes and assess impact while protecting the privacy interests of individuals.”

The guiding principles for ethical use of social determinants to improve health include:

* Care coordination: Identify individuals with SDOH needs, coordinate delivery of holistic care, and facilitate connections to additional services or interventions.

* Recognizing risk via SDOH analytics: Identify risk through use of analytics tools to develop population health management interventions for persons and communities.

* Mapping community resources: Assess individual SDOH needs against available community resources to identify gaps that address health and wellness.

* Service and impact assessment: Assess the results of SDOH interventions and services.

* SDOH as a tool: As a support for customizing health services and interventions, use SDOH as a guide for quality discussions with individuals or their guardians and caregivers to jointly decide which services and interventions are the best fit.

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